I was just working with a patient, coaching her on posture, and found myself explaining how the multifidi and transversus abdominus muscles fight against one another. Our conversation went something like this:

She asked, “So you want me to exaggerate the curve of my lower back?”

I said: “That is just the first step. I don’t want you to stay there or you’ll come back to see me for low back pain! So if we take it in steps, Step 1 is to stick your buns out so that you are standing in a gymnast posture. Step 2 is to draw your belly button up and in, cinching up your midsection. If you watch in the mirror as you’re doing this you can see how pulling your belly button up and in draws you out of this extreme position and softens your lumbar curve by rocking your pelvis back ever so slightly. This natural, soft lumbar curve is your neutral spine and where you want to be.”

She said, “Am I supposed to stand like this all the time?”

I said, “Yes, but it’s not easy. Good posture requires your muscles to work. The positive side of this is that holding good posture burns calories throughout your day. The challenge is snapping yourself out of the bad habits of locking your knees back or tucking your buns under. As you train yourself to hold neutral spine throughout your day, you will have to set reminders or cues that will trigger you to check your knees, your hips, and your belly button.”

She asked, “Why do I feel a tightness in my low back?”

I replied, “Because you are working muscles that you don’t typically have engaged. This is good. Your multifidi muscles of your low back are working to give you an arch in your low back and your transversus abdominus muscle which draws your belly up and in like a corset, also attaches back there. These two muscles are fighting each other, the first wanting to arch your back and the second holding on tight so you don’t over do it!”

Published by Tasha

9 Comments

  1. What is, if any, difference in your neutral posture compared to Katy Bowman’s “Aligned and Well” posture? It seems the same to me and I use her Dvd and yours both and just wanted your opinion.
    Thanks, I am noticing huge differences in my hip pain and hoping eventually to help my prolapse.

    Reply
  2. You know, Katy Bowman and I teach alot of the same things, we just place a different priority on different exercises. Our posture is the same, except she emphasizes activating your glutes and I emphasize the little muscles, the multifidi, first to extend your spine.
    We both agree that we need more extension of our spine for a healthy pelvic floor and this occurs with both multifidi and glute strengthening.

    I like her squat exercises, but many women can’t get down that low, so the glute exercises I have in each of my workouts are easier on the knees. You’ll find glute strengthening throughout my dvd.

    A key difference between Katy and I is that I teach pelvic floor strengthening as a key piece of the the puzzle in achieving optimal pelvic basket strength. More specifically the coordination of the transversus abdominus with the pelvic floor muscles. Katy, on the other hand, downplays the importance of Kegels.

    Outside of that, I like her work alot. Kudos to you for using us both!

    -tasha

    Reply
  3. Thanks so much for clearing that up for me. It is fascinating how all these things work together. I plan to continue both programs and just want to say how much I appreciate that you and Katy both are helping women with these issues. We need to have hope that we can heal our bodies without surgery.

    Reply
  4. Thank you for your positive thoughts.

    Reply
  5. I was wondering if you could do the DVD more frequently then 3 times a week. I am 2 weeks post postpartum with moderate prolapse and extemely week pelvic floor. Would love to do the DVD every day but wondering if this will do more harm then good.

    Reply
  6. You can, absolutely, do one workout per day! The only limit that I have is to keep your 2 step kegel numbers to 8-10 repetitions/day. Your pelvic floor can become over-fatigued and temporarily lead to symptom increase, but the other muscles worked throughout the workouts are much bigger and can handle a bigger work load. Go for it, and be sure to pay attention to your posture, looking to get some extension throughout your day when you are not holding your little one. One of my favorites right after delivery was to lay on my stomach and perform multifidi extensions (these are in workout 1). you can do these several times a day for gentle extension of the lumbar spine and to lift your tail bone.

    Congrats on your little one!

    tasha

    Reply
  7. Hi Tasha
    I have written to you before and have since purchased your DVD and just tried it. I really like the exercises in level 1. I too have looked at Katy Bowman’s exercises on line also at Christine Kent (Whole Woman) which I’ve purchased and Kegel Queen’s website. I see similarities in all,(except Kegel Queen not sure exactly what she teaches) especially the emphasis on posture. Christine Kent however seems to be against Kegels, I do like her workout which is Ballet based with strong emphasis on posture. Any thoughts/comments?
    Also, in your program, when does one know to progress from level one to next level?
    Sincerely, Deborah

    Reply
  8. Deborah, since you already have several programs, I encourage you to try them for 4-6 weeks each and feel the difference on your body and your symptoms. Ms. Kent and I differ greatly on several issues, especially my coaching of tightening up your entire pelvic basket. Try the two programs and feel the difference and then get back to all of us with your thoughts.

    As for Katy Bowman and I…we have a very similar approach. Katy tends to give less of an emphasis to kegel exercises than I do. I teach a 2 step Kegel exercise as one important component to the rehabilitation of the pelvic floor and entire pelvic basket. I don’t believe it is the only exercise needed, but I do believe it is an important piece of the puzzle.

    I applaud all women that are giving an effort to get information out to women. I would also recommend another site developed by a physical therapist at http://www.pelvichealthplus.com Get as much information as you can to help you sift through the the good and the bad recommendation. The more informed you are, the more “in control” you will feel of your own body, which is important.

    Feel free to ask questions and/or discuss along your journey.

    -Tasha

    Reply
  9. […] instruction on YouTube http://www.youtube.com/user/PTPartners#p/u/3/hcTEUKp7zsY and my blog http://hab-it.com/blog/?p=227 as a starting point.  The healthy changes to follow will all benefit your pelvic muscles and […]

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