(Piano music)
00:10 This podcast was recorded at State Library Victoria on Aboriginal land. The land of the Wurundjeri people of the Kulin nations. We pay our respects to their elders past and present.
00:21 (Piano music)
00:30 P: Hello, welcome back to In Those Days. I'm here with Christina Adams.
C: Hi Penny, how are you?
P: I'm good thanks. How are you?
C: Great.
P: Now, recently the National Library of Australia released their Trove Strategy and they had some different scenarios about how Trove might be in the future depending on how much funding they get. But they also had some stats in there.
C: I love some stats.
P: Thought I'd share it with you.
C: Have you pie graphed them?
P: I haven't. The first thing. Trove has 6 billion cultural heritage items in the digital repository. 6 billion. And from 900 Australian collecting institutions.
C: That's insane.
P: I know. And mostly it's libraries at the moment but they kind of would quite like to sort of extend that out to other cultural and collecting institutions, which could be an exciting direction for them in the future. Now, Trove gets nearly 64,000 visits per day.
C: That's a lot.
P: And only around 10,000 of them are me.
C: Wow. How many times to you log on?
P: To be fair, I'm just constantly there. Always got a Trove tab open. And the average user time spent on Trove is 6 minutes and 2 seconds.
C: That's not you.
P: No, that's definitely not me. But that's actually really quite high because most other organisations, 2 minutes would be really, really good. So the fact that people are spending that long. Obviously I've never spent only 6 minutes.
C: Cos you go down a lot of rabbit holes.
P: Particularly not at bedtime. I find 3/4 of an hour just goes like that on Trove. And then I'm like, 'Oh it's late again'.
C: And then you're tired and grumpy the next day.
02:09 (piano music)
02:18 P: It's time for us to introduce our next guest who is a physiotherapist, she's a lover of travel and the life of the party, I think. It's my sister, Mary-Anne Tangey!
C: Hi Mary-Anne
M: Hi, thanks for having me. What a great intro, Pen.
C: It was solid.
P: Did I miss anything important about
M: Yeah, you can sum me up in 3 words I reckon.
C: And for those of you who can't see. Penny laughed so hard her headphones fell off at that point.
P: Maerz, have you used Trove much?
M: Only in preparation for this event.
P: Yeah, Mary-Anne cheated and went and searched.
M: I was worried
C: Were you freaking out?
M: I was worried about a blight on my professional integrity if I didn't have a quick look.
P: Cos we are going to be talking about Mary-Anne's professional area today, which is, Mary-Anne's a physiotherapist. We are going to be discussing anatomy generally today. This is not specific medical advice for anyone. And if you have any issues you should go to see a health professional.
C: Or write to Dolly Doctor.
P: Yep.
M: Or even if you don't have any issues and you just want to know a bit more about it.
P: And which area of
M: I'm a pelvic health physiotherapist so I help people with their bladder and bowel and sexual function.
C: That really freaks me out.
P: Christina and I are very mature and will be fine with this.
C: If I was told I needed to come and see you I would probably need alot sedation.
P: She's very good!
C: Yeah. I don't wanna talk while you're inside.
P: I told Mary-Anne that, I've given her some feedback on other physiotherapists. 'Just make sure'
M: We do like to have a conversation during an examination. It's just a
C: Just a friendly chat.
P: If we're finished. And we're now just chatting. Take your hand out.
C: No need to rest it in there.
M: There is a reason.
C: Even in winter.
P: Mary-Anne's explained it. Explain it, professional reason.
M: So the reason. We wait between contractions to give the muscle enough time to relax and then contract again. So if someone's got tension in their muscles sometimes.
C: I would be very tense.
M: Sometimes you are waiting ten seconds to allow the muscle to recover before you ask someone to do another contraction.
P: So it's not actually just a social occasion.
M: No.
P: I'm just wondering Mary-Anne if maybe you should tell people what the pelvic floor is before we begin.
M: Sure. The pelvic floor is a muscle in the bottom of the pelvis. It's a, it creates like a hammock in the bottom of your pelvis. And it's quite a large muscle. If you put your 2 hands together, it's about that size. It goes from the front of the pelvis all the way to the back. It's got a number of functions. Pelvic stability is one. But also it helps to support all your organs and keep them in your body.
P: Which you need.
M: Which you need. And also when it squeezes and relaxes it helps with both sexual and continence function.
C: Noone likes the thought of a prolapse.
P: But they happen.
M: Yes they do happen. Pelvic organ prolapse, vaginal pelvic organ prolapse is when the pelvic organs start to come down into the vagina.
P: Okay.
C: Which is not where they should be. I've only ever seen it happen in chickens and ducks.
M: Well Christina you're living a priviledged life.
C: I am. I am. I had a duck have prolapse surgery once.
M: Oh yeah. Don't they have cloaca?
C: Yeah. Yeah.
M: What kind of prolapse was it?
C: Yeah well, it was all hanging out. So I don't really know but I paid quite a lot of money to have that fixed at the vet. That's the kind of person I am.
P: Big animal lover.
C: Yep.
M: Would have been uncomfortable.
P: Yeah. I hope that duck did its Kegels after that.
C: She came home with a routine.
P: Okay so then, I in, my search strategy for this, I tried to, I just looked up 'pelvic floor' in Trove. Not a lot of articles. And there's a few reasons for that I think. Back in the day, not necessarily the same understanding of the anatomy.
C: Women were just vessels.
P: Correct. Pretty much. And then also even if it was understood medically, maybe not going to be published in the paper 'cos considered taboo, you're not going talk about it. And then also they would use different terms as well. So but never-the-less I did find some articles under pelvic floor and I think it's interesting to go back and look at those now.
M: Can't wait.
P: And this is also particularly good because Christina is a horsewoman. Is that fair to say?
C: I'm not quite sure what the connection is here Penny but yes I do ride horses yes.
P: Because I, have you ever given much consideration of whether you should be riding astride or side-saddle? As a woman.
C: This is interesting because I remember in year 10 science my teacher decided to bring it to everyone's attention, I don't know why we were talking we were about hymens, bit weird. Bit weird in year 10 science but she pointed out that quite often people who ride horses won't have a hymen, because they'll have broken that.
P: Is that by?
C: Sitting on a horse. And I have never felt more targeted or stared at in my entire life.
M: Could have sat side-saddle.
P: Mary-Anne, can I ask if you ride a horse, are you still a virgin?
C: Can you get pregnant in a spa?
M: That depends on the definition of sexual intercourse. If you, are we talking hetero-normative sexual intercourse.
P: No we're not!
M: When do you become not a virgin?
C: I did used to have a riding instructor who said if you found peeing easy after your lesson you hadn't ridden properly.
M: So there is some, something behind that. So in generals there's some activities that require you to create tension in your pelvic floor to create a base, a stable to base to work from and horse riding is one of those. And you need to relax your pelvic floor to urinate so that makes sense.
C: yes.
08:46 P: Okay, shall we get started with this article?
M: Yes please.
P: Because it's titled 'How should women ride' and it's from the Adelaide Advertiser on the 13th of July 1914.
"The recent order of the German Emperor requesting the wives of all German army officers to discontinue the practice of riding their horses astride gives new interest to a question on which doctors and other scientists have long been sharply divided."
So this was a big question that people were wondering about.
M: Surely, they hadn't been considering it for too long. Because it would have been so taboo to even consider astride before that.
P: Well, I think it was becoming very trendy from basically the start of
C: Because it's not unbalanced and weird.
M: Are we going World War I kind of era when cavalry?
P: Yeah, but this is the Emperor, the German Emperor who was the leader at the start of the first world war so, I don't know, maybe he should have been, had better things to think about to be quite honest.
C: This was his side-hustle. He was really into it.
P: Okay.
"On the one hand are authorities who claim that habitual riding astride is a serious menace to a woman's health. The new seat, they maintain, involves severe strain to the abdomen and tends to displace certain vital organs or at least to weaken their supports."
Does it displace vital organs Mary-Anne?
M: Any impact sport would cause some movement but if you've got the ride support structures and your pelvic floor's, then you should be able to withstand those forces.
P: "On the other hand are authorities of equal eminence who say that riding on a side saddle results in curvature of the spine and other deformities. It is, they further charge, dangerous to the rider because there is greater danger of her being dragged in case the horse falls and bad for the horse because it is more liable to make the animal's back sore."
M: Just a quick comment. When do women's posture change the most? When they're bearing babies.
C: Yes.
M: They're worried a little bit about horse riding but not about pregnancy.
C: No, well that'd stop the line.
P: That's a good point though Mary-Anne. It's not the biggest problem women are facing.
M: No.
P: I will say, I learned something about side saddles. Do you know much about, have you ever tried a side-saddle Christina?
C: I have once.
P: I did not
C: Extremely uncomfortable.
P: realise
C: Alarming.
P: That a side saddle is not simply sitting sideways on a saddle.
C: No.
P: There's a little hook for your leg to go over.
C: It's a very precarious feeling.
P: I had no idea. So you're not, I always thought they just got up there like it was a chair.
C: No. Very alarming feeling.
M: Do you have much control?
C: I felt I had none. Doing that. It was just a, I guess it was a bit of a fun thing. Someone had one and their horse was used to it and we had a bit of a fool around with it. But it was very alarming.
P: Okay so then the article, the rest of the article is basically quoting from the Lancet, a medical journal, with the conclusions from that journal. So
""No doubt with the old-fashioned style of riding habit and stirrup there was a very considerable risk of the rider being dragged if her horse fell," says a writer in the "Lancet," in summing up the various arguments for and against riding astride; "but with the modern safety skirt"
C: Safety skirt.
P: "and safety stirrup this danger has practically disappeared."
I did try to find out what a safety skirt and basically it just seems to have buttons along the seams.
C: That makes is very safe.
M: What's wrong with a pair of pants?
P: What's wrong with velcro?
M: Well that hadn't been invented then yet.
P: I don't understand. But anyway, they did seem to feel that this skirt was a very safe skirt.
C: Right, I will have to investigate.
P: Me, Mary-Anne.
C: I feel like maybe I'm wearing an unsafe skirt. I'm a bit scared.
M: Oh my gosh we're all wearing
C: Not safety accredited.
P: Okay. It goes on.
"It is usually said that a good lady rider on a side-saddle is in no danger of being thrown unless her horse falls. No doubt the seat is a very safe and secure one, but it is more difficult to learn to ride well on a side-saddle"
M: Did the men ever try them, do you reckon?
C: I don't think so 'cos they're alarming. And I mean, and the idea that you're never going to get thrown. You're on a 600 kilo animal that's petrified of its own shadow. It doesn't matter how you're sitting on it, at some point you gonna get thrown off.
P: You've been thrown off?
C: Oh yeah. I actually had an x-ray done recently at a chiropractor and she didn't know anything about my history at all and she took one look at my coccyx bone, she said 'Do you ride horses?' I said, 'yes', and she goes, 'Yeah, cos you've obviously fallen on your arse hard, a lot.' Yes I have. So she said 'Your skeleton would be what would be put up at university and we would be asked what sport does this person do'. And that was me. So, yes, I've fallen off quite a bit.
P: You're an example.
C: I'm a shining example.
M: It's amazing.
P: "At first sight it might appear that the astride position, involving as it does some separation of the thighs, would cause relaxation of the muscles of the pelvic floor and so predispose to displacements."
M: Okay this is a ye olde thing with a tiny, tiny element of truth in that you do feel more apprehension when your legs are widened if you do have a prolapse. Cos it opens the hiatus between the muscle. So, a little bit. But I'm still not on board with this.
P: Yeah, I am actually quite scandalised by the use of the phrase 'separation of thighs'.
C: Get some anti-chaffing shorts on.
P: "In the case of a rider with stirrups of the ordinary length and with a proper seat, there must be an amount of pressure on the pelvic floor more than sufficient in our opinion to counteract any relaxation due to the separation of the thighs. Further than this, whenever the saddle is gripped as it instinctively is, the contraction of the muscles of the thighs is accompanied by a contraction of the muscles of the pelvic floor."
Ah, is that true?
M: This is a, this is where the misconceptions come from, this one article. You know all those thigh-buster things that you used to be able to get in the '80s. You can still get 'em. And people come in 'I've been doing my pelvic floor exercises. I'm doing my thighs'. Yeah, maybe you get a little bit of co-contraction but no that's not isolating your pelvic floor.
P: Right.
C: And do you know the other thing is you're actually not supposed to be gripping your saddle. If you're actually riding properly you should not be gripping on with anything.
M: And then the other thing is, like, what percentage of body weight is going down through the pelvis compared to the stirrups.
C: You should have your weight, basically, through your feet.
P: I'm very disappointed with the Lancet. Very disappointed with the Lancet.
M: Was it a medical person who wrote it rather than a horse rider.
P: Yes. Ah, yes. Although you'd reckon they'd all had a go in 1914.
C: Not many other options for transport.
M: City folk.
P: Yeah, and their buggies.
"At the very time then when a displacement appears to be most likely to occur, for instance, in taking a jump or restraining a restive horse, the thigh muscles maintaining the grip upon the saddle come into action. Their contraction is accompanied by a corresponding contraction of the muscles of the pelvic floor, and any tendency to a displacement of the pelvic organs is in this way counteracted."
As we discussed.
M: Yeah, but you could just turn your pelvic floor. Like it's a reflex, you know.
C: I guess in, in life, hanging on to something for dear life, you're probably not worried about what your pelvic floor's doing.
M: No, quite right.
C: And it's not going to be a sustained thing.
M: But it's an automatic reflex. So like if I cough, my pelvic floor turns on beforehand. If I jump and I land, my pelvic floor will support me.
P: And that's what I was told with returning to running after having a baby that you shouldn't be thinking about your pelvic floor when you're running, 'cos you can't
C: Do you have trouble turning off your thoughts about your pelvic floor?
P: No, I'm very disciplined about it. Mary-Anne does.
M: All day, every day. I love doing it on a Sunday too.
C: Yep, yep.
P: Why Sunday?
M: Today.
C: Get lots of reps in.
P: And you don't go to church anymore so
M: No, what else have we got to do.
P: "Our objections to riding astride for women, if we were asked our opinion,
would be based not upon any possible danger of injuries to the pelvic organs, but upon the view that the seat is not nearly so secure a one for the average woman rider as that on a side-saddle, and because the danger of being thrown is much greater."
C: No.
P: I feel like you're not
C: That's a really lame argument.
M: I'm just not on board. Still not.
P: "At the same time, the risk of being dragged if thrown is certainly less, although, with a properly made safety habit and stirrup, even on a side saddle this risk is a very small one.
"Any danger of injury to the pelvic organs when riding astride must be associated with the greater insecurity of the seat"
Which we don't agree with.
"and the increased risk of being thrown, and not with the position itself, which we do not think in the case of a healthy woman is likely to have any injurious effect upon the pelvic organs."
So Mary-Anne is there anything that horse riders should be aware of with their pelvic floor?
M: I don't. Have they had babies? Or not had babies? Have a problem? Have they got risk factors like, there's a whole range of considerations so. That's too hard to answer.
P: Yeah, it's more about your individual circumstances.
M: Correct. To my knowledge, riding a horse, one day a week, I don't know if anyone's done a study to that. To see if it increases your risk of prolapse. It's more about your anatomy and how many babies you've had and if you had forceps deliveries and if you've got constipation, straining all the time.
C: Yep.
P: Cool.
M: Sorry to bring it down.
C: Once you mentioned constipation.
P: Well that is another very important factor with the whole area.
M: Yes. Yeah, apparently 30% of people have dyssynergic defecation where they, or defecation disfunction where they don't know how to appropriately relax their anal sphincter to poo.
C: Wow.
M: So they're straining to poo rather than relaxing letting go, so, you know, it's a common thing.
P: Yeah. And we're not taught about it in schools.
19:58 (Piano music)
20:02 P: And this was from a weekly column by Hygiea, that's who they said wrote it, a penname, on health, which was published in the Brisbane Courier. And this article is from the 14th of May 1932. And it's a weird article, and it starts of as a dialogue between the columnist and this person who they're calling the Professor. And we're gonna skip that bit because it's confusing and I don't I don't understand it. There's a limerick and there's some very offensive stuff.
C: Don't ever put a limerick in.
M: It's a good general rule in life.
P: They don't make sense, that's the whole point.
C: No.
P: They did have a very frank discussion though about exercises that women should be doing for their, to help prepare for maternity and for their pelvic floor. And so I thought it would be good if we could discuss these with Mary-Anne and see if there is any benefit to some of these.
M: This is good prolapse is not my specialty. I'm moving into things I do every day here. Good.
P: "Exercises in Development. Plenty of exercise, especially pelvic floor
exercise, during the developing period of a girl's life, is one of the best preparations for maternity; and investigations have shown that it is the sedentary, rather than the strenuous, life that makes for menstrual disorders and irregularities."
M: Are they talking about teenagers?
P: Yes. They are talking about women, girls should be preparing for their ultimate role in life, obviously, to have children when they're teenagers by doing their pelvic floor exercises.
M: I mean, pelvic floor's a lifetime commitment but I can't imagine that that form of preparation so early on would be needed. Maintenance. You know, you optimise your pelvic floor and then you maintain it by doing exercises a couple of times a week, I mean they could do that.
P: Anyway, he goes on, and I'm assuming it is a man.
"But there is a happy mean. It has also been shown that violent exercise,"
C: Violent.
P: "particularly competitive games and races, or excessive physical strain;
C: Settle down ladies.
P: "undertaken during menstrual periods, may do a great deal of harm."
C: Gross.
M: That is inaccurate. Sorry everyone. You can't have 5 days off.
P: You're right to violently race your friends.
M: Yeah that's right. There is increased risks of injury during certain times of your mensural cycle due to the hormone changes. And we're working that out a lot more now, a lot more recent evidence about that in regard, as female sport becomes more professional. So, maybe they were preemptively
P: Way ahead.
M: Way ahead of their time.
C: Highly likely.
M: But yeah, nah, keep exercising.
P: Okay.
"The second half of exercise is deliberate rest, and rest, or only moderate exercise, is certainly indicated for these few days at least."
M: No, and look,
C: And don't wash your hair at that time.
M: And definitely not in-line with the Australian Guidelines for Physical Exercise.
P: "I have also heard it said that the athletic girl has a bad time at her confinements, but this is not true provided, of course, she maintains the tone of her muscles after marriage."
M: Is anyone else feeling a little bit ill?
C: I had a bit of vomit in the back of my
"Girls that have shown marked leadership during their single life sometimes surprise their friends by "going to pieces," but the cause is not physical. It is generally an indication"
C: Of hysteria!
M: Yeah, that's right. Send them to an institution.
P: Yeah, you're right.
"It is generally an indication that the girl was at all times highly strung,"
M: Ah this is brilliant.
P: "and that even her leadership resulted from emotional excitability and enthusiasm which gave her first place amongst staider companions."
So basically, if a girl's showing leadership.
C: Knock her down.
M: Knock her down. Tall poppy.
P: She's probably just annoying and bad.
M: And not a good person
C: And ultimately, she'll be a shit mum.
M: And she's gonna be a shit mum.
C: With a loose pelvic floor.
M: That's right, she's gonna fall to pieces, physically and mentally.
P: "Adequate exercise and adequate rest for the abdominal muscles are of
especial importance to all women. The abdomen has a musculature set in
three layers crossing one another like 3-ply wood,"
M: Yeah, they're talking about the abdomen.
P: "while the pelvic muscles form a definite sling."
Well that's true. Isn't it?
M: That is true.
P: That's a hammock.
C: That was the cupping of the hands earlier.
M: No-one got to see that. It was a beautiful moment.
P: We've all been cupping our hands.
"The normal functioning, position, and development of the internal female organs depends to a great extent on the tone of the pelvic sling and the abdominal muscles."
M: Yes.
P: That's true! Oh my god.
"The strain of bearing children puts these muscles to the keenest possible test,"
Is that true?
M: The straining during childbirth. Yeah. Oh yeah.
P: "and it is in order that they should not give under the strain, and in order that they should subsequently regain their tone and their shape, which do so much to make up the figure, that women should keep them in a constant state of excellence."
C: Eww!
M: So, I agree that they should keep them in a constant state of excellence.
C: So they look hot at all times.
M: The rationale. Yeah, so you look hot, or so you're not wetting yourself. I don't know which I'd choose.
C: It's hard to pick a priority, isn't it.
P: "There is no need even in the woman who has borne half a dozen children
for flabbiness, sagging walls, or the stretched white lines that mark many an abdomen."
M: Yeah no.
C: Isn't that just stretch marks?
M: Doing your pelvic floor is not gonna help your stretch marks everyone.
P: I think they have confused a few different issues there, to be honest.
M: Correct. Correct. I'm just flabbergasted so I'm not saying anything.
C: It's important that women just keep on as good breeders. Good looking breeders, isn't it.
M: That's basically the aim. You've gotta please your husbands.
C: Husbands.
P: Well, you know, yeah if you're lucky enough to outlive your first husband.
C: Give another one a go.
M: No, you probably die in childbirth.
C: Or while you're riding astride. Sorry.
M: Quite right, quite right.
P: In your non-safety skirt.
M: Yeah, that's right.
P: "Then, too, corsets and supports have a very definite, though a limited, function in assisting muscles to bear an undue strain, and particularly the strain of childbirth, or the strain on a seat after an operation for appendicitis, or in similar conditions. On the other hand, it must not be forgotten that the muscles are all sufficient if adequately developed; while if unduly compressed they not only waste, but, worse still, the intermittent pressure causes fat to be laid down."
Is that true? You squash your muscles and then
M: No, so the disuse you get conversion. So if your muscles start to atrophy and your muscles decrease and they're not working then yes, you'll have a change in the tissue composition so you might feel more soft. But they're not wrong that using braces in the long term does mean you don't have to use your natural support system, your muscles as much, so maybe it does lead to disuse.
P: Okay. Alright so now we're onto the massage and exercise program.
C: Good.
P: Which we are to get your professional opinion on Mary-Anne.
"It is not mere selfishness for a woman to take care of herself"
M: Correct.
P: "thoroughly before she bears a baby."
I don't know if at other times you're allowed.
C: No, it's all about bearing of the baby.
M: No, only in the fertile years.
P: "She regains her strength and independence much sooner, she retains her youthful appearance and figure much longer,"
C: Critical.
P: "she is not liable to suffer from nerves, and she certainly makes a more even-tempered and cheerful mother."
C: Good.
P: Basically, it's okay to look after yourself if it makes you more attractive and less of a pain.
M: That's correct.
P: And I have given all these exercises that are listed here a go, which is why I am looking so cheerful.
C: Yeah, I wasn't sure what had changed, Penny.
M: You've got a glow about you.
P: Thank you. Okay, here's the first one.
"It is an advantage that much can be done in the way of massage and exercise while lying down and after the bath."
M: Oh yes, I see what's going to happen here.
P: "Lying flat on the back without a pillow, for example, raise the head from the bed as if trying to look at the toes,"
M: Doing a crunch.
P: "10 times to start, increasing to 20."
So it's like a very little crunch.
M: Functional isn't it?
P: Yeah. So that seems fine. It seems like it is the beginning of a
M: So when are these? These are pre-birth?
P: Yeah.
M: Yeah, you can do some crunches if you want.
P: Yep.
C: How did you find those Penny? Did you find them rewarding?
M: They're not pregnant at this stage? This is prep for pregnancy?
P: Yeah. It was fine. I mean, my physio made me do something that was slightly harder.
C: But you're advanced.
P: But I don't think I've been doing them properly, anyway we won't go into it.
M: We can talk about it later.
P: I'm a bit concerned about that area.
M: You can get on the floor and show us.
P: "Secondly, bend the knee and bring it up towards the chin; now grasp the ankle and straighten the leg with some force, drawing the palms of the hands firmly up the back and sides of the legs towards the body. Repeat this exercise two to four times with each leg."
M: Is that a massage? Is that what we're going for here?
P: I think so.
C: I would not relax during that.
P: It just felt like stretching your leg up in the air, to me. And it didn't seem to have much to do with your abdominal muscles or pelvic
M: I mean, I'm a physio so I'm very good at visualising the anatomy and people and that's quite trick.
P: I don't have great flexibility, so it was hard for me to get my leg up in the air as well, and grabbing my ankle. It wasn't easy.
M: No, I'm glad times have changed. It doesn't seem like it's very functional or practical. I'm assuming they're helping with swelling of the legs when you're pregnant.
P: No this is your pre-pregnancy. This is your teen girls are doing this
M: Take that off the syllabus.
C: Just getting ready.
P: All women are meant to be doing this but yeah.
"Next contract the abdominal wall, and then allow it to relax, repeating this 20 times quickly. This should be done in time with the breathing at first, but as you gain control of the muscles the movement becomes"
C: You're doing that now, aren't you? I can see.
P: So, contracting the abdominal, you're going to want to make sure you're doing it properly because people could interpret that very differently couldn't they.
M: You could, you could. Maybe they're talking about the transverse abs and the core stability stuff that you do in Pilates. Is that what they're saying? It sounds like they're timing it with the breath like you do in...I'm not sure.
C: That's very confusing.
P: It's unclear what we're trying to achieve apart from being more cheerful and
C: And approachable. And more pleasant company for your husband.
M: Amenable. Well, they haven't found one yet.
C: No, but they're working on it. Putting in the hard yards.
P: "Fourthly, take in a deep breath and now breathe it out, forcing all the air out of the lungs with a steady contraction of the muscles of the stomach. Then let the muscles relax, and breathe naturally again. Repeat this several times morning and evening, and you will find that with practice enough control is gained to contract the muscles without having to expel the breath each time."
M: Is this like a mindfulness exercise?
P: I don't know.
C: It's very confusing.
M: Focus on your breath.
P: This is the best one though.
"After the bath, when up, do the following exercises: Bend forward and downwards; place the open palms on the insteps, draw the hands firmly up the legs and trunk and over the breasts, at the same time taking a deep breath through the nose and throwing the head back; then bring the hands round under the arms"
C: You've lost me.
P: "and go gently down and back to the ankles, touching the skin all the time."
C: Eww.
P: "Repeat this as frequently as you can, short of fatigue."
I could do that all day. You're just standing still and running your hands over your body.
M: Up, down, up down. I mean, it's probably good for spinal mobility.
C: And you look like a dickhead.
M: You get a little hamstring stretch.
P: I mean, it's not bad for you.
M: That's correct.
C: But not essential.
M: None of these are doing any damage. This is good.
P: Okay, so that's all the exercises. And then at the article the columnist and the Professor have a little more of a chat and the Professor 'Oh well, that would be good but women won't do it.'
M: Because we're lazy?
P: Or stupid.
C: Or hysterical. You just don't know.
P: He doesn't clarify about but they're just, and then he does another limerick, which doesn't make sense.
M: This is 1942?
P: No, this is 1932, I think. This is before Kegel exercises were invented cos that was in the late '40s.
M: Weren't the Swedes massaging pelvic floors about that time?
C: Of course they were.
P: So, they're aware of the pelvic floor. They're aware that it's important but maybe not targeting it very well with their exercise program.
M: Now, it's not surprising, male and female pelvic floors work in different ways. So they don't know how it works. They're the ones writing everything, and they've got no idea, cos they don't have one.
P: And Mary-Anne, do people usually do their exercises?
M: Depends what the motivating factors are.
P: Okay.
M: Depends how busy they are. There's a whole socio-economic, what are things going on in their lives. We look at things from a bio-social perspective. Lots of reasons. But yes, people do in the pelvic health scheme, if people show up for appointments, they generally do their exercises because they're there for a reason.
P: That's interesting. That's good.
M: And a reason that has a lot of value to them.
P: Yeah. Because I imagine there sometimes is a bit of a barrier for people to go along to an appointment in the first place.
M: Yeah, there's lots of barriers, from the way the health service is set up, the cost if you want to go privately how people awareness of the pelvic floor and the importance of it.
P: And people don't know how common issues are either. Because people don't talk about it.
M: No, it's taboo.
P: So, it sounds like you know having a prolapse is this terrible very rare thing that probably only you have but actually there's probably heaps of people that you know.
M: Yeah, that's correct. So, with pelvic organ prolapse up to 50% of women can experience prolapse over their lifetime and then only 6% of those people would actually have symptoms and like know that they've got a prolapse, but when you examine them.
P: They do have some degree of prolapse.
M: Yeah, so that's right so so many people have got these things going on and we just don't talk about it. People are pretty good in Mother's Group, they have a chat in them.
P: Yeah.
M: You know what's going on in a mother's group. But before that, or maybe people who aren't parents, or
P: And same with incontinence as well. People really act like adult incontinence is like the worst thing that, you could never admit, you could never talk about it. But it's actually really common and
M: That's correct. And then the other side of thing, is normalising it. You get people coming and saying 'Yeah but I've had a baby so I'm gonna wet myself a couple of times a day. Been expecting this.' But it's treatable.
P: Yeah, so what would you like people to know about, is there anything you'd like to say finally about pelvic floors or pelvic floor health, or
M: Yeah, so there's a couple of great resources that you can look at if this brings up anything for you. There's CFA.
P: Not the Country Fire Authority.
C: The Fire. The Pelvis. It's all linked.
M: Probably the most important thing is that if anyone has any questions or queries or issues that they reach out for help. There's a good website, the continence.org.au, which is the Continence Foundation of Australia's website with great resources and lists of ways you can access support and like we said earlier, continence or pelvic issues are common but not normal.
P: Look, we probably are as guilty of it as anyone. I think we've done some nervous giggling during this.
C: Only a little bit.
P: Really, we've gotta talk about it.
M: And I find it hard to like listen to those articles or even respond to them because it's so far off what we do and what we think now.
P: Do not take Mary-Anne's silence as agreement
C: Complicit approval.
M: It's just shock that that's. And the same with the prolapse stuff. I'm just gob smacked.
P: Well, thank you very much Mary-Anne for coming in. This has been very enlightening.
M: No worries.
P: I'm sorry it was all wrong.
M: I'm glad it was all wrong. We've changed.
P: We've come a long way.
M: We've come a long way.
P: It's a sign of progress. And thank you Christina for sitting here feeling
C: Alert and alarmed
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