Correct Activities for Pelvic Organs and Nerves?

Submitted by mom.of.three on June 23, 2011 - 4:42pm
Body: 

I am new to the idea of a forum, but I have several questions involving exercises and the whole woman workout...
First, I should share (more than) a little background information. I have always been a very physically active woman. Some time back, I recall my doctor telling me I had a tilted uterus. Since my mother said her uterus was also tilted, I never put much thought into it, elevating my thighs with pillows if I had some discomfort. But, about 2 years ago, I realized that I had some sort of prolapse. I did a little self educating and was planning to make an appointment with my family doctor about ways to correct it during the summer,

as I am a teacher. Before I made the appointment, something in my body went wrong, starting with what seemed to be pulled muscle(s) in my lower back. The following day, my left leg and foot experienced tingling, numbness, then excruciating pain. I saw a physician's assistant at a minor-med facility and was diagnosed with a pulled, swollen muscle, pushing on a nerve, and sent home with pain medication. I woke up with no feeling in my leg, falling to the floor with no muscle control in that knee and thigh. I saw my family doctor who ordered an MRI on my lumbar spine. There was no sign of nerve root damage, though there was a slight disc bulge in the lumbar spine that is not unusual for someone my age - 51 at the time. I convinced him to keep me out of the hospital and to let me experience the last day of school with my students with my word that I would use a wheelchair and go to the ER if things worsened. For 3 days, my leg had no feeling and I could barely move it to get into the car, but I could move it to the right or left, but not huge amounts. I had to use my hands to lift it, pulling it up at my ankle or under my thigh to get into the car. It was also on that 3rd day of numbness, I saw my doctor again, who was stumped, with a stat order to see a neurologist. We were able to make an appointment with a neurologist for the following day, who examined me and ordered more testing. During one of his office tests, I saw a strange reaction from him when I could not lift my leg while lying on my back. I was elated when I had feeling and felt pain later that day. Again, no tests (MRI's, Spinal w/ Contrast, Pelvis CT and a Bone Scan) indicated nerve root damage in my spine or a growth impairing the nerve.
A friend suggested that I have a massage, as a series of massages helped relieve sciatic nerve pain for her. I was able to see a massage therapist who is an RN and who tried to educate me about muscles, nerves, and the female anatomy. Luckily, my daughter, who is also an RN was with me. It was during the massage, when she locating my discomforts, that the therapist questioned about any difficult pregnancies or births, that my daughter brought up the idea that I was going to investigate options for a prolapsed uterus. (My neurologist said that had nothing to do with my leg nerve.) The therapist, who at one time worked in labor and delivery, talked at length about muscles and organs in the pelvis, suggesting that I see a gynecologist about a pessary. She said 95@% of the people have anatomies by the book, but 5% have bodies that work right, but are not in the same as the 95%. My femoral nerve might have taken a detour?!? My family doctor was gone and I was discouraged that my phone conversation with his nurse did not support this theory or refer me to a gynecologist. My neurologist sustained the injury was in my lumbar spine. I pursued on my own, finally finding a doctor in another town that could see me in two weeks, the shortest amount of time I could get. A week after my initial exam with the gynecologist, I left her office with a pessary in place, Within half an hour, I had different sensations in my leg. Within 3 hours, I was able to move my left leg in ways that I couldn't before, and that evening, I was on my back and my left leg could raise over 6 inches from the floor. Within 2 days, I could raise it over 18 inches!
So, with my limited education in anatomy, I have concluded that my prolapse is some-how related to my femoral nerve damage. My new neurologist is not convinced that the two are related, though no tests or MRIs she has ordered have concluded a cause. She is happy with the progress I am making.
I have completed 7 months of physical therapy helping me regain strength and mobility in my leg. I have been doing the stretches and exercises given to me at home.
My last set of PT sessions included an exam and exercises from a PT who specializes in helping women with incontinence issues. (I didn't think of my issues involving incontinence - just a little dribble now and then.) She also discussed muscle structures explaining the purposes of the exercises and how they should help my tilted, prolapsed uterus. Two of those exercises include variations of Kegals.
- I am not sure if they are counter-productive to the Whole Woman Posture and Workout. This is my first concern...
- I do this in bed after emptying my bladder.
Lie on my back with 2 pillows perpendicular (To my spine) and a third pillow on top, under my bottom (bum?) and lower spine (to be similar to the wedge that was used at PT), knees bent, feet on the bed, to support my back . Tuck, my abdomen towards my back, titling my pelvis. Place a small pillow between my knees and squeeze my knees together (against the small pillow) for a count of 10 while kegaling to that count of 10. I don't keep count of my repetitions, but I have worked up to repeating for over 5 minutes.
- Another exercise that I do, but not as often...
stand up straight, use the back of a chair or counter for stability, bend at the knees, lower my bottom like doing a plie' and keegal at the same time.

- Do I continue these exercises, or is there a way I should vary them?

- I have read most of part one of the book and several sections in the 2nd part. I have watched the DVD completely, reviewing several chapters/sections. I am getting an education, but I am unsure about the kegals. Something has been helping me, I thought they were a part of my progress.
- I was able to complete the beginner's workout last night, though it was difficult for me to be comfortable sitting on the souls of my feet completing the spinal stretch. The discomfort was in my thigh (quads) and knee... a pressure. My thoughts are that my discomfort has to do with my nerve injury and maybe limited muscle strength in my thigh and upper knee. My plan is to come up with a variation until I can complete it successfully. My thoughts...
- stretch my quads before putting pressure on my thigh.
- try a pillow between my tush (bum?) and feet.

I feel very good about educating myself. I am really wanting to "Be me again" and enjoy an active lifestyle. I realize that I have more than one issue going on, and I am hoping to fix them. (Or to get to a point that I can live with them.) Oftentimes, when my bladder is full, I feel pressure in my pelvis and in my leg. My leg begins to tingle and feel weird pings. (Again, it makes me think that there is a nerve that took a detour in my pelvis and something is bumping or rubbing against it.) The doctors don't have an explanation. I don't know if my symptoms are from something that is on-going or if my symptoms are remnants of an injury from May. I am improving! I am not where I want to be and I am hoping that using my education and experiences from the Whole Woman will help rectify things.
2 weeks ago, I went to my gynecologist wanting a vaginal hysterectomy. Though my gynecologist is not convinced that this surgery is the answer, she understands why I am connecting my prolapse to my nerve damage. No doctor has an explanation. She has suggested that I hold off and continue to educate myself... Now, I understand that my uterus is more than just a place where my beautiful babies developed and it is still a useful organ. I don't want a hysterectomy and more problems!
I am hoping that by using WWPosture and complete the workouts, my uterus and most likely bladder will go into the correct position and rest against my pelvic bone. Am I understanding that correctly?
- Does the pessary keep that from happening?
- I am confused about what I have read about a pessary and what I thought I understood from my gynecologist. I was thinking that may gynecologist said that the pessary was using the pelvic bone as a shelf like it was supposed to. What am I misunderstanding?
- Does the WW Posture and Workout correct a tilted uterus?
- I am also hoping that the movement of the organs will remedy any pressure on my nerve if something indeed is putting pressure on it.
I read in forums last night about two women who had experienced what was referred to as "Dead Leg" after a vaginal birth. It seems that explanations referred to a spinal that deadened the nerve...but could it have been a pelvic organ putting pressure on a nerve that detoured the normal anatomy route? Could these two women and me be part of the 5% of women that have nerves that detour the routes that are the norm?
When I transferred to my new neurologist, as I was explaining my situation to her, she asked me if I had a hysterectomy. She said something like she had seen patients with similar symptoms to mine with women following a hysterectomy, but not before. That's a concern...is there a correlation? Does it have to do with spinals, the length of their surgeries, or the routes their nerves take?
I wonder if there are more people like me that have had this very unusual situation, and because it is so rare, they, too, get no explanation. Did they get relief and how?
- I am hoping that the Whole Woman Posture is the solution and that I have the patience to let it work for me.
- I am hoping that I am doing things correctly.

If there is anyone who can relate to these questions and issues and can help me understand, bless you. I am happy to see so many women have been helped. Thank you for the knowledge. Thank you for the hope.

Christine

June 23, 2011 - 8:32pm

Hi Mom,

You might begin by taking a look at this thread on the genitofemoral nerve and prolapse. I think your instincts are good and the possibility exists that the prolapse aggravated and inflamed that nerve. I’m less inclined to believe it is an inherited anomaly that suddenly erupted three births and 51 years later - but rather a chronic degeneration that is likely postural in nature.

If this is indeed the case, it is uterine anteversion that is needed to un-hinder the round ligament/genitofemoral nerve/inguinal canal complex. The pessary demonstrates that beautifully. If anteversion is the cure, lying on your back doing kegels is not conducive to that end. Plies in WW posture make much more sense. I don’t want to argue with your success, so must ask you to use your own awareness to try to understand what is helping and what is not. Yes, when sitting on the soles of your feet, place a pillow under your tush rather than stretching your quads to the point of pain.

The uterus and bladder are actually above the pubic bones in normal anatomy (we often say they rest on the true bony pelvic floor). The gynecologic view is that the pessary sits horizontally on the pubic “shelf” parallel with the pelvic “floor”. However, you will likely gain the awareness that the pessary actually sits vertically atop the pubic bones, pushing the bladder and uterus forward in the process. If the pessary is comfortable, it shouldn’t interfere with your progress. However, I’m not sure that is true over the long run. Over time it might be good to see if you can obtain the same level of result without the pessary. Yes, a tilted uterus is the first stage of prolapse and the WW work aims at completely anteverting (un-tilting) the uterus.

Hysterectomy destroys and distorts much of the anatomy of the pelvis, resulting in significant nerve damage in a huge percentage of that population. Spinal anesthesia can also have far-reaching effects. I wouldn’t assume these women had anatomical anomalies before their procedures.

Bringing the body back to natural posture resolves so very many irregularities. I, too, hope you are able to gain positive results with this work.

Wishing you well,

Christine

mom.of.three

June 24, 2011 - 8:54am

Christine,
Thank you! I am filled with lots of positive emotion right now! I am so thankful to have hope to my situation and I thank you for all of this information and especially the support!
I will do the exercises without the kegals. I feel good about that.
Another question...is elevating my pelvis while on my back for 5 - 10 minutes counter productive or helpful? I was thinking that I will continue squeezing a small pillow between my knees for my inner thighs unless this would put pressure on my abdomen. Maybe that is why the PT had me elevate with the wedge (pillows at home)...to lesson pressure on my abdomen pushing on my uterus? (The pillow I squeeze between my knees is really one of those memory foam contour pillows that's about 9 inches. There's a flex...not too firm. I liked it better than the baby soccer ball that we have...very little flex. At PT, I used a small soft ball that had a lot of flex.) My thought is to continue this exercise without the kegals.
My plan is to for sure continue the WW beginners routine until I feel ready to progress at the 2nd level.
Also think posture. (It is hard to think, "Don't pull my belly in." - Am I thinking right?)
We are talking about many years of poor posture and bad habits...and I understand that every person is different...but when do most women feel that a change in the prolapse is being made? Is it gradual or an "Aah-ha moment?"
Again, I thank you! I hope that you understand how grateful I feel right now! You are blessing!
Mom of Three (Beautiful Children)

louiseds

June 26, 2011 - 3:46am

I just googled 'genitofemoral nerve neuropathy' and got 18400 hits. Take a look. I have previously been interested in pudendal nerve neuropathy, so I figured ...

It seems that because this muscle threads itself through the middle of the psoas muscle it is prone to being squashed, and no doubt stretched, as well in some postures, in the same way as the pudendal nerve.

Louise

mom.of.three

June 27, 2011 - 10:17am

Louise,
Thank you so much! I have read about 10 of them so far...so much information...it is hard for my brain to digest. It makes so much sense ...and I have to figure out what to do with this information.
So I'm figuring if there is pressure on this nerve, it travels to the femoral nerve and affects the parts of my leg? Pushing the uterus up with a pessary takes that pressure away? But the uterus needs to move in a place to support itself, so the pressure will stay away. I hope I am understanding this correctly.
I am thinking, "Sit up straight, be sure the lower back is pushing forward...head up...shoulders down...breath inhaling is expanding my belly"...Am I doing it right? Will that make it go away? Do I do more?
But at the same time...
I am so full of a good feeling...thank you! I am so grateful to your help...to Christine's help...Thank you!
I will go back to reading some more...And print some diagrams to really look at and maybe understand better.
And do the workout!
Thank you...Your and Christine's help means so much to me!
Mom of Three (Beauiuful Children)

louiseds

June 27, 2011 - 7:37pm

Hi Mom.of.three

With pudendal nerve entrapment it is thought that the stretching of the nerve is the problem, not so much the squashing of it. I see no reason why the femorogenital nerve should be any different. Pudendal nerve entrapment is most common in women who have had hysterectomy, and whose remaining pelvic structures are therefore suspended in artificial configurations, and there are also permanent sutures in there holding the vaginal vault and bladder in place, so these are in tension, and therefore solid structures where there would normally be bags of jello. I know a woman who had hysterectomy as a result of POP, and now has this dreadful pudendal nerve entrapment, which leaves her in permanent pain. There are many women in her situation and the medical fraternity are only now developing therapies and surgeries to block the pain and alleviate the entrapment. It is hell for these women.

Wholewoman posture will move your pelvic organs forward and up to their correct anatomical positions, where they are supported on firm bone, rather than hanging in mid-pelvic cavity by their connective tissue, nerves and blood vessels. In addition, the lumbar spine, the source of these nerves, will be diagonal, rather than trying to stand up vertical, so it will be lower. The two factors could very well be the key to your healing. Many nerve problems take quite a while to heal, and for their inflammation to resolve, so don't expect results in the pain department for many months while the nerves settle down. You may get lucky.

We think of the posture as being based on a raised chest. Your head should be not strained up. It is more like hanging from a string fastened to the crown of your hair, rather than the fontanelle, so it keeps your neck tall and your chin slightly tucked. Your upper spine will be straighter than normal, not like an Olympic swimmer. Your shoulders should be relaxed, and they will relax forward slightly, not be held back.

The raised chest puts your rectus abdominus muscles into slight tension and puts the right curve in your lumbar spine. Of course this will create slight tension in many other muscles in your upper body, which are often slack, so it may take a while until you do it intuitively. this is why there is a lot of lifted arms and 'wing flapping' in WW exercises to strengthen them. Women are not renowned for being strong in the upper body, but we need to be strong in the upper body so we can nurture, gather and do our daily activities without slouching. Keeping your knees slightly flexed will help to keep your lumbar curve in place. Locked knees make it too easy to tuck your butt and tip everything backwards again. Bend forwards from the hip joints to keep your pelvis stable. Mini-skirts are now dusters because your body needs to be able to stick your butt right out to keep your centre of gravity stable when bending over.

I don't know how the pessary will affect this nerve bundle. It depends where it sits. It has to push some structures sideways, but I am not sure how that affects the path the nerve has to take. My guess is that once that nerve is no longer stretched it won't be so prone to other irritation.

Of course you have to realise that I am not a doctor. All my anatomy is self-taught, but you can learn just as much as I have with the aid of a couple of good anatomy books, a model skeleton and the Net. It is all about loads, fulcrums, centre of gravity, and pure mechanics. It is also about understanding what happens to the pelvic region in any position and ensuring that your own understanding of one situation can reconcile itself in the other positions we can use our body in.

Posture is not so much a way of standing, but ways of using your body parts in relation to each other while doing what you do during the day. WW posture principles can be used in any position. Check out Christine's YouTube videos. Wholewomaninc is the channel.

Louise

mom.of.three

June 27, 2011 - 9:19pm

Louise,
Thank you again! So much information! I think I will print the third paragraph and place it by/on my mirrors...I have never looked at myself so often...to see if I am standing,walking correctly. Not admiring...though one of these times I'mm going to say..."Hey...I,m doing it without thinking!" Then, I shall be happy with myself!
I also will take a peek at you tube. I am not very computer savy...but my 16 year old can help!
Sometimes I also wonder if that pessary is bothering things...so last night I took it out and kept it out through many sitting hours this morning...but there was a discomfort in my leg...so I quit being so adventuresome. The heaviness while walking and most of the tingles in my leg went away within 45 minutes...maybe less after I replaced it. I'll try again in 2 more weeks...
Again...thank you. I read quite a lot this afternoon...and will more tomorrow! I really appreciate the information...and especially the support. There are no words that express my appreciation...WOW! That's a very short but powerful word and,yet, not enough. Thank You so much! I wish you many smiles! (You sure have helped me have some.)
Thank You and Wishing you Smiles,
Mom of Three (Beautiful Children)

Daphne11

February 21, 2013 - 9:04pm

Wow, Christine, I am so happy that you responded to this issue.
Thank you,
Daphne11

osmari

February 21, 2013 - 10:08pm

You thanked Christine and I am also thanking you because reading your post encouraged me to read all the posts above yours. WOW, a mystery has been solved for me. After my pessary was inserted the first time, I noticed a tingling on and off pain in my upper left leg. I mentioned it to the gyno at the next visit....she seemed to think it had nothing to do with the pessary. But every once in a while after the pessary was removed for cleaning and then reinserted, the same thing would happen. So now I know there likely was a connection. I wonder how mom.of.three is doing? I hope things turned out well for her. I am learning so much on this website!

solita

February 21, 2013 - 10:12pm

Reading this very informative post, It has made me think that I must have a inflammation on a nerve because my right leg its colder than my left leg ( I do not have prolapse) I will keep walking with WW posture and hope it will help to get the temperature of my leg back to normal.
Have a good weekend.
Solita

louiseds

February 22, 2013 - 4:24am

Hi Solita

The cooler leg might also be because the circulation is not as good in that leg, rather than a nerve sensation problem.

louiseds

February 22, 2013 - 4:35am

Hi Momofthree

A ring pessary will stretch the vagina to be bigger sideways, at the point where it sits. This means that the tissues that are made wider must also reduce in length. This might take up some slack tissue but it might also prevent the vagina from lengthening sufficiently to allow the uterus to move far enough forward, ie the pessary may be preventing the organs from repositioning themselves on the lower abdominal wall. So, when you remove it, the organs simply slip down, and stretch their nerves, which leads to pain.

After you remove the pessary, perhaps you could try doing some firebreathing on knees and elbows for a bit, to allow your tissues to come deep inside you and stretch out your vagina for a while before you stand up and get on with your activities. Give them all a bit of a jiggle and they might just go back to where they belong. It would be great if you would try this and report back if it worked, even momentarily.

When you stand up, I suggest that you finish your firebreathing after an inhalation, so your belly is big when you stand up. This will stop you from pulling it in as you stand up.

Louise :-)

osmari

February 22, 2013 - 8:46am

I can't thank you enough for the explanation of the stretch! You know, I often wondered if that big thing stretched something inside! Now I know.

My philosophy is that "out of everything bad comes some good"....I am reminded each time I come on this site....how out of each of our bad experience with prolapse, we are able to help each other by sharing our knowledge. Of course, Christine gets the BIGGEST thanks since she is our pessary guru! :)

I have tried firebreathing a few times, but since I don't have the DVDs yet, I am not sure if I am doing it correctly but you are right, I think my bulge went in but once I stood up everything was down again. Thanks for the info in the last paragraph. You are a well respected gem!

I also read your post on lubricants. You might have read that I have not had a pessary in since December and am supposed to be fitted for a cube after my insides heal from the damage. (I am still wondering what to do about that.)
I want to be totally sure, before I put any lubricant on so I have to ask again: Do I put it right on the part that hangs down? I am actually frightened in case I have a reaction since in the past I have had allergy problems; but, I don't want the parts to dry out either!! Right now, I am pain free but often uncomfortable with the weight of the bulge hanging....with the tampon in now and then, I am more comfortable.

Once again, many, many thanks for all the much appreciated education.

solita

February 22, 2013 - 11:29am

I will have to go to my GP and find out what is the reason, the cold weather this Winter has kept me inside the house.
Thank you again for your help.
Solita

louiseds

February 24, 2013 - 8:28am

Hi Osmari

Allergy is a systemic thing. It comes via your immune system, so if you use something that you are allergic to, on a sensitive bit of skin, it should cause irritation. Not always the case though. And vulval and vaginal tissue is not exactly the same as skin. Sensitivity is not quite the same.

I would try using a little bit of any lubricant first, before using a lot, and I would only use it in one spot first. Try inside your elbow first. Then try it on your vulva, then on the bits sticking out, then the whole vulva and vagina If you have a reaction it will only be in a small area, rather than all of your vagina and vulva. Yes, I would put it on the parts that hang down. Then when you get into firebreathing posture straight afterwards, your lubricated bits will all slide back in easily and take the lubricant in with them.

osmari

February 24, 2013 - 12:07pm

I always appreciate your replies. It did occur to me to try olive oil on one spot first but I did not figure out where since I was worried about a reaction... SO you gave me great ideas. Many thanks.
Now I just have to buy some as the olive oil I have has been around for quite a while since I don't use much oil in cooking.