Are you hesitant to try vaginal weights?

Learn more about the impairments that can be treated with kegel weights and evidence-based clinical reasoning that debunks some of the myths surrounding weight use.

Utilizing Vaginal Weights

Vaginal 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.

There are two methods of weight utilization to address the endurance and power components of muscle strength. As with any other muscle group in the body, specific exercises and usage can be prescribed 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. 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, the bladder should be emptied prior to use, weights washed with soap and water, and when starting out, a day of rest should occur in between exercise sessions to avoid overexertion of the muscles.

Patient Populations That Will Be Successful With the Weights 

1. 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 kinaesthetic awareness.  This may lead to doing Kegels improperly. 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 out.
2. Low tone: 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.  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.
3. Postpartum: After 9-12 months or so, patients can lose the postpartum diagnosis in certain circles even though their symptoms are secondary to pregnancy and childbirth. I’ve had tremendous success prescribing the weights to new moms who are at least 3 months out because the weights save 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. 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 postpartum mom will have difficulty completing these. The weights are a lifesaver for them and they often get dry or correct mild to moderate prolapse after a few weeks or months.
4. 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 can experience stress urinary incontinence and prolapse even though they have never had children or explicit trauma to the pelvic floor.  Postpartum 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
5. Those who cannot afford pelvic physiotherapy for incontinence/prolapse: Vaginal 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 supportive resources to help you through the process.

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