Dear Dr. Oz,
I let it go (kind of) when you brought up “beautiful women in spandex” as a motivating factor to take yoga.
“Yoga is the most important exercise of my daily routine. Being surrounded by beautiful women in spandex should be reason enough to join a class, but if you need more motivation, consider this: Yoga eases stress, lowers blood pressure, slows heart rate and increases flexibility.” - Dr. Oz (From June 2010, Natural Awakenings Magazine -- Everyman’s Rx from Dr. Oz)
Ick. Don’t you have an editor? You can’t go around saying creepy stuff like that, dude.
Anyhow, what I cannot let go of (without at least one blog-lashing) is your SUPER KEGEL recommendation. I was excited to see Pelvic Floor Disorder (PFD) making its way onto daytime TV. That’s great. Really great. It helps get the word out that we are dealing with a super-epidemic of falling organs. Note: The show would have been even better if it included the fact that MEN have their organs falling down too, only they don’t fall out, but down...right onto the prostate.
The topic was timely and important. The episode was, however, lack luster in the areas of Causes, Treatment Options, and, of course, the SUPER KEGEL. I figured there would be the standard Your Pregnancy Caused Your Prolapse presentation (yep!) and some inaccurate content about age and lost muscle mass, blah blah.
My (first) favorite part was (and I am paraphrasing): Pelvic organ prolapse occurs because your pelvic floor is weak due to age or pregnancy damage (never mind that women who’ve never had children, men, and men who have never birthed children have a high incidence of PFD), and while the pelvic floor organs don’t weigh very much, these muscles fail under the weight of your entire body. HUH?
Hello...Your pelvic floor organs are not holding the weight of your body. That’s what you have your skeleton for as well as the muscles in your legs, hips, and trunk. The pressure in your pelvis does not skyrocket when you carry an extra 20, 30, or 70 pounds on your BODY. This “logical” deduction is clearly derived by those who don’t seem to understand geometry, physics, or the actual definition of weight very well.
Message to all: Extra weight on your body does not especially place extra weight on your pelvic floor. (What DOES place large amounts of strain of pelvic floor organs is downward pressure, which we'll discuss later...)
Attention all “scientists” out there, or people who review literature for fun. One cannot deduce causation from epidemiological studies. You are not researching cause. You are researching characteristics. CORRELATION DOES NOT IMPLY CAUSATION! If you don't know what the previous statement means, then you should never use the terms "there is research that shows..." or "according to the literature...".
My (second) favorite part was the recommendation that, “if you have a prolapse and it doesn’t bother you, you can go to your grave knowing you had a bit of prolapse.” Ummmm, I guess that’s OK advice if you notice your prolapse at age 85. If you are less than 85 (say 28, 38, 48, 58, 68, or 78), I suggest you pay attention to the fact that your organs are thinking of vacationing south this year and take care of the problem before the seriousness advances another stage or before they think about inviting their friends to travel with them.
My (third) favorite part was the recommended exercise (of course) the SUPER KEGEL.
Is it a bird? Is it a plane? No, it’s the newest member of the Comic Book Characters found on Day Time Medical Advice.
Seriously, if you didn’t watch the episode, see if you have a friend who Ti-Voed it.
Evidently, when normal pelvic floor tone is not happening in your tired, old, over-birthed, over stretched, over-loaded (from an extra 30 pounds) pelvic floor, then do this:
Pretend you are a little kid trying to “hold it in”. Cross one leg over the other and sit back by bending your knees (like in a little chair). Then, squeeze your butt, your knees together, and, of course, tighten your Va-Jay-Jay (Dudes, you can do this too -- just tighten your Pro-Tay-Tay).
Perfecto! You now have strengthened all of the motor programs for incorrect pelvic floor function.
Quick anatomy/exercise prescription lesson, Dr. Oz. This exercise is not a Kegel. A Kegel exercise is a very specific, clinical thing, that, when blended with other motor programs changes into something entirely. In fact, people doing Kegel exercises incorrectly exacerbates PFD, which is why physical therapists have to spend so much time helping people FIND their pelvic floor muscles instead of simply squeezing (guess what?) their butt and thighs at the same time. Nice one.
Now, I don’t want to confuse my readers. I am not a fan of Kegel exercises as a thorough, correctly designed program for PFD because Kegels treat the symptom and not the problem. There is much (much) more to understand about your pelvic floor (i.e. how the PF is involved in gait, for example) than how to contract and release these muscles. There is much more mechanics involved with what keeps items up and closed in your body than what is taught even in college-level anatomy and physiology. That all being said, you still need to be able to FIND your pelvic floor and know HOW to signal it to do what you want (i.e. relaxing your PF during vaginal delivery is essential!).
Do you need SUPER STRENGTH to have a healthy pelvic floor? Absolutely not. The MORE IS BETTER argument doesn’t hold up with muscle tone. There is simply the right amount to optimize physiological function. MORE IS BETTER only applies to BBQ beef tri-tip sandwiches when one is 31-weeks pregnant. Or, is that just me?
I got a lot of emails about the SUPER KEGEL, which makes me happy, because it means that you are paying attention. And I also got to hear from my favorite Pelvic Floor Royalty, the Kegel Queen. As you can imagine, she wasn’t that thrilled with Dr. Oz’s prescription, either. You can read her comments on the episode here.
Next blog: Let's talk about downward pressure and how it pushes the PF organs out.
Next meal: Tri-Tip Sandwich.