Why Biofeedback Isn’t Always the Best Approach in Pelvic Health
Biofeedback has become a buzzword in pelvic floor therapy. It’s often marketed as the “gold standard” or the most advanced way to retrain the pelvic floor. And while biofeedback can be an incredible tool in certain contexts, it’s not a one-size-fits-all solution. In fact, for many patients, it could make symptoms worse!
What Is Biofeedback?
Biofeedback uses sensors (often placed intravaginally, rectally, or on the surface of the skin near those areas) to measure pelvic floor muscle activity. The results are displayed visually on a screen, giving patients “real-time feedback” about whether they are contracting or relaxing their muscles.
I should add that it’s one of the most heavily researched interventions for pelvic floor dysfunction. Why? Because it’s relatively easy to replicate in a study: place a sensor, get measurable data, and compare results across groups. Research thrives on standardized protocols—and biofeedback fits that mold.
But pelvic floor therapy in real life is anything but a cookie cutter protocol. Each patient’s body, history, and goals require a unique and nuanced approach—something much harder to package into a randomized controlled trial.
Why Biofeedback Isn’t Always Enough
1. It Only Measures Electrical Activity—Not Strength, Coordination, or Function
Biofeedback picks up electrical signals, not the quality of the muscle contraction. A patient may “score high” on the monitor but still have poor coordination, incomplete relaxation, or compensatory movement strategies that keep their symptoms from improving. You also need to consider other electrical activity in the room to avoid interference (i.e. unplugging the hi-lo table, turning off all of the lights, and putting cell phones and other electronic devices outside of the room). It can be a real pain in the butt (pun intended)!
2. It Misses the Bigger Picture
Pelvic health is about more than the pelvic floor itself. The breath, hips, core, posture, nervous system, and even emotional factors all influence pelvic function. Biofeedback doesn’t account for these whole-body contributors. It also implies that kegels are the answer to improving your pelvic floor strength, which we believe is rarely the case (more on that later).
3. It Can Create Over-Focus
When patients stare at a screen trying to “chase the graph,” they may disconnect from their body. The very goal of pelvic floor therapy is to restore natural, coordinated, subconscious function—not to make someone dependent on technology to know if they’re doing it “right.” This also goes for the kegel devices people can purchase for home use. While it can be fun to play a game while doing these “exercises” at home, we believe that mindful and functional movement is always the better option for long lasting relief.
4. There Are Better First Steps
For many pelvic health concerns (think painful sex, constipation, prolapse, or urinary urgency) manual therapy, breathing retraining, behavioral strategies, and functional movement patterns are often more effective entry points than biofeedback. In fact, biofeedback could make these conditions worse if you’re focused on improving your contraction strength or if you’re getting incorrect information from the device (which is more often than you think- ugh!).
5. It’s Not All That Functional
It’s not like you can wear the biofeedback device while you’re at work, school, or on a date! Could you imagine?! The tools that we provide are transferable to your everyday life, so you don’t have to wait until your next appointment to start making progress, you can see improvement with the work you do at home too.
When Biofeedback Can Help
With all of that said, biofeedback can be valuable in the right context:
Assessing resting tone in different positions for labor preparation
Tracking objective changes over time in research
Supporting those who learn best through visuals or who need more feedback in the beginning
Would prefer external options to understanding their pelvic floor strength/coordination
The key is knowing when and how to use it—not defaulting to it as the answer for every pelvic floor problem.
The Bottom Line
Biofeedback is a well-researched, replicable tool—but it’s still just one tool. The most effective pelvic floor therapy looks at the whole person—their movement patterns, habits, nervous system, lifestyle, and goals. Sometimes biofeedback fits into that puzzle. But often, the real breakthroughs come from individualized assessment, hands-on therapy, and empowering patients to trust their body again.
You are looking for a whole person approach to your pelvic related symptoms? Click here to request an appointment and talk to our staff to see if we could be a good fit for you!