Another Newbie - Placed into correct forum(?)

Hi and Welcome, Trueblueone,

I am not familiar with Pilates equipment or these particular exercises you describe, but do have a sense of their overall anatomic framework. Like yoga, Pilates was informed by the scientific view of the orientation of the human pelvis, which was/is wrong.

Since their framework is wrong, what can we say about the rest of their programs and equipment that promote exercise based on inaccurate anatomy? The ASIS are never in line with the symphysis (except in every medical school in the country/world), and they do not tilt forward and back. “Anterior pelvic tilt” is a misconception. The pelvis is already tilted all the way forward. What you feel when you tilt your pelvis forward and back is the ilia moving medially and laterally as you lock and unlock your sacrum. The ASIS are sharply out in front and the pubic bones come together well underneath you - like straps of a saddle. They are very easily palpated vaginally.

For years I have been battling PTs who tell me I am completely off the wall. They teach posture like you do. “First you ‘set’ the thoracic curve (scapula slightly retracted); then you ask the patient to tilt their pelvis all the way forward, all the way back, then settle on the position that feels most right for them. We are all different...” Where is the natural logic in this?

The only “neutral” spine is the spine that is unfettered by “bracing” of any kind. Our breath sets the stage for natural human posture and all you have to do is follow the uncontrived breath to understand how all the parts fit together. Alexander (the Alexander technique) discovered that the most natural way in which to hold the head and shoulders was that which freed the voicebox to the greatest extent. Unfortunately, no one figured it out from there because the entire literate world conceives the pelvis to be a bowl that is best supported by building a strong core of muscle around it. To do this, we would need to “brace” our abs and tighten our glutes. Never mind the fact that this posture completely disrupts the flow of the breath, the pathway of which organizes organ placement throughout the body.

We are concerned with building a strong abdominal wall that is in line with the natural position of our hips. This is really in opposition to the “core” framework. You are pulling it in and we are pulling it up. In pulling it up, our lumbar spine extends naturally and the concept of “neutral” becomes non-existent. Our scapula are allowed to widen naturally to the fullest extent and the thoracic spine is brought into line with the cervical spine and head. This work flattens the unnatural (and unattractive) hump at the base of the neck that always appears in women who are wrapped tightly around spinal flexion.

Regarding whether Pilates caused your prolapse and whether you should continue with the exercises I will leave for you to consider.

All women need to go through the pessary drill for themselves. Some believe a pessary slows the progress of prolapse and other believe the opposite. Many of us find we are much more comfortable without them once we begin to pull the organs forward.
I think traditional “yoga breathing” is to pull the abs in with exhalation (?) We only do this in the extreme during stomach vacuum exercise and rely on passive transversus retraction the rest of the time. As far as the Pilates breathing you describe, bracing the abdomen on inspiration obstructs what the body is trying to do with every breath! It is our natural breath that pins our pelvic organs into position inside the rounded lower abdominal wall.

We need a large flock of WW teachers to de-construct the age-old, incorrect, and completely entrenched philosophy of “core”.

Wishing you well,

Christine

Hi Trueblueone

I confess that I saw your post last thing last night before heading off to bed, but found it very dense with information, so I left it until this morning when my brain feels a bit more able to cope with it.

You certainly are a woman of action, a bit like me, jumping and ordering the book (when that was all I could order five years ago) as soon as I found the site. Thankfully there is now a better editon, and the DVD, both of which I know you will glean a lot from. I would find it very difficult to understand all this anatomical function stuff without the book in particular.

Yes, many women speak of a feeling of betrayal at finding out about POP only when they are diagnosed with it. It is a hard pill to swallow, and crazy that we are not taught more about it. Unfortunately, I agree with Christine, that the obgyn industry which supposedly teaches us this stuff about our reproductive organs, doesn't seem to know much about it, so they are not in much of a position to teach us about it. As you say, they recommend Kegels for the related incontinence issues but know they are not the complete answer (because they don't fix POP, but have a role in waking up a moribund pelvic floor to help with continence and for better sexual function) but don't know why. They often recommend surgical repairs, but surgery for POP is a very blunt tool that does ill-conceived renovation jobs usually solve the immediate problem for a time, but often fail dismally with time. Obgyns know this, and a lot of them are now 'humble' enough to admit that surgical outcomes are unpredictable and often unsatisfactory in all but the short term, setting women up only for further problems. That is about all they can offer, except for pessaries.

I think Christine does know something about it, but only because she has started at the beginning again, with anthropologist's, and human woman's eyes, not surgeon's eyes, to uncover the real nature of female anatomy. We (Members) are now working with her work and our own experiences to further de-code our bodies so that all women can know the full picture, and decide for themselves how they will see their own POPs and their own future. You will find these Forums a home of lively debate as we learn together about our bodies. I don't think doctors are necessarily evil, just that they are naively working with a grossly incomplete model, one that is based on anatomical studies of cadavers which are, by definition dead and unresponsive, and cannot stand up by themselves to demonstrate how their bodies work. The other problem with the medicos is that they cannot or will not *think* past their horizontal model.

Anyway, it is hard for me to understand the specifics of what you are talking about because I am not familiar with Pilates but I can see, as Christine has pointed out, that there are some problems with Pilates as you describe it, and I think you can see that there may be some things you have been doing that risk doing your body more damage.

One of the authentic things I really like about Christine's work is that there is very little special equipment involved. All you need is a woman's body, which you work with in its vertical orientation, because that is the orientation that our musculoskeletal system was designed to work in. I think it is the only way to exercise the body in ways that strengthen the whole body, not just parts of it. Why work horizontally when you can work vertically?

You are also at an age where many women discover POP for the first time, or else some post-baby loosening develops into full-blown POP as we near menopause. Our muscles lose strength more easily and our connective tissue starts to give way. It all starts to fall apart. The only way to counter this seems to be to ensure that all the bits that need support get good support, ie bone. The pelvic organs, as we have all found out, are the case in point, with our large female pelvic floor. Strength of the pelvic floor is one factor in keeping our organs safe. As the back stabilising door, they need to close properly, just like a spring-loaded garden gate, but they do not have to be made of steel, because there is nothing actually resting on top of them. Our organs do bounce off them during the resolution of incidents of high intraabdominal forces, ie breathing, coughing, physical exercise, but they do not have to counteract gravity, as we have been led to believe. They would be much thicker, like leg muscles, if they were designed to hold anything up. As it is they are multi-layered, and quite thin, designed to vibrate like a drum skin, rather than distend and suspend.Our organs are in fact held forward and out of the way by their fascial supports and the action of the body winding itself up with its movement and breathing, to keep them there.

Even doctors admit that ligaments that comprise the endopelvic fascia are quite loose and incapable to holding any organs in one place. Of course they are. These organs have to expand and contract, and move out of the way of the intestines when they fill. They need to be mobile, but not quite as mobile as mine! How does the body cope with this mobility? It tucks them away at the front, resting on an expandable and resilient abdominal wall, on a boney platform. If the convoluted endopelvic fascia becomes damaged the body has this fallback mechanism of support.

It just makes sense to me, and I understand more every day.

I would encourage you to learn about your own body. Try it out. Feel it. Do things with it, and critically analyse what you have been taught by your Pilates and therapist teachers about what is 'correct' for the female human body. Only then will you be able to befriend this body of yours again and do with it what it was designed to do. You will eventually know which pieces of apparatus it does not like, and which exercises are counterintuitive for it. In the meantime, join our discussions and learn how the Wholewoman body works.

Only you are ultimately responsibile for the efficient workings of your body. Seek the truth.

Cheers

Louise

Hi trueblueone,

Welcome to the forum. It sounds like we're going through very similar situations - I just turned 50 this past summer, have never had children but developed a cystocele about 2 months ago which I'm wondering if a year of Pilates apparatus sessions twice per week was a factor in causing. I love movement and fitness and had planned to go through Pilates teacher training in a couple of months but now that is all on hold until I figure out what I can and can't do. What I am doing is Flamenco and Zumba dancing, while always trying to be in WW posture, and functional strength training, always in standing or prone position. I'll let everyone know how things go and do keep us posted on your own situation.

Peace

Welcome, Trueblueone:

A while back, I did Pilates reformer work for a year or so. Then my lower back gave out (who knows why), and I did months of PT with McKenzie back extensions to work that out. I didn't go back to Pilates because I wasn't sure what my newly "reformed" back would do. Later on, about four years past menopause, I discovered the POP, which presented as a mild cystocele. I've been dealing with POP for about two and a half years.

In my admittedly limited experience with Pilates, I think what would most undo Whole Woman principles is the emphasis on sucking the belly button to the spine. Christine has pointed this out in her writings and DVD. We are trying to get our pelvic organs to move up and forward within our abdominal cavity. Sucking them in and pinning everything back would seem counterproductive to our goals.

One can never know whether doing Pilates contributed to the development of prolapse. One just has to assess how to go on from here. I'm afraid I don't know what "reverse crunches" are, so I can't comment on that.

I'm trying out a pessary right now. So far, I like the way I feel with it in. I don't feel the prolapse, which is a huge psychological relief for me. I'll chronicle my experiences as time goes on. Up till now I had used a tampon to hold things up when exercising vigorously or just feeling "droopy," but they can be sort of drying. I only used them on occasion.

I recommend the First Aid for Prolapse DVD with the Whole Woman workout on it. I don't do the dance routine part (slight lack of coordination here), but the mat portion and the rest of the beginning and advanced workouts seem very beneficial. My shoulder girdle really could use some additional strength and stability, which is addressed in the routines where you hold a baton overhead. In the Dictionary of Movements on the DVD, Christine explains why she included certain exercises. I bet you'll never find another workout DVD that talks about how an exercise affects the round ligaments of the uterus!

Take care, and know that you are not alone. We are all in the business of figuring out what works for us.

Saddleup

Hi trueblueone,

I agree about the questioning of ribcage and pelvic placement. Especially when supine on the Reformer carriage, or anytime really apparently, it is not good for POP - and I'm also wondering about all the core work being focused on now and what women, particularly younger women, will experience down the road.

I've not done reverse crunches but it seems there's a picture somewhere on this site of Christine doing facedown crunches from a bar - can't remember where. Maybe someone could point us to that photo. :) Actually, maybe that's not a reverse crunch - is a reverse crunch done supine with just lifting the tailbone off the floor? I've also not done standing routines since the POP but have a standing Pilates DVD from Physical Mind Institute that I ordered awhile back but have never looked at. I plan to check it out soon and see what might be doable for me. (By the way, the training I was thinking of taking is Polestar which I was very impressed with but whose training I'll not do now because of the POP.) I've asked on the forum about doing pull-ups, which I can't do now but want to be able to do, and someone said it's ok to do them but not to brace (don't know if that's the right word) the abs. However, I can't seem to attempt a pull-up/chin-up without using my abdominal muscles. I really need and want to do strength training but am still figuring out what I can do. I'll definitely keep you all posted about things.

You asked how I've been since finding the POP. Well, I scheduled an appt. with my ob-gyn, who's very open-minded and progressive, about 3 weeks after realizing something was not where it was supposed to be,who said after doing the exam, "oh, that's just the urethra" with no mention of surgery. I only really feel it just inside the vaginal opening if I put a finger there. I'm at the end of perimenopause - haven't had a period in 4 months, then did not have one for 5 months before then. Hopefully, being in the WW posture will prevent the urethra from dropping more.

People on the forum have said sex is not a problem. It's always been somewhat painful for me, I think because my uterus is retroverted, but I always position myself on top or sideways which has worked well. I've tried sex a couple of times since finding the POP and hubby hasn't seemed to notice. He's very understanding and knows what I'm going through.

Christine, I'm also interested in being involved in teaching others about the WW posture. I live in southern California so let me know if you ever come this way.

emmalu

Hello everyone- thought I'd toss my hat into the ring here and weigh in on the weight-lifting conversation. Pull-ups should be no problem, when I do a pull up my body is actually pulled into wholewoman posture quite naturally- and sit-ups you can get around by using a vertical knee raise stand. You can also work the abdominal muscles by doing the plank positions from yoga (standard and side). But the truth is once you get very comfortable in wholewoman posture you will find that you can do most exercises because you will know exactly when something is bothering your prolapse and you will stop. Simple as that.
Run, jump, swim, hike, sit-up, push-up, pull-up, dance, walk, stretch, step, lift, ANYTHING.

Amen! is all I can say.

Louise

Hi Alemama

Well, I wonder if I can magic one of these things up with some rope, some broomstick and a roof truss. I have a qualified personal trainer coming Monday morning to do fitness tests for DH and self, and to help us to work out how to get the most out of the elliptical.

She told me over the phone in her best Pilates voice that she will be getting us to do crunches for a core strength test. I politely said, "I don't think so. I have POP, and I don't do crunches for anyone!. Can I do leg raises instead?" "Yes, that should be fine," she said. Only trouble is that I think she thought I meant the 'lie on your back and raise both legs' type of leg raises! I don't do those for anyone either!

So, now I have a home gym engineering challenge. I'll keep you posted!

It is going to be interesting. She is a zipper and a tucker, and she is 6 months pregnant. Life gets more and more interesting by the day.

L

Hey Louise, if you have a counter top with an L shape you can get in the angle- bum toward the counter and pick your knees up that way.
Ha! to your trainer. On so many levels. I have done fitness testing in the past. Really fun! All I know is that the hand of fate is in your trainer's life and you are going to help her- too bad you will be paying her :)

Hi alemama,

I'd like to try the sit-up you're describing. How exactly do you use the counter top?

thanks

As far as I know these are both acceptable in WW land...

http://blogs1.marthastewart.com/photos/uncategorized/2008/01/22/mary_pla...

http://www.arthritistoday.org/Fitness/Exercise-Videos-and-Photos/Abs-exe...

Though I think it would be very difficult and very clumsy to do either of these with the hands like in these pics. I can't seem to find a picture of a more solid placement of hands and wrists, but I find it helpful to put elbows down right below shoulders, hands come together and fingers overlap loosely. One pinky goes in front of the other and the outside of both hands goes to the ground, so hand, wrist, and forearms are all solidly on the ground. It is not hard to keep them here, very little strain but sold grounding.

Hi Alemama

The fitness testing session was worthy of a topic of its own. I was able to translate everything she wanted me to do into Wholewoman thinking, thanks to knowing a bit about anatomy from my Wholewoman reading. She only wanted me to do two crunches to see how far forward I could get my hands without my toes coming off the ground. POPs were fine afterwards and are fine this afternoon. I would not have done them if she wanted me to do a timed series.

I am still working out how to write the topic. Watch this space. BTW, the trainer is expecting a baby in April! This is going to be very interesting...

To others who are interested, I did see somewhere a picture of Christine doing these Bent Leg Raises, except that she did them with straight legs! Go Christine! You rock! You are one tough lady! It took my breath away! I think it might be on the First Aid for Prolapse DVD? It is a very good alternative to crunches, and of course is paralleled by the leg raises in the Wholewoman ballet workout!

My trainer tells me that our local gym has the special piece of gym equipment needed to do these leg raises without having to head out to the workshop for a metalwork project. You can see it quite clearly in the picture of Christine doing it in the Wholewoman Center. (I think I will stick to the ballet workout.)

Yes, I agree Aza. I actually did the first one last night, and my 'core' came out as satisfactory. My trainer preferred to use the single crunch test. However, I could see that the two exercises would assess the 'core' in different ways, and would possibly come up with different results, but that is another story.

The interesting thing is that I got to 40 squats on the squat test and got bored. She was happy for me to stop, as I had exceeded the top fitness level for aage and gender for the test. And one of the reasons I wanted to get assessed is that I thought my lower body needed some work! Turns out that it is upper body and abs that need work. Cardio fitness was OK too, which blew me away, because I have been very sedentary for the last month or so.

Cheers

Louise