Ladies, do you do pelvic floor exercises?
I’m sure, like me, you’re aware of how important they are. Yet, also like me, when it comes to training these muscles, you’ll probably remember that they exist every fortnight or so, and exercise them by squeezing ‘down there’ how ever many times you deem useful (10, 15, 20 times?) before getting distracted by something else.
Needless to say, there are lots of things wrong with training your pelvic floor muscles in this way:
- You don’t really know if you are squeezing the muscles correctly
- You aren’t sure if you are squeezing for long enough, hard enough, or a many times as you should
- You don’t have any way to measure your progress
- It’s boring as hell, making it very easy to become distracted
Thankfully, some very clever ladies out there have designed a sleek little gadget and app called Elvie to overcome all of these problems.
And I mean it. They have thought of pretty much everything and have really made pelvic floor training as convenient, simple, and engaging as possible.
To say I’m impressed is an understatement… But we’ll come to that shortly.
First, you need to understand exactly why this kind of training is as important as all of the other kind of training that you put your body through in the name of wellbeing.
What are your Pelvic Floor muscles?
Both men and women have pelvic floor muscles, but this article will focus almost entirely on women's anatomy.
Your pelvic floor is a funnel-shaped sling of numerous muscles and fascia that sit between your tailbone and pubic bone.
I personally find this really difficult to visualise, and therefore find their role difficult to understand. And I’m sure I’m not alone. So to help you understand the complexity of your pelvic floor, here’s a little bit of info on their anatomy…
In a side view of the pelvic region, your pelvic floor muscles would appear like a hammock, spanning the underneath of your pelvis. Above it is your pelvic cavity; the area within the bones of your pelvis that contain your reproductive organs, bladder and colon.
Another view of your pelvic floor - from below, for example - would show the numerous muscles that it comprises of and the various directions that they work in.
To give you an idea of the complexity of the pelvic diaphragm, here’s a list of some of the many muscles that sit within it:
- Levator ani (pubococcygeus aka pubovisceral, pubovaginalis, puboanalis, puborectalis, iliococcygeus)
- Obturator internus
Still doesn’t make much sense? Here’s a collection of diagrams that helped me to understand the shape, location and complex nature of the pelvic floor:
The Function of your Pelvic Floor Muscles
The pelvic floor provides support for your crucial pelvic organs including your bladder, intestines, rectum, vagina and uterus. So, when your pelvic floor muscles are weak, these areas cannot function as well as they should.
Most obviously, perhaps, your pelvic diaphragm helps to maintain continence by controlling the urinary and anal sphincters. In other words, it’s pretty damn important for bladder and bowel control.
If you’re into fitness, you might notice weak pelvic floor muscles if you’re running, skipping or bouncing as part of your workout. You might also notice weakness when laughing or coughing. And it’s not uncommon! According to information from Elvie, 1 in 3 women have pelvic floor problems.
In fact, high impact exercise can negatively affect the pelvic floor. If you're frequently participating in high impact sports, from gymnastics to running, you are likely applying a regular downward pressure to the pelvic floor. Over time, this can cause the pelvic floor to prolapse.
Your pelvic floor plays a crucial role in giving birth and contributes to sexual sensation.
Finally, your pelvic floor muscles also help to support your other core muscles for everyday strength and stability.
Factors such as pregnancy, childbirth, aging, being overweight, and abdominal surgery such a having a cesarean section, can lead to the weakening of your pelvic floor muscles
Pelvic Floor Training
The above points make it pretty clear why an optimally functioning pelvic floor is so crucial.
To improve your pelvic floor, you can do what are known as Kegel exercises, or Kegels, so named after the gynecologist Arnold Kegel who first described them.
Kegels can develop and maintain strong muscles, prepare your body for pregnancy and help you to recover more quickly from childbirth, regain or improve bladder control, enhance sexual sensation and pleasure, and improve your overall confidence and wellbeing.
According to Mayo Clinic (a globally well-known nonprofit medical practice and medical research group, and a resource that I often refer to), here’s how you should be doing Kegel exercises:
Find the right muscles
To identify your pelvic floor muscles, stop urination in midstream. If you succeed, you've got the right muscles. Once you've identified your pelvic floor muscles you can do the exercises in any position, although you might find it easiest to do them lying down at first.
Note: Don't make a habit of using Kegel exercises to start and stop your urine stream. Doing Kegel exercises while emptying your bladder can actually lead to incomplete emptying of the bladder — which increases the risk of a urinary tract infection
Perfect your technique
Tighten your pelvic floor muscles, hold the contraction for five seconds, and then relax for five seconds. Try it four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.
Maintain your focus
For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
Repeat three times a day. Aim for at least three sets of 10 repetitions a day.
This is fairly standard instruction on how to do Kegels. Probably what you expected.
However, you can’t be sure that you’re performing these exercises correctly, and you can’t be sure that you’re making progress.
It can be pretty difficult and demotivating to exercise muscles that you will never see. It’s like trying to improve your body composition without ever using a tape measure or mirror, or losing vast amounts of body fat without reference to a set of scales.
Here’s where Elvie comes in. At last!
Elvie: Your Most Personal Trainer - Review
I remember hearing about Elvie when it first launched and being really intrigued. It was the first device of it’s kind and one that is genuinely useful to every single woman out there.
Of course, pelvic floor trainers aren’t revolutionary. They’re been around for many years. However, they’re generally pretty unappealing: bulky, indiscreet and uncomfortable objects that look as though they should reside strictly in a medical practice. I once read about a similar technology to Elvie called KGoal, but I’m not sure that it’s even available in the UK.
So back to Elvie...
After finding out that I was desperate to try this product, the lovely Elvie team (part of women’s wearable tech startup Chiaro) really kindly sent me one to trial. So, I’ve put my trust in the amazing women behind the brand and have given just 5 minutes a few days a week to exercising with my ‘most personal trainer’.
Look + Feel
Firstly Elvie is a beautifully designed product. Perhaps subconsciously that’s what initially drew me to it.
The product itself, as well as the packaging, is all tranquil turquoise and white (some of my favourite colours).
It looks clean, fresh and unintimidating.
Sperm shaped, basically.
Elvie consists of a pebble-like main section, which you insert. And a tail that stays on the outside for discreet and easy removal, as well as to transmit uninterrupted data to the app.
All Elvie devices also come with an extra cover so that you can adjust the size of Elvie to best suit your body.
Super easy to insert and comfortable to remove. Elvie is made of medical grade silicone (latex and rubber free) which makes it feel soft and smooth (as well as 100% waterproof for quick and easy cleaning).
Elvie comes into a small, white, cylindrical pod, which doubles as Elvie’s wireless charging station. You just pop a USB cable (supplied in the box) into the end of the pod and leave it to power up!
Elvie is essentially like one large, ultra-sensitive button, that connects with the Elvie app. It’s covered in force sensors to measure the strength of your squeeze.
This squeeze is represented on the Elvie app as a gem icon that moves vertically on your phone’s screen. The harder you squeeze, the higher the gem goes.
This instant biofeedback from the Elvie device means that you can see your muscle activity in real-time; as you squeeze, the gem lifts. It guides you through the workout, keeping you focused and making it more enjoyable.
As well as force sensors, Elvie detects if you are exercising incorrectly by using motion sensors. These help to ensure that you are engaging the right muscles, in the right direction. Pushing down, for example, can be damaging to pelvic floor muscles and will be discouraged by Elvie.
Just as pelvic floor muscles that are too weak (hypotonic) can be a problem, over-squeezing and causing abnormally tense (hypertonic) pelvic floor muscles can also be an issue for some women, so I like that Elvie also reminds you to ‘relax’ during workouts.
The brand has created a measure called LVs in an attempt to quantify your pelvic floor strength. I like that there is a numeric value assigned so that you can see your own progress, although there is no spectrum on which the numbers sit, so there’s no indication of whether your muscle strength and control is poor, average or outstanding.
In addition, I’d love to see the LVs become a measure of comparison. Not so that women compete, but so that you understand how you compare to other women who share your age and lifestyle (including whether they’ve gone through childbirth, or not). I’d like to see information like this to give a little more context to the measurement, as well as for personal motivation.
Your LV score can vary a lot from session to session, so don’t be put-off if you don’t see the numbers go straight and steady in an upward direction! In fact, the app calibrates before you start each workout (you squeeze to set what is likely to be your maximum LV for that session), so that the targets on each game/exercise are realistic for you at that specific time.
The exercises are like basic games, in which you control the movement of a gem with Elvie and your pelvic floor muscles, rather than touching the screen with your fingers as you are likely used to. You can perform them either when lying down or standing.
The games are designed to incorporate a number of different elements including:
- Strength - squeezing as hard as you can to send the gem as high as possible
- Lift - lifting the gem to cross a target line
- Pulse - pulsing your pelvic floor in rapid succession to hit targets (this reminded me of jumping to collect rings when playing Sonic on Sega Dreamcast as a child!)
- Hold - lifting and holding the gem above a target line for a number of seconds
- Speed - pulsing your pelvic floor muscles as quickly as possible to hit and clear a stack of targets
- Step - contracting and holding your pelvic floor muscles, before further contracting and holding, as if making the gem climb steps
There are four different levels within the app: training, beginner, intermediate and advanced. It takes around ten workouts to move up a level and unlock new games (the above elements are introduced as you increase level).
The best bit is that each workout only lasts around 5 minutes.
Ultimately, it’s worth doing pelvic floor exercises. And it’s worth using Elvie to ensure you are always motivated to do them, and to ensure that you do them correctly.
The product is beautifully designed, the exercises are simple to follow and the overall design of the app makes the training really motivating. Hopefully in the near future, Elvie will also be able to offer more context to the LV scoring system.