Pelvic Floor Muscle
Training and the In ToneŽ Device
Marja Sprock, M.D.
Imagine trying to walk or stand without using your leg
muscles; not a very realistic picture. Except for when
we lie down, there is a lot of pressure on our pelvic
floor. This pelvic floor has nothing to do with the
ground you walk on.
Strong pelvic floor muscles will
protect against stress, urge and
mixed incontinence as well as
pelvic floor prolapse
pelvic floor is the bottom of your abdomen, your pelvis.
Our abdominal load needs to be supported by pelvic
muscles, connective tissues and ligaments. Organs attach
to connective tissue and if not well supported by
muscle, attachments may break over time.
Once the muscles and therefore the support weaken, we
may see prolapse or descending organs, like bladder,
uterus, rectum or small bowel. Remember the inside out
sock idea? The entire inside out sock will be too much
to just be corrected by training the muscles; however it
will always do some good and also may increase the
chance surgery or a pessary (small support shelf like a
diaphragm) will work.
Vaginal birth may damage some of the connective tissues
and muscles. Damage to the muscles and connective
tissues makes it difficult to provide support to the
pelvis, the lowest part of our abdomen. We can relax the
muscles and urinate and have bowel movements, actively
pulling up our pelvic floor will help with continence
and prolapse. Training the muscles cannot cure all
damage; however we can at least make them as strong as
Do not practice your pelvic
floor muscles while urinating;
it leads to dysfunctional
voiding and bladder damage
women do not have a good concept of how to contract
their pelvic floor muscles. Even though it may seem to
help to identify the muscles by attempting to stop the
urine flow, it is not a recommended method of training.
It will lead to dysfunctional voiding. The bladder
contracts to empty and the pelvic floor relaxes, by
contracting and practicing your pelvic floor muscles
then, you can prevent the bladder from completely
Pelvic floor muscle training is important; it can
help with prolapse and incontinence as well as increase
the chance of long-term success of surgical repair.
Ruby a very active 75-year-old came to the clinic
complaining of leaking urine and sometimes stool.
Ruby did not have any organs protruding through her
vagina. She was diagnosed with a complete lack of
ability to voluntarily contract her pelvic floor
muscles. The most effective way of tackling the problem
of getting to know how to contract your pelvic floor
muscles, is with the proper person and computer guidance
and training through biofeedback and some added nerve
stimulation. At Central Florida UroGynecology, we aim to
teach you the pelvic floor muscle training in a few
private training sessions and most women are able to
continue strengthening and keeping them strong at home
or on the road. Yes, once you know how, you can do
pelvic floor exercises anyplace and anywhere.
For some people, like for Ruth this was hard to keep up.
Ruth had looked into devices to help her contract the
muscles and guide her through a program. In addition,
she liked to get some feedback from the machine, like in
the office, of the muscles getting stronger. She knew
her muscles were improving, since her incontinence was
getting less; but liked to have a device for at home.
Ruth asked about the In-ToneŽ device. She heard Medicare
reimbursing for a significant amount of the cost of the
device and she desired to have the extra help.
though you can do your pelvic floor muscle exercises
anytime and anyplace, some people prefer the feedback
and guidance of the In-Tone device.
Central Florida UroGynecology, Dr. Sprock is an In-Tone
provider and the In-Tone can be bought at Central
The In-Tone device costs $595; however several
insurances, including Medicare will reimburse you for
most of it. For people with Medicare, the self-pay
is less than 10%. Remember, no insurance will do the
exercises for you; device or no device consistency is
If you do not like devices, understand now it is not a
good idea to stop your urine flow midstream and wonder
if there are other tricks that may assist. Placing one
or two fingers in the vagina and trying to squeeze, will
give you a Kegel or pelvic floor contraction. If you do
not feel anything moving, keep on trying or have us at
Central Florida UroGynecology help you on your way to a
lifelong of pelvic health. We can help you on your way
with biofeedback, pelvic floor muscle training to reduce
urine leaks in stress, urge or mixed incontinence and
control the release of gas or bowel movements. Also it
will reduce the pressure and or bulging of the pelvic
How often should you do your exercises? The In-Tone
device will guide you through your daily program and
will tell you how long to squeeze and keep you
motivated, since you can see on the monitor if you are
The data can be downloaded on our computer and discussed
or you can decide to keep it all in the privacy of your
How often do I tell people to do their exercises; well
you can do them in front of the traffic light, waiting
in line at the grocery store or in church. Hold the
muscles for a few seconds and let go. You can hold and
let go quickly or hold longer, it will all benefit your
At Central Florida UroGynecology we will assist you with
the correct teaching of your pelvic floor muscles. Take
our short course and take it up from there, and/or use
the help of the In-ToneŽ device; important is that you
practice your Kegels/pelvic floor muscles and keep them
I often hear: I tried the Kegels, they do not work;
well you may not be able to correct your more extensive
problem with the Kegels, but they will always make it at
least a little better and for some lucky people like
Ruth, correct the entire problem in a non-invasive way.
By the way, she loves the In-ToneŽ device, since she
gets the feedback and she is now dry.
Central Florida UroGynecology in Rockledge -- your
center for pelvic health. Call 321-806-3929 and schedule
a consultation or
leave a note here.