Biofeedback in Pelvic Health: What You Need to Know

Author: Dr. Anisha Drake PT, DPT, WCS

As a pelvic floor physical therapist, I've seen how biofeedback can be a valuable tool for some patients. However, it's not a one-size-fits-all solution. In certain cases, biofeedback may not be effective or may even frustrate patients if not used thoughtfully. How do you know if biofeedback is right for you? Let's explore what biofeedback involves, when it is used, and some of the limitations of biofeedback in pelvic health.

What is Biofeedback?

Technically speaking, biofeedback is a technique where the patient receives real-time data as muscles are doing their job. Commonly, this term refers to a device known as EMG Biofeedback, where sensors attach to the pelvic floor muscles and track the muscles’ activity as they contract and relax. During the “early days” of pelvic floor rehabilitation, this was the only tool to help physical therapists assess how the muscles were working. As a result, many medical professionals believe pelvic floor physical therapy and biofeedback are one and the same. Fortunately, our knowledge of how the pelvic floor works has improved, and more effective treatment options are available. Biofeedback is no longer the holy grail of pelvic floor rehabilitation. It is a tool that can help many but it is not a necessity. Many studies now show that biofeedback is not superior to other interventions like exercise and manual therapy. In several cases, biofeedback may lead to worsening of symptoms, or at best, not produce any lasting effects.

When Biofeedback Falls Short

Knowing how and when to use biofeedback is imperative. Even if you are referred to PT for biofeedback, a physical therapist should first evaluate whether this tool is appropriate for your unique situation. Here are two hypothetical, simplified scenarios where biofeedback would not be helpful.

1. When the pelvic floor is the “victim”: Pelvic floor problems sometimes are the result of other things going on in the body. For example, a patient whose pelvic floor muscles may be too tight due to underlying issues like weak glute muscles or myofascial restrictions. In these cases, other interventions such as manual therapy to release tension and strengthening of supporting muscles is often more effective.
2. Compensating muscles: Biofeedback can give helpful information to allow pelvic floor strengthening. However, it can be hard to tell whether the patient is using the correct muscles. Additionally, biofeedback is often performed lying on the back or in a different position that doesn't translate to daily life. If the patient cannot train the muscles in a functional position or movement, progress may be limited. It's crucial for therapists to tailor the approach to each patient's needs to make biofeedback effective. In many cases, patients move better mimicking functional movement patterns without the addition of biofeedback.

What This Means for Patients

Bottom line: Biofeedback is a tool, not a cure-all. If you're considering biofeedback for pelvic health issues, it's essential to work with a skilled therapist who can assess your specific needs. Is this the correct treatment for you? How long do you need it? What other treatment tools may help? The right approach will help you make progress and find relief from symptoms. Just because you’ve heard of biofeedback or someone has recommended it does not mean it’s the best treatment for you.

Takeaways

- Biofeedback works best when tailored to the individual's condition.
- A comprehensive approach that includes manual therapy and strengthening exercises may be more effective for some patients.
- Working with an experienced pelvic floor physical therapist is key to achieving the best results.

Wondering if biofeedback is right for you? Looking for other tools to alleviate your symptoms of pelvic floor dysfunction? Set up an initial consultation with one of our pelvic floor PTs to determine your best course of care.