5 Patient Populations That Benefit From Pelvic Floor Weights
How my patients have flourished with the Intimate Rose Kegel Exercise System
By Amanda Olson, DPT, PRPC
Perhaps you have been recommending pelvic floor weights to your patients for years, and have found yourself in a rhythm of recognizing a few key demographics that respond well.
Perhaps you have never used them or recommended them to your patients because you forgot about them following your Level 1 pelvic health course.
Or, perhaps you have not been recommending them because you do not feel that they complement your clinical practice.
You may not have considered all of the patient populations that may benefit from use of the weights, or how they may accentuate your pre-existing therapeutic exercise prescription.
Below are key impairments that I treat using kegel weights, and evidence-based clinical reasoning that debunks some of the myths surrounding weight use.
Pelvic floor weights are utilized by inserting the weight just above the levator ani, and is supported by all of the pelvic floor muscles collectively. If the weight begins to slip, it prompts the patient to contract the muscles via proprioception. Finding the proper weight to begin with involves some trial and error.
Intimate Rose Kegel Weights For Pelvic Floor Endurance & Power
There are two methods of weight utilization to address the endurance and power components of muscle strength. As we would with any other muscle group in the body, we can prescribe specific exercises and usage to address the patient’s unique impairments. To address endurance, the patient will determine which weight can be held in place while upright for 15 minutes. Training then consists of placing the weight and maintaining it in the vagina during light activities and chores such as showering, dish washing, or getting ready in the morning. To address muscular power, determine the heaviest weight that can be maintained for 1 minute, and utilize that weight to perform repetitions of kegels.
Patients who have achieved muscle strength of 4 / 5 or 5 / 5 can place the heaviest weight tolerable during the 15 minute test and perform therapeutic activity with the weight placed. This may consist of marching, mini-squats, sit to stand, upper extremity movement, lifting weights, stair climbing, or heel raises. Eccentric muscle strengthening may be achieved by having the patient gently pull on the weight while resisting.
For best success, advise patients to empty their bladder prior to use, wash their weights with soap and water, and to allow for a day of rest in between exercise sessions when starting out to avoid over exertion of the muscles.
Patient Populations That Have Success with Intimate Rose Weights:
Patients with poor proprioception:Loss of proprioception occurs often with nerve damage associated with pregnancy and childbirth
,surgery, radiation, and other trauma. The brain may have a hard time locating the pelvic floor muscles even after the nerve has healed, creating poor kinesthetic awareness. This may lead to doing kegels improperly. As we all know, sometimes people just have poor body and spatial awareness without true nerve damage. By placing the weight into the vagina it draws the brain’s attention to where the pelvic floor is because it applies pressure. The weight then provides a mechanical cue to the pelvic floor to pull up and contract, lest the weight fall out1.
Low tone: Our patients with underactive pelvic floor muscles. This may be due to neurological impairments, natural aging, genetic disposition, and injury associated with childbirth and pregnancy or surgery. This may include women with “non-contracting-non-relaxing” pelvic floor muscles, which is often due to poor proprioception as discussed above. These women often benefit from initial education and training in proper pelvic floor muscle activation using visual and tactile cuing or biofeedback. Once they have established pelvic floor muscle strength of 2 / 5 or 3 / 5 the weights then become appropriate for training strength.
Post-partum:This seems obvious, however after a certain period of time a clinician can neglect to consider the patient post-partum. After 9-12 months or so they can lose the post-partum diagnosis in certain circles even though their symptoms are secondary to pregnancy and childbirth. I have had tremendous success prescribing the weights to new moms who are at least 3 months out because the weights saves them time if they place them during light household activities, thus allowing them to multi-task.
The current evidence suggests that 80-100 kegels per day are necessary to get a person dry who is incontinent, and that using the weights is equivalent to performing kegel exercises in isolation.2 A new mother is busy, exhausted, and has little time for herself to complete large quantities of kegels per day. Even the most motivated or best intended post-partum mom will have difficulty completing these. I have heard clinicians sometimes pass these women off as flaky, non-compliant, or unmotivated which is entirely unfair. The weights are a life saver for them and they often get dry or correct mild to moderate prolapse after a few weeks or months.
Athletes: Athletes who are incontinent or experiencing prolapse are generally very motivated by progression, and often require a higher level of strength to safely conduct their physical activity. Athletes that endure high impact in their sport including gymnasts, basketball players, and track and field athletes (throwers, runners, jumpers) can experience stress urinary incontinence and prolapse even though they have never had children or explicit trauma to the pelvic floor. Post-partum distance runners also tend to experience stress urinary incontinence and prolapse secondary to pregnancy and childbirth and these symptoms can be compounded with running. Athletes will benefit from using the weights to create both concentric and eccentric muscle contraction in order to strengthen the muscles against the ground reaction forces or intra-abdominal thrust pressure that is placed on the pelvic floor during impact sports. Eccentric contraction is achieved by pulling on the weight as the patient is contracting the pelvic floor muscles.
Patient who cannot afford formal physical therapy for incontinence or prolapse:How frustrating is it when we find out that a patient cannot attend formal pelvic floor physical therapy because they cannot afford it, yet we want to help them and know that they need our services. Perhaps their deductible is sky-high, or they have already utilized all of their physical therapy benefits. Kegel weights use is an effective method of strengthening the pelvic floor with room for progression. Intimate Rose vaginal weights offer 6 progressive weights with a written instruction manual, and numerous resources including excellent customer services, online blog articles written by a pelvic PT, and exercises with pictures to allow for variety. This is a key population for me because I am able to offer the patient a method for addressing their issues and there are resources available to support them.
- Hay-Smith J. Physical Therapies: weighted vaginal cones. 3rd ed. Plymouth, UK: Health Publication Ltd; 2005: Chapter 15.
- Cammu H, Van Nylen M. Pelvic Floor exercises versus vaginal weight cones in genuine stress incontinence. Eur J Obstet Gyneco Reprod Biol.1998; 77:89-93.