3-D Image of the Pelvic Muscles and Ligaments

The Pelvic Floor in 3-D:

1. Pelvic Floor Muscles: https://www.youtube.com/watch?v=P3BBAMWm2Eo
2. Pelvic Floor Ligaments (1/2): https://www.youtube.com/watch?v=Bf_sr2qRRWs
3. Pelvic Floor Ligaments (2/2): https://www.youtube.com/watch?v=Bf_sr2qRRWs

More on Pelvic Anatomy

These are much more complex than the other two posts and may make your brain hurt. They focus on the muscles and fascia that sit above the pelvic diaphragm:
http://www.youtube.com/watch?v=49yeRmj3cIo
http://www.youtube.com/watch?v=7fZfpNJHQTM

My Biofeedback Machine

I wanted to show you the biofeedback machine that I rented. It is called U-Control Incontinence Trainer. It comes with either vaginal/anal or electrode sensors. I understand that using the vaginal/anal sensor gives a better EMG reading for the pelvic floor. I chose to get the electrode sensors, however, because I have other tight muscles and I figured I could multi-task on my rental. The three links attached will help fill you in on the details. The youtube video does a good job and gives you the information on how to use it and where to get the equipment. A youtube video shows the vaginal/anal sensor. If you use the electrode sensors, you place the yellow and blue connectors to the immediate right and left of your anus. The black connector goes on a bony part of your body like your iliac crest, aka hip bone, and is the ground. There are two sensitivity settings: x1 and x3. The x1 is more sensitive and probably what you want to eventually work with, but x3 also will read the electrical conductivity of your pelvic floor muscles. You may be able to get to the lowest reading (I rarely did), but feel good about just going lower into the A, B, and C range (you can see this on the photo below at the bottom of the unit). It means my nerves were pretty calm.

Overview

Equipment and Costs

I used this for 3 months and now can get to a relaxed state in about 2 minutes. I also learned what sitting and lying positions help relax my pelvic floor.

You can buy or rent this equipment. I rented for 3 months from the company listed on the unit. I made sure my doctor's prescription had "incontinence" on it as one of the symptoms to treat as it is part of the name of the machine proper "U-Control Incontinence Trainer". I have a P.T.'s recommendation, a doctor's prescription, and a good PPO plan and the reimbursement went through. I can't remember how much I paid out of pocket. The company offered to put my rental cost towards a purchase of the machine. I declined, but hope that was the right choice...

Update Nov. 26, 2015
I'm thinking of doing this again, this time as a purchase. To that end, the best price I found online for purchasing this is at http://www.lifematters.com/u_control.asp 

U-Control™ Home Continence Trainer 1 Channel of sEMG Price $334

Then you add: T3425: UniGel Pre-Gelled Single Electrodes. Package of 100 for $35 (each electrode lasts a while); or the T6050: vaginal sensor for $50, and the cable.

How to Kegel

After many, many years of not "getting it", I think I may understand how to Kegel.

First, if your Kegel muscles are very weak, you may not feel like you are doing it at all.

Second, if your pelvis is messed up, it is the release of the Kegel that is more significant that the contraction.

Third, for me I have figured out that a Kegel is 1. tightening my anus, 2. have my clitoris "nod down", and 3. closing up the vaginal entrance. Don't flex your butt and don't use your transverse abdominus.

If you are trying to release your pelvic floor, don't strain to hold it. Just initiate the Kegel for 1-3 seconds and then release and try for "non-doing" relaxation (i.e. don't try to consciously "enlarge" your anus). This may take a lot longer than the Kegel - 30 seconds? 1 1/2 minutes? 4 minutes?

If you are trying to strengthen your pelvic floor, then hold the Kegel just until you start to lose control and your Kegel gets shaky.

Here is where the biofeedback machine really helps as it measures your muscle contraction and relaxation through electric impulses.

Physical Therapy Continued...

I am now in week 5. The last two weeks have been biofeedback! Very challenging to get to a resting muscular reading. And that is lying down. I haven't figured out standing or walking. I am going to see if I can rent/buy a biofeedback machine for myself.

We are Kegel-ing which I never before understood because I was too weak to do it. Basic concept is to pull in your clitoris, vagina, and anus all tight. Then before you start shaking with weakness and lack of control, relax completely. Like really completely. This is perhaps more important than the Kegel itself - to get that release of the muscles of the pelvic floor.

She has a computer with a picture of a rose. The Kegel is trying to get the rose to close up and be a bud; the release is trying to get that rose as open and large as you can. I experimented with different thoughts: envisioning the rose, making my mind blank, thinking of my pelvic floor opening. The biofeedback machine gives you numbers as your muscle tension releases or increases.

Week 4
First session: Not great, but okay.
Second session: Pretty darn good, all things considered.

Week 5
Third session: Awful. Also, P.T. is taking away from my normal exercise/relaxation time so that is at odds. I am hanging in there, but hope to become more independent. If anyone knows of a biofeedback machine place, I am ready to rent or buy.

My psychotherapist and I will discuss "butt clenching" in our next session. The butt clenching, as I understand it for myself, is related to anxiety, mechanical instability and habit.