(image by Megumi Igarashi, Japanese artist who was convicted of obscenity law offences for making a vagina canoe)
I’ve been following the recent advances in pelvic floor technology with great interest.
A few years ago there were only mostly clumsy devices to help women do their pelvic floor exercises. One or two of them were useful (and remain so) but, the rest would be quickly consigned to the knicker drawer to languish for the rest of all time along with your very pretty underwear that you “keep for best” and never actually wear.
Smart phones and pelvic floors make a great combination, and, it wasn’t long before iFanny apps appeared on the market.
Some of these are good products, they’ll take you through an evidence based pelvic floor programme with visual images to show you when to breathe, lift and squeeze and relax. They are, however, unable to tell you whether you are doing the exercises correctly, and we know that about 30% of women bear down when doing pelvic floor exercises.
That is the big challenge in pelvic floor re-ed, how do you know if you are doing the exercises correctly or not? If you want to fix your bingo wings you’ve usually got a pretty good idea of what your arm is, what it does and what it looks like when it’s working - but, your undercarriage? Not so much. And, doing pelvic floor exercises incorrectly can cause more problems than you were trying to solve.
Certainly, a 1:1 session with a physiotherapist will sort you out, but, we also know that women are often reluctant to come to clinic. Everyone is busy, and attending clinic eats into a week that’s already a good two days short. This is one of the main reasons women never quite get around to fixing their undercarriage, making time for yourself can be really difficult.
I’d like to see a gadget which can tell you are doing the exercises correctly, can encourage you to remember to do them and record progress. And, if I was your clinician I’d like to see what you were doing and adjust the programme, that’d be amazing. And, if could be any colour other than pink, well, total result. I’m a bit sick of pink in women’s health.
“you can have it any colour, as long as it’s one of these”
I was sent a sample of pericoach, and…goodness, it did all of those things! I’m a bit of tech dinosaur, but, I wouldn’t ask anyone in clinic to try something I hadn’t done myself, so…
The unit comes in a grey plastic box which doubles as the charger. You can leave it on your bedside table with confidence because there is nothing on it that screams “THIS IS FOR MY BROKEN FANNY”. It looks like it might have a bit of jewellery in it.
The device itself is smooth and light with internal sensors which measure the power your pelvic floor muscles can generate. There are no wires! It provides accurate biofeedback with each contraction, which you can see in real time on your smartphone app.
Sometimes, women benefit from having something to squeeze against in order to get the hang of a pelvic floor contraction. The pericoach does that, but also helps visualise the muscles’ working because you can see on the phone screen what your pelvic floor is doing. The device is callibrated and the measurements are accurate, and so we can have confidence in the data the pericoach provides.
The pericoach prompts you to relax your muscles too, which can be a challenge for people with overactive pelvic floors. Remember, an inflexible pelvic floor can be just as problematic as a weak one. We need our breathing and pelvic floor to be co-ordinated, and seeing the muscle action on the screen can be really helpful.
You are not limited to using it in lying or sitting, as you get stronger then the device can be used in functional activities and still give you feedback.
(not this, though. If you can do this without leaking, you’re probably fine)
The main challenge for physiotherapists is to get people to remember to do their exercises at all! The gadget prompts you if you have if you have not used it, which is way nicer than me phoning you up to nag you.
Being able to track a patient’s progress without any guesswork is a game changer for a clinician. I really like the portal which means I can access a home programme remotely and see what progress is being made. It blows my mind that not all consultations have to be in clinic now, we can review via face-time or skype and reduce the number of clinic appointments you’d need. Of course, if you haven’t actually used the thing I might still phone to nag. It’s a skill I don’t want to lose.
My only concern would be whether the pericoach can be picked up by other bluetooth devices…would your in-car speaker phone start blaring out what your pelvic floor has been up to that day? Or worse, would someone else’s in-car speaker phone broadcast your innermost data? Pericoach say not. Still, be vigilant for bluetooth hackers, just in case.
Maxine is brilliant, find her on facebook.
All in all, as a clinician I’d recommend the pericoach. It’s not a cheap option, but, I think of it as a good solution to the challenges of doing a pelvic floor contraction properly, relaxing properly, charting progress accurately and progressing accordingly. It’s accurate and I trust it’s data collection.
Pericoach is an effective tool in addressing continence or prolapse issues that women have. That really matters, because we have got to move for health, and leaking is a barrier to exercise. Luckily, there’s no need to put up with it.
For further info about the device see: http://www.pericoach.com