Pelvic floor muscle training, commonly known as Kegel exercises, is the first-line treatment for various conditions, including urinary incontinence and pelvic organ prolapse. These exercises involve the voluntary contraction and relaxation of the muscles that support the bladder, uterus, and rectum. While manual Kegels are effective when performed correctly, the rise of assistive devices has introduced new options for individuals seeking to enhance or simplify their training. These devices, often referred to as Kegel machines, aim to address common challenges like difficulty isolating the correct muscles or maintaining consistent effort.
Categorizing Kegel Assistance Devices
The devices designed to aid pelvic floor strengthening fall into three main categories, each operating on a different principle.
The first category includes weighted vaginal cones or balls, which are simple, non-electronic tools used for passive resistance training. These devices are inserted into the vagina, and the user contracts the pelvic floor muscles to prevent the weight from slipping out, providing a form of biofeedback that confirms muscle engagement.
The second category comprises biofeedback devices, which are typically inserted probes or external sensors that measure the electrical activity or pressure generated by the pelvic floor muscles. They translate this physiological information into real-time visual or auditory signals, often displayed on a smartphone app. This immediate feedback helps users confirm they are contracting the correct muscles.
The third device type is Electrical Muscle Stimulation (EMS). These devices deliver gentle electrical impulses through internal probes or external pads placed on the skin. The goal of EMS is to cause an involuntary contraction of the pelvic floor muscles without the user needing to exert conscious effort.
How Assisted Devices Target Pelvic Floor Muscles
The two active device types, biofeedback and EMS, facilitate muscle training through distinct mechanisms. Biofeedback devices act primarily as a sophisticated learning aid, helping users establish a strong mind-body connection with their pelvic floor. Many people struggle to correctly identify and isolate the pelvic floor muscles, with studies suggesting a significant percentage of women unknowingly use their abdominal or gluteal muscles instead of the target muscles. Biofeedback provides immediate, objective confirmation that the user is contracting the correct muscles, improving technique and ensuring the exercises are effective.
EMS devices, in contrast, bypass the voluntary muscular control pathway by directly stimulating the nerves that control the pelvic floor muscles. The electrical pulses cause the muscles to contract and relax involuntarily, effectively performing the exercise for the user. This passive contraction is particularly beneficial for individuals with extremely weak muscles who cannot perform a voluntary contraction, or for those who have lost the sensation required to feel the muscles working. EMS settings can be adjusted to target different muscle fiber types—lower frequencies stimulate slow-twitch fibers for endurance, while higher frequencies target fast-twitch fibers for strength.
Comparative Effectiveness: Devices vs. Manual Kegels
The central question of whether Kegel machines “work” is often answered by comparing their results to traditional, unassisted manual exercises. Manual Kegels are highly effective when performed correctly and consistently, but compliance and proper technique remain significant hurdles for many users. Biofeedback devices address the technique issue, offering real-time guidance that helps users master the pelvic floor contraction faster than verbal instruction alone. The visual feedback and gamification often included in connected devices can also significantly boost motivation and adherence to the training program.
For individuals dealing with stress urinary incontinence, combining manual Kegels with a biofeedback device has been shown to produce better therapeutic effects compared to manual Kegels alone. EMS devices offer a solution for those who cannot achieve an effective voluntary contraction, providing an automated way to build muscle tone and strength. Their primary benefit is often improved consistency and the ability to work muscles that the user cannot consciously engage.
Medical Guidance and Safe Application
Before beginning any pelvic floor training regimen, consultation with a healthcare professional is strongly recommended. A physician or a pelvic floor physical therapist can correctly diagnose the underlying issue, as not all pelvic floor problems are caused by weakness. They can also ensure the device is appropriate for the individual’s specific condition and guide the initial use, which is especially important for proper technique with biofeedback or safe intensity settings with EMS.
Certain medical conditions represent contraindications for device use, particularly for electrical stimulation. Individuals with an active cardiac pacemaker or a defibrillator should avoid EMS devices due to the electrical current. Internal devices, whether biofeedback or EMS, are not recommended:
- During pregnancy.
- In the presence of certain infections.
- If there is irritation or broken skin in the area.
- If an intrauterine device (IUD) is present (consultation with a healthcare provider is necessary).