Intensive Seminar Series for Men with Prostate Surgery - an Update

Herman & Wallace instructors Bill Gallagher PT, CMT, CYT and Richard Sabel MA, MPH, OTR, GCFP are currently leading a four-session workshop for men who recently underwent prostate surgery. They recently completed the second two sessions and shared their story and experience with Pelvic Rehab Report:

You can read their dispatch from Sessions 1-2 here.

The group was a rousing success. In fact, the opening narration to Star Trek, with some modification, can be used here: The pelvic floor program was, for many, the final frontier. It’s 4-week mission: to explore strange and unusual sensations, to boldly go where man has never gone before, works well. Everyone had fun. There were lots of laughs, but some cognitive dissonance too - especially the first week when we were learning the pelvic breath. However, by the end, most were smiling as they felt the dance between their respiratory and pelvic diaphragms.

In fact, the pelvic breath led to some interesting discoveries. Everyone found it relaxing, and a majority, for the first time, could sense the movement and dimensionality of pelvic floor, thereby making it easier to differentiate the front, back, left and right quadrants. Some additional discoveries were 1) only noticing movement on one side, 2) feeling the whole pelvic floor move, but discerning differences among the quadrants, 3) those with pelvic pain found it easier to pinpoint and release, 4) one participant discovered he was breathing paradoxically and 5) several of the participants were surprised to hear that the front quadrant is where the “action is” for improving urinary incontinence and sexual function. Everyone agreed that the pelvic breath lesson helped fine-tune their practice.

Prior to our workshop, Kegels was the exercise of choice, or rather lack of choice. Most were given a piece of paper with the instructions. A couple were actually taught the exercise, but not always given good information. One member was told by the urologist to squeeze his anus during the exercises. Learning that there were other exercises - or lessons, as we like to call them - surprised some participants who thought Kegels was their only option.

The Tai Chi lesson also created some cognitive dissonance as participants tried to maintain the pelvic breath in Standing Stake. There were also some unprintable comments on what some felt in their quadriceps after being in the form for a minute, but by the end, 2-3 minutes was, as one participant said, “no problem.” All of the participants could sense how softening the knees and dropping the tailbone - key elements of Standing Stake - reduced the stress in their lower back, freed the pelvic region and made it easier to breathe and sense the pelvic hammock.

The final session, which focused on learning to use the pelvic floor in everyday activities such as lifting, standing, bridging in bed, was met with pleasant surprise. Sensing how engaging the pelvic floor made each of these movements easier, clarified the contribution these muscles make in day-to-day activities. As one participant said, “although it felt funny at first, using my pelvic muscles added a little propulsion to helping me stand.” After four weeks, although the stress incontinence had not resolved, most noticed an improvement, meaning less leakage and pads. Everyone felt more hopeful now that they had more tools at their disposal.

We plan to meet with the group for 2 follow-up sessions late in the fall. At that time we’ll have a “check –in” to see how everyone is doing, review the lessons and based upon the needs of the group, teach 1-2 new lessons.

Eight weeks after the program we bumped into “Jack” - he was the paradoxal breather and, at 82, he was the oldest participant. “Jack” shared:

“I’ve been practicing your program and didn’t force my breathing to change. I kept working gently like you recommended, and after 4 weeks it changed (his breathing) and hasn’t come back. By the way I’m no longer incontinent. That went away too.”

When we asked Jack how often he practiced, he said everyday, which obviously was the key to his success. Unfortunately, too many give up too soon.

All of the lessons came from our “Integrative Techniques for the Pelvic Floor & Core Function: Weaving Yoga, Qigong, Feldenkrais & Conventional Therapies” online courses and live program. As mentioned in our previous blog, the lessons can be used one-to-one or in groups. From our experience, the group format is extremely effective for pelvic floor work. Participants learn from each other as much as they learn from us. Most of all, groups lend themselves to everyone having fun, which keeps the work light and playful. Not a bad thing when focusing on the “down under.”