Hab-it Exercises Forums Ask Tasha! Questions on Hab-it program, and fear making cystocele worst

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  • #54642
    Laura
    Guest

    Hello Tasha,

    First of all, thanks so much for your work, for sharing your knowledge to help women to better understand their bodies and be aware of the ressources they do have to improve their health.

    I had my first baby 8 months ago, and one month after I started feeling a heaviness and ‘something’ (like a misplaced tampon) in my vagina. I have been diagnosed with first degree cystocele (well, I saw different health professionals and their opinions ranged from I have nothing, to mild cystocele, to 2nd degree cystocele+1st degree rectocele… It surprises me it can be so subjective!).

    Since then I’m doing (almost) daily Kegel exercises and hypopressive abdominals, prescribed by a pelvic floor PT I worked with for two months in Spain (where I’m from). I do feel better, and more confident and positive, but I’m still not recovered: I feel kind of frail (I don’t dare to run even to catch the bus), I get more easily tired, and I still feel the prolapse most of the days.

    So I would like to add some prolapse-safe exercises to my routine to get my core stronger and hopefully become my past self again. Your Hab-it Pelvic Floor Exercise program seems great for that but I’d have some questions:

    – Is it adequate for me if I already worked with a PT on doing Kegels and hypopressive abs?

    – If so, is there any contraindication in keep doing my routine together with the Hab-it program (overcharging my transverse abdomini or my pelvic floor)?

    – Right now I’m on a pretty long (three months) trip with my partner and our baby. I try to not push myself too much but still my level of activity is quite high (hiking, sometimes biking, visiting, driving…). Sometimes I feel mild pain in my pubic muscles, which I guess is an alert to take it easier. Appart from this discomfort, can my prolapse actually get worst because of this level of activity? Should I better wait to start your program when I get back home? (From my side I want to start asap, but not if this will be contraproductive!)

    – I’m still breastfeeding my baby. I heard this causes my muscles to be weaker than usual. Is that true? If so, am I right now in a higher risk of my prolapse getting worst?

    As you can see, I’m a little worried not doing anything that might make my condition worst… Any clarification you can provide will be most welcome.

    Thanks very much!

    Laura

    #55087
    Tasha
    Keymaster

    Laura,
    I like the hypopressives, but I will encourage you to stop your Kegels for a moment. Lets begin work with the Hab It workouts, but skip the Kegels. You have already established the co-contraction of your TA and pelvic floor muscles with the hypopressives – now you need to ensure that you have a solid anchor (tailbone) with multifidi activation and solid hip rotators and hip adductors.

    You need to shore up the rest of your pelvic basket – not just the floor and front of the basket.

    The only thing you can do wrong at this point is to over work your pelvic floor and send yourself into a hypertonic muscle spasms. Read through my Posture section within the Educate Yourself section and begin to put this all together. You will begin to feel strong and secure again.

    You have a great start – you just need to round it out. Read through more information within the Educate Yourself sectin for a deeper understanding of your entire pelvic basket!

    tasha

    #55240

    Hi Tasha,

    Thanks for your encouraging answer! I purchased the video and I’m looking forward to start it : )

    To make sure I understand you well, do you think the pain I feel sometimes in my pelvic muscles can be due to an hypertone of them, or hipertonicy could be a consequence if I continue hypopressives + Kegel+ Hab-it?

    Finally, I found some entries on Ask Tasha about breastfeeding and apparently it does causes muscles to be weaker. In that case, am I at risk of make my prolapse permanently worst if in a situation of pressure on my pelvic floor..? I ask because I wanted to breastfeed my baby until one year, but could consider stopping earlier if it’s putting at risk my recovery.

    Thanks again!

    Laura

    #55989
    Tasha
    Keymaster

    Laura,
    Working Kegels without consistent relaxation to be sure the muscles are letting go can lead to hypertone or pelvic floor muscle spasms – and yes this can cause the pain you feel. I encourage you to continue Hab It and the Hypopressives but also start to focus on your posture, chest up, tail bone lifted. With this change of focus you should note improved sympstoms and increased strength within 3-4 weeks.

    An yes, with breastfeeding your estrogen levels remain lower and therefore your tissues a bit more lax. You can expect a mild improvement in your pelvic floor tone after cessation of breastfeeding. Please do not stop. Just follow up with good habits, good posture, and consistent exercise. When you are done breastfeeding you may or may not notice an improvement in your symptoms. It is not dramatic, so the benefits of you breastfeeding far are out-weight the negatives!

    tasha

    #56061
    Laura
    Guest

    Thanks again for your answer Tasha! The posture part is probably the most difficult for me since it’s about doing if all day.. For the moment, I have teached my partner the main points of good posture for him to remind me when I forget myself, which is often : )

    #56389
    Tasha
    Keymaster

    Remember, posture during your day is more about positioning than contracting any muscle. Ask yourself , where is my tailbone? Are my knees locked, is my chest up???

    Tasha

    #57339
    Laura
    Guest

    Hi Tasha,

    I wanted to give you some update after a couple of weeks stopping Kegels and doing Hab-it on alternate days, as I continue with the hypopressives (though some days I manage to do both, a workout and 15min hypopressives).

    After I stopped doing Kegels, I felt no more pain for a while (maybe a week) but since the last ten days more or less, I feel pain again. It’s on the pubic crests area when walking, and also as if I had an irritation on the sides of my vaginal opening. And often, even when I’m lying down, I feel as if my pelvic area is tense. Since stopping Kegels, I also note a sensation of fullness in my rectum many times, even if I evacuate almost daily.

    So I’m no longer sure if stopping Kegels is good for me or not. I must say also that I’m a little obsessed with this issue and I may be more sensitive to the whole area than usual… I know you can’t give me any diagnose without seeing me, but:

    – any idea why I could be feeling pain again and the fullness sensation in rectum?

    – And what would be your recommendation about Kegels in the future, like, once pain disappears should I start again with 8-10 per day? Or if I continue with hypopressives/Hab-it that should be enough?

    On the other hand, I’ve been trying to be aware of my posture (and correct it!) during the day and I keep unlocking my knees, opening my shoulders and untucking my tailbone. But, of course, some more questions : )

    – How to hold neutral spine while lying on my back? I used to think I had to have my back flat against the ground but I realize this means tucking my tailbone. Is it ok then to leave a curve between my tailbone and my upperback (more or less where my bra strip is)? I can easily fit my hand under this curve, but not my arm.

    – At the end of the day, I feel kind of a stretching pain in my lower back. Is this a good sign because it means my multifidi are working, or on the contrary, I’m doing something wrong?

    Bonus question: What do you think of the wheel pose in yoga? I really like it and used to do it before my pregnancy but haven’t done it in a long while out of fear of making things worse.

    Thanks very much!

    Laura

    #57939
    Tasha
    Keymaster

    Laura,
    Every symptom of pain and rectal fullness that you describe is a sign of hypertone in your pelvic floor muscles. It’s quite possible that it improved when you stopped doing Kegels, but if in your posture work you are contracting your pelvic floor all day long – it could have put you right back to the muscle spasms again. Posture is difficult to master – it is positioning, but not strong muscle contractions – your description of your low back being tight is a sign that you may be over contracting your low back extensors, taking your posture almost to a gymnast posture, insted of just being sure there is a gentle lift of your tail bone.

    Let me direct you to my Educate Yourself section to read the Pelvic Floor Muscle Spasms topic. Within those entries, I refer to Maximizing Blood Flow to your pelvic and reference another Women’s Health Physical Therapist, Brianne Grogan’s relaxation program. This may be great for you! Also, while you are on that section of this site, also read through all the entries on Posture to help yourself find that happy medium 🙂

    As for your other question – No don’t go back to Kegels. I would rather see your TA and your glute strength improve! And having a gentle lumbar curve that you can put your hand under when laying on your back is perfect!

    tasha

    #58291
    Laura
    Guest

    Hello Tasha,

    Again thanks for your answer!

    I could finally see a pelvic floor PT yesterday and she confirms I’m very tense on my pelvic floor : (
    That’s probably because I’m so aware of the prolapse constantly and trying not to make it worst, that I’m unconsciously contracting my pelvic floor all the time. Also, it turns out that all these months, while doing hypopressives and other exercises, I was firing my obliques instead of my transverse, actually pushing down instead of lifting. I’m a little discouraged with these infos but better knowing it now than later.

    So what she recommends is to get back to the basics, re-train the connection between my pelvic floor and my transverse (which I’m unable to identify right now) and get rid of the habit of firing my obliques whenever I cough, lift weight, etc… Instead, I should do ‘the Knack’, a simple contraction of my pelvic floor before these efforts. She has also re-taught me hypopressives focusing as of now on thoracic breathing and lengthening my spine.

    The good news is that after stopping the hypopressives I’m no longer feeling pain. At least I have that : )

    Well I’ll try to be patient and focus in these basic things. I hope to give a more positive update next time.

    Thanks!

    Laura

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