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- Leslie Howard.
Incontinence is one heck of a conversation killer. And that's only on those rare occasions when it enters conversation at all. Granted, it's not a topic that pops up over cocktails or at office picnics or the gym. Leslie Howard says it should.
"Fifty percent of all women have experienced some form of incontinence at one time or another," says the longtime yoga teacher. "They think it's normal, because that's what they've been told." This attitude of helpless resignation infuriates Howard, who focuses her practice on the largely unsung region of the female body called the pelvic floor, situated between the perineum and the pelvic cavity. Too little tone and/or too much tension in these layers of muscles, nerves, and connective tissue is typically involved not just in bladder problems, but also in digestive, spinal, and sexual woes.
"It's amazing how many women can't even have intercourse because it hurts them too much," Howard says with a shudder. "They can't even think about it." One common pelvic-floor problem is organ prolapse, in which the bladder, uterus, or other organ protrudes into the vagina.
"Think of your torso as a 'tote bag' for your organs," Howard proposes. "The pelvic floor is the bottom of the tote bag." If it's weak, so the simile goes, the bag's contents spill out.
The typical chain of events too often goes like this: shame-induced silence followed by a life spent in adult diapers or by "very, very invasive" surgery such as a hysterectomy. Howard realized how pervasive that silence is when she mentioned her interest in pelvic-floor yoga to her personal physician.
"My doctor told me that during an exam with a female patient, she always asks three times whether that patient has been experiencing any incontinence. She has to ask three times because, the first two times, patients just say 'No.' They won't even admit it to their doctor."
In classes such as the four-session series starting Thursday, July 30, at 7th Heaven Yoga Center (2820 Seventh St., Berkeley), Howard demonstrates how to identify the pelvic floor's various parts and shows students how to assess the conditions of their own pelvic floors. She also teaches yoga poses that stretch, strengthen, and otherwise promote wellness in that region. It's a more effective, proactive, and up-to-date approach, she asserts, than Kegel exercises — a repetitive squeezing technique that has been the anti-incontinence standby since the mid-20th century.
She also gives her students homework assignments. Some of this homework involves digital insertion, but the first assignment is always: Talk about it. Increased awareness, Howard says, can end some of the health crises we too often take for granted. "It's just tragic that women are told today that it's normal to be incontinent after a certain age," she says. "The adult diaper business is a multibillion-dollar industry. I tell my students to go out and say to all their female friends: 'Hi! How's your pelvic floor?'" 7:30 p.m., $70. 7thHeavenYoga.com
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Thank you for your work bringing women's attention to this! I agree that it's something we never talk about. I had severe stress incontinence after the birth of my daughter despite doing Kegels the way I thought the midwife had taught me. It wasn't until I went to a physical therapist who specializes in pelvic floor issues that I realized I had been doing them all wrong. I don't even know if the midwife had ever thought about the issue;she went through the instruction in this very perfunctory way and I might have saved myself a couple of years of heartache and embarrassment (and a lot of laundry) if I'd just learned a little more about this area of anatomy the first time.
Congratulations on your empowering classes Leslie and drawing attention to a major health care problem no one wants to talk about . Pelvic floor dysfunction has a high personal cost to women and last year cost $26 Billion in North America. Your classes obviously take the time to let women identify how their pelvic floor muscles work - so many practice Kegels incorrectly and keep reinforcing an incorrect action. If women are taught to train their abdominals in isolation (sit ups), it may lead to incoordination between core and outer abdominals, causing PF muscle dysfunction.
Lets keep talking about the pelvic floor until the stigma and mystery is removed and women freely share correct information about these amazing muscles which control continence, assist with spinal support and sexual sensation.
Mary O'Dwyer
Down Under Physical Therapist
www.holditsister.com
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