Challenges with whole woman approach

hi there
I don't have enough time right now to go through all of your concerns, but I'll try to begin.

first, I'm curious how you've come to your conclusions, what is your training/experience?
I'm coming to this as a Physical Therapist with a prolapse, just so you know my background.

- YES. it is impossible to diagnose anything conclusively over the internet. over and over we recommend that women see their health care providers when they find something is amiss. however, many health care providers are not forthcoming/completely honest with women re: prolapse. we've heard this story over and over again. there is no reason a woman who has seen her dr, been told nothing is wrong but feels pressure/bulge/whatever cannot or should not learn more about her body and condition and be proactive about it. in absence of other health concerns or prior history of trauma, there is nothing dangerous about this work.

-pelvic floor exercises do nothing for many many women with prolapse. they did nothing for me, and I KNOW I was doing them correctly adn religiously. my pelvic floor muscles were STRONG. they did nothing to prevent my prolapse (I began kegeling when pg with my first) and did nothing to help the prolapse once it developed. I am not alone. many many women are told by their PT's or dr's that they are doing kegels incorrectly which is why they aren't helping. if you read the blog entry on kegels, that might explain this further. kegels are fabulous if you have stress incontinence. kegeling during a cough, sneeze or any increase in abdominal pressure (ie lifting) will help counteract the pressure from above the bladder with pressure from below, thus preventing urine from being squeezed out involuntarily. it will not prevent a prolapse. not kegeling during a sneeze will not cause a prolapse.

- lumbar lordosis as described by orthopedists and physical therapists is part of a whole postural problem. as described, it is most commonly found with a forward head, jutting out chin, shoulders rolling forward, increased thoracic curve and locked knees. this is not healthy for anyone, and this is exactly the opposite of the wholewoman posture which emphasized pulling the spine up so that the neck is long, shoulders are down, knees are never to be locked. thoracic spine elongates. if you are really in touch with the movements and position at each spinal joint, you can see that a lumbar lordosis happens higher up than the increased curve that happens with this posture. there is no evidence, that in absence of other spinal issues, that this increased lumbosacral curvature is detrimental.

- when in WW posture, the abs are lengthened but TAUT. they are ACTIVE and not floppy. this maintains functional strength. you will not have a flat belly while standing this way, but after a while you will have strong abs. they are busy stabilizing your spinal position all day long.

-how does using your transverse abdominals tone the uterus?

- I'm not sure about the next paragraph, not sure I'm understanding the concern as you mean it.
upper part of posture you're ok with, lower part you think puts too much pressure on the pelvic organs? the lower part of the posture is all about an anterior pelvic tilt (nutation). this creates a space for the pelvic organs to rest anterior to the vaginal opening and places the pubic symphisis underneath the uterus/bladder/vaginal canal. in this way, the force of your breathing coupled with the angle of the spinal curve, pins those organs in place, rather than blowing them out (down)
not sure if this is what you're asking.

- personally, I believe that a typically healthy person doesn't need all these external resistance forces to maintain healthy posture. that's just a personal belief and maybe it doesn't belong here, but I can't help it. natural function strength comes from function. if you look through some of the ballet workout, it addresses that entire pelvic 'floor' from head to toe through functional movement patterns.
if someone enjoys exercising with therabands and balls, I say go for it, but keep the pelvis anteriorly rotated and the spine elongated while you do. I don't know much about how the specific exercises you mention work for a prolapse, so I can't say more about them.

- I'm with you about stress. and anyone that goes searching on the internet for medical/health advice should be aware that it is not possible to get definite diagnosis on the internet. people who borrow trouble from reading about things they don't have and assuming they do have those trouble, well, that's part of a greater issue.

I've got to go tend to my little ones now, but one more thing, I haven't come across any evidence that 1-weaning helps a prolapse and 2-c/s can prevent one.

Hi Highland Cow

You have just about covered everything and a a bit more. Some of it agrees with Wholewoman, but some of it is quite the opposite. I have a heap of questions seeking clarification of some of the terms you have used in your post, but first, please tell us where you are coming from. If you have a professional background or work from a particular model in all of this, what is it? I would like to understand your thinking before trying to clarify your theories and work out where they fit and how they fit together.

Cheers

Louise

Highland cow- pretty much ALL of your post was opinion. I am always wary of posts like this one because the writer takes their opinion and states it as a fact and then tries to sell it as a cure.
Christine has done research- tons- peer review- published in medical journals- research. If you think the picture painted here about surgery is scary then you are starting to understand the research which proves that surgery for POP is not a great solution. It isn't fear mongering. It isn't sensationalism. It is simple fact based on medical research. Please take care not to misquote the book. If there is a quote from the book that you are having trouble understanding please include page number references so we can hash it out. I am sure that there is not a part in the book that addresses soul loss and hysterectomy as fact.
Is hysterectomy the most terrible thing that could happen to a woman? why would you even ask this? of course not. Any woman would tell you there are much worse things in life. The terrible part is that we are missing informed consent and that surgeons are forsaking the hippocratic oath- first do no harm.
Sounds like you are interested in developing your own protocol for therapy for prolapse with your kegal and other exercise recommendations. Please don't advertise here though before you have done the research. We pretty much all know that kegals do not at all reverse prolapse or prevent it from occurring.

and it is a personal issue for me to hear you touting the age old "weaning" nonsense. Why in the world would you do this? Fact: when a woman resumes her menstrual cycle her estrogen level are back to normal. Encouraging women to wean is such a sorry recommendation. Lactational amenorrhea is good for prolapse. It gives the uterus time to recover from pregnancy and birth.
Fact: C- sections do not prevent prolapse or further prolapse.

then of course there is the quick and easy- wholewoman does not encourage lordosis, wholewoman does not diagnose over the internet, prolapse does not prevent you from walking, wholewoman posture creates tone in the lower abdominals, it is impossible to have anything less then a full blown prolapse- you either have one or you don't. While one person may not have all the answers it is possible for one person to be an authority on a subject.
And there is always a gold standard for treatment. This is the person who knows the most and the treatment that works the best.

I hope you are able to see the facts soon.

Hi Highland_Cow,

Thank you for your comments and I welcome this opportunity to clarify the Whole Woman framework. Aha! now we understand why you have been greatly influenced by the classic medical model. I am going to encourage you to try to put aside your concepts for a few moments to consider the following realities.

First of all, thank you for lending the expressive phrase “blow down effect”. That physiologic process is at the core of this work and I hope I can help you see it in proper perspective. In normal anatomy intraabdominal pressure, created by the respiratory diaphragm as you say, first strikes the lower abdominal wall. This is very easy to experience and is irrefutable. There is some rebound effect that happens at the back of the pelvis, the proof of which is the concave human sacrum formed that way by the gentle, yet constant force of the bowel molding into it. The fairly vertical “floor” takes the least “blow” and rebounds very well when stretched into its fully functional dimensions.

When the lower belly is being artificially (with effort) held in, its ability to take the blow the way nature intended it - is lessened. The path of internal pressure then changes to give more force to the floor. This is the beginning of our problems.

Is there any other way of pulling in your belly than using the transverse abs? Please understand as an occupational therapist that the amount of load the spine can bear without injury is greatly reduced when the abdominal muscles are pulled in. Without a healthy and natural lumbar lordosis (which is more pronounced in women) load is transferred to the intervertebral disks. This is now classic orthopedic information. The transverse abdominis bandwagon - which must be a great embarrassment to prominent PTs who got on board - is in the process of being completely dismantled. The transverse abdomini are flank muscles as are both sets of obliques. You actually have very little muscle in your lower belly. Rather, it is covered with thick, white connective tissue. The outer rectus muscles are the only ones that cover most of the central belly and you are right - they are continuous with the pelvic diaphragm. What it sounds like you may not be aware of is that, like the pelvic floor, they become fully functional in their lengthened position. Just like an abdominal diastasis is best corrected by posture and movement that directs the muscles centrally, so too the pelvic floor. We have always given instructions to strongly contract these muscles while lifting. Just like we have always said that over-contracting them causes problems and stretching them into their functional length creates proper pelvic alignment.

The flat, hyper-toned female belly is a cultural fabrication that women find extraordinary difficult to obtain. This does not translate as a big or floppy belly. WW posture is not about letting the belly flop out, but lifting the chest and leaving the lower abdominal wall unimpeded so that it can accept the breath. Women here know and understand this at a visceral level and that is why we believe it is people like you who are under the spell of a large and well-established cult.

Let’s talk a bit about muscle resistance and the bladder. According to the people who have had the closest look, “Anteriorly, the bladder lies against the lower abdominal wall. It lies against the pubic bones laterally and inferiorly and abuts the obturator internus and levator ani. Posteriorly, it rests against the vagina and cervix.” (TeLinde’s Operative Gynecology) The relatively free-floating bladder is held in place by the pubocervical fascia that surrounds the cervix and anchors into the pelvic sidewalls and the pubic symphysis in front. “Ligamentous” support includes the superior pubic ligament (through fascia) and the median umbilical ligaments. Importantly, the superior pubic ligament becomes continuous with the inguinal ligaments, which with the round ligaments of the uterus, travel down the lower abdominal wall to embed into the vaginal labia. This seems like a pretty adequate support system, but once you understand how closely the organs are packed within the pelvis, you see that the position in which they are held by their outer framework has a great deal to do with prolapse. The sometimes very heavy bladder shares a common wall with the vagina and how it is held (against the lower abdominal wall) determines whether or not it flops backward into the vaginal space. Holding the belly in compromises this anatomy.

So...The obturator muscles line the anterior pelvic side walls, exit the pelvis through an opening between the sacrotuberous and sacrospinous ligaments, make a radical 180-degree turn to travel deeply under the gluteals and attach near the top of the outer thigh bone. The obturator externus muscles and ligaments are part of the deep lateral rotators of the thigh, which allow external rotation, or “turnout” at the hips. Think about this. In standing position when you do this sort of movement, the obturator muscles are fully shortened. This is how muscles work - by shortening. The term “engaged” is correctly applied to a muscle that is doing its work by shortening.

Contrarily, you are saying that these muscles are “engaged” while they are being tensed by the non-shortening exercise of squeezing a ball. Do you see? The Thera Band exercise “engages” the obturators - but not fully as does a simple external rotation as shown above. Your concepts make no sense and I am saying this with all compassion for your inaccurate view of human anatomy.

Dancers have always known that tight external rotators are a huge problem, causing such things as arthritic changes in the hip joint. Whole Woman posture instructs to always walk with the pelvis properly aligned and the feet pointing straight ahead to prevent this sort of damage.

Now, when the external rotators are fully “engaged” while in standing WW posture (the above hip rotation photo), the muscles and ligaments at the front of the pelvis are fully stretched. In the process they pull both the bladder and uterus forward.

The only thing I have to add about breastfeeding is that oxytocin is a tonic hormone.

The jade egg is a terrible concept. The delicate balance of female pelvic organ support is kept by weighting the organs toward the front of the body. How in the world can adding more weight to the back be of any possible benefit?

What more can we say about c-section and hysterectomy?

Please understand that I realize how difficult it is to become free of the anatomical misconceptions of your field. I wish you luck.

Christine

you've got lots of questions, which is great, and the best way to come to understanding. I'm just getting overwhelmed by so many at once. so not that I'm intentionally ignoring any of your points, I'm just taking one at a time.

many of the pictures I've seen of African Women show them standing and moving in a very natural WW posture. I didn't know that they were born with pelvic shapes different than ours. many animals I've seen do have a visible lumbar curve, though I will say that I don't see very many animals on a regular basis.

how can kegels not prevent a prolapse? well, first I can tell you that they didn't in my case. secondly, kegels do not strengthen the vaginal wall, which is where the prolapsing organ bulges. the pubococcygeal muscles are not strong enough -even with all the kegels in the world- to hold up the weight of a uterus, bladder and rectum. the support for these organs is largely from above. cutting the support system from above, ie c/s, does not prevent prolapse. there have been women here who have not even had babies and they've had prolapses. so its not just a postpartum thing. I'm not saying there is no value to a kegel program. its great for managing stress incontinence, its great for sex. I personally have found traditional kegels useless for prolapse, in fact I believe they make my rectocele more pronounced. and I still wonder, if kegels hold up the pelvic organs, should we be walking around in a state of constant pelvic floor contraction? it just doesn't make sense. no muscle group works that way. in WW posture, your pelvic 'floor' muscles are again stretched taut and are active. just not in the typical kegel sense. as an OT, I'm sure you know that nothing beats functional exercise for improving function. if all I wanted was to improve my measurable strength of contraction, well, kegels with external resistance would probably be the way to go. but I don't give a hoot about my muscle strength score. I just want to live symptom free and get rid of the bulge.

and the estrogen...all I've been able to find about estrogen is that its been shown to decrease vaginal dryness and plump up vaginal tissues. it doesn't act directly on prolapse at all. dryness can make the symptoms of a prolapse worse, plumped up vaginal wall can disguise the symptoms too. I'd be interested for anyone to explain how estrogen lifts the bladder though.

tone in the lower abdomen. I'm not sure how you are using 'tone'. the layterm 'tone' usually refers to muscle strength. but 'tone' in therapist-speak is a muscles resistance to a passive quick stretch. I know this is not consistent with what many PT's and OT's believe, but I don't think (based on my personal and professional experience) that there is a whole lot we can do to permanently change tone in a given muscle.
if we talk about strength however, we all know that muscle strength is built by using a muscle. but what are our goals? many women who are aching to improve their abdominal 'tone' are looking to look better as defined by our culture. they want their cute prepg flat bellies back and I don't blame them.
you will not get that flat belly with WW posture. but I've got more strength in my abdomen than I had before I got pg, even though its not flat. I'm not sure why you feel the posture doesn't work the transverse muscles, mine are active all the time. firebreathing and nauli give the lower abs quite a workout as well. the big difference, as I see it, between nauli and situps (even done in correct order) is that nauli works the abdominals as they are elongated, while situps work the abdominals as they contract. I am not sure about the correct order of contraction during a situp that you talk about so I can't really comment on it. from a WW standpoint, the purpose of abdominal work is to strengthen the postural support system for the purpose of stabilizing/reversing/preventing prolapse. the point is not to tone the abs, that is a side effect. if you've got another exercise that will help with prolapse, please share it! alemama's bringing nauli to the forum was very well received. the key is that we really arent' interested so much in exercises that compromise pelvic organ stability as described by christine, because thats what this site is all about.

no one gets angry by those asking questions for clarification purposes or for honest conversation. there are plenty of people I am sure, who disagree with christine, but you won't find many here because, yeah, this is christine's site. so its probably not the best forum for those who don't subscribe to this stuff. and I think that this is not everyone's cup of tea, and that's fine. no one's looking to convert anyone or form a cult or anything like that. if it doesnt work for you, that's ok. we actually want to hear about it to figure out why it didn't. but its not something you can do alongside exercises that are contradictory to the premise and then say it didn't work, ya know?

I agree that with a new and very mild prolapse, you probably don't need this posture to keep things in. until things get worse. now, we don't know who gets worse and who doesn't and why. plenty of theories and plenty of anectodal stories that contradict the theories. like the 20-something yo woman who was here a few years ago, never had kids, and had a worse prolapse than me or my sister who's had very medically managed births (7 of em!) and no prolapse in sight. but if I had it to do over again, when my mw told me that my 'anterior wall was loose' after my second baby, I wouldn't have bothered with all the kegels and instead learned this posture to prevent an all out prolapse.

I'm also not visualizing how strong abdominal muscles support the pelvic organs as well as breath force and bone.

I agree with you about not focusing on the negative. listen, my mom just had a rotator cuff tear repair surgery. lots of potential negative side effects there. once she decided to go ahead with the surgery, I stopped discussing the possible negative outcomes with her. prior to her choice I went over it all with her, made sure she understood what could happen (even if not likely) because that is what an informed decision is. so if anyone is set on surgery, after making themselves fully aware of the risks, then yeah, stop reading about the risks and start visualizing a positive outcome.
the problem is that it isn't easy for most women to find a comprehensive lists and description of the different types of pelvic surgeries and the risks they carry. so informed consent is not so easy to come by. but that is another story.

got to get back to the kids

I see a point of misunderstanding/contention in the term “functional”. The abs are doing their functional work by (1) lengthening to create the “barrel effect” that equalizes intraabdominal pressure and stiffens the body to hold upright posture and (2) shortening to move the torso toward the legs. Both are functional movements and the muscles contain two different types of fibers to allow for both kinds of work.

Highland cow. Of course your post got attention. All posts on this site do.
Your cessation of breast feeding and subsequent improvement doesn't convince me that breast feeding is bad for prolapse and I hope you won't encourage anyone to stop breast feeding. One of the very best ways to care for your baby is to nurse. I can't imagine that there are two sides to the story. Breast feeding does not cause prolapse or make existing prolapse worse. It isn't a judgment to disagree with an inaccurate assertion.
I wonder if you have ever met an african woman. I assume you mean african american. In this culture these women hold their bodies beautifully. Watch any r and b or pop video- go to any school- church- etc. you will see the lumbar curve and raised chest.
you think a true piece of research should give both sides. Research isn't a literature review. The book explores every treatment option I have ever heard of for prolapse. I don't find it lacking.
You say you are not trying to advertise anything- seemed that way to me with your claim that kegals are great and the specific exercises you listed - and wonder "why do you folks get so angry about any dissenting voice?" From what I have seen here no one is angry. We are simply engaging in a discussion with you about your assertions and assumptions.

Oh...and Highland, you make me sound like an ogre :( Disagreement is always welcome here - it’s how we learn. Actually, we love disagreement - but it doesn’t mean we’re going to cave to conventional “wisdom”. The “It’s my sandbox” card only gets played when someone is being vile.

thanks for pointing that out christine

I was using the term 'functional' to distinguish between movement patterns we use as we go through the course of our typical day, vs the type of movement patterns PT's oftentimes use in targeted strengthening programs (ie lifting a heavy object calls upon many groups of muscles working together and not necessarily in a linear way as opposed to a bicep curl).
so applying it here, I meant that I find WW posture uses the abs and pelvic floor muscles in a way that is quite different than situps and kegels.

Yeah...I was using it like that too.

Another thing. Lifting is just problematic for humans. We manage it quite well - and men are much better equipped for it than women - but all the same it’s very stressful. In order to lift anything heavy, we must destabilize our “barrel” by shortening our abs and lessening our lumbar curve. Internal pressure is now freely blowing out the back and that’s why it’s so necessary to contract the pelvic diaphragm. The major functions of the multi-talented pelvic floor are helping objects go out and sealing pressure in. Kegels are indeed helpful postpartum, but not at the expense of the rest of the barrel.

I had no trace (confirmed by drs and physio) after my first, very traumatic Vaginal birth that caused bad pelvic floor damage. 6 months after having a c-section to avoid more damage, I am diagnosed with stage 2-3 prolapse. So the c section info is not correct. I have no doubt the surgical procedure caused my POPS (not helped by having to contend with weak pelvic flood muscles).

Cheers
fc12

Hi Highland Cow

You have been very busy with your research in the last few months. I now see where you are coming from. I am guessing that you have been influenced considerably by Pilates. There is so much information out there. The challenge is to work out for yourself what the 'truth' is. We all do this by comparing sources of information and working out what reconciles with what. We build up a picture of truth by putting all the info we find together like a jigsaw puzzle. We look for evidence of the truth of assertions. We look at conflicting information and work out how it comes to conflict. Usually somebody has made a cause and effect connection which is not correct, or else they have misinterpreted some information, or else they have an axe to grind or a theory to prove, and will tell lies to make it all fit in together.

I have not taken the surgical repair route because of the evidence in Christine's book of the unpredictable results of surgery and the plethora of reported complications and side effects, all of which are described in the chapter on surgical repairs. Some of them sound horrendous. The complication and side effect rates are very variable and do not represent an acceptable risk for me to take if I don't have to take them. I would rather live with the symptoms that I can control to an acceptable level for me, and I know that, should I find at some stage that I can no longer manage them, I will investigate surgical repairs.

Christine didn't make up all these complications, side effects and failure rates. Surgical specialists documented them in their very own, well-respected, peer-reviewed professional journals! And yet, when I asked my gynaecologist at the time about them, I was not told about most of them. Why?????

I have not yet heard any specialist prove Christine Kent wrong. Many surgeons admit that the failure / complication / side effect rates are not good, but they still continue to offer these procedures to women. Why?????? Because women unquestioningly trust their doctors and accept their offer of surgical repairs. They are often not told the full risks, and it is very difficult for a woman to find out these rates of failure etc, if she doesn't know what she is looking for!

We are hearing on these Forums more and more gyns, obs and physical therapists admitting that surgical repairs are all they can offer, but they are not offering them as a matter of course, particularly to younger women. Why??? Because they know what is likely to happen some time down the track; further prolapse and continence problems which will need more surgery for the woman to become symptom free again. The doctors know this is a slippery downward slope.

My involvement in Wholewoman, and my belief in Christine's work is because I have seen the evidence that the surgical repair route is not a safe, predictable route, and because I have the evidence in my own body of the success of her techniques, and I can see why these techniques work. This is my decision. I don't have to do it. I am a total sook when it comes to taking unnecessary risks.

Keep researching. Keep your mind open. Ensure that the information you believe all reconciles. You too may eventually come to realise the truth of Christine's anatomical model.

I do have some difficulty with some of the concepts you describe and some of the assertions you make in your initial post on this topic, eg "walking and moving with a lardosis is not very good for your back", "sucking your belly in is not an inherent problem in itself if you use the transverse abdominals to pull it in, therefore toning of the uterus", "blowing down effect can also be created by being tight under the ribs, pushing the diaphram out to the front", "people have this pattern of holding tension under the ribs thus are constantly putting extra pressure on pelvic floor", "if you squeeze a tube of toothpaste at the top it will come out the bottom. this is all about your abdominal pattern", "breast feeding keeps tissues stretchy and makes you more vulnerable to prolapse", whilst surgery has its drawbacks it does work for some people (okay probably for 10 years then another op)". I would like to see you justifying these statements. Show me the evidence. I don't think you will be able to because I don't think you fully understand what you have stated. I think you have extracted statements from your reading and are using them out of context. Some of them are partially true. Some of them I have found to be untrue. Some of them are meaningless jargon.

BTW, "because my Pilates teacher said so" is not evidence. ;-)

Highland Cow, I am sorry if I seem to be hard on you. I can see that you have done a lot of reading and research to have come as far as you have in the last six months, from your first posts. I can only encourage you to be as critical of what you read outside of Wholewoman Forums and materials, as you are critical of what you read here.

This is a public Forum. We all know that it is only one of the sources of information available to women with POP. Anybody who accepts Internet resources as unquestionably true is asking for trouble. We all need to be critical of what we read. What we are trying to do here is decode the truth, and put all our experiences together to collectively solve the puzzle of what it is best to do about POP, which is something we cannot do anywhere else. Conventional gynaecology and urogynaecology have come up with their solutions, which many of us do not find particularly appetising. That's why we do all this dicussion, to refine other ways of managing POP.

Bring on the discussion. We all learn from each other.

BTW2, I can tell you why you don't experience as much uplift doing Kegels cross-legged as you do in other positions. It is because when you sit cross-legged the pelvic floor muscles are already taut, so they do not rise far. When you are lying or standing in non-WW posture your pelvic floor is quite flaccid and saggy. That's why you can lift them so far! Think about it.

BTW3. IMO, information is never disempowering, unless it is lies that we cannot detect. Opinion dressed up as fact can be disempowering if we are not sufficiently critical of it to unmask it. Lack of information is what is really disempowering! Who is holding back on information? Not Christine, that's for sure! The challenge for all of us is to find the truth for ourselves. Now that has potential for real empowerment! Buyer beware.

Cheers

Louise

Sure, there are women who say they have no problems after surgery. Sure there may be some of those who really don't have problems. I can only say, "Lucky them!" I think there is probably yet another group who do have some problems, but they are less than the problems they were previously having. I am not prepared to take the risk. I am going OK, and would rather be as God designed me, than altered.

It is all so relative.

Yeah, anger scares me a bit too. I think it scares most people, but I know that it is not personally directed, so it doesn't bother me personally. It bothers me when people take it personally and get frightened off. I think that is sad.

Re "If I go full on with the WW posture do you think the 1cm or so anterior wall drop that I have would disappear? Would it prevent any prolapse in the future? What is the evidence for this? Ha ha evidence!!!", If I had only 1cm anterior wall drop I wouldn't be too worried about it! Re the future, I think Wholewoman posture is good for all women and it will help prevent the abuse of our body's structure that could cause longer term problems. No I wouldn't guarantee that the 1cm will shrink to nothing. No, I cannot give you evidence. I just see the sense in it. It works for me. That's why I practise and promote it. It is not about absolute cure for me. It is about conserving what I have, and living OK as I am.

I didn't really think you believed everything on the Internet. That's just commonsense. ;-)
That's why I think it is OK for any of us to make assertions in good faith. Women do not have to take them on board. Any woman with half an education is capable of understanding enough anatomy to understand where Christine is coming from, and to judge for herself whether to accept it or not. Some will. Some will not. Just because I believe in her work does not mean that I think everybody should believe it. I am not custodian of any bodies or minds, other than my own. I hope I can teach my daughter to examine Wholewoman for herself. I hope she will come to the same conclusions as I have, but I have no control over that.

Re "Question about the sitting postures - if cross legged or legs out front as suggested, the spine is straight, how is that maintaining the WW posture?", it looks from the side or back that the spine is straight, but the spine does not follow the profile of the skin, as you will see from anatomical diagrams. It curves inwards in the lumbar region, just like it does when standing. The 'hinge' is the hip joint. Tight hamstrings (or pyriformis? might prevent your holding the WW posture). If the spine is straight then the profile of sitting posture is c-shaped and slouchy. Not good at all. Is that what you mean?

I guess the end of the story is that there are many different kinds of practitioners who each have a solution for many types of pain, according to their discipline. Often they conflict with each other. That doesn't necessarily mean that one is absolutely correct and the other is absolutely wrong. All it means is that there is disagreement about cause and treatment. Neither of them will be right for all patients/clients. Each will have outstanding success with some patients. Sometimes, good luck has a lot to do with fixing a problem. The human body is so complex. I think it is up to us to learn as much as we can and apply it to our own bodies. I have had very good and very bad experiences with doctors, chiropractors, physisotherapists and massage therapists. I am still learning.

I am a woman of Faith. I believe in a supreme God. I have some difficulty with people of my faith who say, "We are right and the others are wrong." I think that is pretty arrogant. Equally I have some difficulty with people of other faiths who say they are right and we are wrong. That is equally arrogant. Surely only one can be right. We cannot all be right, or can we? Perhaps the level of understanding of God by all of us is still at such a primitive stage that we are all mostly wrong because our human thinking capacity leads us to the wrong conclusions about God! But you have to start somewhere to begin to understand these mysteries.

The human body is so complex that I think any one practitioner does not have the complete understanding that s/he purports to have. Even I, a lay person, can pick holes in some of the stuff I read on the other sites on the Net. I haven't been able to pick a lot of holes in Christine's work. All I can do is attempt to understand, and find healing where I can find it.

Cheers

Louise

the increased lumbar lordosis in pregnancy is not the same as the increased lumbar curve that occurs with teh WW posture.

in pregnancy, the uterus rises up out of the pelvic cavity pulling the bladder (to some degree) up with it. which is why some pg women (myself included) have improvement in cystocele during pg.

Let's get back to the initial topic.

Wholewoman is not magic. It is real, and backed up by research and experience. It works well for many, many women, but not everybody wants to take it on as the number one set of tools. Some women cannot seem to make it work. We are all trying to deal with similar problems with our bodies and we are all trying together to share what we find out from our bodies and from different therapies.

Our bodies are all different from each other, though built with the same model, and Members often have other health problems that compound the differences. I don't have a problem with allowing women to take it or leave it, or taking some things and leaving others. I do have a problem with people who say it is irrelevant, but that is for another thread.

I also have a problem, Highland Cow, with your constant, inaccurate criticism of WW, but I can live with that. The work speaks for itself through the posts of women who find it helpful. I think I have said about all I can say to you, so I won't be continuing with this discussion.

Jackie, I wish we could offer you more. I think you have the capacity, and now the knowldege, to get as much out of Wolewoman as you can.

Cheers

Louise

I haven't posted anything in a while, but here goes.

H-C, I am trying to figure out what your purpose is for posting what you have. It seems to me like you are trying as hard as you can to prove Christine wrong and getting some kind of thrill out of it. I cannot know what is in your mind, but this is the tone that I pick up from your posts. It is very disturbing to me. This site provided me with hope and encouragement when I could find none elsewhere. If surgery and kegels worked for most women, then Whole Woman would not exist. This is not a personal attack, and I don't expect a reply. I must go to my kids now, but I just had to write something.

why then aren't little girls walking about breathing through their lower belly with a lumbar curve?

My girls (4yo and 2 yo) have round bellies, nice lumbar curve and they use abdominal breathing all the time.

when you push too much in birth the walls get damaged and you need to tone them back up again to give support to the organs above

You cannot tone up vaginal walls b/c they only contains smooth muscle and connective tissues. Smooth muscle tissue can't be made to contract or relax by conscious control. You can only tone your pelvic floor, and toning is more effective by maintaining optimal length (w/ lifted tailbone and pelvic nutation).

Okay one more thing - c-section. Can someone please tell me why it cuts the support from above? In Uk they don't cut your abdominal muscles they pull them apart. Does this mean you can't do the posture if you've had a c section

IIRC during C section the surgeons have to separate the uterus from the bladder, so their fascia can no more support each other and it can lead to POP. We have members who experienced this.

I'm getting tired of the drama.

when I post here, my goal and aim is to be helpful and encouraging. I really think that I don't have any bias against the hysterectemized woman. when I use the term 'altered' and I use it more than one case, I mean to replace the word 'damaged' or 'ruined'. and really, anyone who has had any traumatic injury -surgery included- may find themselves with a somewhat altered body. this does not mean they are any less of a person, just that the physical body they inhabit has changed. the unfortunate reality is that a uterus helps support the other pelvic organs. not having one makes it harder to manage a cystocele. the whole 'soul' thing has already been hashed out, I think on the hysterectomy forum, for anyone who is still upset about that.

Most women who find themselves here come for education, advice, encouragement, hope, ideas for managing prolapse nonsurgically and not so much to make friends. those who don't like the premise or find it cultish or defensive or tunnelvision-like probably are not going to find this work helpful and there's really nothing I can do about that. for those who find this helpful, many of them move on with their lives because they no longer have to think about their prolapses, they are managing well without us, and therefore don't stick around.

I don't think I am a narrow minded person, this stuff was way out there for me when I got here. I was PT in a hospital years ago, a very medical-minded person who now selectively vax's my homebirthed children. so I've opened my mind along the way. you may not agree with me and that's ok. we may have to agree to disagree. and when it comes to my personal life and choices, I have many friends and family members with whom I agree to disagree.

we can even agree to disagree via email or offline about the value of this work. but I have a hard time not jumping in to disagree with information presented here that is inconsistent with WW. not because I've been indoctrinated into a cult, but because I personally have seen this work, and it makes sense to me. I'm not angry, I'm not defensive. but I'm tired of this back and forth.

nothing works for everyone. sometimes I read a self-help type book that has undertones I don't like, but there is usually something to be learned from everyone so I take from it what is useful to me, and disregard the rest. I don't know why this becomes such an issue here.

In terms of specific Q&A, if anyone has a specific question, I find it alot easier when that question (or even two or three) is its own post and not tangled up with overall criticism of the site.

so I'm not avoiding any of this, I just can't respond well when its presented this way.

I am sick of the drama and back and forth. I don't post too often but I do read several times a day to be encouraged. All of this drama is discouraging to me. I have been doing this work for almost a year now. I have severe prolapses with lots of pain. Some of the stuff helps me and some doesn't. I use what I can and leave the rest. It doesn't mean it won't help someone else. What I do get every single day is the feeling that I am not alone. The knowledge that other people have their ups and downs too. There is great comfort in that. Don't mistake passion for anger. We need to take charge of our health because the drs look for the quick fix. I have been told by 3 drs that the only answer for me is surgery. Well, it's been 15 months since my baby was born and I am still hanging in there.

I am thankful for the support, the information and idea exchange, and that someone cared enough to take up this cause.

Thank you all you beautiful whole women!

pages 174-187 for research.

Highland cow, the thing that is so weird is that you keep insisting that "people feel the need to be so defensive"- I have not seen that at all. I think we have all communicated very respectfully. No one here feels threatened by questions. You claim that all you are trying to do is "get answers to a few questions" but it is obvious to many here that you have something else going on.
You have mentioned on multiple occasions how bothered you are by "all the anger and defensiveness" and how concerned you are for the propagation of the Wholewoman message. You have advice for how to reach the masses and yet you do not even believe in this approach to preventing, stabilizing and reversing prolapse. Can you see how strange this is?
You say "I'm not being arrogant here" but I have to respectfully disagree.

I'm with you there Clavicula- My kids move and breathe in this same way!

you can tome the vaginal walls, I have done it myself. What was hanging out a lot more after birth aint hanging out no more! The action of a kegel is contracting and relaxing, what else is it doing? I was under the impression the muscle was smooth and striated.

It was not Kegels, it was your body's recovering process.Here is a quote from this book: Anatomy of the vagina

"The microscopic vagina consists of a mucosa that is made up of multilayered noncornified squamosus epithelium.The underlying stroma consists of collagen admixed of elastic tissue. Beneath the stroma it is smooth muscle interspersed with collagen. The entire vaginal wall thickness in a menstruating woman ranges from 2 to 3 mm."

I recently got back from holiday and have been having horrendous back pain, so for one reason and another haven’t been able to post. This is just a brief one, as typing aggravates my back and I won’t weigh into the debate that’s been going on for that reason. But I wanted to repeat something that I have posted elsewhere about my personal experience that may be useful for others.
When my POP flared up quite badly about 3 months ago, the posture and the exercises did nothing much to help, in fact most of the exercises seemed to make it worse. Thanks to the input of a wonderful cranial osteopath and physiotherapist, I’ve realised that I wasn’t actually in the posture at all, even though i thought I was, that I couldn’t in fact be in the posture because of structural problems, which they have been addressing in their different ways. Doing the exercises whilst not in posture (even though I thought that I was) made things worse. I can now do the posture and my POP has improved enormously.
My point is that many women on this site have no problem doing the posture and exercises correctly because they have no other structural problems impeding them and they are the ones who benefit. I wonder whether the women who get no benefit are simply not doing them correctly even though they are doing their best and think that they are (as with me). In any event, I would heartily recommend that anyone not getting good results go for an assessment with a physiotherapist or cranial osteopath who really understands the true cause of POP and female anatomy. This may be easier said than done of course. Both of mine seemed to have pretty much the same views as Christine so I have obviously been very lucky.
Incidentally, although I have a pre-existing spinal condition, the cranial osteopath thinks that this is only part of the problem and some of it stems from a couple of physical injuries that I sustained when pregnant. He also commented that the position in which I gave birth (on all fours) probably wasn’t a good position for me, with my particular back condition. So advice I would give my daughter is to have some cranial osteopathy before, during and after pregnancy, as well as doing the WW stuff.
Re Kegels, fine if the pelvic floor is weak and needs to be toned. If it isn’t, then I’d recommend leaving well alone unless you get yourself thoroughly checked out, as it’s possible for the pelvic floor to be too strong in relation to other muscles and exacerbate POP.
In summary, if WW isn’t working for you, please don’t assume that the theory is faulty and rush to apparent “alternatives”. We all have anatomical differences and even quite subtle ones can have an impact. Following instructions from a manual or the internet, however clear they are, may not be the answer because sometimes there is no substitute for some one-to-one assessment and therapy. If there is an obstacle and you manage to address it, then the WW approach has a fair chance of working.
One more thing - I'm pretty sure that my POP only became symptomatic as a result of doing Pilates. My current physio is a Pilates person and she's working on strengthening weak muscles that are causing the POP to aggravate when I do almost anything. She never tells me to zip and hollow, keeps an eye on what I'm doing so that I'm not increasing intra-abdominal pressure and checks my posture according to WW principles. So obviously there are different approached within Pilates ( my physio has also trained with Diane Lee, mentioned elsewhere on this site)
And I’d just like to make it clear that this only my personal experience here! All the best Judith.