I have performed Kegel exercises off and on in the past then I read on “WholeWoman.com“, Christine Kent wrote that Kegel exercises can actually worsen a prolapse and cause further prolapse. I know you and her both prescribe the same posture, but why do you think she says that about Kegels?
I want to make a very strong point. Christine Kent of Whole Woman and I DO NOT agree on posture, Kegels, breathing, muscle activation, and more. The path she prescribes is very specific, which simply does not work for a physical therapist who is always evaluating various treatment paths, depending on the patient’s symptoms, lifestyle, activity level, etc. In other words, I believe it’s important to recognize that there are a lot of different paths available to get to the same point.
To address my approach to Kegel exercises: I believe it is naive to think that Kegels are all one has to do to control incontinence or prolapse symptoms. But, Kegel exercises are certainly a very important piece of the puzzle. An appropriate Kegel sequence, as I teach and as Brianne Grogan at www.pelvichealthplus.com teaches, includes both squeezing the muscles and elevating the muscles. This 2-step process is necessary to activate all of the fibers of the pelvic floor. It is this pelvic floor that is the soft tissue barrier closing off our pelvic outlet. Our pelvic floor lends support to our rectum, vaginal canal, our bladder, our uterus, and urethra. These are not passive muscles…they actively contract in a healthy body and when we lose the ability to contract these muscles efficiently and effectively, we begin to see symptoms of incontinence and/or prolapse. So Kegel exercises are one of the main components of an effective rehabilitation program.
To address my approach to posture: Christine Kent and I strongly disagree on posture. I teach a neutral spine which is a natural, subtle lumbar curve that requires activation of both the multifidi muscles of the low back and the transversus abdominus (lower abdominals). Co-contraction of these two muscles will automatically turn your pelvic floor “on” so that you naturally hold a healthy tone in your pelvic floor throughout your daily activities. This neutral spine position gives a slight lift to your tail bone, putting your pelvic floor muscles at the perfect length/tension to contract efficiently and effectively. I teach posture that requires muscle activation to hold and support our body in its optimal position. This same posture has a positive impact on bone health, breathing, and muscle function throughout our bodies. Christine’s posture instruction puts clients in an extreme position of extension in their low back and asks women to simply let their belly hang out and fall forward. I don’t think there is a physical therapist that would support this instruction and I would be willing to say that every woman adapting this posture will suffer from mechanical low back pain, if not immediately, then down the road at some point.
I hope I have not spoken too strongly, but I definitely wanted to draw a clear line between programs I would refer you to such as www.pelvichealthplus.com and www.prolapsehealth.com, versus others that I would avoid. Let me know of any other questions you have.