Pelvic Health

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.

Picture 37

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…


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…):

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!