I am confused

Hi Samsmum,

I apologize for the confusion. I wrote the FAQs a long time ago and that reference is to a dvd that is no longer on the market.

We do not yet have data that the postural work will be of great benefit to post-hysterectomy women, but my belief is that it will.

My little granddaughter has arrived for the evening - I will write more about this tomorrow.

Christine

Hi again, Samsmum,

Opening up the postural work to the post-hysterectomy woman is a new path we’ve embarked upon. As you probably know by now, the uterus is the central hub and anchor of the pelvic interior. It provides primary support for the bladder and rectum, and because it is tethered in an ingenious way to the front of the body, keeps the vaginal walls pulled upright. For many years, my sense was that the post-hysterectomy pelvis was too unstable and unpredictable to safely work with. But at some point it dawned on me that they actually may need this work at least as much as we do. The post-hysterectomy bladder needs to be pushed toward its natural position over the pubic bones and the vagina needs to be held upright.

Post-hyst women no longer have the major muscle/ligamentous system pulling the pelvic interior forward and the urethra/vagina/rectum up. What they do have is the weight of their entire intestinal system, which is still connected to the top of their back vaginal wall. If we teach these women how to balance their intestines comfortably and naturally forward, might this be the ONLY reasonable way to avoid vaginal vault prolapse as well as severe cystocele/rectocele? If we also teach them to apply mild compression to the joints in between their spine and pelvis, might the classic post-hysterectomy body shape be somewhat prevented?

There are some problems however. First of all, it is my belief (and the experience of surgeons) that the female pelvic interior is much more alike from woman to woman than different. However, there are many different ways to do a hysterectomy and the post-surgical pelvis can be radically changed from normal in any number of ways. For instance, might encouraging natural sacral movement and spinal shape have a detrimental effect on sacralcolpopexy (where the top of the vagina is tethered to the spine)? Might it cause even more pain to the woman who has had one side of her vagina secured to the sacrospinous ligament (the vagina is not long enough to reach the ssl on both sides)? Might trying to gently correct spinal shape in the woman who had her uterus removed years ago create undue pain and is it even possible? We do not have answers to these questions.

I think the sacrocolpopexy has proven that (1) surgeons can create a pelvic interior that is fairly resistant to intraabdominal pressure, and (2) the reconstructed pelvis has only a small fraction of the ability to withstand internal pressures that normal female anatomy has.

So for now, we are recommending that women learn the Whole Woman Posture and use a pelvic compression belt for support - certainly while exercising. The belt we carry fits the WW model of pelvic organ support better than any other I have found. The exercise routine in FAFP is very rigorous and I think only the beginning program is suitable for the post-surgery woman.

Please don’t hesitate to ask more questions, Samsmum, and also to let us know of your progress.

Wishing you well!

Christine

Hi Samsmum
In your position I would be asking the hospital and/or surgeon what procedures were performed. You could probably also get this information from your health insurer, or the invoice for the surgery, ie Item Numbers. This is so you do know what changes have been done to your body, so you can picture what is now your pelvic structure, in order to understand what the posture and any exercise will be doing. This includes, but is not limited to, WW exercises. It is really important for you to know what you are doing with your body at any time.

Hopefully you have recovered from the surgery and are now far enough away from it to feel comfortable about finding out the details, and understanding the changes, as you will be living in this body for the rest of your days.

Cheers

Louise

Good question. I tell the post-hysterectomy women I work in my studio with that the firebreathing might be very good for their pelvic interior IF it feels comfortable on their spine. It is really a wonderful way to work the lower spine, but many post-hysterectomy SIJs may be malpositioned. I do have reservation about nauli, however. I think it might be more risky to perform a sustained abdominal vacuum without the central hub of the pelvis. We don’t have enough information at this point, so use your best judgment.