Central Florida UroGynecology

Marja Sprock, M.D.

Pelvic Floor Muscle Training and the In Tone® Device

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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.

The 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.

Strong pelvic floor muscles will protect against stress, urge and mixed incontinence as well as pelvic floor prolapse

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 we can.

Most 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 emptying.

Do not practice your pelvic floor muscles while urinating; it leads to dysfunctional voiding and bladder damage

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-Tone® device. She heard Medicare reimbursing for a significant amount of the cost of the device and she desired to have the extra help.

Even though you can do your pelvic floor muscle exercises anytime and anyplace, some people prefer the feedback and guidance of the In-Tone device.

In-Tone

In-Tone Device

Central Florida UroGynecology, Dr. Sprock is an In-Tone provider and the In-Tone can be bought at Central Florida UroGynecology.

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 key.

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 organ prolapse.

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 improving.

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 improving.

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 pelvic health.

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-Tone® device; important is that you practice your Kegels/pelvic floor muscles and keep them in shape.

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-Tone® device, since she gets the feedback and she is now dry.