I was just interviewed for an article on Lifescript.com (I’ll post it when it comes out) and in looking for some research to share, I came upon this from the Journal of Obstetrics and Gynecology:
The number of American women with at least one pelvic floor disorder will increase from 28.1 million in 2010 to 43.8 million in 2050. During this time period, the number of women with UI will increase 55% from 18.3 million to 28.4 million. For fecal incontinence, the number of affected women will increase 59% from 10.6 to 16.8 million, and the number of women with POP will increase 46% from 3.3 to 4.9 million. The highest projections for 2050 estimate that 58.2 million women will have at least one pelvic floor disorder, with 41.3 million with UI, 25.3 million with fecal incontinence, and 9.2 million with POP.
In case you were wondering, POP stands for Pelvic Organ Prolapse (lesser known than the more commonly used acronym for organ prolapse, WTF!) Holy cow, ladies. It’s time we change course of this slow moving ship called Women’s Health. If the existing treatments are “scientifically proven to work”, then how do you explain the doubling of incidence in the next forty years? Let’s get off this crazy ride try something new. As promised, I am giving you some homework to start right away.
1. If you have an organ prolapsing, you must reduce your impact activities until you have better muscular strength. Once the organ is prolapsing, it is clear that you don’t have the strength to hold up your organs. True, your ligaments can carry the load for awhile, but here’s the thing about ligaments:
Your ligaments cannot, ever, shrink back to their original position. They are not like muscles and tendons in that way. If you use your ligaments to hold up your organs (or stabilize your knees or sacrum, for that matter) instead of using your muscles, the ligaments will stretch out like the elastic on an old pair of knee socks. You know what happens to the top of socks after you’ve stretched out the elastic? How they kind of sadly swamp around your calf? I call socks at this stage Quitters. Don’t let your ligaments become Quitters! (Oh, and P.S. Your ligaments don’t sag because they age, but rather because they have been subjected to your bad habits for longer!)
2. Get out of your heels ASAP.
This one is better explained with a picture taken from Podiatry Management, written by genius podiatrist William A. Rossi.
As a biomechanical scientist, I have been trying to educate everyone (including the most educated of the medical community) about the damage heeled footwear brings to the entire body. A positive heel instantly impact the biomechanics of ALL of the joints, which includes the sacroiliac joints and the hips. In fact, my pelvic floor thesis and corrective exercise program dealt primarily with the legs when treating PFD. You can’t correct the smaller problem until you deal with what created it.
From the article: Perhaps the single most visible difference between the shoeless and the shod foot is the elevated heel under the shoe. The numerous influences of the shoe heel on the foot and body column are not fully understood by most medical practitioners. The practitioner commonly speaks of “sensible” heels. Such a heel does not exist. Any elevated heel under a shoe automatically initiates an altered series of foot and body biomechanics.
Can we please have three cheers for Dr. Rossi? Hip, hip…!
I happily recommend Earth Footwear (going barefoot is good too, but in the real world, most of us need shoes), and the Glide is my favorite style, especially for all the walking you are going to need to do…
3. Walk, but STAY OFF THE TREADMILL!
The treadmill is a no-no for anyone with a hip, pelvic floor, psoas, or knee issues. Sounds weird, right? You thought walking was walking? Nope. Ok, fast physics lesson. On this planet, things move forward by:
A) Pushing backward
B) Using A Credit Card
C) Leaning forward, and then falling.
If you guessed “A and C”, then you are correct. If you guessed “B”, then you’re probably a large bank. To truly move forward using your muscles, then you have to generate an opposing force. You understand this when swimming, or when dipping an oar into the water. Even your tires push back to move the car forward. It’s how things are done. If you are falling forward, then not only are you NOT using your posterior, you are using your joint cartilage to cushion the fall. And there’s not an unlimited supply. Walking correctly means you get to use your BUTT muscles. The gluteal muscles extend the hip (fancy words for lifting the leg out behind you), but on a treadmill, because the belt is moving toward you, you don’t get to push back. Instead, your lift your leg out (hip flexion) and fall forward. Congratulations, you burned up a lot of calories but weakened your pelvic strength. Try taking your act on the road (as in, not on the treadmill) and practice the “ice skating” feel of a pushing-back gait pattern.
4. Stop sitting on your sacrum!
In addition to your pelvic floor muscles, your organs are also held in place by ligaments. One major ligament to the uterus is attached to the sacrum, so if the sacrum is pushed into your pelvic bowl, the uterus moves down. Even a diligent exercise program can’t override the constant and displacing physical pressure. Check out this video to help you find a better way to sit (keeping in mind that you can stand up as well…): http://www.youtube.com/restorativeexercise#p/a/u/0/aRtKFUCAwd4
Make sure that you’re not thrusting your ribs (anatomical experts say that your ribs are different than your pelvis…) but are rolling your pelvis forward. Sit on a rolled towel to help you find the correct pelvic tilt!
Alright, you’ve got your tips. Let’s go to it!
Further information: http://www.ncbi.nlm.nih.gov/pubmed/19935030, Footwear: The Primary Cause of Foot Disorders. A continuation of the scientific review of the failings of modern shoes. Podiatry Management. February 2001. William A. Rossi, DPM.
Thanks so much! This page plus your squat page are totally doable starting points for me!
Hooray for Dr. Rossi! Great quote and diagram from his work. He’s probably considered a whack job by many of his peers.
I think it’s very difficult for most of us to grasp the significance of what heeled shoes do to our bodies. There’s an enormous cultural bias for high heels. What a price to pay. Thanks, Katy, for the sensible info and “homework”.
Thanks for posting these tips! I sat up straighter in my chair after watching the video clip
I already don’t wear heels but I didn’t know that about treadmills. Keep the tips coming!
Is the increasing numbers of PFD sufferers partly or largely due to the age of the population? ie as the babyboomers age, are they creating a “bulge” in PFD numbers? (sorry for the pun)
Dawn,
Yes, I think that, according to this study, the predictions are derived based on the increase in advanced-aged populations and the effectiveness of the current treatments.
I would predict that this current younger generation, one who has sat almost entirely since birth, thanks to home and school computers, will even demonstrate higher numbers, but, we’ll have to wait about 25 years to see if I’m right!
- Katy
Are you sure these numbers aren’t PFD-up (he asked as he sat staring at his monitor.)
RExI or VIRGIL, that is the question. You commit to RE and the need for so much of what VIRGIL offers just disappears. Sorry, VIRG.
[...] recommendations are suggested here and include avoid high impact activities temporarily, wearing heels, walk (but NOT on a treadmill), [...]
Hi Katy. I first heard of you from one of my patients. I do work with incontinent women. She brought me an article about squatting. I found it very interesting. She squats and does very well with it. I have been reading your news letters and find them very informative. Much of what I do is centered around a patient’s posture. They all find it the most helpful part of their recovery. So thank you.
I was wondering if I might share some of your material in my blog and site you as the author. I have mentioned you to many of my patients and encourage them to read from good authorities, you being one of them.
You are right about incontinence info being slow to get to the general public. Every one of my patients has never heard of my very simple approach to restoration. At best they know kegels which they usually find don’t work as a single approach.
Keep up your great and fun approach to staying dry. Sandie
Sure — you can contact me with your specific requests at katy@katysays.com
I had a hysterectomy last summer. Have noticed a smooth ball shaped thingy (?) at the vagina opening. Is this a sign of some sort of prolapse? Should I be more concerned than I am? I do not have pain, and it doesn’t come through the opening. I just notice that it is there. I found your squat info and will start those. I guess I’m thinking that as I age, I’m 48 now, I may see if slide through the vagina opening. So I better get squatting huh?
Tami, I have prolapses and that sounds like a cystocele or bladder prolapse. If you haven’t already visit your gyn or a urogyn and try to find a good pelvic floor physiotherapist who doesn’t just tell you to do kegels.
Good info. Didn’t know about the treadmill issue. What about other machines like an elliptical?
So what about when your ligaments are ALREADY stretched and you have prolapse(s)? I have had some degree of prolapse since my first child at age 24.
Now at 31 and 4 kids I have prolapse of well, everything. Will PF strength/alignment really help or am I too late?
Great post Katy, thanks! Alex
@K – I don’t think it is ever too late! Try the tips in this post and read the other posts listed under “pelvic floor” for more stretches to do. Don’t get into full squatting right away though, you need to prepare your muscles and joints. I thought I’d quick and answer your question since the author is on maternity leave right now. Good luck!
p.s. I am not the expert, Ms. Bowman is. I just read the blog and get her RX exercise videos. Oh and the “Down There For Women” exercise video may be a good resource for you also.
I think you have the wrong link to the video about sitting properly. When I click on it, it takes me to a video for the Maui squat. I did find the correct video on your youtube site about sitting though. Thank you for all you do!
Katy,
Question…when I pee it sometimes feels like it pools before finally heading out of my body. If I lean forward, it’s better. I also don’t have UTI’s anymore since I’ve started leaning forward and waiting until I’m totally done. They haven’t said anything really about the pooling or have found anything. Should I just do more pelvic floor exercises or therapy?
Thanks,
Dani
Hi Katy,
How can an individual tell, without an internal exam, their pelvic floor muscles are tight?
Thanks
This is really helpful info, although the video was a bit disappointing – any chance you have time to refilm it?