Strong Foundations: Understanding Pelvic Floor Health

This episode delves into the basics of the pelvic floor, explaining its anatomy and function. It highlights how the pelvic floor is an essential support system for the organs in the pelvic region. Pelvic floor dysfunction, which can occur due to weakness or spasms in the pelvic floor muscles, is discussed along with its associated symptoms. The importance of pelvic floor therapy and the role of pelvic floor therapists are emphasized in improving pelvic floor health. The concept of prehab, which involves strengthening the pelvic floor muscles before childbirth or surgery, is introduced. The effectiveness of different interventions, such as Kegel exercises, weighted kegels, electrical stimulation, and biofeedback devices, is explored. The differences between electrical stimulation and electromagnetic stimulation for the pelvic floor are highlighted, with electromagnetic stimulation showing superior and longer-lasting results. The podcast concludes by emphasizing the importance of increasing awareness and taking steps to protect and repair the pelvic floor to maintain optimal function.

 

Key moments in this episode are:

00:51 Pelvic bones create a bowl

01:31 Pelvic floor as bottom of the bowl

01:45 Function of the pelvic floor

03:32 The under-recognized high tone pelvic floor

04:25 What a pelvic floor therapist does

06:54 Insurance coverage for pelvic floor therapy

07:28 The concept of "pre-hab" rather than rehab

08:19 The Kegel exercise

10:24 Dr Arnold Kegel

10:59 Ben-wa balls

11:57 Electrical stimulation to the pelvic floor

12:54 Evidence for benefit of vaginal weights and electrical stimulation

13:49 Limitations of studies on electrical stimulation

15:10 Animal studies of the pelvic floor

16:16 Biofeedback devices for pelvic floor

17:24 Which therapy is best for you?

18:40 Excessive marketing claims of over-the-counter devices

21:22 Electromagnetic therapy to the pelvic floor

22:07 Data about electromagnetic therapy

 

Here's the study comparing Kegels, electrical stimulation and vaginal cones: Castro RA, Arruda RM, Zanetti MR, Santos PD, Sartori MG, Girão MJ. Single-blind, randomized, controlled trial of pelvic floor muscle training, electrical stimulation, vaginal cones, and no active treatment in the management of stress urinary incontinence. Clinics (Sao Paulo). 2008 Aug;63(4):465-72. doi: 10.1590/s1807-59322008000400009. PMID: 18719756; PMCID: PMC2664121.

This study used vaginal biopsies to show beneficial effect from electrical stimulation: Sarmento ALC, Sá BS, Vasconcelos AG, Arcanjo DDR, Durazzo A, Lucarini M, Leite JRSA, Sousa HA, Kückelhaus SAS. Perspectives on the Therapeutic Effects of Pelvic Floor Electrical Stimulation: A Systematic Review. Int J Environ Res Public Health. 2022 Oct 28;19(21):14035. doi: 10.3390/ijerph192114035. PMID: 36360918; PMCID: PMC9658412.

And this one shows the deeper effects of electromagnetic stimulation to the pelvic floor: Sylantieva E., Zarkovic D., Soldatskaia R., Evgeniia A., Orazov M. Electromyographic evaluation of the pelvic muscles activity after high-intensity focused electromagnetic procedure and electrical stimulation in women with pelvic floor dysfunction. Sex. Med. 2020;8:282–289.