A little test


Hi everyone,

I've developed a little test that women can do themselves to illustrate the futility of kegels. Would some of you try it and post back?? I want to put it in my book, but need it to be validated beforehand. I know many of you won't understand all the terminolgy, but I think you'll get the gist of it anyway.

Here it is:

No one is better able to experience the dynamics of pelvic organ stability than a prolapsed woman. The following test will enable you to feel the difference in organ support when the pelvis in counternutated as opposed to the highly stable position of sacral nutation. It will also enable you to appreciate why Kegel exercises serve little or no purpose in the treatment of disorders of pelvic organ support. This test is best performed lying down in a private and relaxed setting, such as first thing in the morning before getting out of bed.

• Begin with a Kegel, or pelvic floor contraction, and feel that your tailbone is being drawn closer to your pubic bone.

• While keeping the contraction, pull your navel in toward your spine and sense that the rectus abdominis muscles and the pelvic diaphragm can move in tandem. When one contracts, the other can easily contract, and when one extends, the other extends.

• While maintaining this level of intense contraction, bear down like you are pushing your organs toward the vaginal opening. You will see that the pubococcygeus offers no resistance and a moderate prolapse will come easily down.

• Now reverse the dynamics by arching the small of your back.

• Feel your pelvic diaphragm tighten as it lengthens from pubic bone to tailbone and tightens across the middle.

• Allow your rectus abdominis muscles their full extension by pushing your navel out and over your pubic bone. Feel the isotonic contraction of the transverse abdominis deep in your lower belly like a pair of hands squeezing around your hips.

• While maintaining this level of extension, bear down like you are pushing your organs toward the vaginal opening. You will find that with your pelvis in this nutated, extended position, the organs are being held at the front of the body and able to resist the forces of intraabdominal pressure. These are the dynamics of pelvic organ support created and sustained by natural female standing posture.

I did not really get most of that but - I have only found Kegls help in urinary incontinence if done right and not overdone... The posture is what helped the prolapse :)


Me too, since i started pt I have noticed less frequency. i don't do kegels all day long. I just do sets of 20 reps two to three times a day. It has helped me not to wet my panties thru all this hacking from the flu. But I hope the kegels is not more damaging to the prolapse.

Right, and that’s why if kegels are going to be practiced at all they should be balanced by lots of exercise done with the sacrum tilted forward, like walking around all day in the posture! In fact, sacral nutation, while widening the sit bones, actually causes the pubic bones to squeeze more closely together at the top. You can sense a tightness in that area with the standing posture. We've had so few women with primary UI so I don't know yet, but I think we will find in time that the posture is a more accurate stabilizer of the urethra than kegels.

Anyone else? I really want you to experience the difference in muscle movement and organ support between these two primary ways of pelvic movement. It’s not that I have anything against kegels! It’s just that even our top institutions do not have the anatomy right, something women themselves can comprehend once they know what to look for.

I didn't try the test but I stopped doing kegels because it made my rectocele worse.

OK, well I tried it, (I think I did it right), and I do see what you mean! (I am still scared to bear down AT ALL as I am so focused on thinking "UP' all the time). I still feel though, (yes you can get annoyed at me Christine), that for me kegels help somewhat. They pull the cervix up to a point where it is almost out of reach and of course elongate the vaginal length too. I know Christine, it's like banging your head against a brick wall isn't it! :) I AM totally on board with the whole posture thing though!

I tried it, sitting up, though, while I was reading the instructions. I definitely felt the difference. I'll try it lying down tomorrow morning.

I'm with you about not wanting to bear down!

I'm interested, though, in how kegels could worsen prolapse. I have been doing kegels with resistance and feel it's helping.

Although, I will tell you this. I had been doing kegels for 6 weeks, then vaginal weights for another month or so, prior to finding your sight. While I did feel that the muscles were getting stronger, nothing effected my prolapse as rapidly and with staying power like the postures and exercises you've recommended have. In fact, today, I was out grocery shopping, on the first day of my cycle (usually the worst), carrying my 24 pound baby on my hip in my sling, without any discomfort, feeling great. A month ago, normal outings like this were sources of major stress, as I could barely carry baby while trying to hold it all in, not to mention get a few groceries here and there.

I was feeling so grateful to you, Christine, for your work. I feel like I have my life back, even though I still have prolapse. Really, I feel like I have my life back, only three weeks after getting your materials.

Thank you. I wondered whether I would do the things I used to do.

I will continue to do my kegels, but am interested in how to do them soas not to worsed the prolapse. I l ikethe feeling of more strength in my pelvic floor muscles.

And I acknowledge what you say as true, at least in my experience. Kegels alone are not enough.


Thank you so much Michelle and Marie for trying this and reporting back. I know we are all attached to our kegels, and shifting paradigms is not always easy. It’s very important that we do so, however, because we have been taught something that is at best unhelpful. They may work to stabilize the urethra for the short run, but they also create tension opposite of the anatomy that keeps our organs in place. Who knows if they can actually cause or worsen prolapse, but there is no anatomical basis for their helping.

The female pelvis is actually very well designed to be in that posteriorly-tilted, contracted, pulling in position, but only when our insides are being stuffed with a long, strong organ keeping everything in place. ;-)

Really, the human body is an anti-gravity, omnidirectional organism that can move any way it wants to. Belly dancing and giving birth are two examples of pelvic ability (and necessity) to move in both directions. The issue is routinely putting the body under strain patterns that pull our tissues and organs against the grain, so to speak. The human pelvis evolved to favor sacral nutation, or the rocking of the top of the sacrum forward and the tailbone back and up. This is synonymous with pelvic and pelvic organ stability. I think women are bearing the results of chronic spinal flexion much more so than men.

Pelvic floor contractions do not lift the muscles up, they only close the levator muscles like a pair of elevator doors. Kegels cannot make the vagina longer. Yet, it is good to exercise these muscles. The pelvic diaphragm is indeed a major stabilizer of pelvic anatomy.

So…the key is to “kegel” while keeping a forward pelvic tilt. Try it both ways – pelvis tilted forward and pelvis tilted back and you will see for yourselves that you are “winding the pelvis up” in the forward tilt and “ unwinding the pelvis” in the backward tilt. Things are so tight when you contract with a forward tilt that you can literally feel your urethra straightening and tightening. The actual kegel is a lot less effective in the backward tilt – and that is how everyone does them!

Now…you can set aside 15 minutes a day to do this…and burn a few brain cells in the process….or you can walk around all day in the posture and when you feel like things are coming down a bit, bend slightly forward and tighten. This shift is immediate and effective. And all your musculoskeletal aches and pains go away in the process.

:-) Christine

and I most definitely NOT like the results of the first test. my bladder felt like it was about to pop out of my body. of course, once I reversed the tilt of my pelvis, nothing moved.

Hi, I have tried the test and these are my impressions:
in the first way things go down very easily
in the second way, arching the back, I find more resistance, but, ahould the test be made with legs stretched or bent?
I tried both ways and it seems to me that it works better with stretched legs, but I used to do my kegels with knees bent, so I am abit confused.
What do you think?

Hi Ornella,

I’m glad you tried it, for it’s good to see these things for ourselves. The bent knees would actually help in the counternutation of things and the pulling of the organs to the back of the abdomen. You can feel the spinal/pelvic floor extension best with straight legs, and since we are trying to get an idea of our standing anatomy, straight legs are best for this.

You can actually feel kegels more toward the back of the perineum (around the anal sphincter) with a posterior tilt (navel-to-spine) because the sit bones have moved in toward the center, while the ischial spines have slackened. There is more loose tissue to contract back there and that’s why the contraction feels more intense. When you arch your back, the sit bones widen, the area between pubic bone and tailbone lengthens, and the ischial spines increase their tension across the middle of the pelvic diaphragm.

This is very revolutionary information that you can only find at Whole Woman! The gynecological literature has chosen to ignore the musculoskeletal workings of the pelvis entirely, while orthopedics never bothered to put together how vital a notion for women it is that sacral nutation causes the ischial spines to pull toward each other and in doing so constricts the circumference of the middle of the pelvic outlet. Somehow the well-known physical therapist Diane Lee missed this, as did dance physiologist Eric Franklin.

The “squeeze” we should be after is one that narrows the front half of the "true pelvis", thus providing a backstop to the tightly packed pelvic organs occupying the front of that space. The pelvic diaphragm IS the key player in this process, but IT IS NOT THE PUBOCOCCYGEUS!! IT IS THE COCCYGEUS MUSCLES, IN WHICH THE SACROSPINOUS LIGAMENT IS EMBEDDED, THAT PULLS THE ISCHIAL SPINES TOGETHER AND NARROWS NOT ONLY THE PELVIC DIAPHRAGM BUT THE ENTIRE CIRCUMFERENCE OF THE FRONT HALF OF THE BONY BIRTH CANAL. This constriction is a major factor in female pelvic organ support.

We sense this movement as a tightening up of the entire pelvis and it can only be achieved by standing in the Whole Woman Posture™. If you sense while in the posture that you are more pulled together, you are! You have actually narrowed the middle of your pelvis like squeezing around the middle of a toothpaste tube. As a result, the organs are trapped in a narrower space at the front of the pelvis with a strong, sinewy wall of muscle behind them. And understand that doing kegels on your back with your legs bent causes the exact opposite – the pelvic diaphragm to widen while pushing your organs back against it.


Hi Ornella,

I re-read the post I wrote to you earlier and realized I needed to make a couple of corrections. In trying to do so, I deleted it! Good thing I posted it (and successfully made the corrections!) in my blog - hope you will take the time to read it - the blog is on the home page.

What I needed to fix was my use of the term "pelvic outlet" incorrectly. What I meant was what is known as the "true pelvis" - the cylinder of bone and ligament also known as the birth canal. The "false pelvis" is considered to be the two ilia, or hip bones. The ischial spines, and therefore the "toothpaste tube" effect, are located in the middle of the "true pelvis."


I have been thinking of this since you first posted it and I must say I don't think I am doing the test right. My PT taught me to do kegels by "pulling up and in". Up would be the pelvic floor tightening and In would be the transverse muscle tightening. So I do both in tandem when I do a kegel.

I guess that affects your test??? Just confused, that's all. :-) What's new, right?


Mainly cos I have no memory and by the time i've gone a laid down i've forgotton the above - lol

But to be honest I do not believe Kegels are totally futile - They did help me not to leak all the time. But for the prolapse itself they did nothing. So althought I feel we need to do them bladderwise I will try to get my idiot printer to print the above to can try while actually prone lolol