cystocele,good news

Hi trueblue,

Thanks for the positive stories. I know how you feel. I'm 5 months pp and recovering from a horrible pregnancy (developed cystocele 17 weeks into my 2nd preg). I would say I've felt increasingly better since I've hit month 4. I walk a lot, do housework, carry/wear my baby, and my prolapse is behaving. I'm no longer feeling it all the time. Some days are bad, but those are mostly the days when it get irritated i.e. dry/burning. I have just tried Vit. E. oil and that helps immensely. I think we will all get better. It sounds like you are doing everything right. I hesitate to post too much about my progress because I don't want to jinx myself. I"m going to wait til' 1 year postpartum to calculate my baseline. Read stories from granolamom and alemama. They have both struggled in pp period and have gone on to have more babies and have recovered again! You will be fine. Think positive and keep doing the right things.

hello and welcome

just a few answers to your ??'s

- my prolapse did not get worse after the (vaginal) birth of another baby. I'm pg again, and I have full confidence that while it may get worse right afer the birth, I will be able to get back to my baseline

- I only think about my prolapse when I'm posting here. rarely, I have a 'bad' day when I feel a bit more bulgy, but I rest up the next day and I'm fine

- I don't walk all day, but I run after my four kids all day long. my discomfort right now is pg-related, but otherwise no POP discomfort, and it doesn't get worse at the end of the day.

-I wouldn't ever choose a c/section in hopes of avoiding POP, or more damage to an existing POP. for me, the risks to mother and baby do not outweigh the gain, especially since there isn't any real evidence that a c/s can prevent POP

I think its wonderful that you've taken so many steps to help yourself heal, and that you're feeling better. If you have the time, I highly recommend reading up on the faqs here and learning the posture. the posture is what is repositioning my pelvic organs and keeping them in place. knowing that my bladder is in a more stable position is what gave me the confidence to get on with my life.

mostly I just walk (in posture of course!) on the treadmill. I'd prefer to walk outdoors, but we get so many rainy or cold/icy or hot/humid days here that its hard to do that consistantly. and if I go out, my two yo comes along and that is not aerobic exercise at all. we stop to look at EVERYTHING. with the treadmill, I work it into my morning routine before dh leaves for work, so I know I have my exercise time 6 days/week.

between that and the nauli/firebreathing I'm sort of fit. I keep promising myself that when the kids are a bit older I can get the entire ballet workout down, or go back to my weights. for now, this is good enough for me.

I live almost 10,000 feet above sea level -- everywhere I walk is uphill!! Walking uphill is supposed to be good (and I've found that to be true) for prolapse. The more incline, the better. If you are using a stoller, be sure that it is a waist height or higher, and resist leaning forward into it as you push.

Trueblue: remember that in a c-section, the surgeon must CUT through the abdominal structures and MOVE the bladder. I do not see how that artificial manipulation and injury can be any advantage over what a woman's body is naturally designed to cope with. (As Louise says) think of it like a wet wool sweater. If it is just overstretched, there is still the chance to rewash, dry, and reshape the wool. If it is cut . . . well, mended knits are very sloppy, puckered up things no matter how skilled your sewing is. Also, 3.5 months pp is around the worst time for a lot of ladies. I think you can look forward to better times in the months ahead.

I remember Jane (fullofgrace) mentioned that her POP was C-sec related. During the operation the surgeon must dissect the bladder from the uterus, so they no longer can support each other properly. I wouldn't risk that.

Tasha Mulligan, MPT, ATC, CSCS
Creator of Hab It: Pelvic Floor DVD www.hab-it.com

I have 3 children, ages 5, 3,and 22 months. I experienced a cystocele, grade III, after my first delivery and again after my other two. I didn't feel as though it got worse and through knowledge of my body, my recovery and resolution of my prolapse was faster after each delivery. I tell my patients that having a prolapse is like having a weak back, you will always have to be aware of your posture and perform the correct strengthening exercises to prevent symptoms from returning. Actually these are exercises that all men and women should be doing for overall better posture and body health.

I am a triathlete and have no symptoms at this time.

Tasha

Hello Tasha,

Well, let’s have a little talk.

You have been a member for some weeks and clearly must understand the underlying principles of this work. I must surmise, therefore, that you are ready for a challenge to your very conventional views of anatomy and exercise.

First of all, the pelvis cannot remotely be compared to a basket with fruit lying at the bottom. That is the classic medical model you were taught in school and it is simply wrong. The pelvic diaphragm does not “hold up” the bowel, bladder and uterus. These organs are suspended over the pubic bones (which are absolutely not positioned as you have them in your anatomy lesson) and kept there by the force of our breath, the shape of our spine, a convex lower abdominal wall, ligamentous connections, and the weight of the organs themselves. The bowl, hammock, and floor concepts are beyond useless and even harmful to women trying to understand their true nature.

At some point are we going to get past trying to convince women of the elusive “correct” kegel? Please.

Tasha...put on your thinking cap and let’s talk anatomy. In treating cystocele you have women on their back performing a “correct” kegel. ”Feel the belly pull in as you contract your pelvic floor.” Can we agree that these two tandem elements of muscular movement are indeed what you believe to be therapeutic? And that women are indeed “strengthening” their pelvic floor while doing these exercises?

Okay...so then you describe “counterclockwise” rotation of the pelvis (another inaccurate representation of anatomy), WHICH DEMANDS CONTRACTION OF BOTH THE ABS AND THE PELVIC FLOOR MUSCLES, as a position of “disengaged abdominal muscles” and “relaxed pelvic floor muscles.” Therefore, you have women “engaging” the muscles while on their back, yet “disengaging” those same muscles as the EXACT same body movement is rotated in space.

It just doesn’t make sense, Tasha. Your core concepts are wrong and therefore, all the exercises and information that flow from that misjudgment are also faulty.

There is no doubt that prolapse and incontinence often reverse in young, active postpartum women. That is a testament to the strength of the natural female design. However, we have ample data that the exercises taught by classic PT are not enough to sustain reversal through the lifespan.

It is high time women learn the true story of their anatomy and frankly, I deeply resent you undermining my efforts to do so. Tell your flawed story somewhere else - but beware that we will be deconstructing it at every opportunity.

Christine

A few questions, did your pop get wors after haveing more children? Not sure - it has not gotten worse after having the 4th child. At the time of the 2nd and 3rd pregnancies I didn't really know it was there- though I knew *something* was not right. I got my diagnosis after the 3rd birth and an unstitched tear. I think it can get worse for sure- especially with tearing and especially initially. But I know it can get better too.
Does it get so god that you stop thinking about pop? Yes it does thank goodness
Does it get so god that one can walk all day without discomfort and things getting wors? Not for me. but really who wants to walk ALL DAY? and the good news is that by morning you feel great again.....
Would you choose c-sectoin to avoidmore damage ? nope. I like natural birth for the best outcome for the baby. AND the mom!

A few questions, did your pop get wors after haveing more children?

Mine got a little worse after my second (and last) child, but it got a whole lot worse years later, in my 40s.

Does it get so god that you stop thinking about pop?

Oh yes. I still think about POP every day but only for a total of minutes, not most of my day.

Does it get so god that one can walk all day without discomfort and things getting wors?

Well, it's always there, and walking is sometimes uncomfortable but often it is not uncomfortable and I don't think about it. When it is uncomfortable I think about how lucky I am that I can walk, I'm not in a wheelchair or bedridden. That makes me feel like the POP is no big deal.

Would you choose c-sectoin to avoidmore damage ?

NEVER. It increases your risk of needing a hysterectomy for excessive bleeding on the spot, and that will make POP much worse. It is major surgery; tremendous complications can happen, complications much worse than POP.

Here is my addition/edit of my last post re Tasha.

I have now taken a more thorough look at the website. I think she is on the right track with her recommendations for light kegels to address incontinence.

The animated diagram of her posture model does not relate to reality. The diagram has no cervical curve on the spine. In her good posture the head is thrust forward further than in bad (c-shaped) posture. In reality the head moves backwards as the spine moves into neutral position from c-shaped posture. The head has to be held back further in good posture, or else the woman would fall forwards. However it does illustrate how the pelvic floor loosens and is more hammocklike and saggy in c-shaped posture. I am a little confused by the spoken description of posture on the clip, but they are only samples of the DVD, not the full version, which might clarify it a bit better. I am not inspired by these shortcomings and inconsistencies to buy the DVD to find out.

The section with the woman in black illustrates quite well what happens with c-shaped posture in relation to the tipping back of the pelvis and the subsequent unstable positioning of the pelvic organs. She talks about the importance of maintaining tension in the back and stomach muscles to maintain neutral spine. As I understand it, both back and stomach muscles have to be relaxed for the spine to be neutral. Otherwise the spine would be in compression, which is not neutral at all. Please correct me if I am wrong.

The clip is only a portion of the posture section. There are a lot of things it does not show that are fundamental to WW posture. I cannot comment on what I have not seen.

Tasha, you have been a Member for a couple of months before posting. You have obviously been motivated to post by something you have read here. What are your comments on Wholewoman posture as it relates to your version of good posture?

L

The spinal and stomach muscles are not at all relaxed in WW posture. Their functional length keeps the muscle fibers in a state of constant tension to uphold the ribcage and torso. We teach the concept of relaxing the lower belly, but the upper belly and chest are taut as are the long muscles of the back.

Christine, could we have a look at this?

I figure that muscles are either:-

* in active contraction (working),
* being stretched passively (by the antagonist muscle's contraction on the other half of the lever),
* or relaxed (just sitting there, in Wholewoman posture, being finely balanced between contraction and being stretched, by our brain and the nerves that supply the muscle and those of its antagonist muscle). This would be the muscles functional length.

I think it is gravity working on the multi-curved spring which is the spine, the pelvis and its downward extension into the legs, with the movements of our hips, shoulders, arms and legs acting like outriggers and counterweights, and the fine adjustments done to our balance by our brain and nervous system to maintain that equilibrium. This allows our body to stay upright. All our muscles need to be in a neutral, not contracted/tense state, while breathing, digesting and all that other stuff, like a boat bobbing on water.

'If I was God', I would design a body that did not have to keep muscles in tension, just to stand upright. That would use up too much energy, which might be needed to launch a spear or lift a baby. It would also put a lot of pressure on the discs between the vertebrae. At rest, I figure that the 'vertical' tension created by the abs and back muscles needs to balance the compression in the spinal discs. These discs will always be in *some* compression because they carry the body 'above' them. They also have to have the ability to bear more load on one side or the other, or backwards and forwards, without rupturing.

In a body that doesn't do much work, muscles don't have much tone, ie they are not capable of doing much compression work, for an extended period of time, or stretching out fully, and they will waste. This is the inflexible body of the couch potato.

In a body that does a lot of work, muscles will have better tone, ie they are capable of working hard, for an extended period of time, and stretching fully. This is the strong, flexible body of the highly trained athlete who is fit for competition.

Most of us fall in the middle, with some muscles that work better than others. However, everyday movement in relaxed posture will maintain as much tone in all the muscles as they need to do everyday tasks like walking, breathing, lifting light loads, running, reaching, sitting, dancing etc. I cannot see how any muscle is any different from any other, PF or other thin, sinewy muscles, heart or other smooth muscle, shoulder or thigh muscles.

My theory is that we don't have to have our bodies in a state of preparation for high level competition to remain functional and continent, though of course some level of appropriate exercise and activity on a daily basis that pushes our body to a higher level is much better for our bodies than none at all, or irregular strenuous exercise.

If the owner of the body decides to become an athlete, she has to strengthen all the muscles in her body, including the pelvic floor, to balance intraabdominal forces being bounced off her abdominal muscles, so that she can do extraordinary things with her body.

The pelvic floor and the abdominal muscles (rectus, transverse and obliques) and all those back muscles need to be equally strong enough to reflect the intraabdominal forces that are generated during the tasks each of us undertakes, whether it be rising for the couch to fetch another beer, or running a marathon, or sneezing.

Am I right that when you say the back and stomach muscles are in tension, they are not floppy? I have previously thought that by tension you meant 'contraction'.

Would you please clarify the different states that muscles can be in?

let me preface by saying I'm having a hard time maintaining a train of thought these days, so I might not have read the last few posts correctly.

muscles at rest, have tone. this is not the lay term 'tone' which typically refers to strength. tone, as used by PT's means 'the muscles resistance to a quick passive stretch'. sort of like a rubber band, some are tighter than others and give more resistance, but a muscle with high tone isn't necessarily 'tight'. this is a neuromuscular setting in the CNS that affects the way a person's muscle behaves at rest, and also when active. so a person with low tone (extreme example is a child with down's syndrome) must use more energy to move than a person with high tone within the normal range. a person with abnormally high tone (extreme example is someone with spastic cerebral palsy) must work extra hard to move the antagonistic muscles because the muscle tone is so high, it is difficult to relax the fibers. most of us fall somewhere along the continuum, within a normal range.

that said, our postural muscles, when we are upright, are active to some degree. even with perfect posture and alignment of spinal bones, we must keep our equilibrium against forces of breath, movements of extremities, and even the gentle breeze. muscles that are relaxed force us to lean on our ligaments which results in that notorious posture of chin jutting out, rounded shoulders, kyphotic thoracic spine, increased lumbar lordosis (not to be confused with the increased curve you might get with ww posture).

tension can be active (contraction) or passive (a stretch by antagonistic muscles or postural position). but even to maintain the right amount of tension for the given activity, a muscle will be somewhat active. there's three kinds of muscle activity (and I forget the correct terms) but one is when the muscle contracts (a bicep curl), one is when the muscle lengthens (the bicep action when controlling the straighting of the curl - if you do this very slowly you can feel it) and the third is when the muscle doesn't change in length at all, it is a stabilizing force or resistance to joint movement.

there is definitely a 'use it or lose it' concept when it comes to muscle strength. in the case of the couch potato, not only do certain muscles waste away to some degree, but others become tight and inflexible. joint capsules can become tight as well. this of course, sets up a vicious cycle because once you're tight and weak, muscle action is no longer optimal and posture becomes compromised necessitating compensations to maintain balance which compound the tight/weak patterns.

but when someone breaks the cycle and attempts to provide the body with optimal posture, the other pieces start to fall into place. because with optimal posture, there is an economy of energy (my physics teacher used to say Mother Nature's a cheapskate), but still I think most of the major postural muscles are actively maintaining tension for the better part of the time we are upright. at least that's my understanding.
not all muscles are called upon as frequently as say, the paraspinals and glutes, and that is evident by the type of muscle fiber they are made of but that's another post.

granolaboy wants the keyboard.
I hope this makes some sense. if not, disregard my pg brain rambling.

This subject is at the core of our work, Louise, and thank you for expressing the question so eloquently.

As I write about in STWW, science has distinguished two basic types of muscle fiber in the body - type I (slow twitch) and type II (fast twitch). Type I muscle fibers hold sustained, low-grade activity, while type II are the muscle fibers of movement. Many muscles are thought to carry these two types of fibers in a 50:50 ratio. That ratio is probably skewed more to the type I side in the pelvic diaphragm.

Several muscle groups in the body have been described as “postural muscles” and include the hamstrings, gluteals, erector spinae, latissimus dorsi, and abdominals. These hold us upright even when we are not moving. If we did not have this constant, minimal tension in the body the compression of our bones would cause a general implosion.

Another example is that of the pelvic floor while we’re sleeping. Even while sound asleep, type I muscle fibers keep tension so that our sphincters do not relax and we remain continent. However, when deeply anesthetized all muscle fibers in the body completely relax and we must be cathed. The pelvic diaphragm is capable of very little movement, however its constant state of tension is of utmost importance.

As we know, the practice of building up the pelvic floor is ubiquitous throughout the treatment of pf disorders. And as you know, I believe that concept is both erroneous and useless at best. I believe the small benefit that is gained from kegels in women with SUI is offset by the large negative results of kegels in women with bladder instability (urge incontinence). I also believe teaching women proper whole-body movement makes kegels for SUI irrelevant.

Contracting the pelvic floor is opposite of the movement that creates pelvic organ support. It is a useful and essential movement, which we exercise every time we urinate, defecate, and have intercourse. But it is a movement designed for helping things go out, not keeping things in. Even during sex, women naturally contract on the outstroke.

PT has not been able to explain why kegels are of so little value. Nor why women have prolapse and incontinence while their pf muscle strength tests sky high on the kegel-o-meter. So recently they have described another condition - that of “tightness” and “spasms” of the pelvic diaphragm. Clearly, this is an iatrogenic condition!

Muscles become tight when they are held in constant contraction. The pelvic floor is contracted when the tailbone is tucked under. Posture and lifestyle cause most women to spend their lives in this condition. Surgery often tethers the pelvic floor into permanent contraction. HOW IN THE WORLD CAN ADDITIONAL CONTRACTING OF THE PELVIC DIAPHRAGM BE EXPECTED TO AID SYMPTOMS OF TIGHT AND SPASMING MUSCLES?

We all have the ability to see the logic here. It is not rocket science.

I have been searching for a good model for the illogic of repetitive motion of the pf as “therapy”, other than the scores of women who have experienced worsening symptoms with intense pelvic floor “training”, and have found one - in men!

It seems men suffer from pudendal nerve entrapment much more often than women. And the symptoms can be horrendous - even leading to suicide. The pain in their genitals is extreme and sex becomes impossible. Athletic men are the ones prone to this - particularly baseball catchers. It is thought the repetitive movement of squatting and standing up to catch and throw the ball increases the strength of their pelvic diaphragm to the point that it compresses branches of the pudendal nerve. A full squat tucks the tailbone under and is the equivalent of a kegel.

Dr. Glazer is simply applying one misconceived, but conventional and therefore accepted, technology to an altogether different problem, which in time will be proven just as futile. Vulvodynia is an inflammatory disease that is made better or worse by hormonal status and the cascade of inflammatory molecules flowing from metabolic processes, which are completely controllable through diet and natural medicinals. Breast and ovarian cancer are also inflammatory diseases as are fibroids, arthritis and Alzheimer’s.

It is a serious time for women’s health as we discover that for all these years we have been sleeping with the enemy.

I need to depart the forum for the next several weeks as I work on producing Diet for the Whole Woman DVD. It will contain everything I have discovered about the process of inflammation and will be as important a work as STWW.

Lots of love to you all,

Christine

The pelvic floor relaxes for urination and defecation, but then contracts at the end so we remain relatively “clean”.

Hi ladies,
Tearing can be bad for prolapse that is what i have experienced and learned it here toobut how to avoid it?.
For my first child they gave me a tear (without asking) for my second one they gave me a tear and i got prolapse issue
Now we want third one and i am sure they would give tear again .My question to you is if i maintain my posture before after thd delivery will it help to stop things coming down?
Regards
Champion

Well, that certainly is the whole idea! But no one can predict any individual's results. Every one of us will be better off WITH this posture correction, than we would be without it. So there's really no other sensible way to approach this. - Surviving