Pelvic Floor Party: Anniversary Special

Once upon a time, there was a tiny little post called Pelvic Floor Party on a blog called MamaSweat.  Did you hear of it? Well, a LOT of people did — it was kind of freaky — and it added an element to pelvic floor exercise routines across the globe. Because it has been a year, Kara Thom, the author of the original blog, and I got together (in cyberspace, because I have a new born and she has, like, 47 kids) and interviewed each other.

We split up the interview, half on my and half on her site. Here’s one part below. Follow the link at the bottom to read the other part (including my favorite changing-table shoulder stretch.) I hope you enjoy Kara as much as I do. She’s hilarious. You know, for a mom.

KATY: Ok, super-popular blogger-fit-mom. Just HOW MANY PEOPLE read Pelvic Floor Party, Kegels Not Invited? What was it like to have that many people read your blog? That’s more people than have read anything, ever. Except for the Andrew Weiner Wikipedia. Tell me, did it make you make a lot of money?

KARA: I went from a little-known blog with around 15,000 visitors in my first year, to more than 70,000 my second year, and the Pelvic Floor Party posts were responsible for that. Finding fitness in the chaos of motherhood is all well and good, but apparently, much better when done without peeing your pants. And, one year later–happy anniversary Katy darling!–it remains my most popular post. And since I just checked the stats, here’s a few interesting factoids: the last three people who read “Pelvic Floor Party” were from Paris, Egypt and Ireland respectively. We jokingly referred to it as the “post heard round the world,” but it definitely is a message spanning the globe. It’s not trending on Twitter yet, but it’s hard to compete with the wave of political sex scandals.

Money? Have I made a lot of money? (She laughs heartily.) I have made exactly 0 dollars and 0 cents. In fact (she crawls onto her high horse) a large, prominent women’s health website asked to buy the post for their site, but we couldn’t come to agreeable contract terms (they wanted all rights and I wanted one-time rights) so I turned down the offer. I’ve also been approached by advertisers but that just doesn’t feel right for Mama Sweat right now (you’re welcome dear readers).

KATY: How did the squat/kegel information change you, personally? Did you really start squatting?

KARA: Oh goodness. Is that my pelvic floor conscience? I squat all the time and I shamelessly pee in the shower. I have not gone camping since that post, but I’m certain there would be no peeing on the shoes. That post also helped me put two and two together because I had been doing Cross Fit workouts (famous for deep squats) for about 8 months by then and had already noticed that my usual nagging hip pain/low back issues had disappeared. I knew I was stronger and it was helping but didn’t understand until you ‘splained it to me: a strong booty is the back-up power for the pelvic floor and in my case with hip flexors like clam shells, I need good glutes to pry them back open. But what I love about the information is that squatting, while good to include in a workout, should also be part of the way you move in general. If whatever I’m doing requires me to be low to the ground I rarely bend over, now I squat.

One thing though, worth mentioning: once you get pelvic floor strength you still have to maintain it, as I learned when allergy season hit. I could safely get through one sneeze, but the double sneeze reminded me that my pelvic floor needed more attention. And, with my increase in triathlon training this summer, guess what I’ve done less of? Less strength training and yoga has also had ramifications for the aforementioned hip and low back. At my age, foregoing strength training and stretching is not an option.

KATY: What have you been doing since writing that blog? Lying around eating bon bons and stuff, or…?

KARA: What exactly is a bon bon? If it’s dark chocolate with a touch of sea salt, then yes, I’ll admit, that sort of bon bon crosses my lips occasionally. But the lying around part… hardly. Last summer Hot (Sweaty) Mamas: Five Secrets to Life as a Fit Mom went to press, and before it did you better believe I included this all-important info in the book. That post generated a few other exciting opportunities for me, including a video for Experience Life magazine, where I got to demonstrate the Bowman Squat for all to see.

I also wrote a yet-to-be-published article for Health magazine, that included squatting for pelvic floor health, as you know because I interviewed you! (Katy’s note on Kara’s squat: First of all, I remember typing Kara an email on my iPhone at 4AM while on vacation in Hawaii to give her tips to make the squat “better” in terms of alignment. Note her bolstered knees and ankles. To work the glutes even more, the shins should be more vertical and less angled forward. Someday, I will get my hands on Kara Thom’s psoas. Then she’ll REALLY have something to post about :)

KATY: What is doing a book, I mean after writing it, like? I ask because I have one coming out in November and I thought all the work was done but then I see all the stuff you’ve been doing to follow up. What is it like having a book out? (Here’s the cover. Cute, right?)

And, FYI, here’s a picture of me finding your book in a California Barnes and Noble — and, guess what — my name is in it! Sweet.You are awesome. What’s it like to be awesome? That’s a lot of questions, isn’t it…

KARA: Let’s start with, “What’s it like to be awesome?” Here’s the visual: I’m wearing sweatpants and a race t-shirt. It’s early in the morning so no one has come in yet to do my hair and make-up, and I’ll need a little make-up because I just popped a zit on my chin (I thought being awesome would give me clear skin). Oh, what was that? No one is coming in to do my hair and make-up today? There are still toilets to clean and laundry to fold, noses to wipe and under-appreciated meals to make, but I can’t help but feel awesome anyway. I get enormous satisfaction that I’m writing about topics that interest me and matter to others, but mostly I get to do it while watching my foursome grow. One of my daughters asked me the other day: “Mom, will your book still be alive when I grow up because I want to read it when I’m a mom.” So yeah, the post-book-birth process is as hectic, if not more, than the time spent writing it, but I love that it’s out there and I’m privileged to have books to promote and children I adore, and often at the same time, like today when two childcare options have fallen through.

KATY: What’s next for you? More kids? More marathons? More squatting? I want to know how being a super-fit mom and a super-fun blogger plans for her future.

KARA: More books, marathons and squatting for sure, but I’ve maxed out on kids. I love pregnancy, birth, babies, but I have officially moved out of that stage and am focused on helping them become the people they’re meant to be (I’m hoping at least one of the four likes running and triathlon as much as me, is that too much to ask?). This is just as fun and rewarding and I’m sleeping more at night (most nights) so that’s a perk (except when I get sucked into twitter–@mama_sweat if you want to keep me up too).

To read the other part of the Kara/Katy coffeetalk, click here: http://mamasweat.blogspot.com/2011/06/hows-your-pelvic-floor.html

Also, post “your story” about how this new squat/pelvic floor information affected you (your PF, your hips, low back pain, birth, whatever…) if you would like it included it my next book NO MORE KEGELS! If it makes it in, you’ll get a free copy. I’ll autograph it to0, which will increase it’s value by about $0.02. Maybe Kara will sign it too. I’ll ask her 🙂

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23 thoughts on “Pelvic Floor Party: Anniversary Special

  1. I have been trying to get my pelvic floor back to an acceptable level for 3 years now after a very speedy second birth with a little prolapse (not sure what lapsed but it affected the birthing canal). MIdwives didn’t have much advise apart from Kegel exercises. Physiotherapist, a man, was extremely embarrassed about the problem and under his breath told me about cones you could use to strengthen pelvic floor but he didn’t know anything about them. He also told me to just generally get fitter. Gynaecologist suggested pelvic floor exercisers that worked temporarily. In the last year, I have lost 10 kg of weight and got much fitter by enrolling myself onto a fitness instructor course with the aim to teach post- and ante-natal classes. I still couldn’t do jumping jacks or skipping without little leaks. I ended up teaching Kegels in my classes even though they hadn’t really worked for me!! Coming across your explanations on pelvic floor toning, posture and squats was an absolute relevation and I am happily skipping now. On top of that, my almost constant sacrum joint pain is much more manageable and after specific backside exercises it disappears. I am very happy to be able to pass on your pearls of wisdoms to pregnant and post-natal ladies in our town. Thanks.

  2. Hi Katy. A friend referred me to your site and I have been going over and over the pelvic floor posts andam planning to implement a lot of your tips. I’m having a very hard time with my pelvic floor, am in a lot of pain and having anxiety attacks over it all. I had a serious pelvic floor injury after the birth of my 2nd child, a horrible hospital VBAC where I was made to do purple pushing and had forceps assist which tore right through all of my muscles. I had uterine/bladder/rectal prolapse 🙁 🙁 and went through months of pelvic floor physical therapy, which did help some. That was 3 yrs ago and now I’m pregnant with baby#3 and planning my HBAC and very excited about a different birth this time. BUT.. within the past week I have seen the re-emergence of my prolapses 🙁 I admit, I have gotten very lazy, have not worked on my pelvic floor in.. well, ages. So its weak, and now that I’m 23+ weeks pregnant and baby is getting bigger, I feel my old prolapses kind of starting to bulge and its majorly freaking me out. I don’t want it to affect the baby or me or the birth I am planning. My mw said to do kegels and I was doing them till my friend referred me here. I’m going to switch to squats and strengthening the glutes.. but I’m in horrible pain, my lower back and hips are killing me with this issue. And I’m freaked out and nervous about making the prolapse worse. 🙁 I guess my question is.. what is the safest and most effective thing I can do to help get my pelvic floor strong without making the prolapse worse? I hate this bulging feeling, I wish so much I had stayed on top of the pelvic floor exercises all along and didn’t get into this situation. Now that I’m here, I’m miserable and freaking out. Can you provide any insight or advice? I want to get it stronger, but don’t want the prolapse getting worse. And also, I’m concerned with how it could affect the baby or pregnancy, I’m basically a paranoid mess now that this is going to make baby come to early or makemy homebirth impossible, both which would be devastating. ANy help ismajorly appreciated!! Thank you!! 🙂

    1. Jami,
      1. CONGRATULATIONS. You should be very happy and excited.
      2. Relax. Take a deep breath, and then another one, and relax. Sit there (right now…) and let the tension out of your muscles. All of them. Relaxing and breathing and letting worse-case-scenarios out of your head is the BEST thing for you and your baby. You are both going to be fine.
      3.At 24 weeks starting to squat will be to advanced for you. Start with all of the other exercises that lead up to a squat, but you can leave the squat aside for now. I strongly suggest the DOWN THERE DVD. It’s easy and will cause no downward pressure on your pelvic floor.
      4. Try to stop beating yourself up for what you haven’t done and make a list of three things you WILL do every day (that you can handle, i.e. stretching my calves and hamstrings.)

      Understand that prolapse comes NOT from excessive weight on the PF but from DOWNWARD PRESSURE that you create. The first thing to do is relax your belly. You’re already pregnant, so it’s not like you’ve got a belly to hide 🙂 The old habit of sucking it in has become a mindless one — most pregos do it even with the lovely big belly because it is an autopilot kinda motion. Relax it.
      5. Next time you use the toilet, sit there with your eyes closed. (Wait, there’s more…) Relax your stomach. And relax it some more. DON’T STRAIN on the toilet. Instead, relax everything in the neck, shoulders, gut, low back, and pelvic floor until *your bathrooming things* come out.
      6. Watch the *how to sit* video here: http://www.youtube.com/user/restorativeexercise#p/a/u/1/aRtKFUCAwd4 and make sure you aren’t sitting on your sacrum…even on the toilet. Especially on the toilet 🙂

      You are going to do GREAT! I am glad you have a strong intention to HBAC, but you need to back this intention up with some body training. You can do it. Let me know if I can help you with anything else — I’m your birthing cheerleader over here 🙂

  3. So Katy, why were you unable to kegel until 4 wks pp? — because your muscles had been overtaxed in pushing out junior?

    I found the Squat Post when I was about 3 mos pregnant and began squatting daily right away. I’d even squat on the toilet, up until I grew into a hippo and feared I’d crack the loo in two. I had a quick, intense labor and pushing phase — I don’t know how much of that is attributed to squatting. But hey, at least squatting has given me a butt.

    Thanks for the anniversary post.

    1. I actually had a complication that required vaj surgery and then I was flat on my back for days with no movement. I think that was it…

      1. Woah Katy! I just went back and read your birth entry. I’d read it before but forgot how serious your post birth complication was. Your cheerful attitude makes it sound easy peasy, which I am sure it was not.

  4. I’m just now coming to the PFParty. At the beginning of my second pregnancy in May 2009 hubby and I were in a one-vehicle accident (one guess who was driving, and it wasn’t me). I sustained abmonimal and tailbone bruising, and was completely miserable for most of the pregnancy. On top of it all, because of the trauma, I developed a leaky bladder that I had hoped would go away when the baby was born — but it still persisted. I had planned on seeing a doc this summer about my options, but guess who’s pregnant with #3 due in September? I’m not exactly sure how I stumbled across the PFParty info this week, but I’ve resolved that for these last 9 weeks of baby baking inside that I’m going to do squats and will continue them postpartum. I’d rather not go see a specialist who will tell me surgery is my only answer, because quite frankly that scares me. You’ve given me hope that I can have a normal non-leaky life without surgical intervention and harmful drugs.

  5. I am a physical therapist who has worked with women with pelvic floor problems as well as working with the problem on myself. I had excellent short term results with the traditional kegel and strengthening core muscles and all muscles that attach to the pelvis but knew there needed to be more for long term results. REXI has been fascinating to me because the proper alignment, shoes and basic REXI stretching and strengthening exercises has definitely been more successful than the methods I previously used. Personally I have regained compete control even when jumping on the trampoline except when I have a full bladder or bowel and at this point I am not doing any kegels. My sister had a hysterectomy and surgery for incontinence and it only “lasted” about 3 or 4 years. Surgery is NOT a cure all or an easy way out. Thank you Katie for your expertise. If my input can be of any help for your book or if you would like me to expand on it let me know.

  6. I am about 5 weeks pregnant and because I remembered your lovely advice from last year, I have been focusing on squatting regularly. It’s odd to think that we make childbirth more difficult by sitting in chairs, but, there you have it!

    I’m hoping that squatting may help prevent re-tearing of my perineum, though I guess fixing the slight incontinence is probably a good reason to keep it up too. It’s probably important to realize that squatting isn’t just an exercise you do every other day, it’s a regular part of your lifestyle, and one that takes some getting used to since we don’t do it much in our culture.

    I thoroughly look forward to being able to jump on trampolines again!

  7. Hi Katy,

    I am very interested in all you have to say about Kegels and glute strength, etc. As another of nine, a runner, and overall exercise enthusiast, this is vital information for my future lifestyle. I have been working with a sports physical therapist who is extremely knowledgable about pelvic floor issues for women athletes. I also see a another physical therapist who specializes in the pelvic floor. Both of them agree that Kegels are not the only answer and that in fact, they can weaken the pelvic floor if the areas of the core are not strong…especially glutes, etc. Thanks for your great site !!! Whitney

  8. Hi Katy,

    A friend put me on to your site and so I have been enjoying reading a number of your articles. However, I am a tad confused about one thing in particular. Hopefully, you can clear this up for me? I am a Personal Trainer and work with mums on a daily basis. The majority of the mums I see display Lordotic Alignment patterns and low levels of Transverse Abdominal strength. I rarely see mums who tuck their pelvis under (granted, they are out there… but they are a minor breed in my neck of the woods 😉 You have a lovely picture of a lady in black (Is that you Queen of DU?) standing with beautiful alignment on you blog above. Lovely lady in black (LLIB) is not sticking her butt out, she is slightly tucking her pelvis under just enough to allow for a beautifully neutral lumbar curve (not by squeezing her glute’s I would assume, but, by engaging her TA with that slight tuck of the pelvis). I have read your advice to stick the butt out and not to tuck the pelvis under, however, this advice seems in conflict with the LLIB photo above? Also, if we stick the butt out are we not increasing the lumbar curve unneccessarily to Lordotic alignment, which creates lower back pain? Do you mean don’t tuck the pelvis under when squatting (i.e. keep the natural curvature of the spine – neutral alignment – rather than rounding out the lumbar spine) or are you actually saying don’t tuck the pelvis under at all? I love your blog Katy and I agree with many aspects of what I have read so far… I’m just a bit confused on this particular point.

    1. Hi Jenny,
      Thanks for reading! I suggest that you read through a few more posts, especially to really “get” the difference between rib shearing/thrusting and lordotic curve. Most people (orthopaedics included) don’t measure lumbar curve objectively, that is, with numbers, points, lines, etc. The excessive sway that you are seeing is not because of over anterior tilt, but because the ribs are displaced anteriorly. I teach the specifics of this mis-measure in a clinical setting, so that it is more accurate. I just got back from teaching 40 physical therapists the difference between the subjective “swayback” evaluation and the actual measurement, only for them to realize that every patient they’d seen in the last 10 years of practicing had been misread as an anterior tilter than what they actually were — a rib-shearer. This is why you think you are seeing more lordosis — because you are not looking at the lumbar spine, but at the entire curve and have no way to really measure.

      Untucking is not a blatant ExRx, but just one needed for post-tileters. Of course, rib dropping is the next piece (did I mention read more posts? 🙂 The picture in alignment is me — not tucking, but in a neutral pelvis. As you likely know, the TVA does not move the pelvis, so any skeletal displacement of the pelvis during TVA contraction is the body mistaking the psoas for the TVA — read “what a waist” to get a better picture of that!

      If you really want to learn objective alignment and biomechanical science, I suggest reading from the beginning and let the data fine tune the body reading that is often taught, but is unfortunately, filled with subjectivity. Hope this (and a bit more reading) clears it up! I’m all for a neutral pelvis — as this is the only position you get full abdominal contraction in.

      Cheers, and…back to my vacation!
      Katy

  9. Katy:

    I just finished 6 weeks of physical therapy for diastasis recti and then was diagnosed with 1st/2nd degree prolapse. I am interested in the information you are sharing and wish to start working on fixing the prolapse issues, but do not want to re-open my diastasis. I find that there is so little information out there for either issue and am struggling to find things to heal both and get my life back. Any suggestions/information would be greatly appreciated.

    Thanks!

    Betsy

  10. Hi Katy, I just wanted to say thank you for replying to my above uninformed question, especially when you were on holidays!! I am working through your blogs and have purchased your book and a DVD to understand more. I would love to do your course when I can free up some time in a year or so. Thank you so much for all of the information that you share! It is greatly appreciated.

    Cheers,

    Jen.

  11. Forgive if you have already had this question. I am a mother of 5. The last were twins. My questions is, are the deep squats the kind you see every child do when they look at something low (until they of course learn incorrectly from us that bending over is the more “correct” way to do it)? I just think about my kids and how they squat at nearly everything low. Thanks!

  12. Still confused about squatting… read many many many of your posts, watched many many many of yours video’s. Please help clarify this for me… When squatting is it a static squat, so go down and stay for let’s say 10 seconds, focusing on the sticking the butt out, using the butt muscles and alignment of ankle to shin, then come up. OR go down for the count of 10, hold for the count of 10 and return up for the count of ten. Its seems you explain the squat, show the squat, more explanation of the squat and say do the squat all day long but what’s the tempo, or repetition of the squatting process. Please clarify this. My bladder prolapse is getting better as I’ve doing lower leg exercises strengthening my leg and butt muscles, doing TVA to work on diastasis, and going to PT to work on pelvic floor (I know you don’t like kegels, working on relaxing in between to fully strength the pelvic floor out). Please clarify the count or temp of the squat!

    1. Different parts of the squats are good for different things. The glutes are most used in coming up, when there’s a more-than-less vertical shin. Staying down has merit when it comes to stretching things out, but that’s not going to be the focus for everyone. My suggestions for squats are to do it less like an exercise (with frequency, timing, repetitions extremely regimented) and more like you would do it in ancestral life — spreckeled throughout the day, some longer (think going to the bathroom) and shorter (think picking things up off of the floor). There is no one ExRx that is right — there’s just how you’ve been using your body to date and changing it to look more like natural movement — the reason you don’t see a tempo or count.

    2. Anita, how is your prolapse doing and dis all the squats help? How bad was your prolapse? I hope you see this six months later. Just wondering if there is hope for me.

  13. Just found your site and am very excited about giving this a try. I had a hysterectomy 3 years again and about 7 weeks later started with leaking. Have tried medicine which didn’t do anything but go e me UTIs. Have been doing lots of kegels and since seeing your info want to give it a try. I will let u know if there is any improvement!

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