Physioterrorist

Submitted by zoeUK on July 19, 2007 - 11:24am
Body: 

Hi ladies,

I was lucky enough to get a cancellation appointment with a continence Physio today. Amazingly quick for the NHS but just rang at the right time :-)

I am only joking about the 'terrorist thing - she was very nice really!)

She examined me and said that she didnt think the Cystocele was too bad and would grade it as a 1. She made me cough and bear down and said it was still only slight. I know this was because I was lying on my back as when I stand it is at the opening to my vagina, but still, she said it wasnt bad.

She reckons that because I am only 7 weeks pp and still have relaxin and other pregnancy hormones in my system there is a lot of scope for healing. She did test my PF muscles and said she'd give me a 2 and a half out of 5 and that I was contracting them correctly but I just need to strengthen them more. She suggested I do 5 sets for 5 mins every 3 hrs (when I feed the baby) I have read that you guys dont reccommend too many kegels..do you think that is too many?

Anyway, she also recommended standing as little as poss and lifting nothing heavy for the next 3 months till my hormones have balanced out again. What do you think to this?

She also said a pessary would be a good idea in this period as it would take the pressure off the ligaments and facia and then it may have more chance to heal...has anyone else heard this?

I feel much more optimistic, but would value your thoughts on her advice too as since my GP gave me such a damning 'YOU MUST HAVE SURGERY' prognosis I am a bit wary to trust what any 1 individual says.

Thanks again ladies,
Zoe x

zoeUK

July 19, 2007 - 11:26am

P.S. She said no aerobics or running and nearly had a fit when I told her I had been on the trampoline! She recommended swimming and exercise bike only - waddya think to that?

I have a beautiful 7 wk old baby boy and a wonderful 2 and a half yr old daughter who make it all worth while :-)

Christine

July 19, 2007 - 12:49pm

Hi Zoe,

I am asking the world of women and their healthcare practitioners to look at prolapse from a completely different perspective. I know it’s a stretch given the prevailing medical myths of our time, but all I can do is put it out there and hope as many women as possible can make use of the new paradigm. You have to really work to comprehend it though, so you can act intelligently and healthfully.

The pelvic organ support system is based on bipedal posture. It is only when our torso is weight-loaded from above that the pelvis literally winds up into its most supportive configuration. This configuration pushes the organs toward their natural positions and allows the breath, as intraabdominal pressure, to flow through the body unimpeded – literally pinning the organs into position rather than blowing them out of the body. Weight loading from above means sitting or standing using the strength of our naturally-curved spine and not a couch or chair back.

Given this is the case, why would we want to deprive the body of the very physics that create and maintain the conditions of organ support?

Say a postpartum woman lies in bed for six weeks doing kegels. If she is being fed well and taken care of, surely this will build her cellular health and perhaps bolster her immune system. But can you see that it is doing nothing to strengthen the fundamental way in which pelvic organ support is maintained?

I encouraged my postpartum daughter to alternate rest with sitting up and walking while holding her spine and pelvis in their natural shape. If you are going to rest, then rest. If you are going to be up, stretch into this posture so the pelvic ligaments tighten and the fascial planes within your pelvis are extended in positive ways. All aspects of the posture are vital – particularly a relaxed belly, pulled up chest, shoulders down, and elongated head and neck.

I’m not a fan of trampoline jumping because it negates the resistance from gravity that we actually need to push our organs into place. The branches of Western medicine that deal with women’s diseases do not understand how gravity actually co-creates the pelvic organ support system, and therefore treats natural weight-bearing as the enemy.

Contractions of the pelvic wall happen throughout the day as we sit, stand, and move with a naturally positioned spine. It is good that these muscles return to their optimal length and strength. However, in no way can pelvic wall muscles support pelvic organs that are leaning against them. This is not their function. In natural posture the organs are tipping toward the lower belly and away from the pelvic wall.

I think all women need to go through the pessary drill to see if they can find one that works. A thin, silicone ring taking the natural axis of the vagina and working to keep a cystocele or rectocele from moving further into the vaginal space may be just the thing for you. Btw, we need more science on this, but my guess is that every molecule of relaxin has been removed from your body.

You will likely be working with this the rest of your life, so it is good to learn these natural biomechanics common to all human females.

A year into menopause and several years into pelvic stability, I am enduring a month-long occurrence of sore breasts, pelvic congestion, one spot of blood, difficulty urinating, and episodic urinary incontinence. Gentle and continual pulling up into the posture as well as general health support is allowing me to maintain my usual life routines until my body moves past this uncomfortable period. This has included jumping and leaping on a wood floor, which only serves to help, not worsen my present condition.

Wishing you well,

Christine

MeMyselfAndI

July 19, 2007 - 2:22pm

My Physio told me to relaxxxxx on the Kegels (As had Christine somany times) I think I would not do that many - Only because I did tons and all I got was a much lower draggier cystocele and uterine prolapse than ever!
Now - I would say if you wanna do Kegels - Just do one long Kegel every now and then - Then relax... I might do ten a day now - no more...

As for the pessary - To be honest personally i wouldnt (Tho I see Christine has written below me so I would go with her - She is the Guru on this lol) - I feel the body relies on it and then the strengthening that you would normally be doing - doesnt happen cos of the pessary. If a pessary (In mu Opinion) Is in place then the muscles are not working as they would normally do - And it is like when you support a broken bone - Yeah good for a bone - But if you continually strapped up a twisted ankle - You would get a weak ankle. But different people would choose different ways to deal with things.

As you are post partum your body is healing at this point. To be honest if sitting for hours on end fixed things - We wouldnt all be here and it would really impact life lol. Rest - sit - And if it makes things feel easier - sit alot. But remember that when you are stood - in posture - After a while - standing will not be the problem it may have been :-)

Enjoy your baby - And do a few kegels - It helped me with leaking no end - Never have I felt so 'un-leaky' lolol

Take it easy and work your way up to normal life again - Posture will help you - and ife will continue in a fabulous way :)

Sue

Look into the eyes - They hold the key!
http://www.bringmadeleinehome.com/img/maddy544x150Banner.jpg

MeMyselfAndI

July 19, 2007 - 2:24pm

Take it easy on it for a while - Till you have got your body back 'under control' Then step lightly into your routine and see what your body tells you :) LISTEN to your body and do aerobic activities :)

I've never tried trampolining tho lol. But I do step - :-)

Look into the eyes - They hold the key!
http://www.bringmadeleinehome.com/img/maddy544x150Banner.jpg

zoeUK

July 19, 2007 - 4:22pm

Thanks for your input everyone.

Of course I would have loved it if you all had said 'yes, everything your Physio said is right and you will undoubtedly be better in a few months' , but I came here for the truth and real - life experience which is what I get from you all.

Thankyou especially Christine for your long response. What you say does make perfect sense but as you say it is sometimes a battle to challenge my 'world view'.

I am in no position with a newborn and a toddler to sit around for the next 3 months anyway, but I do plan to take it easy as much as possible as I feel my body needs rest and time to recouperate from my horrendous pregnancy quite aside from the prolapse. On reflection I am rushing into the exercise thing because I really want to regain my figure. This isnt the wisest thing to do right now so I will stick to walking, swimming and stretches for the next few months and keep focussed on a healthy diet instead.

I will certainly carry on with the posture as it makes much more sense now I understand the theory more fully....It just took a while for my post pregnancy brain to 'get it' LOL. Having said that, now my brain understands I just have to keep reminding my body to comply!!!

Sue, I see what you are saying about the pessary and I put the very same theory and sprained ankle analogy to the Physio...She said she could only go by her experiences and said it had been helpful to many women she'd seen.
I think I'll give it a go as I am really very uncomfortable and if it's only temporarily worn I wouldnt have thought it would do much harm. I have a sneaky suspicion that I wont get on with one though as I really do not like the idea of having a plastic ring inside me for long periods, I'm very sensitive and have a feeling I'll be uncomfortable but we'll see.

I do feel that I have received something very precious from my appointment today and that is HOPE. As the Physio assured me there is very often great improvement over the next few months for a lot of post partum ladies she has seen. This is so much better than my GP's prognosis which left no room whatsoever for my body to heal of it's own accord.

I am coming to accept that I will always have to be mindful of my posture and how much I lift and how, but that can only be a good thing for my health in general.

As far as kegels go, I do tend to tighten my PC muscles a lot throughout the day when moving in certain ways and lifting my baby etc. so I guess my muscles are being exercise there naturally anyway. I think I'll do a few sets but not so many as recommended - to be honest I probably wouldnt keep it up anyway.

Thanks again for your honesty, wisdom and help!
Zoe x

I have a beautiful 7 wk old baby boy and a wonderful 2 and a half yr old daughter who make it all worth while :-)
I have a beautiful 7 wk old baby boy and a wonderful 2 and a half yr old daughter who make it all worth while :-)

Christine

July 19, 2007 - 5:01pm

I think you'll do just great by dropping the aerobics, doing the kegel regimen as prescribed by your PT, and utilising the posture as much as possible. It's hard at first but gets easier with time until you can't be any other way without creating discomfort. :-)