KEGELS THE RIGHT WAY

Hi Cynthia

When talking Kegels I think it is important to keep it all in perspective. Kegels can be very useful for exercising the muscles of the pelvic floor, which improves their ability to act as sphincters for the pelvic organs, and it does mean that the 'back wall' of the pelvic cavity is covered in 'stronger, more bouncey elastic' rather than weaker elastic. Kegels will also improve your awareness of the whole pelvic area which will enable you to be more mindful of how you move, and what is happening in there during different activities. Having this awareness, and 'stronger elastic' can also enhance your sexual experiences.

However, Kegels will not enhance support for the pelvic organs past having 'more bounce' and ability for the pelvic floor to not sag back all the time. The pelvic organ supports are primarily the three dimensional fascial tissue that surrounds each organ, like flexible honeycomb, supporting each organ in three dimensions. Prolapse happens when that three dimensional support net is damaged and the contents spill out and fall backwards if gravity is pulling them in that direction. The only way to prevent pelvic organs sagging back and down is to tip them forwards so their centre of gravity is over the pubic bone, and not over the vaginal opening, and give them room in the lower belly to move into, so they can stay in place, supported on bone.

The rectum is a bit different because it sags forwards if its supportive fascia are damaged, and if there is a space to move into. The important factor with rectocele is to prevent regular distension of the rectum into the vagina by preventing constipation and the straining to empty that goes with it.

So Kegels are a secondary tool in the battle to keep your organs inside your body. It probably doesn't matter what time of day you do them, but like all exercise, muscles will get fitter when they can move through their full range of movement. I think you are the best judge of how much pressure caused by your organs will reduce their movement at different times of day. I think I would just do a few several times a day, rather than an organised workout. Like many practices, a few often, rather than a lot in one dose, will be more effective. They are little, sinewey muscles that are not designed to pump iron. They are not designed to be primary load supporters, simply to kind of bounce back and forth in response to intraabdominal forces, like a drum skin.

It is WW posture during waking hours, clothing that give your lower abdomen room to expand, a diet that keeps your system moving, and whole body exercise to strengthen the muscles that will maintain WW posture and help you to go about your daily activities in a physically efficient way, that will look after your prolapses.

Kegels are background exercises. WW posture stretches the drum skin tight (see STWW, edition 2). Without WW posture your pelvic floor muscles will still be floppy.

Hope this helps you to see where they fit in to the whole system.

Cheers

Louise

Hi Christine;

I studied very intently your advice about how to do kegels. Is there a particular time of day that it is best to do this set? Like first thing in the morning, or just before bed? Is there any benefit to doing them standing? I had started adding them to my pre morning walk stretches - am I helping at all? Hurting myself?

This forum has been such an enormous help to me. My quality of life has improved dramatically since I began asking for help and trying the suggestions I have received. I know it is easy to say, but try not to be too discouraged (if that is the right word, I do not want to presumptuously name your emotions) by women turning to surgery. The pressure in our society for women to be "good women" and listen to "the nice doctor who knows best" is enormous. And of course the temptation of a quick fix instead of a long road of work is also enormous. But it is so rewarding to learn to listen to your body and give it what it needs naturally.I am very thankful that both of the doctors I have seen - my GP and my urologist - are very supportive of me working on myself instead of them working on me. You just keep on keeping on and if someone does opt for surgery, well, surely there are forums and groups and supports out there for them as well.

Cynthia

Hi everyone, Thanks again for all the info. It does give one hope! Christine, I just ordered your book and CD and can't wait to get it. I understand that after losing 50 pounds my body needs some time to adjust to it's new self. I think that maybe doing your program while it adjusts may be a great thing. My sister and I both have pretty severe cystocele and rectocele problems. She has opted to have surgery right away and is looking for a good clinic. She has about decided to go 2 1/2 hours from home to a clinic in Mississippi (we are in Alabama). I, on the other hand, am squeemish about any surgery I don't absolutely have to have. Some days I feel like just getting it over with and having the surgery because I'm so uncomfortable. Then I come to this site and remember why I don't. I'm 61 years old and in good health. I recently read a post about using two tampons to hold things in place. One tampon seems to turn sideways and come right back out. I'm not sure how to use two at the same time. Anyone else know about this and can give me instructions?

Hi Denise,

Thanks for helping to clarify this point - I edited my original instructions to hopefully make them more clear.

Here's another exercise we do that may also help you get a better feel for the one above. We do a series of exercises like these and then end with the following:

While sitting crosslegged clasp your wrists with your hands at sternum level. Breath IN through your nose and hold it while leaning slightly forward (spine straight!) while you pull your pelvic diaphragm up strongly. As you do this try to pull your arms apart all the while holding them tightly with your wrists. Your lower belly will expand over your thighs with the in-breath. Release and repeat.

We are creating the maximum amount of intraabdominal pressure while also providing the proper anatomical place for it to go, so that pelvic organs are moved into their rightful positions.

Hope this helps!

:) Christine

when you say take a deep breath in while moving forward over the tops of your thighs...by moving forward, do you mean leaning your upper body forward over your thighs or just your arms? just want to be sure im doing all this right. thanks for your help. Denise

Christine I think Nauli stretches facia. Maybe that is why I have had such great results with it. Maybe it is that with Nauli you forcefully stretch it and then by staying in the posture the facia is able to sort of rethink itself....

Blue- sorry you are having a rough time. A cough can be so discouraging. Just try to get in a good position as much as you can when you cough and rest well so you will feel better soon. And don't freak out if things are worse for a little while- they will get better again.
((((safecyberhugstoyoutoo)))

Thank you for the clarification, Christine. Like Mae, I too wondered if "work" referred to the sling and mesh surgery mentioned in the sentence that preceded your "responds well..." comment. I wonder if an edit of your post clarifying "ww work" might be something to consider for future search results(?)

On a bummer of a note, I've been lying low lately due to a severe cold. Love, love, love my dear granddaughter's little hugs and kisses, but her little cold bugs via sniffles and sneezes, this grandmom could do without!... Every sneeze and cough is testing the limits of this already popping POP of mine, that's for sure; pushing a head/chest cold into an 'outa body experience', of sorts, if you know what I mean. = : /

I'll 'see' you gals once I hit the better side of well. Be good

(((safecyberHUGS)))
~♥Blue

Mae...maybe we are saying/reading it differently...by "work" I meant ww work :)

Hi Christine,

I am curious about the comment you made to Dancin about the Cystocyle repair, "if you have your uterus, cystocele responds very well to this work." The doctors have always told me that my uterus would have to come out when they did the bladder repair because it would just drop anyway and then I would have to have another procedure to remove it. Are they wrong about that?

One of the deciding factors for me against surgery was I wasn't willing to give up a perfectly good uterus unless I really had to, so I began to look for other alternatives and found you. Glad they didn't suggest "just a repair" because I didn't know much about all this back then and I might have let them do that!

Just curious...as always.

Warm regards,

Mae

I'm glad you are not opting for surgery, but please do keep us posted on the course both you and your sister take. Cystocele does not respond well to surgery - hence the need for additional "reinforcement" procedures such as sub-urethral slings and vaginal wall mesh. Yet, if you have your uterus, cystocele responds very well to this work - recreating the natural shape of the external framework your internal organs suspend from. To answer your question, STWW talks about the importance of healthful food, but is not a recipe book. It's all about the breath, gravity, and posture...I hope you enjoy the book!

P.S. Congratulations on the weight loss...use the search function here to learn about the "rectal pillars" and why rapid weight loss can make prolapse worse for the short term. If you are interested in no-meat, no-dairy cooking, you might enjoy Diet for the Whole Woman.

Hi Granolamom,

I wouldn’t sit down to do a bunch of kegels either, but someone newly diagnosed or postpartum might.

However, a version of what I described here is part of my daily firebreathing program, which not only moves organs toward their natural positions, but also frees the spine. The energy gain is tremendous.

There's something else, which I won't know until we get more data from women. It never occurred to me until I developed this program that there might be a need to stretch the lower abdominal fascia. One would think that for many of us that area is stretched enough! But is the internal fascia really open in a way that not only allows the organs to move forward, but also allows the lumbar spine to fully expand? When doing the sort of exercise I described above, there is a feeling of deep stretching of the inside of the lower belly. I think it feels great, but we'll have to wait to determine the benefits.

Christine

first, thanks christine for that clear description of the pelvic diaphragm.
but I've got a question...

why kegel? if we kegel the way you describe, is the goal to reposition the bladder and urethra?
as opposed to strengthening the muscles so that they hold the bladder in its proper place?

sounds like that makes sense, if I'm understanding it correctly. because I didn't think a strong pelvic diaphragm could really do that (support the pelvic organs I mean).

Christine, Thanks so much to you and all these ladies for the information you share. My sister and I both have pretty severe cystocele problems. She has decided on surgery - I have not. I am getting ready to order your book. Does your "Saving the Whole Woman" also have diet information in it or do I need to order something else? I've recently lost 47 pounds which only seemed to make the bladder situation worse for the time being. I don't take any hormones but my doc has told me that bio-identical HRT will help the cystocele. I'm 61 and learning alot from all of you about how to live with this glitch in life.

Hi Louise :)

Actually, the buttocks muscles are the outermost, emergency part of our fecal continence system…and if yer runnin’, yer squeezing ‘em together! And if you’re squeezing, then you’re tucking your tailbone.

Yes…the raised arms are maximizing the motion by working the big fascial planes. You should feel a very strong squeeze around your urethra. You feel it a bit less around your vagina and even less around your anus because of what I described above.

You can certainly do them without the arms and even sitting upright in a chair.

Cheers,

Christine

Hi Christine

I find myself questioning the tucking the tailbone when I am in a real hurry. I find that walking quickly and not breathing, in exaggerated WW posture will get me there best. My body tells me not to tuck my tailbone under as it will put me in a bowel opening posture, which is exactly what I don't want at the time!!!

Looking at the technique you have described, raising the arms will tighten (like a drum skin) the pelvic wall across the ischial spines and from pubic bone to coccyx/sacrum. Correct? Are you saying that I then have to pull up all those orifices as well?? It doesn't feel like they are contracting hard until I actually pull up at the end. Am I doing something wrong?

Cheers

Louise

If this post was confusing it is because in the third bullet point I wrote "increasing" when I meant "decreasing"....sorry.