Posture and PT visit

Hi Frankie

Three things occur to me.

1 What is the core? I have had a similar debate with myself. My PT gave me a heap of exercises to strengthen my core, ie mainly my transverse abdominus muscles when I had ruptured discs. Her idea was to strengthen these muscles as a kind of corset to support the lower spine. She did also give me a heap of exercises for all those other muscles that stabilise the pelvis and lower spine but I had to do them lying down. Several months later I had made little progress. It has only been since doing similar exercises standing up, and also learning some Feldenkrais, that I have been able to mobilise more muscles. I think Christine's concept of the core is similar, except that whole body exercise in a vertical position is the basis of it, and exercising all those muscles against gravity is how it it done. The transverse abdominus muscles are left relaxed to allow the lower belly to create a space in front of the pubic bone for the pelvic organs to rest, instead of having a taut lower belly which will push the organs backwards so they are suspended in mid-air over the vaginal opening. My transverse abdominus muscles feel stronger than ever since changing my posture, perhaps because they do a lot of passive work absorbing everyday intraabdominal forces from everyday movement, which would otherwise be bouncing off the top of my vagina, ie my relaxed transverse abs are now the floor of my abdomen in Wholewoman posture. Does this make any sense???

2 More pelvic floor muscles on the right than the left. Maybe there is some nerve damage either from the cutting during episiotomy, or pressure during the birth, and that side needs some extra attention and waking up of the nerves, ie they need to learn how to work again, in which case the PT's advice makes sense. Can you feel any movement at all on the left? If not, some electrical stimulation type therapy may help you to wake them up. I had this after my second birth and it helped immensely.

3 More pelvic floor muscles on the right than the left. Maybe there was some muscle tissue removed to 'neaten things up a bit' when you were being sewn up again, and there is indeed less muscle mass there? Or maybe the obstetrician didn't catch all the layers of muscle, and some remained unsutured, as sometimes happens, and what is left stays quite loose.

Christine could comment on this with greater accuracy than I could. Hope she posts.

I would disagree with the PT though on what happens to the abdominal muscles in proper WW posture. I'm not a PT though! If you get into posture by tilting your pelvis forward you may indeed stretch the abdominal muscles and put a lot of strain on the lower back. However, if you first imagine yourself hanging from a string from the crown of your head with relaxed shoulders, then lift the bottom of your breastbone, making your breasts more prominent, it will simply flatten your upper back and neck and give you a larger radius in the lumbar curve. Now relax your lower belly and your pelvis will tilt forward slightly all by itself, throwing all your pelvic organs forward. You don't stretch any abdominal muscles at all, but they are not contracted either. In this posture your pelvic floor muscles will be quite taut (see Christine's book, 2nd ed for details of how this happens.)It is all to do with the way the pelvis reshapes itself when it is tilted forward.

Pelvic floor muscles that are alive and well are indeed an asset for any woman, both for bladder control and full enjoyment of sex, but you can only work with what you have. You might like to try and find out more about what is happening 'down there'.

Hope this is helpful.

Cheers

Louise

Hi Frankie,

Always my point in this work is to help women develop their own body knowledge so as to not be misled by a woefully out-of-touch system of medicine, which certainly includes PT. No, the woman hasn’t a clue what she is talking about, but you can understand the anatomical truth of your body from your very own experience and therefore not be deluded by bizarre theories that TRULY date from the Dark Ages.

When you stand in the Whole Woman Posture with your chest lifted and your lower belly relaxed, do you feel like your pelvis is tilting forward? You should, because in reality it is tilting ALL THE WAY forward just like in four-legged animals. Imagine the horizontal spine of a quadruped with hip bones that are long, narrow and pointing in the direction of the animal’s head. In humans, the hipbones (ilia) have widened and rounded, but they are still oriented in the very same direction! The problem is, we have been given this notion that the pelvis is a “basin” with a “floor” that can “tilt” forward to the detriment of the rest of the body. While short iliacus muscles (those that line the ilia) can pull the pelvis toward the legs causing undue curvature in the lumbar spine, it is important to understand that the pelvis is already tilted completely forward. It is an anatomical fact that we have an essentially horizontal spine AND PELVIS. The spinal curvatures are what have allowed us to become vertical. It is a profound truth that we are horizontal from the hips down and vertical from the waist up.

Now “engage” your abdominals. Feel that your tailbone has dropped and understand that your horizontal sacrum is now slightly less so resulting in counternutation of your pelvis and loosening of the pelvic ligaments that stabilize your spine. Now bring your pelvis back to NEUTRAL and understand that it is unnatural to tilt the pelvis any way other than its true bipedal alignment. If you have a rare and odd-looking hyperextension at the lumbar spine and extreme tightness when you try to rotate your hips, then work on lengthening the iliopsoas muscles.

Muscles have a “functional length” upon which their optimal strength depends. A shortened muscle is a weakened muscle. This is basic myophysiology that you can test yourself. Stand with your tailbone tucked under and your abdominal wall pulled in. Make a fist and pound a couple of times on your tummy. Now stretch into WW Posture and do the same thing. Are the muscles stronger when they are “engaged” or lengthened? Try the same thing with leglifts or lifting a heavy pan off the stove. Which way feels stronger? Also, the rectus sheath cannot be pulled together more tightly than while in this posture! Any degree of "engagement" separates this area.

Louise is right…the female core reaches from our last pair of ribs to the bottom of our buttocks. It is true that we should engage our core muscles during activity…which is best done by stretching into our proper anatomical shape. The minute we pull our abdomen in and tuck our tailbone, we have weakened and destabilized our core. Please forward this information on to your PT.

:-) Christine

P.S. We need a t-shirt that says TWO THOUSAND HARD-CORE MOMMIES CAN’T BE WRONG! Really…what better proof do we have than all these bomber moms without back pain?

P.S.S. I am 55 and can still make myself look pregnant...fascia has a very long memory.

first let me say that I don't have much time right now so I didn't read louise's post, but I'm sure she probably gave you some good information

I just wanted to add my $.02 as I am (or was in pre-baby life) a PT myself. and I had a separation of the rectus abdominus after the birth of my third which did not heal even though I was exercising my 'core' all day long. it DID heal, much to the surprise of my mw, by 3 mo pp this time around and all I was doing was posture and firebreathing. so go figure.

as a PT, we say that an overstretched muscle is a weakened muscle. think of a rubber band that's been overstretched, it gets weak, no?
BUT when you are lengthening a muscle as you use it (say, in the wholewoman posture your abdominals are long but active) it is not becoming weak at all. what is more likely, ime, is that the paraspinals become weak in people who slouch. they hang over their fronts but do abdominal work thinking that they're working their core and meanwhile the back muscles get stretched out and weak. they end up with an imbalance which, imo, predisposes them to back injuries.
what I love about the WW posture is that the muscles both in the front and the back are all active. talk about stabilization. it doesn't get much better than that. my core is active as long as I'm in WW posture. when I'm walking, pushing the buggy, washing the dishes, lifting, etc. yes, my belly pooches out and I look like I'm 3 mo pg. I think I will look that way for the rest of my life. I am ok with that because I know that my pelvic organs live in there and I like them over my pelvic bones. but my abs are stronger than they've been in a while.

re: strain on the low back, an anterior tilt will place undue strain on the low back if you aren't keeping your shoulders broad and down. its all connected so if you exaggerate a curve on one end you need to balance it on the other. if you don't then the low back muscles have to hold up your head because the weight isn't distributed well over bone (ie the spine). you'd likely end up with neck pain too. and tmj.

PT's, like many doctors, know their fields well but are so used to seeing something a certain way that they have a hard time looking at something through a different lens. so to answer your question, yes there is some truth to what the PT said, but I think your PT doesn't have a good grasp of what this work is about.

I'm still not sure what I think about pelvic floor strengthening. I know I'm extremely weak in that department and my prolapse has never been so high and small. contrast with when I found the thing I was kegeling daily and could probably crack walnuts with my pelvic floor muscles. so whatever. but yeah, applying resistance is a good way to stregthen any muscle. not sure why it would matter if one side was stronger than the other though, unless it bothered you. the two sides might never be exactly equal in strength anyway due to the epis. scarring. but I am curious to see what happens if you do try it.

I was posting the same time as christine and I just read her post
I say an overstretched muscle is weak and she says a shortened muscle is weak!
I think we are both right, as christine said muscles have an optimal length. anything shorter or longer isn't going to be useful.

So much information! You guys are great!

I have been keeping posture for 10+ weeks now and am still finding I get both upper and lower back pain. Well actually its lower back PAIN and upper back ACHE. I notice my lower back pain more so when I am out and about doing alot of walking, it gets to the point where I need to sit down or bend over and stretch it out to try and relieve some of the discomfort. At times the pain takes by breath away. I have also noticed that I have started getting pain in the pelvic area. I am trying to concentrate more on lifting my chest rather than tilting my pelvis as I think I am overing doing it on that part. I get really frustrated with myself for not being able to just get it and do it right.

I do have a habit of lifting my chin up rather than tucking it in when I walk, someone at work used to tell me I walked around with my nose in the air like I was stuck up! This is a VERY hard habit to break and I don't even realise I am doing it. Whenever I get a pack twinge or feel my prolapse more I reasses what I am doing and I usually find I have to lift my chest and bring my chin down.

I know this will all come together in the end and I have started working on the plies (boy do they make my leg muscles hurt!) so I am hoping once I strengthen my whole body it will get easier.

Ouch, just had a twinge just above my left hip area and I am sitting down! I feel like I am 106 not 36!

Thanks for all the info.

A

Hi Anita

Just keep trying. You will get there in the end. I used to have both upper and lower back pain for a couple of years and put the lower back pain down to ragged lumbar discs, which may have been the case at one stage, but dong all the right exercises didn't fix it.

Learning Feldenkrais has knocked the lower back pain on the head. It is hard to believe that something as subtle as the exercises I have learned can have such an amazing effect. It is about re-establishing unused or underused nerve pathways that have gotten out of practice as a result of injury, faulty posture or whatever, so your body can use all the muscles and nerve pathways at its disposal to move as efficiently as possible and spread loads as well as possible. All my plie and leg lifting muscles and nerves went to sleep so I was maintaining pelvic stability with my glutes, hamstrings, back muscles and tummy muscles, instead of all those deep muscles that join the lower back, pelvic bones, sacrum, and femur. Now I am using them more there is less strain on the first group of muscles. My upper back and left shoulder and neck are still a bit stiff, but I am confident that I will eventually get that sorted too.

It seems like a long journey, but my prolapses are better than they were three years ago and my whole body feels better. It is simply a matter of one step at a time. Keep perservering.

Cheers

Louise

Forgot to address the bit about the episiotomy scar and nerve-muscle damage. It would be really difficult to predict if and how the area might improve, but my instincts tell me gentle massage over “resistance training” would be better.

Just wanted to mention that after giving birth women have a levator ani diastasis just like the abdominal diastasis (diastasis recti) often left after full term pregnancy. The pelvic sphincters do help to pull the inside edges of these muscles together, but understand that the sphincters are doing the pulling as the passive muscles follow. The pelvic wall is basically just that – a wall that rebounds intraabdominal pressure.

Just as in diastasis recti both sides of the pelvic wall musculature are brought into closer proximity with one another when we stretch the muscles to their full length. Like doing stomach crunches with a diastasis recti, kegels on your back shorten the area and widen the diastasis, making it harder for the sphincter contractions to close it. Stretching those muscles out while contracting the sphincters results in the maximum closure possible.

Christine,

I gather from what you are saying, the half hour I spend doing floor exercises in yoga would be better spent standing up? It's always such a relief to finally get to sit down. Are most exercises for the abs better standing up, say with our arms lifted to the ceiling like in half moon?

Hope your new home brings you blessings in the New Year!

Judy

Change what you can change; be happy with what you cannot.

Hi Judy,

There are lots of good exercises sitting down and for sure do what you like and what feels good. With my program, we are strategically reinforcing this posture in a total body workout. I have simply decided the best way to do that is to start slowly and mindfully at the barre and then pick up the pace in the center of the room while adding weight, balance, and locomotion. Then we take off the weights and literally dance across the room. Afterwards we lie down on the floor and stretch. That’s simply my program. I do not like crunches and wouldn’t do them sitting or standing.

This brings up a good point though. Belly dancers must tuck their tailbone to slacken their abdominal muscles so they are more mobile to shake and shimmy. I think this is all well and good as long as these women bring their pelvis back into neutral for non-dancing posture.

:-) Christine

Oh…we’ve been living here almost two years now. The property sold bit by bit and last spring the house was the last to go. I'm fine with it...a calling sort of evaporates a lot else in one's path.

I have no doubt that the two are related. my old tears were all on the right and that's where my prolapse is more evident. symmetry is a myth anyway. at least in my opinion.

Hi Frankie,

I’m so glad to hear that you are understanding these concepts and I’m sorry to sound so severe sometimes! :-/ It’s just that MOST of those in charge of our health and well-being have gotten it so very wrong! Their perspective on how we are supposed to be is far removed from what is truly human, having been replaced by a largely mythical Gym Creature that by her very nature cannot be fully functional. I will try to explain why, but first take a look at the posture of this beautiful young native woman.

You see that she is not pulling her stomach in, but rather lifting her chest in a very easy and natural way. This is the beginning formula for the remainder of her structural life. When she becomes pregnant, the weight of her fetus will move her abdominal wall further and further out front. This is WEIGHT, which equals intraabdominal pressure that the body responds to by holding forward. After the baby is born, her fascia will have remodeled and she will easily balance the weight of her infant by sticking out her chest and upper abdomen. This is the bipedal way of the human female. She may or may not revert back to almost her pre-pregnancy proportions, but forever after holding her abdomen and chest in this way will facilitate tireless standing, easy lifting, and pelvic organ support. Her pre-pregnant, pregnant, and post-pregnant states are simply different degrees of the very same posture.

Why would it be any different pushing a buggy or carrying a sack of potatoes? Why would the belly be anatomically arranged to stick out with carrying one thing (an eight pound fetus) and pulled in for carrying something else (a barbell)?

I suppose it’s possible that we could’ve been created/designed/evolved into the shape of an octopus and to give birth from the top of our head. In that case we would be subject to an entirely different set of physical laws that govern our functionality. But we are human females with a very distinctive FUNCTIONAL design that has not changed in eons even though an entire world of modern day therapists and instructors are trying to negate our very shape.

Here’s to the beauty, grace, and functionality of our natural design.

Christine

wow, christine, that's a great picture

Hi Christine

So glad you managed to find this picture. It is very difficult these days to find pictures of women in developing countries in natural posture, who are not wearing so much clothing that it is impossible to see the lines of their bodies. It is probably to do with religion and potential for sexual exploitation I guess - sad. Once again, the baddies of this world censor everything so that we cannot learn how to 'be' from these primitive people whose bocies have not been pummeled by the media and reshaped by modern society and its activities.

Cheers

Louise