A nagging kegel question, sorry

Sure, you can clench those muscles in an effort to keep from wetting your pants, but is that how you want to go through life? Doing so does not address the problem, and will aggravate prolapse. - Surviving

How long have you been working on the incontinence program? The pee on pee off excercises look very promising, and with all this work, does take time before results are seen. Maybe, just give it some more time. If you are still having problems, a consult with Christine may be the next step for you.
Best wishes.

Veggiemom,
That is wonderful that you have been able to keep your prolapse symptoms away with the posture work, that is what this work is all about!
Maybe a consult with Christine is what you need about the sneezing incontinenece. She may have some ideas, or have some modifications that you could do in your particular situation.

I think your question makes a lot of sense. I have tested out the same quick contraction in supine because it's also the muscles for sex, right? But there's no way I'd do any squeezes upright. I'm all about relaxing my belly and not sucking and tucking! At this point I don't regularly do the quick squeezes minimally as you describe but I don't see the harm and if it's helping then great!

I've read responses by ukwholewoman on the kegel question who advises (someone will correct me if I'm wrong no doubt) that this can be done (if you choose) safely on all fours so that the belly is relaxed and organs protected. Try it maybe to see how you feel this way?

Yes....if you must do this, don't do it lying on your back. - Surviving

There are also tons of threads on here about all the different kinds of incontinence women have experienced, from stress to urgency, caused from episiotomies, birth, etc. I was just reading through a few of them. Maybe you can find something that clicks with you from those posts. Also, looking through the incontinence program again may be helpful.

I think maybe the reason you aren't finding this addressed to your satisfaction, is that despite your study of the WW work, you are still holding onto the conventional model of the pelvic organs which says that it is strong muscles that hold everything in.

While you are working on this, if you need to squeeze the muscles when you sneeze, then go ahead if you like, just keep lumbar curvature in place. If you want to kegel, do it as suggested on hands/knees so that organs are properly aligned. I am wondering if your specific health issues are hindering the re-establishment of lumbar curvature. It does take time for all of us. - Surviving

I can't find the thread but am sure there's one where Christine talks about how many women with prolapse actually don't suffer urinary incontinence due to the way in which the organs are displaced. I for one had terrible leaks after baby number one and this time have to have one helluvu sneeze with a full bladder to leak at all which is interesting. I think kegels do work for incontinence (awaiting barrage of outrage here) BUT it's the risk of the strain they put on prolapses which is the catch 22. We use these muscles daily to finish peeing and bowel movements and during orgasm so I don't think there could be so much harm done with a few a day in a safe way if they help. I have recently been doing a few 'test' kegels on all fours at various times of the month (symptomatic and asymptomatic) to gauge how things feel internally pressure wise. It was back when I was three months pp and quite symptomatic that I felt my bladder pull further into my vagina doing a rep of kegels on my back with knees up. Scary. I didn't do them like that again after this!

Hi Veggiemom,

“Strengthening the muscles” is simply a wrong concept. Exercising the full range of motion of the pelvic wall is certainly important, which we do in many of our exercises (pelvic rocks, pelvic circles, firebreathing, etc).

Quadrupeds have a thick, powerful wall of muscle at the back, which wags a tail. Humans have a thin, sinewy wall of muscle (and a lot more fascia) at the back, the primary function of which is to control intraabdominal pressure. The secondary function of the pelvic wall is to help things go out. The pelvic wall is not adapted to holding things in.

In human bipedal posture, the pelvic wall follows the movements of the bony pelvis. When the lumbar curve is in place and the tailbone lifted, the wall closes side-to-side like a pair of elevator doors. Most of this closing pressure is happening at the level of the urethra, which is called the external urethral sphincter - and it is important. The back vaginal wall clamps down tightly against the front vaginal wall (I think we should coin “vaginal nutation” for this movement) to form a closed, airless space, protecting itself against surrounding organs being pushed into it. This is why we do not have vaginal air unless we stand on our head or such. The human anal sphincter is a powerful, double walled organ that protects itself against the forces of gravity in the standing position.

You can feel this for yourself. Sit on a firm surface with your lumbar curve fully in place. Now kegel. Where do you feel it most? You should feel in mainly around your urethra. But you can’t get much movement out of the circular contraction because the wall is already closed side to side! Now slump back, flatten your lower spine and contract. Where do you feel it? Around your anus primarily. Because the vagina is more open side to side, you feel the circular closure there as well.

This is how the self-locking mechanism of the bony pelvis and vagina protect against prolapse and incontinence.

*Any movement toward the round, purse-string closure of a kegel is an equal amount of movement away from the side-to-side closure that is our bipedal urinary continence system.*

Maximum closure of the urethral sphincter is the direct opposite of contracting the pelvic diaphragm. Do you see?

As I have said elsewhere, the only possible anatomic reason for kegels improving urinary incontinence is that they draw the bladder toward the front vaginal wall to form a cystocele, which kinks the urethra in the opposite direction. Most women here with significant cystocele have little trouble with SUI.

Kegels are just the wrong concept, but every woman needs to experiment and figure that out for herself.

Christine

A round, kegel contraction is secondary closure of the three sphincters of the female pelvic wall. Primary closure is side-to-side. You are stopping the flow of urine midstream after much of the pressure has been released from your bladder. If you were experiencing strong contractions of your full bladder, bowel, or uterus there is no way on earth contracting those muscles would hold in their contents. You know if you have to pee really badly you make it to the bathroom by contracting the sphincter muscles. However, if you are about to wet your pants, the ultimate response is to stop and strongly cross your legs, effectively squeezing off the side to side closure of the pelvic wall at the level of your urethra.

Some women can’t let go of the idea that kegels help, so have at it. You are not going to do the kind of damage Miss Diagnosed described lying on her back. I want our other readers to consider, however, that sitting over the toilet and doing sets of contractions is pulling the urethra-bladder angle (the sharp right angle at the level of the bladder neck) backward toward the vaginal sphincter. All of urology and gynecology know that it is loss of the “posterior urethrovesical angle” (the back wall of the bladder neck that gets pulled backward toward the vagina) that results in SUI.

Certainly a few kegels are not going to be an issue in the slightest. It's just the mindset that sets of kegels as daily exercise are beneficial that is problematic. I can sense my pelvic wall tightening so many times throughout the day when I turn, twist, stand up, sit down, etc. This is why making a focused exercise program out of tightening the vagina seems so absurd. What if we did that with the anal sphincter? lol.

I think Christine has been rather generous with her time, Veggiemom, coming on here to debate kegels with you. But this isn't the purpose of the forum. You can do all the kegels your heart desires, as long as readers realize that they have no place in the WW work and that they can worsen prolapse by pulling the organs into the vagina. - Surviving

it seemed more like you were making a point than asking a question, veggiemom, because you continued to argue it even after Christine came on to give you her thorough explaination of why Kegels don't work for either prolapse or incontinence. I think in your mind you want it to be as simple as squeezing a few muscle and have yourself convinced that this is what is working for you, when it could very well be just the posture work actually doing the job. And here you are giving the kegels all the credit.
Kegel away if you want to, but that is not part of Christine's work, and if you read the introduction page, you will find that we are not here to debate about her work. Call that closed minded if you want to, but I don't want to waste my time yet again talking about the tired subject of kegels on here, especially when Christine has proven through her research that they don't actually work.

Have it your way, veggiemom. I don't agree with you, but I'm done discussing the issue.

Veggie mom I appreciated all of your questions and I read in your responses exactly what you said. Thank you. I learned a lot.

This is a very helpful thread for newbies too! I am sure many people wonder the same things. If Christine is happy to come and explain things in such detail then that's great for all of us. I'm not sure why this provokes such frustration every time? These questions help people coming to the site for the first time before they get to the business of using the search feature and keep things fresh and clear in all of our minds.

None of Christine's exercise programs should cause pain or a lot of initial discomfort, unless someone starts out too zealously, or has other medical issues (as it seems you have, veggiemom). If you cannot do pee on-pee off, and you feel that continuing kegels is key to managing your incontinence, go ahead and do them. But it is clear that you fully expected some push-back on this issue, so I just don't get what the big deal is now that you got some! - Surviving

The question has been raised before, by the way. I remember Christine and another long term member argueing about kegels for incontinence right here on the forum.

What bothers me about your posts is that you said you couldn't endorse Christine's work, because of the incontinence part. Christine created that incontinence program as a continuation of her work, to more fully explain how this work helps incontinence too, but you couldn't find anything useful in that information?
I did go back over those modules again, and I have to say it was very helpful and had great solutions and additions that will help anyone interested in helping their prolapse or their incontinence.

This is a good thread. Why? Because it provides information/explanation. And it goes to show that even people who have been doing WW and purchased materials still might have questions/need clarification along the way. The usual "do the posture, be quiet and come back with your success story" is not always helpful and actually stops newbies from asking questions.

Hmm....if that is your summation of what we do here, then maybe you should spend a little more time on the forum! - Surviving

I think we have to remember that there are many people in the prolapse/incontinence business besides WW. Someone can’t legitimately just start teaching the WW work without becoming a WW practitioner. Therefore other modalities, such as kegels, have to be the foundation of what they teach or promote on their websites and classes.

We also have people that for whatever reason have always been sort of at odds with or critical of these forums. Such is life. What astonishes me is why they hang around waiting for the chance to make a cheap shot.

What I would like to say at this point is, for heaven’s sake be more creative! Anyone who tries to kegel on her back with lumbar curvature in place will quickly learn it is a completely futile endeavor! The wall is at the back, the organs are positioned at the front, and the angles they make with their channels are the most critical aspect of organ support. Pulling the bladder neck toward the back in this way is very stressful for the urethra/bladder angle.

While you are at it, why not use a dildo (not plastic!) to hold the organs in their places as you give yourself an orgasm? Or have intercourse with your honey bunny as you squeeze him in a rhythmic way? This is truly good for prolapse, as many many women have found out for themselves.

I believe you were heard, Veggiemom, and I thank you for asking the question. Please don’t take our responses personally, as the subject matter is more than a little irritating to us at this point. Kegels are a male response to a female problem and have no place in our work.

Let’s all move on. Please.

Christine

{{{{group hug}}}}

P.S. Squats are great exercise for the arches of the feet! Otherwise, the position is no different than sitting upright in a chair! ;-)

Veggiemom, c'mon! You said "I felt bad I could not whole-heartedly endorse the incontinence part".

Your messages were read and read and read, they were not misread. - Surviving

Veggiemom,
It's not the initial question that bothers me, as everyone thinks, but what happened after the question was answered. I hate pulling quotes out of sentences, I just don't think it is fair to people, but, you said that you found no worsening of prolapse doing ten quick kegels. That gave me the impression that you weren't really paying attention to the message. If I took that out of context, then I totally apologize.

We need to get beyond this kegel thing, because Christine's urinary incontinence program as well as all her other work up to this point is all we need. Trusting in that work can be a leap of faith for some, and I get that, but those that never do are really missing out on all this work has to offer.
Best wishes to you, veggiemom.

I just wanted to say that the day we stop asking questions is the day we stop growing! I always taught my pupils that if they had a question there would definitely be someone else in the class who was wondering the same thing! Most of us are so glad to be here on this site but have only arrived because we asked questions! I certainly questioned my doctor's opinion although many of my friends do not and I am amazed at how they nearly all have hysterectomies, so sad. I have more understanding after reading this thread ,thanks to all concerned. I send you hugs and thanks Veggiemom we r so lucky to be Whole Women! :)