• Emily Reul, PT, DPT

Biofeedback

When you squeeze your pelvic floor muscles (PFM), how long can you hold the contraction? 1 second? 3 seconds? Are you not sure? Many times, people can feel the initial squeeze but the contraction tapers off as they try to hold it and it is less apparent whether they are still squeezing or not. If holding this contraction is difficult for you, you pelvic floor physical therapist may use biofeedback in your treatments. This week we’re going to talk about what biofeedback is and who is it useful for.



Biofeedback is a way to help make pelvic floor muscle training (PFMT) more efficient and effective. It is similar to an EKG of your heart but instead of measuring the activity of your heart muscle it measures the activity of your pelvic floor muscles. Sometime biofeedback is referred to as sEMG (or surface electromyography). Electrodes are placed either externally (stickers around the perineum and anus) or internally (sensors shaped like a tampon inserted into the vagina or anus). These electrodes read the surface electrical activity to measure muscle contractions and strength.



These biofeedback device uses the electrical activity readings to create a picture that allows you to see what your pelvic floor muscles are doing in real time! The YouTube video below is a great example of biofeedback in action. When Jeanice squeezes her PFM you see the purple line on the screen rise, and as she relaxes her pelvic floor the line drops down.


A pelvic floor physical therapist is a great resource to learn how to train your pelvic floor muscles properly. You can use our free searchable databases on our website under Find a PT or ask your healthcare provider for a referral to a pelvic therapist.


If your provider recommends biofeedback training for you, they will likely use a medical grade (and very expensive) unit in their clinic. If you want to continue with biofeedback training at home, there are more affordable options like the Elvie or Joy On that can be great (and are much more affordable).

Biofeedback can help to treat these common pelvic floor dysfunctions (Bo, 2015):

  • Stress urinary incontinence

  • Incontinence after radical prostatectomy

  • Preventing pelvic floor dysfunction BEFORE radical prostatectomy

  • Bowel incontinence (gas or feces)

  • Constipation

  • Nocturnal enuresis (bed wetting)


If you don’t like to undress or insert something vaginally or rectally, biofeedback may not be the best treatment option for you. It’s important to remember that PFMT alone can be effective in treating stress urinary incontinence without use of biofeedback (Bo, 2015). On the other hand, many individuals find the visual feedback motivating it can help to improve strength of your pelvic floor muscle contractions and keep you disciplined with your PFMT.


Whether or not biofeedback is a good fit for you, connecting with your pelvic floor is important for optimal pelvic health (now and as you get older). In the YouTube video below, Jeanice explains why we need to train the pelvic floor.




What experiences or tips do you have that can help others? We’d love to hear them. Please join the conversation in the comments section below.  


Here are some great resources to learn more about training your pelvic floor:


For providers, check our online courses to help your clients experiencing pelvic floor dysfunction. Consider joining our Ambassador Program and most of our courses are included with your membership!


Written by Emily Reul, PT, DPT

References

1. Bo K, Berghmans B, Morkved S, Van Kampen M. Evidenced-based physical therapy for the pelvic floor bridging science and clinical practice. 2nd edition. 2015.

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