Hab-it Exercises Forums Ask Tasha! Menopause- Prolapse for Many Years

This topic contains 3 replies, has 2 voices, and was last updated by  Tasha 7 months, 2 weeks ago.

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  • #75356 Reply

    Jenny

    Hi Tasha,
    This is a little long with background about myself…
    I have been doing mostly the first two workouts for three weeks now. I am 58 years old and have been in menopause for about a year and a half. I have had a cystocele for probably more than 25 years. I am an athlete. I was a runner for over 30 years, I did “Insanity” workouts for 5 years, and I swim competitively.

    I had two vaginal births. The first baby, 29 years ago, was “sunny side up” (face up) and tore me severely through the rectum. With number two, I had involuntary strong contractions before my cervix was dilated (only at three). I had surgery to repair a severe rectocele about 20 years ago and this was successful. Attempts to repair the cystocele at the same time were not successful. Recently, I am using a vaginal suppository and some herbs to support myself in menopause medically.

    Many years ago when I was running, I started to become bothered by the cystocele beginning to protrude during and after my runs. I had found a supportive pant through an internet search (though I now know this particular pant puts too much pressure on the abdomen). I wore this and another “V” support for running and for doing Insanity for many years. I could take the pant off after my run or workout, and although my bladder was very low, and even partially coming out, I really did not feel uncomfortable, so I was happy with this for a long time.

    More recently, especially as I came into menopause, my prolapse started to become more symptomatic. I tried four different styles of pessaries. Initially, the ring with support style seemed to help and I used it off and on. But now, I have problems of one kind or another with all designs I have tried.

    When I found the Hab- it program, I was getting pretty desperate because nothing was working and I had a lot of symptoms. When I started doing the program, I realized, that although I am athletic, I had zero awareness of muscles in that area. I am improving with awareness of the muscles and how they co- fire. I am growing in being able to use posture. I can tell that my vaginal area is stronger than it was previously. I am working hard to strengthen the area and to improve my awareness of habits to support engagement of the right muscles. I realized my previous posture was actually causing harm, as I actually caught myself standing with locked legs and literally bearing down when I was under stress. I am monitoring this now. I am working to engage the multifidi as I move and bend and not hold breath during lifting. I have stopped my harmful exercises but continue to swim.

    I found I still need support in my pelvic floor region or my bladder comes out and feels very uncomfortable. I found a different external garment in an internet search. It helps me “stay in place” inside myself better, and feel better, and I find I can still engage and practice using the muscles while wearing it. It has a minimal design and does not press on the abdomen at all. I get down on my hands and knees and reset my organs with the multifidi lift often. I feel the combination of the support and conscious effort to keep everything engaged and reset might be the best option in my case, since letting the bladder stretch lower will keep causing damage. It seems like this way of doing it may help the tissues be able to heal and rebuild with my bladder still prolapsed but improved to being more inside. Do you agree with this approach in my case (with the damage having been over such a long period of time?)

    Once question about the TA exercise on hands in knees in the first video. I have trouble sometimes feeling my pelvic floor move when I try to engage the TA in this position (I can feel it in other positions though). WHen doing this exercise, should the multifidi co contract?

    I’m sure I’ll have more specific questions soon. I find that sensations I had when I first started exercising are changing, and this is good! My internal vaginal wall feels stronger and more toned and that changes the feedback I get when I do the exercises. I may have been relying on incorrect feedback instead of truly feeling the right muscles. I will stay with it until I’m sure I’m getting it right.

    Would love to start doing the cardio and interval routines you have. Waiting a little until I’m sure. Right now Swimming is my cardio!

    Would appreciate your input. SO thankful I found this program. Thank you.

    Questions:
    I

    #75531 Reply

    Tasha
    Keymaster

    Yes, the multifdi has to co-contract in hands and knees TA lift in order to keep us in neutral spine, otherwise we will flex our lumbar spine, which is not what we are working for.

    Similarly when working the seated adductor squeeze, feel the multifidi co-contract with adductors, pelvic floor and TA. You are beginning to see, even if it is a subtle isometric contraction for stability, all of these muscles have to work together for a efficient, effective pelvic support system.

    Everything you said is spot on – I love your body awareness. And yes, if your cystocele is beyond the opening at times, getting on your stomach or hands and knees for multifidi lifts to “re-set” is the right choice as often as needed! The more consistently your bladder is held in an elevated position, the more of an opportunity for our supportive connective tissue (like a spider web) will be laid down in a supportive position under your bladder.

    Hope that all makes sense!

    tasha

    #76198 Reply

    Jenny

    Hi Tasha,
    I can now really feel the engagement of the TA with the pelvic floor in the hands and knees exercise and seated adductor squeeze while feeling the engagement of the multifidi as the tailbone area lifts. For the first time, I can also feel this same set of muscle groups in posture practice throughout the day, and now I’m sure I feel the right thing.
    Because my bladder has been low for such a long time (and comes through the introitus partially), I have not yet been able to keep “inside myself”while standing, however, sometimes I can for short periods. Also, now while seated, I can feel the correct muscles engage and keep my “basket” elevated and my bladder within myself. I have been working the muscles while seated a lot, since I can be successful with this.
    I have some pessaries, but am not using them. They DO interfere with the muscle firing, now that I am aware of what I should be feeling. And also, I feel they would keep muscles and ligaments stretched out, when my goal is for those to become more toned and for the tissue web to fill in to support my bladder. TO help keep myself from coming down excessively during the day, I use an external support garment that helps me “stay in” as much as possible, however, I am focusing on engaging the TA and Multifidi with the pelvic floor throughout the day, as opposed to relying on the external support, even though I am wearing it. I can feel the muscle engagement lift that area off of the support garment, however, I cannot yet from standing lift my prolapse back inside or keep it inside most of the time.

    I have noticed that when I bend forward slightly with legs bent, I can contract all of the target muscle groups for the pelvic basket, and reset my bladder. It slides back up and in when I do this. I feel it moves higher up as I contract my glutes and deep hip rotators, showing how these muscles interconnect with tissue webs in the area to support the bladder. However, since I can’t yet retain the bladder from slipping back down through the introitus, I immediately come back out after the reset. Sometimes I try to contract the adductors and glutes to hold myself in while standing a little longer. SO it’s lots of UP and DOWN right now while standing, but, better than just down without any muscle control. I notice much better muscle tone within the vagina. I do feel I’m gaining some control, but have more healing to do, which may take time since the ligaments and tissues have been stretched down so low for so long. IN your opinion, is it good to keep trying to engage and reset as I have been doing? Isn’t up and down (multiple times per day) better than just down?

    Some specific exercise questions:
    (1)ON the clams and leg lifts. I am able to feel the glutes and deep hip rotators. I am wondering if I should also be thinking of specific co contractions with the pelvic floor and TA on these moves. I do feel that there is a “back to front” feeling engagement of the pelvic floor as I squeeze the glute and do the hold at the top of the leg lift. I try to keep my TA engaged.
    (2) ON the bridge with adductor squeeze, I am not sure if I am somehow engaging my RA instead of the TA on that. I have a hard time feeling the pelvic floor contraction while actually in the bridge, but if I contract the pelvic floor before bridging, I feel I may be engaging the pelvic floor and TA better. Ideas about this- what to watch for?

    SO far I’ve just focused on workout one and two, since my prolapse comes out. Sitting and lying down lets me exercise with it inside. PLus, I would say, it has just been about the last two weeks or so that I am sure I am doing these moves correctly, and really getting the best benefit. However, I would like to think about what might be good timing for me to do more strength training ( I formerly was doing Insanity regularly, and I am still swimming). Considering doing more standing and some of your strength and advanced exercises (and would probably need to wear my external support for that). I would keep working the lying down and sitting exercises to strengthen the pelvic basket, but wonder how I can work on my overall strength without causing harm?

    Thanks for your support. This program has been so helpful.
    Jenny

    #76631 Reply

    Tasha
    Keymaster

    Yes! Reset often. The position you describe with your knees slightly bent and a forward hip hinge is perfect. You can take this one step further and lift your arms up, focusing on your shoulder blades pulling “down and in” while you are in this hip hinge position with your chest up. Then work small knee bends and coming back up to almost straighten your knees. This will be quite a hamstring stretch, but the work to keep your tailbone lifted and chest up will really pull all anterior connective tissue up. Do 8-10 small knee bends/straightens and move on with your day.

    1) Keeping the TA engaged is the perfect focus!
    2) On the bridge with adductor squeeze, when you press your hips up into a bridge, you should see your rib arch as your belly pulls in toward your spine with a TA contraction up and in and gravity helping a bit too. Be sure there is no short breath hold once you add in the adductor squeeze. This exercise should give a strong lift to your pelvic floor because of the muscles involved AND because gravity helps too.

    I like that you are looking to progress to more intense exercise but I worry about some of your old firing patterns jumping back in. Right now you are setting the correct firing patterns – these have to be carried on throughout your day with your breath and neutral spine posture. Stay patient and conssistent x another 2 weeks, and work to progress to workout 3 before we start thinking of adding in any Advanced Exercise Program.

    Tasha

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