How Pelvic Physical Therapists, Doctors, and Nurses Should Prescribe Vaginal Weights For Women

Still have questions? Contact Us I’m Amanda Olson from IntimateRose.com, and I’m a physical therapist certified in pelvic floor rehabilitation. I’m going to discuss the patient populations that I see that I’m recommending vaginal weights to, because I’m having really wonderful benefits with certain patient populations in terms of strengthening, building proprioception, and training pelvic floor muscles. Perhaps you’re a physical therapist who has been recommending vaginal weights steadily to your patients, and you’ve fallen into a rhythm where you’re recommending them for certain impairments. Perhaps you are a therapist who hasn’t touched vaginal weights since pelvic health level one. So perhaps this will bring up some ideas for you to use in the clinic to help some patient populations that could improve faster, or to just have a different training regimen. We know that the literature can apply to certain patient populations and not apply to others. That’s what makes us such skilled clinicians, that we’re able to look at the person in front of us and know what’s best for them. So the vaginal weights were originally developed by Plevnik for proprioception building in the pelvic floor. The very nature of having an object in the vagina is going to improve the brain’s awareness of where that pelvic floor is. So it’s good for my patients who have had nerve trauma that’s healed, whether from pregnancy, delivery, or certain gynecological surgeries; or maybe they’re just motorically challenged, and they have poor kinesthetic awareness. Having that weight, even a really low weight, in there is tremendously helpful. Because a lot of those folks are doing Kegels wrong, and we cue them in the clinic using visual cueing or tactile cueing. I’m lucky enough to have an ultrasound device, so I can actually show them where their pelvic floor is, and they can see it on the screen. Or perhaps you’re trying biofeedback. But then they get home, and everything you’ve taught them kind of goes out the window, because those cues are no longer there, and they haven’t been able to internalize them. So now they’re able to have the weights at home and insert one into the vagina, and they’re able to find it. So we’re having really wonderful results there. The second patient population is just people with low tone, people who are really weak. I generally train them to do a proper Kegel first, without resistance, usually in supine, and then building up into sitting. Then once they have a pelvic floor strength of about three out of five, I’ll introduce the weights to them if it’s indicated. Contraindications are going to be the people that have excess dryness or vaginal atrophy, those kinds of things. But for the rest of them, they tend to enjoy them and progress a little bit more steadily at that point. The third population that I’m using them with is athletes. These could be female athletes over the age of eighteen who may not have necessarily had children,but are experiencing incontinence or prolapse, because they are participating in sports that require a lot of heavy exertion. They can be gymnasts or jumpers who are having ground reaction forces from their landings, or lifters and throwers who are exerting force on their pelvic floor through intra-abdominal pressure. Athletes tend to be motivated by progression, and sometimes they require that extra resistance in order to get them strong enough to counteract the forces that they’re experiencing in their sport. The same would go for active women after childbirth: runners, Crossfitters, recreational athletes. Having that resistance of using the vaginal weights after you’ve done your therapeutic activities, of building up strength during regular sit-to-stand and other transitional movements, is really helpful to get them back to their sport. I saw one particular athlete who had undergone a B-Back, and she had a pretty decent prolapse. After about a month of using weights, she was able to return to running with a really stable pelvic floor, and she ended up being a Boston qualifying marathoner. So we had really good results there. Another population is the postpartum population that is a little bit further out. So sometimes, we think of our postpartum patients as being the women who come in at six weeks or three months. We are treating them for more acute postpartum impairments: maybe pelvic girdle weakness, or pain, incontinence, prolapse — things like that. But sometimes, they don’t make it in during that window of time. Or maybe we’re seeing them a little bit further out, in the nine- to twelve-month window. And they’re still healing, they’re still mending from postpartum-related impairments. But they’re still really tired, and they’re still really busy, and they may have a pretty full schedule. There’s some evidence to suggest that 80 to 100 Kegels per day are what’s required to get people [Inaudible - dry]. And a mom in that window of time may not be able to get all of that done, even though she’s well-intentioned and really motivated. It can be hard to remember, and hard to set aside all of the other things happening in her life, to do that. So with the vaginal weights, there’s a few different training paradigms that you can use that will allow her to multitask and get it done while still getting her other duties done. That goes for any busy person who you know wants to get better but are just not carving out the time to do their exercises. So looking at the purpose of the strengthening, when it’s endurance, you can have them place the weight in for 15 minutes while they’re showering, doing light household chores, or getting ready in the morning. So she’s able to do that, and get her things done, and be done with it. She can also place the weight in and do fewer sets with higher resistance to get more effect there. Coaching them to take it slow and start with maybe one or two sets in one day, to see how they respond, is usually a good idea. General muscle soreness can be expected when you’re starting a new strength program; as with anything in physical therapy, some soreness can come about. But of course, we don’t want to tip them over to the point where they’re too uncomfortable. So it’s usually trial and error. And usually, getting them to a three out of five first, before introducing the weights, is a good idea. The last population that I really see great benefit of using the weights for is the patients who can’t come to formal physical therapy. Maybe they come to evaluation, and we find out that their deductible is really high. Or maybe they’ve utilized all of their physical therapy allotment on their insurance for the year already, and they can’t afford it. Or maybe they live really far away. For me, in the area where I practice, I have some patients who are driving upwards of two hours one way to come and see me. And that’s a lot. They’re not able to come once a week, or even every other week, sometimes, due to the general nature of their schedule and the fact that they live so far away. I know a lot of pelvic therapists live in areas like that, where you might be the only one for a really large radius. So using the weights, with which they can progress themselves in a safe manner in-between visits, or if they can’t come to appointments at all, is really beneficial. The nice thing about the Intimate Rose vaginal weights is they come with instructions. So if you’re not able to see them at all, if they call in and talk to you on the phone, and they’re just not able to come, that’s a good direction to go. The customer service for Intimate Rose is really outstanding. They’re really committed to making sure that the customer gets access to what they need if there’s a problem with the product. The other thing that’s really impressive is if a patient or customer self-refers to the product through the internet, and they write into customer service with an issue, Intimate Rose will go onto either the APTA Section on Women’s Health or the Hermann Wellness database and find a pelvic therapist in their area, according to their zip code, and connect them with that therapist. They’re actually developing a pelvic health network right now as well that will have a list of pelvic health therapists who want to be on that list. So the company really recognizes the role of pelvic physical therapists in helping their customers, so it goes both ways in terms of making sure that people get what they need. For more information, to join the pelvic health network, or to receive a set of the vaginal weights for your clinic, visit IntimateRose.com.

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How Pelvic Physical Therapists, Doctors, and Nurses Should Prescribe Vaginal Weights For Women