Monday, September 19, 2011

Getting to (Another) Point about the Pelvic Floor

As often happens when I interview someone for an article, sometimes we get off topic. I am notorious for starting a conversation about one thing and leading soon to something entirely different, but eventually circling back (because I'm convinced background is incredibly important) and returning to the topic. My husband has cut me off more than once: "What is your point?"

What IS my point? My point is, I learned something in this interview that would be superfluous background for the article but fascinating for me nonetheless and so worthy of sharing with my blog readers.

But first I have to tell you about the woman I interviewed (see, more background!). Her name is Elizabeth Noble, a physical therapist and author of a book I read 8+ years ago after picking it up from the bookstore on the way home from that 20-week sonogram appointment, which revealed not one but two babies. Her book, "Having Twins," is still on my bookshelf. I especially enjoyed the passage where I learned that my love of sweet potatoes might have had as much to do with my twin pregnancy as my family history and age. My twins were conceived between Thanksgiving and Christmas--the height of yam eating season.

Oh grief, I'm really off the point now.

Sort of. I was speaking to Elizabeth Noble, who also wrote the book "Essential Exercises for the Childbearing Year," for an article about positions that can help relieve discomforts of pregnancy. And in that conversation she shared this revelation with me:

"What pregnancy does is reveal to a woman her strengths and weaknesses in her muskuloskeletal system. She would have those problems eventually."

Wowza, huh?

So here we are going around blaming our pregnancies for this or for that (ahem pelvic floor disorder, anyone?) when we actually have our pregnancies to thank for getting us to, and addressing, our future body sooner. Of course, ideally we should prevent those problems in the first place, but we have so much working against us... like chairs and cars and computers and televisions...

Anyhow, "those problems" almost always have everything to do with a weak pelvic floor. I believe increased athletic activity can also illuminate pelvic floor weakness in the same way a pregnancy can. When you're demanding a lot from your body and you have muscle imbalances and pelvic floor weakness--where, begins the genesis of our movement--the low back, knees, hips, even feet, will eventually feel the effects of those weaknesses.

Noble, who also is an anthropologist and founder of the Section on Womens Health at the American Physical Therapy Association, echoed a strategy heard here before by Katy Bowman: Start squatting.

She said, "The pelvic floor attaches to the external rotators of the hips; when you come out of a squat, you tighten the pelvic floor." The problem, she added, is that few people in the western world squat anymore. Even when she travels to Asian countries even the younger people aren't squatting like their grannies.

I found this passage in her book interesting:
The comforts of modern life have more and more removed us from the routine physical work that compensates for these structural weaknesses by muscular development. We sit too much. We use laundry dryers instead of bending and stretching at the line. If you ever drive a car without power steering, or use a manual typewriter after an electronic keyboard, you have felt how labor-saving devices make us weak. Worst of all the "modern improvements" is the water commode--the porcelain throne on which people sit to perform functions that should happen only in squatting. Alas, around the world squat toilets are disappearing and pelvic problems for both men and women are increasing in proportion.
She told me she squats on her toilet seat. "I climb on to them," she said. "I put my feet on the rim of the toilet. It can be a dangerous position; one day my foot slid in." She also said there are platforms people can buy or make to modify their toilets so they can squat on them.

Naturally, I had to try.


It was high time I cleaned my bathroom floor anyway. Part of the failure was that I was trying to watch (wouldn't you, I mean, to make sure you hit the target?) but in bending my neck down, I also tilted my pelvis forward. That meant missing the bowl. Another obstacle: this can't be done with panties around your ankles.

While the Bill & Melinda Gates foundation is in the process of reinventing the toilet for the developing world, we might ask to include a new design for industrial countries so we can take back our pelvic floor.

Meanwhile, I harken back to Katy Bowman's advice: just use your shower to squat and pee.

What else did Elizabeth Noble leave me with? She says if you have to sit, sit on an exercise ball. I sat on one when I worked while pregnant but had since gone back to the chair. Now I'm back on the ball (as I type this on Sunday afternoon my 2-year old is sitting on it behind me and bouncing mightily).

Which brings me to something else she said (a side story? more background? information to support my point? Hell, I don't know anymore) that's worth repeating: The exercises that are good for you to do in pregnancy are good for you to do for the rest of your life.

Keep up those post-partum exercises. F-O-R-E-V-E-R.

Everything I know about pelvic floor health is posted on my website,


Abby Kurtz said...

Really great post! I'll be the first in line for that new toilet. Keep squatting ladies! said...

Great post, and blog! I believe it was your original post on pelvic floor I stumbled on before finding Katy, so thank you! While we could pee in the shower like Katy suggests, it's also super important to be in the squatting position for number twos as well. The platform I'm about to buy is from (much to my husbands disgust!)

Thanks for spreading the word, love your work ;)

Kate said...

Hee hee, I think you meant 'foot' not "food"- it took me a few times to realize Elizabeth Noble didn't let her food slip into the toilet- while thinking, how did that happen, eating while squatting on the toilet, wow, she's good!

Thanks for the great post!

Kara said...

Thanks to copyeditor Kate! Yes that is indeed FOOT not food! Isn't that spell check a mixed blessing?

Runnin-From-The-Law said...

I am rolling over here picturing you trying to climb ON the toilet and squat! He he he.

Thanks for the reminder about the importance of those kegels, squats and other things that help us with our lady parts! Good stuff.

McFamily said...

Can you point me in the right direction to a good post on post-partum exercises? Im 7 weeks pp and ready to get going...