Minimally invasive surgery could relieve patients of back pain.

The story focuses on the 80 percent of Americans that will suffer back pain in their lifetime, and a particular type of back pain — SI Joint (sacroiliac) Syndrome.  Now I wouldn’t consider SI joint pain a “back” or spinal issue because the muscles that act upon the sacrum belong to the pelvic and hip category, but I’m not even going to be picky on this point.  I am, however, going to nit-pick the term Minimally Invasive when talking about the new surgery, SI joint fusion.

Yep.  With just a couple of rods and three incisions, your sacrum can be permanently connected to your pelvis for reduction in pain.

“The procedure works because it stops the joint from moving, and it’s only movement which brings on the pain,” says Dr. Graham Smith.

Correct me if I’m wrong, but this sounds a lot like the Hey Doc, It Hurts When I Do This, Then Don’t Do That philosophy of medicine.  Anyone else get that?

Let’s back up a second to an experience you may have had with a broken bone and cast or sprain and sling.  For those who have had rigid structures limiting their joint movement while healing, do you remember the day the cast came off and how the muscle atrophy (shrinkage) was so easy to see when comparing the “fused” and mobile appendages?  Here’s the thing with muscles,  they need movement at the joints in order to maintain tone, tissue health, and fluid content.  No joint movement, no muscle tone.

Now let’s talk about the sacroiliac joint.  This joint is supposed to have free, non-friction generating movement.  Just like movement of the knee keeps the quadriceps, hamstrings, and calves healthy, the movement of the sacrum keeps the glutes and pelvic floor healthy.  In fact, sacroiliac pain comes from unbalanced muscular-force between the glutes and pelvic floor, and the resulting pelvic floor hyper-tension on the sacrum.  The solution is restoring the function to minimize friction, not fusion.  Fusing this area will not only create core-musculature atrophy, it will cease natural motion of a body part.  Natural motion that was probably important, if your body developed a joint there.  Important movements like child birth, reproductive organ support, pelvic and abdominal support, digestion, and walking.  You know, those types of things.  Do you have SI Joint pain?  Check your butt.  Don’t see one?  Get one.  Your SI Joint will thank you.

Sooo, back to Minimally Invasive.  This term is a misnomer.  An incisions may be small, but the long-term affects of a fusion result in a progressive and accelerated degeneration of all tissues around the location of the fusion.  Most people do not clearly understand the role of the pelvic floor, sacrum, and gluteal muscles in supporting practically ALL human body function.  If they did, they would not be so quick to fuse this area, creating a “limp” in the core muscles that lasts FOREVER.  Minimally Invasive my butt.  My strong butt at that.

Dr. Graham is not incorrect when he says that movement brings on the pain, but not moving is not an option for those of us who know that our body is a self-winding clock.  Fuse a joint, limit your time.  Pain with movement is a signal to be heeded.  The signal is saying, The way you are moving is doing you harm.  The muscles on your frame are not supporting you.  You can fix the way you move, or, you can just lie down now.  Which makes more sense?

While traveling this weekend I found this old catalog and started to read through it.  If you like history and anthropology like I do, you will find that nothing captures a period of time like the stuff for sale.  This catalog is phenomenal.  You can find just about anything in it, from farm equipment to mandolins to toiletries.  This book is like the internet.  If you can’t find it in here, then it probably didn’t exist in 1908.

As a people, we all believe certain things because we think these ideas have always been, but when studying things like this catalog, an anthropologist can collect data showing the dates and global locations such notions developed.  This book is an anthropological gold mine, so I thought I would share a few of the most mind-blowing.

First off, there is an entire section (pages and pages) of trusses.  What’s a truss?  Yeah, I didn’t know either, but from the picture it looked like some kind of belt.  Turns out, a truss is a belt.  A belt with adjustable pads to change where the wearer would like pressure applied to the abdomen, for the purposes of containing a rupture, like an abdominal hernia, diastasis, etc.  It turns out people didn’t know how to use their transverse abdominals in 1908, either. You can get one of these bad boys for infants, those who walked a lot, or my favorite, the Appendicitis Truss.  This guy “is newly invented and now meets a long felt want.  It affords just the right pressure and protection needed for all persons subject to attacks of this dangerous disease.”  Ow, my appendix is inflaming!  Don’t worry, I’ll just put on this here belt and that should take care of this dangerous disease.  Nice.

All you red-heads out there will also be happy with C.H. Berry’s Freckle Ointment.  And I quote:

Nothing makes or mars a woman’s face more than the quality of her complexion and it is absolutely impossible to have a really pretty face, a complexion the envy of her friends, if the face is covered by freckles.

Wow.  That’s good to know.  Thanks a lot, S & R spirit-breakers.  I love freckles.  Doesn’t everyone?

Ok.  It’s gets better.  How about the Genuine Old Comfort Body Brace.  Hold on to your hats…

A woman’s general health, strength, grace, erectness in beauty of form, are regained and retained by wearing a properly adjusted Genuine Old Comfort Body Brace. It will meet and remove the cause of weaknesses and organic displacements by applying its strengthening influence and natural support to parts of the body where it is most needed [i.e., where your muscles are...]. The Genuine Old Comfort Body Brace is highly recommended by physicians for all women suffering from general weaknesses to persons whose shoulders droop and whose posture is neither natural nor correct. It is a proper and comfortable brace for fat people. A large abdomen is often reduced a few inches per month as a result of relief afforded by the brace to the stretched and overloaded muscles.

Men, don’t fret.  There’s stuff in here for you too!  No, nature did not design you well, or else you would have better natural support to all of your, um, Suspensories.  Yes, there are over 20 different suspensories to choose from.  Silk, cotton, special models for slim fellas.  But the best is the Genuine O.P. C. Suspensory.

The best suspensory made.  This is the one to buy.  This Genuine O.P.C. Suspensory should be worn by every healthy normal man.  The vital organs need a suspensory to sustain the nervous vitality, energy and force and prevent strain.  It accurately fits the parts [because nothing says non-vital like constant fidgeting with one's suspensory], supports without strain or pressure.  It is a kingdom of comfort in itself, a source of satisfaction at all times.

A kingdom of comfort?  I am totally in.  I’ll take two.  Oh, and P.S.  The Genuine O.P.C. advertises that there are no buckles on sack.  That’s nice.

There are over 28 styles of corsets to choose from, depending on the type of figure you’d like to have.  Abdominal-Reducing (recommended for stout figures), Easy-Fitting (for those who have a tendency to split them down the sides), Perfect Form (good news, the bust will not cave in and this one is approved and endorsed by physicians and health reformers!), and my favorite, The Martha Washington Misses’ Corset Waist For Girls.  This corset “combines all the good qualities of a waist, is trimmed at the top with pretty edging, and creates a waist that is helpful and will help the girl grow as she should grow.”

Need I say more?  And, whatever happened to Roebuck?

True, biomechanical stillness requires every one of your 600+ muscles to be active, precisely at the same time.  This time-sensitive coordination requires muscle tissue to be precisely at the same (relative) length to maximize the current of electrical communication. Inflexible sections of the spine decrease the health of the nerves that reside there, limiting clear communication.  Stiff, unyielding muscles send “fixed” information from your proprioceptors (sensory organs in the joints, tendons, and muscles).  The data coming from inflexible muscles give incorrect information to the decision making center (brain), which the processing center (not knowing that the information is based on stiffness and not external limitations to the joint) makes an over-correction, or lurching movement to stabilize.

When you try to “stand still”, you will feel these lurching motions happen in all different directions, one right after another.  They are simply your body’s best guess at where you are, as the communicative pathways between the muscles and spinal cord have been allowed to die off.  No bueno.  And, no more!

The stabilizing system of the entire body is the relationship between the proprioceptive system (information coming from the muscles, joints, and tendons) and the processing of that sensory input (what the brain tells the body to do with this info).  If you send a message STAND STILL, then you should be un-moving, 100% of the time you are asking your body to be still.  If you aren’t able to stand still, there is a problem with your nervous system, either at the sensory level (tight muscles can’t determine position) or at the processing level (information isn’t coming clearly through the spinal nerves, usually due to sluggish myelin regeneration…also a result of tight (spinal) muscles.  Your mission, should you accept, is to stop giving yourself a nervous-tissue disease, by doing the things necessary to keep your brain-body connection open, loud and clear.

Quick Test #1:  Start with your (bare!) feet pointing straight ahead.  Line up the outer edges of each foot so they make the number “11″ and make sure you are standing with your heels pelvis-width distance apart.  See how stable you feel.  Do you detect any moving around?  A slight wobble?

Now, close your eyes, and see if there is any change between your stillness before and after.

How’d you do?  Did you feel yourself move more when you closed your eyes?  Here’s what is going on.  Your eyes are not part of the sensory input required for whole-body balance — your muscles, tendons, and bones should know where they are without looking.  The poorer they communicate with the brain, however, the greater you begin to use your eyes to make corrections to your instability.  This visual compensation happens so fast, you’re not even aware of it.  The eyes (and vestibular system) are pieces of a mechanism that balances the head, all of the time, to the horizon, no matter how jacked up the rest of the body has become.  In order to repair the body (including eye muscle fatigue, dizziness, and age-related changes in vision) STOP using the eyes to do the work of the proprioceptors.  This means you have to fix your body’s internal sensory/communication channels.

Quick Test #2:  Get yourself onto one leg, with foot still straight.  No, you can’t bend either knee, No, you can’t reach your arms out to the side, and No, you shouldn’t be holding on to something while testing your balance   In fact, if you find yourself needing to hold onto something to help steady yourself on one leg, work on the first exercise, second level (both legs on the ground, eyes closed) and improve this skill before progressing to a single-limb stance.

Once you feel OK on one leg, close your eyes.  How does that feel?  Lots of lurching at the ankle?

While we’ve all got some whole-body mal-alignment going on, it’s the failure to use the feet over our lifetime that fundamentally messes with our stability.  My point of writing all of this down is, the biological, or fight-for-survival part of the brain feels the constant falling we are doing (even though the more conscious parts of our brain don’t recognize it) with every step.  Imagine the stress falling off of a 100 story building would generate in the adrenals, which shortens the psoai, which dumps a whole lot of stress-chemicals into the blood.  Now imagine you were only falling a fraction of that distance, but with every step.  This small, almost minute sensation (and physiological reaction) accumulates over time, leading to tissue degeneration of your “catching-yourself” parts (i.e. knee cartilage, spinal disk tissues).  The reaction to falling (even a tiny reaction) leads to an over-use of the adrenaline system, a risk factor for diseases of decompensation like fibromyalgia, chronic fatigue, memory loss, cardiovascular disease, insomnia, depression, and declines in nervous tissue health.

My problem with the word balance is it now has come to mean not falling.  Millions of people are taking courses and doing exercises to increase their level of balance (i.e. reducing their likelihood of falling), but because the “not falling” definition is not really, physiologically, good enough, most of us, thinking we are balanced, continue to fall uncontrollably through space.

Excellent neurological health means we get to pick, exactly and unfaltering, where we would like our physical selves to be.  Our body contains a complex information/coordination system, Proprioception, that lets us know, without even looking, where each bone, muscle, and tendon is in space.  Your brain, better than the best engineer, pilot, or computer software program, can balance you both relative to yourself, and relative to your environment…even if your environment changes moment to moment.  This is the level of health that we need to train for.  You have your first four exercises to practice!

If you’d like to hear more, I will be doing my first (free!) Katy Says…LIVE! Join me on-line, Thursday, August 12th, 12:15-1:15 PST, where you can listen to a more-thorough lecture on active stillness.  Let’s go Beyond Balance.  Beyond Not Falling.  Let’s go all the way.

Note:  8/12/2010 TO LISTEN TO WEBCAST, PLEASE Go to Katy Radio, on the top search bar and click on Beyond Balance.  Enjoy!

Psoa muscle is one of my favorite topics to teach.  This muscle has such a rich history in anatomy, and when working correctly gives the body tons of stability.  When not working correctly, it can wreak havoc on the knees and hip joints, degenerate the lumbar spine, and increase fracture risk of the thoracic vertebrae.  Each psoa also attach to the intervertebral disks of T-12 and the lumbar spine.  If your disks are prolapsing into the body, constant psoai tension can be the primary cause.

The word Psoas is interesting, even before getting to what it does.  In modern Greek, the word psoa means “pertaining to the loin.”  In the 1500’s, French anatomist (but obviously not Latin language expert) Riolanus began to refer to the pair of psoa as the musculus psoas.  Because there were two.  Technically, two psoa make a psoai, which was the more common form used by Hippocrates and other ancient Greek physicians.  That’s why you will hear me refer to the psoa or psoai when I do a podcast-tele-interview with Liz Koch next week.  But wait, there’s more.  Before the word psoa was used, ancient Greek anatomists referred to this muscle as the origin or womb of the kidney.

This was a compound between  kidney and the second part, which means womb, origin, source.  FYI, trying to get your computer to type in ancient Greek is a time-consuming task, but I thought you’d appreciate it.  And no, this information did not come from Wikipedia (ew), but from (NERD ALERT!), the Lexicon of Orthopaedic Etymology, which, yes, sits by my bed.  Thanks for asking.

Issues of the psoas are often considered emotional in root by almost every somatic therapist and non-Western trained medical professional.  The adrenals, or organs of reaction, as I like to call them, are located at the top of the kidneys (ad-above, renal-kidney).  One of the psoai attachments are located just at this location.  Anecdotal data shows that the curling tendency (spinal flexion) of the body occurs when stressed, just as a cat (and many other animals) flexes its spine to appear menacing when threatened.  Is it to appear larger?  Is it to protect the vitals?  No one knows for sure why it happens, but still the reflex is in our biology.  Turns out those Ancient Greeks were pretty smart.  Just watch Clash of the Titans.  Not the new one, but the old one.  Harry Hamlin.  Meow!  It’s chock full of history.

There are also structural reasons the psoai do not yield properly, i.e. using them to hold yourself up all the time.  Forward pelvis anyone?  If the psoai released you would fall over, so it turns out your psoa tension may be a self-induced stability mechanism.  The length (and therefore electrical flow) of the psoai are absolutely dependent on skeletal position.  The more you know about where your body is in space, the better you can determine if you’ve got your muscles at the right length.

Anyhow, my point.  Liz Koch (an international somatic educator and creator of Core Awareness™, and author of the Psoas Book, Unraveling Scoliosis CD, Core Awareness, Enhancing Yoga, Pilates, Exercise & Dance, and Psoas and Back Pain CD) will be interviewing me in a format you can all join to listen and ask questions!

When: Wednesday, August, 11th at 12PM PST (3PM EST) Liz is interviewing biomechanical scientist Katy Bowman (that’s me!) on pelvic integrity, sacrum positioning, and pelvic/ foot relationships. Plus, Where is the center of your Core? Find out!

How: Just register here.  It’s free, but you have to get the number to call in (you have to pay your own phone bill, sorry!)  Just go to this link here: http://www.coreawareness.com/teleseminarreg/ Once you register you will get your log-in/call info.

Being a pseudo hunter-gatherer, I attempted to wear my Vibram Five Fingers (shoe-less shoes) throughout my entire vacation, something that was going quite smoothly until my Most Fit Friend suggested a 12-mile hike up behind the Columbia River.  I was totally in. What a great chance to take my VFF into the rough.

This wasn’t my first time wearing my non-shoes, in fact, I had already logged hundreds of “shoe-less” urban miles on the asphalt and concrete of city sidewalks.  That’s why I was completely unprepared for the fact I had to tap out around Mile 4.  Starting off on the trail my flexible feet felt awesome.  I felt so healthy.  So biomechanical.  So…smug.  My feet were mobile while walking, just as they were designed to be, and I could feel every lump of dirt, pebble, and ow…SLATE,  jabbing into my foot.  I toughed it out until I realized that while I had slightly increased the flexibility of my foot over the last year by minimizing shoe use, my intrinsic muscles (muscles between the bones of the feet) hadn’t really worked due to the artificially flat and debris-free surfaces I frequent.

The mobility of the foot is extremely complex.  The foot’s 33 joints allow the foot 8.6 X 10^36 unique positions.  Just in case math isn’t your thing, this means that there are more than a zillion (really!) motor programs you foot could have, each one needing additional brain/body communication.   Our current biomechanical, medical, anatomical, and podiatric texts identify three motions.  That’s how stiff our feet have become.  Just to be clear,  you have the potential for billions and billions of unique foot motions, but we typically talk about three.  Wow. That’s a low bar.

I teach the physics and biomechanics of the foot because of its enormous responsibility to whole-body well-being.  Think of it in this way — the foot’s ability to deform is a method of data collection for the body.   The way the foot deforms to a surface creates a picture of what is underneath the foot.  A healthy foot creates an “image” in the brain (very similar to sonar) that helps the body’s center of mass position itself *perfectly* over the surface’s contours for optimal balance.  When the feet are stiff and tight (and constantly in shoes) the center of mass (in the pelvis) also becomes stiff and immobile.  The center of mass is never being told where to go by the feet.  Eventually you get lumbering, lurching, and unbalanced movements reminiscent of an old or injured body — which essentially the body has become, due to minimal sensory input.

I know all of these things in an academic kind of way, but what I hadn’t really experienced was taking my new foot muscles (new because they had never been over so many rocks for such a long distance) on a three-mile off-road hike that challenged the sensory input of my feet.  My feet were baby feet.  These muscles had never been used and were experiencing fatigue. You wouldn’t take a newborn on a three mile hike, but that’s what I did.  I almost wanted to cry as each step pushed into tired and sore muscles.  My solution?  Putting shoes (still super-flexible, light, and no heel) back on to finish the hike.  I brought my trusty GOLD Earth sandals (really, they are metallic gold with little faux diamonds on them) and finished 9 more miles, no sweat.  My ankles and regularly used foot muscles were fine, it was just the little guys in between my foot bones that were tired!

Through the rest of my 10-day trip, I hiked miles in the Olympic mountains and walked tons all around town.  There was a huge difference in the muscles used on urban terrain (flat and hard) as compared to natural terrain with rocks, uneven ground.  If you can’t tell if you’re “in nature,” just use comedian Demetri Martin’s definition, “Hiking is just walking…where you can pee.“  Oh, and P.S. I peed A LOT in the woods, just because I could.   Love, love, LOVE those squats!  Other notable mentions were my post-walk Super-Open Hips and Hamstrings (I didn’t do any stretching, but let the natural movements be my program and unwind my fascia under the clear-blue sky), and I had ZERO menstrual cramps.  Hello, open pelvis!

There is a very large barefoot movement happening now, which is a wonderful thing, however, we Westerners have a habit of picking a “natural” habit and jamming it into our unnatural lives, i.e. long distances on cements and asphalt.  This takes a good thing (natural foot movement) and creates an unnatural vibrational that leads to fractures in over-loaded foot bones.  Train smart.  Be logical.  If you want natural foot movements for optimal health, walk in natural environments.  Shoes have been protecting us from our over-rigid environment for some time and it takes time (years, even) to restore function.  I also strongly suggest a plan to move toward increasing foot health via increasing range of motion and function of the intrinsic foot musculature.

1.  Start by daily stretching and massage of the heels, mid-foot, forefoot, and toes.

2.  Do your foot exercises (To watch a clip of my favorites, of course:  http://www.alignedandwell.com/_product_87098/Fix_Your_Feet )

3.  Understand that the position of the foot is maintained by the muscles of the hips and make sure you optimize lateral hip (IT Band), hamstring, gluteal, and adductor (inner thigh) strength with full range of motion. Tight hips limit foot function.

4.  Get a super-flexible shoe with minimal (or better yet, no) heel.

5.  Before jumping into non-shoe shoes, deal with your whole body alignment and gait mechanics.  Podiatrists are seeing a huge increase in forefoot fractures from people (even highly-experienced runners!) who land with excessive force on the front of the foot.  Walking should be heel to toe, not landing on the front of the foot.  Running should be done on natural surfaces with body weight stacked correctly (without the torso leaning forward.)

6.  If you get non-shoe shoes, be a walker.  But if you do choose to run, build up your walking mileage for a year before even considering running in them.

7.  Log your miles on a natural surface, with elevation changes and rocky obstacles. The urban jungle is not a natural walking surface, and the friction and traction of this surface coupled with the lack of its yield can be quite damaging to the human body.

Hiking in minimal shoes can yield amazing results. For all of you body nerds out there, this is the way to tap into a greater portion of your brain/body connection.  Do the work!

There are many reasons why walking with little ones is challenging, but the most basic is, they aren’t at the same level of physical performance as you.  They get tired.  Then they get pokey with their little hands and feet.  Then, in a team effort, they all manage to start crying at the same time.  They also seem to manage to do it when you’re at the farthest point from the house.  It’s awesome.  Turns out exercise isn’t always a stress-reducer. Well, maybe us exercising was relaxing for Mom, who got to stay home and take a nap.

So, where does the walking child’s fatigue (I’m tiiiiired) come from?  After all, we are beings that (at all ages) have always walked, for hundreds of thousands of years, multiple hours per day, with our very survival based on walking endurance.  Simply explained, a child’s fatigue is a result of poor training.  Based on my own personal log book of thousands of miles walked, I can say that I have rarely seen a child on a walk beyond returning to the car from the restaurant.  Oh, I’ve seen kids held and packed.  I’ve seen them on skateboards and bikes. I also see kids WAY too old to be in strollers being pushed along while mom is watching her heart rate monitor.  Law of Specificity indicates:  If kids don’t walk, then when they do walk, it’s too hard. Seems like a pretty simple answer, but really, this is the basic principle of exercise science.  Of course kids are playing on jungle gyms and participating in sports — which is fine — but they aren’t walking.  {Don’t get me wrong, I see teenagers glumly walking around wishing their parents weren’t so lame, but I’m really talking about kids aged two to twelve, with developing bodies.}

In the olden days (not like 200 years ago, but 20,000 years ago), walking was inherent to our biological culture.  From a biomechanical perspective, it is clear we need to return to walking this kind of distance for the survival of our biology. We can start with a fraction of the distance.  I can’t say this enough:  Doing other exercise does not replace walking, as your physiology depends on the very particular mechanical signals found in regular, well-aligned locomotion.

How do you get your kids walking?

1.  Start walking yourself. (Uh-oh.)

2.  Start walking with your kids. This is going to go a lot slower than your walk (trust me) but it’s important to walk as a family at their pace.  Discuss that you will be walking “because walking is the most important form of exercise.” Let them help plan the route you take.  Pick a short distance and make that a habit (i.e. let’s walk to the store or to the creek), so they don’t feel the walk will go on indefinitely.  Kids love things that seem to go on forever without end.

3.  Understand that your kids need to develop the motor programming, strength, and endurance to walk with you. Develop your walking distances accordingly, increasing them no more than 10% per week.

4.  You probably need to carve more time out for health. If you only have 45-minutes allotted for walking, realize that this is inadequate time for everyone (you and your kids) to get what they need biologically.  Consider replacing a planned activity with Vitamin D.W. (Daily Walk).  This walk is more important than just about anything…trust me.

One more thing when it comes to kids and walking.  They don’t like walking because it’s booriiiing.  But guess what?  Parents probably think it’s boring too, which is why music and classes and gyms and special outfits exist.  I once heard “If you’re bored, you’re boring.”  Ouch!  But, it’s kind of true.  There’s nothing boring about your body, in dynamic motion, with it’s 200 bones, 230 joints, 600 muscles all alive with neurological connection to your brain with each step.  Nothing boring about the planet you’re walking on and the bugs, animals, and people you share it with.  Develop a daily appreciation for your freedom to walk, and then pass it on.

Many people come to me as adults in despair, wishing that they had had one iota of health presented to them as children.  In overzealous response, many of us are replacing our lack of natural movement with fitness, which can take care of one issue but creates others.  Walking with your kids is free.   No classes, special camps, or equipment required.  No more excuses.  Kids need more than “playing all day.”  They need to be able to walk quite a distance.  Start your family training today.  Their bones and brains will thank you!

Each one of the points refers to a bony marker (something you can clearly see with your eyes, no matter your body composition).  Each point needs to be in the correct spot, relative to other points, and relative to the gravitational force, in order to have optimal health.  If your tissue tension does not allow the points to be in this orientation, then there is a resulting issue with the neurological, lymphatic, and blood flow.   These points are not approximations (like this is kinda a good way to be) but the actual mechanical position your joints should be in for optimal flow and minimal degeneration.  When walking (which you need to be doing, multiple miles per day, to drain your lymph) the only markers that should be changing are the swinging of the arms and legs (and there are specific places those need to be too!)

The physics of the body is a fascinating science, especially when you realize that things we believe to be major diseases are simple things, like points 6,7, and 8 not being vertical.  Or 11 and 12 not being vertical.  Given the choice, would you rather have surgery on your spine, or just get point 11 over point 12?  Chronic headaches? I’d check point 20.  Thyroid slowing down?  Check 20, 10, 14, and 17.  High Blood pressure?  You’ve got more than a few points to work on, but there are points still the same!  Knee osteoarthritis?  ACL damage?  We always start with 1-5.  Adjusting 1-5 is free, takes less than five seconds, and is waaaay more convenient than a knee replacement, I think.  But, what do YOU think?

Getting this information out is essential for the longevity of the naturally free (freedom to move!) and mobile human race.  Without this information, there is only one direction we can go.  Bed-ridden.  Chair-ridden.  Or, like the police officer I saw the other day (who was, less than 40 years old), Segway-ridden.  Hey criminals, want to be successful in the next 20 years?  Stretch and use your legs and steal things from places cars or Segways can’t go.  (I’m not condoning criminal activity of course, but “the survival of the fittest” will always be true, so we’d better change our mindset, fast!)

We are looking for paradigm-shifting health professionals, those looking to transform their community starting with their family, teachers wanting to undo poor alignment practices in the classroom, birthing professionals wanting to reduce baby-or-mama damage due to delivery, and you, sitting at home right now, knowing that you want this information, to learn the science, and pass it on.

We are looking for people who demand their health care makes sense.

If you’ve taken our course and are now out there sharing this information, what do YOU have to say about the training?

Enjoy playing with the 25 Points, and email me (katy@katysays.com) if you’re interested in info on our East Coast or West Coast training.  I know I am.  (Wait, does that mean I should email myself, or what..?)

So, am I hearing you correctly, that you’d like a natural delivery?  Well then, following the science of physiological adaptation, you must train your body specifically.  We need to train for delivery because, while birthing is absolutely a natural event, we have become, it seems, un-natural women.  I know, I know.  You eat organic food.  You take yoga classes and wear Birkenstocks.  You even drive a hybrid car or maybe take the bus every now and then.  Maybe.  And while these are all very eco-friendly things to do, they are for the most part, completely foreign to our animal counter-part, which makes them, completely unnatural.

Natural, in its broadest definition, means “in accordance with nature“.  Well, the last time I checked, nature wasn’t busy designing toilets, or chairs, cars, or shoes.  Nature doesn’t exercise four or five times per week.  Nature doesn’t exercise at all, but rather moves continuously throughout the day.  Nature doesn’t eat foods not available to the location or season, even if they are nutritious.  Nature also doesn’t secrete stress hormone while commuting from one part of the forest to the other, affect metabolism regulation with a flick of a thermostat, or take anti-inflammatory medications at the drop of a “my back is sore”.  We have, within a few thousand years, completely reduced our ability to be “natural”, yet we still partake in these amazing, natural processes of digestion, sensory input, elimination, growth, and of course, birth.

The first thing to understand is, while pregnancy may seem like an unnatural position for your body to be in, it is quite natural actually.  What makes it feel so awkward and possibly uncomfortable is the extreme loading done on an unbalanced, rickety frame.  I once bought a cool table from the Goodwill, even though it didn’t balance quite evenly.  It wasn’t that big of a deal in the store, but once I brought it home and tried to put stuff on it, the lack of stability became more of a functional issue.  It’s the same thing with all of you out there with chronic low back and pelvic pain, feet that are flattening, birthing canals that are narrow, and abdominals that are splitting (diastasis recti).  These are not issues of pregnancy, but issues of pregnancy on an unstable frame.  A woman who wears her pelvis out in front of her (see Mind Your Pelvis for a good visual) is not a Stable Table, if you know what I mean.  Loading her up with 25, 45, or 65 pounds is going to increase the effects of this mis-placed weight and make pregnancy more difficult than it needs to be – way more difficult than it is for other animals.

You’ve come with all the equipment needed for a successful, natural birth – a movable sacrum, a strong transverse muscular system that runs in series with the uterus, and thick thigh muscles that support the entire weight of the torso.  But, guess what?  Poor alignment, especially the forward thrust of the pelvis, turns all of these things off.  The sacrum becomes jammed up and the more mal-aligned the body, the weaker the abdominals.  Thrusting your hips forward also pushes your belly contents right through the wall of the abdomen.  Another Fun Fact:  Diastasis Recti has nothing to do with pregnancy.  It happens in men and women who habitually thrust their hips and have extra stuff in the midsection. Beer or baby belly, it doesn’t matter.  You want to avoid it?  Stop shoving your guts through your abdomen.  Stop thrusting your hips and wearing shoes with heels. If you want stronger leg, thigh, and hip muscles you have to walk…a lot, like animals do.  You have to squat often, like animals do.  If you want to have an optimal natural delivery, you should train with a natural pregnancy.

There are many pregnancy “myths” that have permeated their way into our cultural understanding of birth.  This mis-information makes obtaining the correct birthing mechanics more difficult.  In graduate school I wrote a paper outlining all of the research on what we *think* are birthing truths.  My favorite study was on the pregnancy waddle. You’ve all seen a TV show from the 50s that showed Mom-to-Be in a flowery pregnancy frock with her hands on her back, belly shoved forward, struggling to get up off the couch and walk to the kitchen to get some pickles and ice cream (which I discovered is pretty awesome, by the way…)  Well, that walk isn’t a natural occurrence with pregnancy, but the walk of someone who doesn’t have the strength to carry the additional weight.  My grandpa walked like that too, if I recall.  Yes, your midsection is growing, but if you were in the correct alignment, the glutes, hamstrings, and transverse abdominals should also be growing equal in strength, to keep you walking perfectly upright and not so much like a staggering sailor.

My paper also called for this information to be taught to birthing professionals, fitness professionals, nurses, and doctors, to pass on to moms-to-be, to optimize their mechanical ability to birth easily at home.  General pre-natal fitness has very little to do with real birthing mechanics, as required by the laws of specificity.  It’s kind of like swimming to train for a 25-mile hike.  The swimming isn’t bad for you, but isn’t the best program design.

Some training tips:

• Get to know the geometry of the body.  I’ll continue to post which markers to look for.
• Get out of positive-heeled shoes.  It will make all the difference in the world!
• Squat, a few times every day. See Squat Blog: http://www.katysays.com/2010/06/02/you-dont-know-squat/
• If your body is already too damaged to squat, follow the more basic, non-squat exercises until you are strong enough to handle the full range of motion.
• Walk, walk, walk.  Work up to 5 miles a day, if possible, broken up throughout the day if needed.
• Minimize sitting in chairs and change up your sitting postures often.
• Find your Transverse Abdominals and see if you can fire them. See TVA Blog: http://www.katysays.com/2010/06/22/what-a-waist/
• Stop tucking your pelvis, right now.  In fact, stick your butt out while you’re reading this.

Midwives: What if you could help prepare your mommy’s mechanics?  Moms, Midwives and Every Woman is invited to take this course that will walk you through the exercises you need to know for optimal delivery, pelvic floor health, and knee, hip, & low back longevity.  Now offering 1.95 CEUs to midwives (email me for more information).  And, for those of you post a comment in the next 5 days, I’ll send you a discount code to save $10.00 off.  Read more about the course here:  http://www.restorativeexercise.com/2010/no-more-kegels Please note:  YOU DO NOT HAVE TO ATTEND THE LIVE COURSE!  You can watch and follow the course on your own time frame, in your own time zone!  Course is six 45-min lecture sessions (recorded and ready to watch as soon as you register) and Four Exercise Classes and Lecture sessions (75-minutes) with Q and A, to follow along for thirty days.  Regular course is $99.  With discount, $89.  Register soon to receive your equipment in time!

And, for those of you who want to see some serious natural birthing going on, check out this elephant birth:  http://www.youtube.com/watch?v=llIv20mScP8

“Julie Treible caught a common spring cold this year and lost her ability to speak — for six weeks. The cold had turned into bronchitis, then laryngitis — at least that’s what she thought.

“April 1 I got a cold, and this part never got better — my voice,” says the 43-year-old single mom in a forced whisper.

“Treible communicated with her family using a white board, because trying to talk made her dizzy. She even passed out once and fell down the stairs, scaring her 10-year-old son and landing her in the hospital.”

They put you in the hospital for scaring your kids?

Scopes of her throat, CT scans, an MRI and visits to various specialists yielded no answers. But after an appointment at the Cleveland Clinic Head and Neck Institute, she’s hopeful that will change.

Um, does anyone want to take a stab at figuring out what multiple scopes, CT scans, an MRI, and visit(s) to various specialists cost Treible and her insurance?

Claudio Milstein, a voice specialist, is optimistic he can get Treible speaking again and send her home that day. With Treible seated in a chair, Milstein stands behind her and places his hands on her neck. He begins by manipulating the muscles in her throat with his fingers.

“I’m going to stretch the muscles around your voice box,” he says. A few small pops are audible as he works. “Those cracks, you hear that? Those are normal, so don’t be concerned.”

Don’t be concerned even though this sounds like I may be breaking your neck, okay?

Treible remains silent, wincing slightly as Milstein presses against her voice box. He turns her head from side to side and then presses down on her shoulders. To the casual observer, it looks something like a chair massage.

Dear Casual Reporter, I think it looks something like a chair massage, because it is a chair massage.

While Milstein works, massaging her shoulders, neck and throat, Treible makes a continuous “e” sound, pausing for breaths, then switching to “oooo.” Within minutes, the raspy whisper begins to disappear.

By massaging and relaxing the muscles in her throat, Milstein was able to release the vocal cords and allow Treible to speak again — all in about seven minutes.

“In order to produce voice, you need to have a very good balance of muscle tone in a lot of different muscles that are involved in voice production,” Milstein says. “So an intervention like this, where basically you manipulate these muscles and try to restore the internal balance, is very effective.”

The problem, it turns out, is fairly common. Milstein estimates he sees about 10 patients like Treible every month, some of whom have been without a voice for up to two to three years. One reason for the delay in treatment, Milstein says, is that things like cancer, infection, acid reflux and neurological problems need to be ruled out — and those diagnostics may involve multiple doctors, medications and expensive tests.

Wait, back up a second. The “let’s check if your neck muscles are too tight to allow your vocal cords to work, and then spend 7 minutes fixing that” idea is lower on the checklist than try multiple doctors, medications and expensive tests?  Smart. You can read (or listen) to the rest of the story here:  http://www.npr.org/templates/story/story.php?storyId=128359885

The rest of it goes on to say that no one knows “why” or “how” this condition occurs.   Really?  Are we, a culture that offers the most technologically advanced medical treatments and spends the most on researching treatments, forgetting the basic laws of musculoskeletal science?  Did we forget our freshman-level physiology and anatomy classes?  Ever take biology?  What about Physics 1?

Allow me to clear my throat before yelling YOUR MUSCLES ARE NOT JUST FOR EXERCISE (they’re not even FOR exercise!!!), BUT DRIVE EVERY FUNCTION IN THE BODY, including your vocal cords.  <Coughing fit> In every health issue, consider what the muscles in that particular area are doing.  Underworking?  Overworking? Are they stiff and rigid to the touch?  Sore to the touch?  You might have an inexpensive treatment in massage.  Wait, you mean massage works?  Guess what?  Body work is one of the oldest forms of treatment for many ailments, and currently, a well-trained therapist can be a great source of help from a multitude of aches and pains.

As for the neck and throat area in general, this is a critical part of the body.  Circulation to the brain,  lymph node waste removal, thyroid function, and as you now know, your vocal cords, all require supple, flexible muscles to work optimally.  Stiff in the neck?  Loop a warm/hot wet towel around the neck to “steam” tense muscles, especially after long bouts of talking (especially if you’re ranting).  Find a well-trained, licensed massage therapist to help you unwind those stubborn knots, and finally, stretch.

Stretch your neck and shoulders every day.

Try this:  Let your right ear fall to your right shoulder (yes, it should touch) for a few one-minute bouts per day.  Don’t force it, but allow it to slowly relax and yield.  Don’t forget to do the other side.  Also, let the chin drop to the chest (it should touch here as well), keeping the back of the neck long.

Ok.  I’m done now and unfortunately will not be getting a massage now.  But a hot bath sounds good…

I can, of course, understand why the Kegel Queen might be upset.  I’m sure the article made her feel like someone was storming her castle, and who was I?  Some Squatting Court Jester with a large derriere!  Take a look (her video is great!)

I’m not sure if any of you out there have ever had someone “take you on” in a YouTube video, but it can be quite startling to hear someone you don’t know say your name on film. Deemed Katy Bowman, Kegel Critic by the KQ, I want to point out that while my position on Kegels is they are a short-term band-aid for PF disorder, I am actually not in favor of weak pelvic floors or organs falling out of women. Katy Bowman=Women’s Health Advocate, not The Grinch Who Stole Bladder Control.   After watching the video, I did what any person mentioned in a Kegel Queen video would do.  I emailed her.  And then I waited for her return email.  What was the KQ going to be like?  Heavily guarded?  A royal pain?  Did she even return her own calls (does the Q of England?) or would I have to deal with her court?  So many questions!

Finally, we connected for a nice long chat, and who knew how awesome the KQ was going to be?  (Actually, I did.  No one stutters bogus a la Max Headroom and wears a crown unless they are awesome…)  We talked over many things and I wanted to share a bit of my interview with you.

1.  Was your mother also Pelvic Floor Royalty, or did you marry in?

My reign is actually the result of a coup. With an army of like-minded women, I’ve been working for years to end the rule of high-tech, dangerous options like unnecessary hysterectomies and cesareans. My rise to power is a victory for every woman who wants to keep her body, and her power, intact and use the wisdom of her own body to heal herself.

I certainly have been inspired to use that word whenever I see the made-up “information” that is commonly presented as kegel instructions. Actually the word I’m inspired to use is best avoided in polite company, but “bogus” is an acceptable substitute to describe virtually all the kegel instructions you’ll find online, and in medical offices, childbirth classes, magazines, and on and on.

First: In the Kegel Queen Program we use No Devices, Ever. Women looking for kegel instructions online will be barraged with ads for all manner of things you can put in your vagina and squeeze. But some types of devices can damage the pelvic floor, and inevitably they end up gathering dust at the back of the underwear drawer when women get sick of taking their pants off to do kegels, washing the device, packing it in their overnight bag and having to explain to airport security that it’s not a bomb.

Another major difference is that my program is based on scientific studies, and designed to be done in minutes a day. People who recommend hundreds of kegels or hour-long kegel sessions haven’t studied the research, and they also must not know any actual women if they think we are all going to quit our jobs and do kegels all day! I also emphasize the importance of breathing and correct positioning, and teach how to successfully make kegels a habit — all of which are generally overlooked in most kegel instructions.

Of course, I was already familiar with the way the sacrum moves with squatting or pelvic floor contraction. But your perspective on muscle physiology is new and fascinating to me, and something I’m very excited to learn more about.

Because of the way kegels have profoundly benefited me and my students — eliminating prolapse symptoms, curing incontinence, and leading to radically better sex — the idea that you can squat INSTEAD of doing kegels will be a very hard sell for me. But working with positioning and other aspects of body mechanics to optimize pelvic health is a brilliant approach, and something women badly need. Kegels AND squatting? I’m all over it.

Go to www.KegelQueen.com, and watch a short video in which I explain the Kegel Queen’s Top Three Reasons You Should Never Do Kegels while Driving Your Car. I’ll send you a free PDF with even more detail about that too. You can also order my free “Kegel Myths & Facts” DVD.

And if you want to learn all about the correct way to do kegels, you can order my two-hour audio course, which comes with a Study Guide, two months free access to my members-only web site and live Q & A calls, and other awesome goodies available only with the course, including my book, Keep It Simple Kegels: The Complete, No-Devices, Fast and Easy Guide That Shows You How to Do Safe, Effective Kegels so You, Too, Can Stop Peeing Your Pants, Get Help with Prolapse, and Have the Most Incredible Sex of Your Life.

Now, my two cents.  I think it’s pretty revolutionary to interview oneself, don’t you think?

1.  Why do you hate the Kegel?  Are just you a bad person?

I don’t hate the Kegel at all, but what people need to know is there is a poorly understood, much larger whole-body issue going on in those with PFD that the Kegel doesn’t even touch.  If this larger whole-body issue were addressed, you would never need to kegel to keep your junk in place.

2.  What about all the research that says Kegels work?

I am assuming that most people who say “the research shows that kegels work” are people who have actually not looked at the research beyond the abstract or know the difference between what the research finds (the numbers and measurements) and what the researcher extrapolates (their thoughts on what those numbers and measurements mean).  There is actually very little research showing the long-term ability for a PF “strengthening” program to continue to keep women from surgery.  (And FYI, having the surgery doesn’t seem to keep you from needing more surgeries either, so there. )  Research that shows “kegels work” typically show that kegels done under the supervision of someone (with something possibly inserted into your vagina) register an electrical or mechanical measurement.  Which is different than they have kept someone from needing surgery over a lifetime.

What a statistically larger number of people experience is a short-term (and I’m talking years) positive experience, that, over time begins to decrease.  The positive benefits decrease because the Pelvic Floor cannot, like any muscle in the body, contract indefinitely.  For long term PF function (which means continuous force generation) eccentric (muscle lengthening) function is needed, which requires the muscles on the other side of the sacrum to be working at the same rate that the PF is working.

3. What is a Kegel, actually?

As a scientist, this is another bee in my bonnet.  The research conducted to PF muscle training will use different protocols (aka definitions) for the Kegel.  Some use devices.  Some use long holds.  Some use flicks.  Or flickers (which is flashing the lights as you rapidly clench and unclench your PF.  Just kidding.)  Some teach the relaxation portion.  Some don’t.  Some say do it using a trigger, like a stop-light.  Other evidence shows that using a stop sign (or a shower situation or stopping and then releasing your urine stream) creates an incorrect neurological dependence on these items, interfering with the natural motor programming.  Who knows if the method by which you are executing a Kegel (that your doctor or midwife or best friend or latest issue of Fitness Magazine describes) was even the method researched for health benefits?  The whole science/research thing has become extremely (and ironically) subjective and has resulted in poor exercise prescription.

4.  Why do Kegels work for some people and not for others?

PFD is absolutely multi-factorial, meaning there are a lot of things that happen to result in the situation at hand.   To increase your short-term PF strength benefits, you probably received in-depth instruction and followed a correct, well-thought out protocol (like the KQ has done).  The person for whom it works is also someone who did not have excessive PF displacement during labor, may have paid more attention to alignment and movement (exercise) before they had an issue, and isn’t a runner (A shortened PF cannot handle the excessive G-forces from the impact.  Pelvic floor length may be your salvation!)

5.  Is there any time a Kegel is a good thing to do?

Of course!  Any time you have lost your somatic ability to find your body parts (i.e. finding and moving your body parts with your brain) – as in: I have no idea how to feel my PF – doing a Kegel is a first step to building a brain-body relationship.  The original use of the Kegel was for women just after delivery – probably the best time to begin a somatic lesson in finding your pelvic floor through good guidance.  Also, as people decrease sexual activity, the muscular walls of the PF may have also lost “contact” with their brain.  If you find yourself needing to sweep away the cobwebs “down there” an introduction to pelvic floor somatics may also be in your best interest.

6.  What is the “bigger issue”?

The pelvic floor is not supposed to be a muscle you “train”.  It is a muscle designed to have continuous electrical flow based on the correct use of the lower limbs and muscles in the trunk:  diaphragm, psoas, TVA and TVT, lumbar extensors, multifidus, intercostals, latissimus, gluteus maximus, TFL, etc.  Because of years of mal-alignment and incorrect lower leg muscle development, your larger muscles are not bestowing the PF with the space and support it needs to maintain a healthy tension. That tension is necessary to its ability to generate force.  A Kegel is a good way to “fake it”, but the PF is too small to do the work for the larger, slacking muscle groups.

PFD is a sign that your entire body is collapsing, from the inside-down. While the sneeze-pee and organ prolapse may seem like a huge deal it is nothing compared to the neurological damage to the spine, nerves, and tissues that those nerves supply (especially the nerves running to the lower legs.)  The kegel is a drop in the bucket to what someone with PFD needs to do to heal all their structures.  PFD is a whole-body situation and for optimal, whole-body outcome, the body has to be treated holistically. Otherwise it’s like putting a new roof on a termite-ridden frame.

Where do the KQ and I stand (or squat?)  Pretty much on the same page.   She’s for optimizing Women’s Health, as am I.  She’s taken lots of time to develop a detailed, easy-to-use program with great results.  I like to think I’ve done the same.  It is essential that women realize normal aging does not require organ removal or surgeries to accomplish what your muscles should be doing.  Pelvic Floor Disorder is simply a weakness of the  muscles that attach to the pelvis and the pelvic floor.  This situation is easily changeable.  The conversation between the KQ and me should prompt you to look at the entire problem thoroughly, know your equipment (all of it, not just where your trouble seems to be located) and choose the correct prescription based on lots of information.  Visit KQ’s site (www.KegelQueen.com) and you can sign up for some free PF info, and maybe order her kegel course. I’m going to be working with her on the bigger alignment portion, so stay tuned to the KQ’s email.

(Have you registered for my 30-day, online, whole-body PF health course?  It’s going to be life-changing! Watch me live or on your own time-frame in your own time zone.  Find more information here: http://www.katysays.com/2010/06/23/no-more-kegels-an-on-line-course/)

The Kegel Queen and I have decided to become allies, which makes me some country that I could think of had I paid more attention in World History.   How about I be Australia, then I can be Queen of Down Under, which is kind of like “Down There.”  How do you like my crown?