Any woman with long-standing prolapse knows that Kegels do nothing to improve the symptoms of rectocele, cystocele, or uterine prolapse.
The only logical reason for Kegels improving symptoms of stress urinary incontinence (losing urine when sneezing, coughing, etc) is that they pull the bladder toward the vagina, thereby increasing the symptoms of cystocele.
Women with significant cystocele rarely experience severe urinary incontinence because the bladder bulge kinks off the urethra, much like a garden hose.
So if Kegels do nothing to improve prolapse, why are they still touted year after year, decade after decade, since gynecologist Arnold Kegel and his perineometer made such a sensation in the 1950s?
The answer is because Dr. Kegel, and all of gynecology for that matter, have omitted and denied essential aspects of female anatomy that are crucial to understanding the dynamics of pelvic organ support. Why have they done this? Because gynecology has always been a surgical specialty that views the pelvis in a very limited way. Their conceptual framework of female pelvic anatomy does not include much beyond what they can see from the supine, lithotomy position (lying on your back with feet in stirrups).
To the gynecologist, you have a pelvic “floor” above which the pelvic organs are perched. From this perspective, the vagina acts like a tree trunk, holding the organs over a hole in a soft-tissue “floor” at the base of the torso. Because the vagina is holding the organs up, it must be “strong” and “tight” to prevent prolapse. The gynecologic point of view gives the pelvic surgeon license to perform operations based on faulty anatomic understanding.
In reality, your pelvic “floor” is more like a wall at the back of your body. Human pelvic orientation is not different than that of four-legged animals, a fact pointed out in the gynecologic literature in 1954 by J.W. Davies, M.D. Your pelvic organs are positioned over a truly strong pelvic floor, which are your pubic bones that come together underneath you like straps of a saddle.
Dr. Davies pointed out that if the human pelvis was really rotated backward 90º into a “bowl” shape with a “floor”, the pubic bones would dislocate with every step we took. Not only would it be excruciatingly painful to walk with the pelvis in this position, it would be impossible.
Davies’ research was completely ignored in the gynecologic literature until Dr. Linda Brubaker used his original illustrations to make the same point in her 1996 textbook, The Female Pelvic Floor. Unfortunately, the information had little impact and urogynecology has continued on under an antiquated and erroneous conception of female pelvic anatomy. To do otherwise would render all surgeries for prolapse and incontinence faulty and unsound.
Since the time man-midwifery took over the business of women’s health, knowledge about the female body has been placed solely in the hands of the medical profession. Our own bodies have become so mysterious, and the only major sources of information available to us come from practices based in anatomical misunderstanding.
This is why Whole Woman® has sourced knowledge from orthopedics, pediatrics, physics, the biological sciences, and even traditional dance. There is no understanding pelvic organ support outside the context of the whole body. When was the last time a gynecologist talked to you about the importance of natural breathing in preventing pelvic organ prolapse? You will not find this information anywhere else but at Whole Woman®. Yet, women intuitively know the Whole Woman® work is true, because they live it every day.
When a newborn baby girl comes into the world, her spine and funnel-shaped torso are completely straight. Her three pelvic organs and their channels: urethra/bladder, vagina/uterus, anorectum/sigmoid colon form three long lines, or axes, through this little abdominopelvic space. From the beginning she is raising internal pressures whenever she cries, poops, or is held upright. Yet, she is not in danger or her pelvic organs prolapsing because her respiratory diaphragm (the muscle layer underneath her lungs) and her pelvic diaphragm are made up of the same type and the same amount of muscle tissue, so the pressures simply bounce back and forth between the two sets of muscles.
Once she begins to stand and walk and run, her respiratory diaphragm grows very thick and strong and begins to send powerful bursts of pressure through her torso. These pressures don’t go down willy-nilly, but in a very specific pathway. With every in-breath, intra-abdominal pressure strikes against the inside of the lower abdominal wall. You can test this yourself by placing your hand a couple of inches below your navel and taking little coughs. You can feel the exact place intraabominal pressure strikes first before rebounding against the pelvic diaphragm.
Over the course of sixteen or seventeen years, the female pelvis becomes positioned at right angles to the abdominal wall so that the pelvic “floor” has now become a wall at the back of the body. This is only made possible by profound curvature in the lumbar spine, which is genetically more pronounced in females. Astonishingly, the three pelvic organs have also formed strong right angles away from their channels to become positioned right behind the lower belly. In this way, the pelvic organs are supported by the true bony pelvic floor and the lower belly, just as they are in four-legged animals. It is a profound truth that we are horizontal creatures from the hips down and vertical from the waist up.
Now it is easy to understand that contracting the vagina has nothing to do with pelvic organ support. The organs are carried behind the lower belly, and away from the pelvic outlet at the back of the body. Kegels merely draw the bladder and rectum toward the vagina, in other words, toward the direction of prolapse!
Please don’t think that it’s “bad” to contract those muscles. Strong vaginal contractions lead to orgasm and are wonderful to do in that setting, especially if a penis is supporting the vaginal walls to keep the pelvic organs in their proper positions. It’s just that laying on your back doing sets of Kegels can worsen prolapse symptoms.
Now that you understand more about your anatomy, you can see that any exercise aimed at reversing prolapse must be based in the dynamics of pelvic organ support. This means gravity, the breath, the natural shape of the spine, and the weight of the organs themselves.
So in the video below, I offer The New Kegel, which can be done in a chair, on all-fours, or standing. We are simply increasing the natural dynamics of intraabdominal pressure, and by way of the in-breath and lumbar curvature, moving the organs forward. Optimize the process with Whole Woman® posture by keeping your shoulders down (not back), chest lifted, upper back flat and broad, head pulled up through the back of the neck, and slightly tucking your chin.
Traditionally, women spent hours sitting while doing their work, and female anatomy is designed to move the organs forward even while sitting. However, you must keep a strong lumbar curvature and a relaxed lower belly during the process. Go ahead and sit for hours in front of your computer. Every now and then, throw a few New Kegels in to push your organs further forward.
If we lived in a perfect world, regaining pelvic organ support would be the easiest thing on earth. And you know what? It is.
Click here for The New Kegels video.
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