Pelvic FloorStrengthening.

Bladder leaks, and the reason nobody mentions them

Very few people walk into a clinic and volunteer that they leak when they sneeze, or that they plan their day around where the washrooms are, or that they have stopped running. It is extremely common and almost never mentioned.

Part of why this treatment gets used at all is that it removes the barrier. You sit on a chair, fully clothed, and read your phone. There is no examination, no undressing, no internal device and no gown. For a lot of people that is the difference between getting help and continuing to manage quietly.

How the chair works

The seat generates a focused electromagnetic field that passes through clothing and tissue into the pelvic floor. Motor neurons in the muscle group respond to the field by firing, and the muscles contract involuntarily.

The reason this does something that Kegels at home do not is volume and completeness. The contractions are far more numerous within a session than anyone could manage voluntarily, they are deeper than most people can achieve consciously, and they engage the whole muscle group rather than the part you happen to be good at isolating. A large proportion of people who believe they are doing pelvic floor exercises correctly are not.

Who it helps: stress incontinence, urge incontinence, and after childbirth

People with stress incontinence, the kind of leaking provoked by coughing, sneezing, laughing, lifting or exercise. People with urge incontinence, where the need arrives suddenly and is hard to defer. Many people have both, which is called mixed incontinence and is the most common presentation of all.

People who have noticed a loss of pelvic tone after pregnancy and childbirth, and people in perimenopause and after menopause, when the tissue itself changes as oestrogen falls. What all of these have in common is on our bladder leaks and urinary incontinence page, which covers the causes in more detail than a treatment page should.

Men are treated too, particularly for the pelvic floor weakness that can follow prostate surgery, though the treatment is asked about far less often by men than it should be.

When physiotherapy is the better answer, and we will say so

A pelvic floor problem is not always a weak pelvic floor. Some people have a pelvic floor that is too tight, or one that does not coordinate properly with the rest of the core, and strengthening a muscle that is already over-contracted can make symptoms worse rather than better.

A pelvic health physiotherapist can assess that directly in a way a chair cannot. If your history points that way, we will recommend physiotherapy first, and we are happy for you to come back afterwards if the chair still has a role.

We will also tell you when a symptom needs a doctor rather than a treatment. New pelvic pain, blood, or a sudden change in bladder or bowel habit should be investigated properly, not treated cosmetically.

Who cannot have it

This is the treatment on our menu with the firmest exclusions, and they are not negotiable. Anyone with a cardiac pacemaker or an implanted defibrillator cannot be treated. Neither can anyone who is pregnant. Metal implants within the treatment field, including certain intrauterine devices depending on their type, and active infection are also exclusions. We screen for all of this before you sit down.

At the appointment

You are screened, consented and shown how to sit so that the field is centred correctly, which matters more than people expect. Intensity is started low and increased gradually to a level you can tolerate comfortably. You stay clothed, you stay seated, and you can talk, read or scroll throughout.

Afterwards

There is no recovery period. You may feel a mild muscle fatigue in the pelvic floor, similar to the day after any workout, and you can go straight back to your day.

Sessions are spaced across a course, and the benefit builds across it. We ask about your symptoms specifically at review rather than asking whether you feel better in general, because the change is often noticed as something you stopped having to think about rather than as a dramatic event.