Accessing Hard to Reach Places: Biofeedback for the Pelvic Floor Muscles

Accessing Hard to Reach Places: Biofeedback for the Pelvic Floor Muscles

One of the most common things I hear from clients as a pelvic health physical therapist is “I had no idea I had muscles down there!” If you have been keeping up with our blog, you will already know that the pelvis is full of muscles and other tissues that helps us with our daily functioning. And, better yet, you can control the muscles of the pelvic floor just like you can control any other muscle group. However, sometimes people need help in being able to establish awareness and control in the pelvic floor muscles. Because these muscles are located inside the pelvis, we call upon a special tool called ‘biofeedback’ to help bring awareness to these muscles.

In short, biofeedback is a tool that provides information on what’s going on inside the body in order to help someone facilitate a change in their behavior to positively affect the tissue or bodily function being measured. Biofeedback for muscles is specifically the measurement of how much muscle is firing either during a contraction or a resting period (ie, is the muscle on or off?). One thing Biofeedback is not: a measure of muscle strength. The pelvic floor muscles are a unique set of muscles because they are located inside the pelvis. Biofeedback is helpful in order to access these muscles, usually with the use of a biofeedback machine. This small handheld device is connected to wires that are connected to the patient either by external electrodes placed on the skin of perineum or by an internal sensor placed into the vaginal or rectal canal. These electrodes and sensors then pick up the activity (or lack thereof) within the pelvic floor muscles, both when the patient is at rest as well as when the patient is cued by the therapist to engage or relax their muscles. The information is read by the handheld unit so the patient can see the activity of the muscle and then be able to change their muscular activation as needed. Biofeedback units range from being small, handheld devices all the way to very expensive computer systems. No matter the size or cost of the unit, generally speaking, biofeedback can be used for both strengthening weak pelvic floor muscles (referred to as ‘up training’) as well as training painful, tight, and overactive pelvic floor muscles to relax (called ‘down training’).

While the use of technology is helpful for biofeedback, especially when it allows patients to use home units between PT sessions, there’s another type of biofeedback that is considered the gold standard approach: the therapist! The physical therapist is an excellent resource to help a patient gather information about her body to help facilitate a positive change in muscle behavior. Pelvic health PTs are specialized in using their own palpation and manual therapy techniques (ie, their hands) combined with their clinical expertise (ie, their verbal cues and patient education) during internal pelvic floor muscle assessments in order to guide patients into proper muscle contractions and/or muscular relaxation. As we all know, computers (this includes biofeedback units) are not fool proof. They, too, can sometimes facilitate altered muscle habits that are less than ideal. This is why seeing a pelvic health PT to specifically get to know your own pelvic floor muscles is important in order to access those hard to reach places. Getting in touch with your own pelvic floor muscles with the help of a pelvic health PT will eventually translate into reduced pelvic floor dysfunction during daily life, keeping you pain free and leak free when you need it the most.


Leave a Comment

Schedule your Pilates or Physical Therapy session now!

Covid-19 Notice

06/09/2020 Covid-19 Notice:

Our clinics are open for in-clinic physical therapy visits, telemedicine physical therapy visits and virtual Pilates sessions. This allows us to comply as much as possible with the phased reopening of WA State, while also meeting our obligation as essential infrastructure workers. For in clinic treatment, the PT will wear a mask and patient needs to wear a mask of their own, social distancing is observed throughout the clinic and rigorous cleaning guidelines will be followed. At times during your treatment, it may not be possible for your PT to observe social distancing, such as during certain manual therapy techniques. The need for in-clinic treatment vs. telehealth treatment will be a joint determination between you and your PT. You may review our Covid-19 Exposure Control, Mitigation and Recovery Plan for the details of how we provide safe in-person care.

We are grateful for and support all of our clients who have been able to march and protest in support of Black Lives Matter. In order to continue to provide the safest clinic experience possible for our clients and providers, we are asking that any client who has participated in a march or protest do one of the following: 1.) Switch to telehealth visits for 14 days. 2.) Get tested for Covid-19 and provide us with negative results. Note that Seattle's mayor has cleared the way for those who march to get tested without symptoms and encourages participants to get tested. 3.) Wait 14 days after marching/protesting to return to the clinic. Thank you for understanding that this policy is in place to allow us to meet our responsibility to all clients, which is to do no harm.

We remain passionate about helping you improve and maintain the function of your movement system so that you can do the activities you love. We invite you to follow/Like our  Facebook page, where I am offering complimentary weekly Pilates mat class on Fridays at 7am. All are welcome to participate in these classes or view them anytime on our Facebook page.

Please contact me directly with any questions or concerns. Be in touch with your PT to schedule your physical therapy visit. We are available via clinic phone (206-535-7356) and email ( We will update you here and our Facebook page as things change.

Thank you for your support of this small, locally-owned physical therapy private practice!

Elizabeth Rogers, PT

Owner, Elizabeth Rogers Pilates & Physical Therapy, PLLC