Can you train the pelvic floor muscles by contracting other related muscles?

Abstract

Aims The aim of this study is to assess whether contraction of muscles other than the pelvic floor muscles (PFM) would be of sufficient magnitude to provide a “training” effect for the pelvic floor. Methods Women were recruited via advertisement from a convenience sample of pelvic floor physiotherapists. A thin flexible array of pressure sensors (FemFit) was self‐inserted into the vagina. Participants performed three maximum pelvic floor contractions and completed a randomized exercise protocol. Maximum pressures were determined for each sensor, for each exercise. Wilcoxon paired tests were used to ascertain the difference in pelvic floor muscle pressure between exercises, and between the pressures from the pelvic floor muscles sensors and those measuring abdominal pressure. Bonferroni correction α 0.005. Results Data was obtained from nineteen participants. Mean age 43 ± 11 years, BMI 22.4 ± 3.2 kg m−2. Mean PFM pressure for pelvic floor muscle contractions was 16.3 ± 12.2 mmHg. Pressure in the region of the pelvic floor was significantly higher during a targeted contraction compared to that for all other exercises, except for cough and curl‐ups (P = 0.009, P = 0.013 respectively). PFM pressure was significantly higher than abdominal for PFMC, internal rotators and gluteals (P < 0.001). Conclusion Targeted PFM contractions develop higher pressures compared to abdominal pressure than any exercise tested in this study. The Femfit device was able to distinguish between abdominal and pelvic floor muscle pressures simultaneously. Exercising accessory muscles in an attempt to activate the pelvic floor sufficiently to illicit a training effect is not recommended.

Is Physical Activity Good or Bad for the Female Pelvic Floor? A Narrative Review

“…It is vital to ensure that women are indeed contracting the PFM correctly. We are not aware of commercially available instruments that measure increases in IAP and function of the PFM simultaneously, but new developments are being investigated [28,33]. However, given the location of the PFM inside the pelvis, their close connection to other muscle groups and their inclusion in the abdominal canister that responds to all IAP and ground reaction forces, it may prove difficult to differentiate between opposing forces occurring during physical activity.…”

“…In a study using a novel intra-vaginal pressure sensor that simultaneously measures PFM contraction and IAP during a selection of supine exercises in 21 women's health physiotherapists, the mean vaginal pressure during a PFM contraction increased 16.3 mmHg (SD 12.3) while the corresponding IAP increase was minimal [mean 3.4 mmHg (SD 2.2)] [33]. During an abdominal crunch, the IAP increased 8.3 mmHg (SD 7.3); simultaneously the pressure measured at level of the PFM also increased, indicating co-contraction, to half that of the PFM contraction [mean 8.2 mmHg (SD 8.0)].…”

Reliability and validity of intravaginal pressure measurements with a new intravaginal pressure device: The FemFit®

“…It contains eight pressure sensors (MS5803-02BA; Measurement Specialties), which are mounted onto a flexible printed circuit board (PCB). 11,12 The PCB is encapsulated in soft biocompatible silicone (MED-4901; NuSil). The FemFit® has a total length of 80 mm, a maximal width of 24 mm and is only 4 mm thick.…”

“…[8][9][10] The possibility to acquire reliable intravaginal pressures at different depths along the length of the vaginal canal under a more "ecologically valid" condition (ie, meant to conform and sit within the rugae of the vaginal wall without altering its anatomy), is likely to be useful both for understanding the role of intra-abdominal pressure on the pelvic floor normal function and later on, for decision making when choosing PFM safe exercises (ie, favoring those producing less intra-abdominal pressure) for women with a dysfunctional pelvic floor (ie, stress urinary incontinence or pelvic organs prolapse). 11 The aim of this study is to test the reliability and validity of maximal intravaginal pressure measurements, during PFM contraction and during straining maneuvers while lying and standing using the FemFit®, a new thin, flexible, wireless, and multiarray intravaginal pressure device.…”

“…The possibility to acquire reliable intravaginal pressures at different depths along the length of the vaginal canal under a more “ecologically valid” condition (ie, meant to conform and sit within the rugae of the vaginal wall without altering its anatomy), is likely to be useful both for understanding the role of intra‐abdominal pressure on the pelvic floor normal function and later on, for decision making when choosing PFM safe exercises (ie, favoring those producing less intra‐abdominal pressure) for women with a dysfunctional pelvic floor (ie, stress urinary incontinence or pelvic organs prolapse) …”