Pelvic floor physical therapy and pelvic floor chair therapy both aim to strengthen the muscles that support the bladder, but they work differently. Physical therapy teaches you to exercise those muscles correctly, and supervised training is the first-line guideline treatment for stress leakage. A magnetic chair makes the muscles contract for you while you sit clothed, with more limited evidence. The two can be combined.
How Each Option Works
Pelvic floor physical therapy
A pelvic floor physical therapist assesses the pelvic floor, then teaches you to find, squeeze and relax the right muscles. The assessment may include an internal exam, but only with your consent. You leave with a home exercise program and come back for follow-up visits so the therapist can check your technique and adjust the plan. Some therapists also use biofeedback to help you tell whether you are using the right muscles.
That supervision matters. In a well-known 1991 study, after brief verbal instruction only 49% of women did an ideal Kegel, and 25% used a technique that could actually promote leakage. If you have been doing Kegels on your own without much change, why Kegels sometimes do not work explains the common reasons.
Pelvic floor chair therapy
Chair therapy is passive. You sit fully clothed on the Pelvic Wave chair, and an electromagnetic field in the seat, reaching up to 4 inches deep, causes involuntary pelvic floor contractions: more than 5,600 in a 20 minute session, according to the manufacturer. There are no probes, wires or electrodes, nothing is inserted, and there is no internal exam. Because the contractions happen on their own, they do not depend on you finding the muscle yourself.
A program is 24 sessions over 8 weeks, about three a week, followed by 3 maintenance sessions every 6 months. According to the manufacturer, the chair’s technology is FDA-cleared for the treatment of urinary incontinence in women. Pelvic floor chair therapy at Elume is provided by Restore Innovations, an independent practice located within Elume Medspa in Fairfax. You can read more on the pelvic floor therapy in Fairfax page.
Pelvic Floor Chair vs Physical Therapy at a Glance
| Question | Pelvic floor physical therapy | Pelvic floor chair therapy |
|---|---|---|
| What happens in a session | A therapist assesses you, teaches and checks your exercises, and may use biofeedback | You sit on the chair for 20 minutes while it contracts the muscles for you |
| Clothing and internal exams | May include an internal exam, only with your consent | Fully clothed, nothing inserted, never an internal exam |
| Who delivers it | A pelvic floor physical therapist | A certified Pelvic Wave operator (at Elume, through Restore Innovations) |
| Your part | Active: you learn a skill and practice at home every day | Passive: the contractions are involuntary |
| Evidence | Supervised training is first-line for stress leakage in guidelines | Limited, low-certainty evidence from other magnetic chairs, none on Pelvic Wave; not in NIH or NICE treatment ladders |
| Time commitment | Therapy visits plus home exercise for at least 3 months | 24 sessions of 20 minutes over 8 weeks, then 3 sessions every 6 months |
| Insurance | Often covered with a referral | Usually self-pay; Aetna classifies magnetic stimulation as experimental |
What the Evidence and Guidelines Say
For stress leakage (leaking when you cough, sneeze, laugh or exercise), UK guidelines from NICE recommend supervised pelvic floor muscle training for at least 3 months, with at least 8 contractions 3 times a day. For urgency leakage, the first step is bladder training for at least 6 weeks. Magnetic chairs do not appear in the NIH or NICE treatment ladders.
Research on magnetic chairs exists, but it is thin. A 2021 meta-analysis of six small sham-controlled trials found magnetic stimulation reduced stress leakage in women compared with a placebo treatment, although the authors flagged study-quality problems. A 2025 systematic review of five small studies (about 219 women) found chair-based magnetic stimulation was associated with less leakage, but rated that evidence low certainty. None of these studies used the Pelvic Wave chair; they tested other magnetic chairs.
Put plainly, physical therapy has the stronger evidence base. Chair therapy is an option people consider when exercises have not helped enough or are hard to do correctly, and it is not a replacement for medical care. For the full range of choices, from lifestyle changes to surgery, see the guide to bladder leakage treatment options.
Cost, Insurance and Time
Pelvic floor physical therapy is often covered by insurance with a referral, although plans differ. Chair therapy is usually a different story: Aetna classifies magnetic pelvic floor stimulation as experimental, so chair therapy is usually self-pay. Whatever you choose, ask your insurer what your own plan covers before you start.
Restore Innovations quotes each chair therapy plan individually. The consultation is free, and the full cost of any recommended plan is explained before your first session.
Time works differently too. Physical therapy visit schedules vary by practice, and much of the work happens at home, with exercises three times a day for at least 3 months. Chair therapy asks for more trips, about three a week for 8 weeks, but each visit is 20 minutes of sitting with no downtime. For the step-by-step version, see what to expect from pelvic floor chair therapy.
Choosing Between Them, or Using Both
Physical therapy may be the better first step if
- You have not tried supervised pelvic floor training yet.
- You want the option with the strongest guideline support.
- Insurance coverage matters to you.
- You want a skill you can keep practicing on your own.
Chair therapy may be worth considering if
- You have done the exercises and they have not helped enough.
- You find the exercises hard to do correctly, or cannot tell whether the right muscle is working.
- You would rather not have an internal exam.
- You can manage about three short visits a week for 8 weeks and are comfortable paying out of pocket.
Chair therapy is not suitable if you are pregnant or may be pregnant, have an implanted pacemaker or defibrillator, or have a history of cardiac arrhythmia or atrial fibrillation. Anyone with metal or electronic implants should raise them at the consultation.
Using both
The two can be combined. You might keep up a physical therapist’s home program while going through chair sessions; just tell each provider about the other.
A note for men
Men recovering from prostate surgery follow their own guideline path with their urologist, covered in pelvic floor therapy for men after prostate surgery. Restore Innovations sees men, but the chair’s FDA clearance covers urinary incontinence in women, not men. Men talk through whether chair therapy suits them at the free consultation and keep their urologist informed.
When to see a doctor first
Whichever way you lean, see a doctor before starting either option if you have blood in your urine, pain or burning when you urinate, a fever, sudden new symptoms, trouble emptying your bladder, or leakage that started after a new medicine.
Frequently Asked Questions
Is pelvic floor chair therapy better than physical therapy?
Not on the evidence available today. Supervised pelvic floor muscle training, the core of physical therapy, is the first-line guideline treatment for stress leakage, while research on magnetic chairs is limited, low certainty and did not use the Pelvic Wave chair. Chair therapy is an option people consider when exercises have not helped enough or are hard to do correctly.
Do they do an internal exam in pelvic floor therapy?
Pelvic floor physical therapy may include an internal exam, but only with your consent, and you can ask exactly what it involves before agreeing. Chair therapy never includes an internal exam. You sit fully clothed, nothing is inserted and nothing touches your skin.
Does insurance cover pelvic floor chair therapy?
Usually not. Aetna classifies magnetic pelvic floor stimulation as experimental, so chair therapy is usually self-pay, while pelvic floor physical therapy is often covered with a referral. Check with your own insurer, and ask Restore Innovations to explain the full cost before your first session.
Can you do pelvic floor chair therapy and physical therapy together?
Yes, the two can be combined. Physical therapy teaches you to use the muscles yourself, and the chair adds involuntary contractions while you sit. Let your physical therapist and the chair operator know about each other so the plan stays coordinated.
Talk It Through With Restore Innovations
If you are weighing chair therapy against physical therapy, or wondering whether to combine them, a short conversation can help. You can book a free 15 minute phone consultation, where Restore Innovations calls you, or a free 30 minute consultation in person at the suite inside Elume Medspa in Fairfax. You can also call (571) 299-8780. Consultations are by appointment only.
Sources
- Urinary incontinence and pelvic organ prolapse in women: management (NG123), NICE (2019)
- Bladder Control Problems (Urinary Incontinence), National Institute of Diabetes and Digestive and Kidney Diseases (accessed 2026)
- Assessment of Kegel pelvic muscle exercise performance after brief verbal instruction, American Journal of Obstetrics and Gynecology (1991)
- Efficacy of magnetic stimulation for female stress urinary incontinence: a meta-analysis, Therapeutic Advances in Urology (2021)
- Systematic review of chair-based magnetic pelvic floor stimulation in women with urinary incontinence (Sacarin et al.), Journal of Clinical Medicine (2025)
- Clinical Policy Bulletin 0223: Urinary Incontinence, Aetna (accessed 2026)
- 510(k) K973096, Neotonus Model 1000 Muscle Stimulator System, U.S. Food and Drug Administration (1998)