I'm so excited to introduce an awesome article written by an awesome new friend and colleague, Dr. Angie Meuller. Dr. Angie trained on mainland - being a Dr. and all - but lives here on Kaua`i like me and is mind-blowingly knowledgeable in everything pelvic health, specializing in Mayan Abdominal Massage as well as Hypopressive Training. Angie has worked with these two techniques to change women's lives, reposition their uterus to a correct and healthy state, and teach them how to use posture and alignment to finally release their pelvic floor.

If you ever have a chance to have a conversation with Dr. Angie, be ready to learn a LOT. Like, did you know that the pelvic floor is 80% controlled by the autonomic nervous system? That means even if you can learn to release it through thought, you'll only be able to do this 20% of the time. The majority of the time you want to train this important musculature to be relaxed on its own, which you can efficiently train it to do through breath work.

Also, we have to all remember as women with endo that your uterus is probably malpositioned in some way. I've yet to meet one endo-sister who has a perfectly well-positioned uterus (is it creepy I know that?). No, it's not normal, it's just so common doctors often don't give a second glance at the issue. You can use Mayan Abdominal Massage to reposition your uterus back to center without surgery or other medical intervention. It's an amazingly powerful tool that you can learn to do on yourself and, once centered, you can watch much of your pelvic pain start to melt away.

This stuff is good for women with endo, women with PCOS, women who want to get pregnant, and, well, all women :) Want to learn more? Read on :)

THE POWER OF A CENTERED UTERUS

By Dr. Angie Mueller, DPT

One of the first things I do as a pelvic physiotherapist when helping a women recover from pelvic or core dysfunction, is center her uterus. The uterus is the center of a women- physiologically, biomechanically and energetically. When the uterus is out of position, everything else in the pelvis and core is largely impacted and “out of balance.” The uterus is supported by several important ligaments, which extend from the uterus out to the pelvic bones. The uterus also has ligamentous attachments to the organs surrounding it- bladder, bowel and intestines. So if this magnificent central organ is out of her “center”- leaning forwards or backwards, or tipped to on side or the other- this can lead to a myofascial imbalance in the pelvis and cause symptoms of pelvic floor dysfunction, pain, and hormonal imbalances. 

In treating thousands of women with pelvic dysfunction, I have observed that a uterus which is leaning too far forward (anteflexed) is often associated with urinary incontinence, issues with bladder urgency and frequency, and bladder prolapse (cystocele). A uterus that is tipped backwards is often associated with constipation, hemorrhoids and bowel prolapse (rectocele). A uterus that is leaning left or right is often associated with hip dysfunction and lumbo-pelvic alignment issues. This leads to and hip and/or knee and/or back pain due to asymmetrical pulling of the internal abdomino-pelvic fascia, especially the uterosacral and cardinal ligaments.

If any organ in the body, especially the uterus, is “out of position” it’s blood flow, nerve flow, lymphatic circulation and neuro-hormonal feedback will be impacted. Therefore a mal-positioned uterus can also lead to problems with the menstrual cycle, painful periods, and infertility. When assisting any woman through a rehabilitative process, it is critical to appreciate how her uterine position contributes to and impacts her overall pelvic and core health- from a musculoskeletal, visceral and energetic perspective. 

I have found that the best pelvic therapy outcomes result from use of both passive and active techniques to center the uterus. The first step is passive positioning of the uterus, which is most efficiently accomplished through use of the Arvigo Techniques of Maya Abdominal Therapy®  (ATMAT). A key component to ATMAT, is when the woman is taught a sacred self massage that is done daily. This massage is taught to the patient only by a qualified practitioner, and will help to release any myofascial and ligamentous restrictions that are leading to a mal-positioned uterus. This massage also greatly improves blood flow and lymphatic circulation to the gut and pelvic organs leading to improved digestion and organ detoxification. Once her uterus is centered by the massage, it is important to immediately implement an active technique that will keep the uterus centered. This active uterine positioning technique must trigger the appropriate posture and breath that will keep her uterus centered with movement and throughout the activities of the day. 

The second step to positioning her uterus is active activation of abdomino-pelvic musculature and key fascial chains that elevate the pelvic organs through a revolutionary core neuro-reeducation technique, known as Low Pressure Fitness®. The Low Pressure Fitness methodology involves a seamless progression of postures and poses that cause a reduction in pressure in the abdomen and trigger an automatic response from the core muscles- abdominals, pelvic floor, multifidus, diaphragm. Low Pressure Fitness uses a breathing technique known as Hypopressive Breathing. The term Hypopressive means “low pressure” and refers to a decrease in pressure in the abdomen. Traditional exercise, core training, sports, and most of our everyday activities are Hyperpressive – they increase the pressure in the abdomen. When the pressure in the abdomen is not appropriately managed, pressure increases, and this causes the spine to compress and the organs (especially the uterus) to move downward and away from their optimal “centered” position. But when the hypopressive breath is triggered, the pressure in the abdomen is reduced, the spine decompresses, the core musculature is gently strengthened, all of the organs lift, and the uterus is centered. 

When the uterus is centered, magic happens… the fascial tension in the pelvis balances out; the resting tone of the abdominal and pelvic muscles improve and become easier to strengthen; the blood flow and lymphatic circulation in the pelvis is improved and sexual function and fertility is enhanced; hormones are better regulated and monthly cycles regulate; bowel and bladder function is optimized; the waistline reduces; pain in the back, abdomen and hips is reduced and posture improves. When all of these wonderful things occur, it is directly associated with improved energy, mood, creativity and self confidence. 

So remember, centering the uterus, through both active and passive techniques, is key when treating any woman. The Arvigo® self massage followed up by Low Pressure Fitness® are the most powerful techniques I have found to center the uterus and resolve pelvic and core dysfunction in women of all ages and lifestyles.

If you want to learn more about Dr. Angie or any of these techniques, check out her site at www.corerecoverypt.com or follow her on insta @corerecoverypt. If you want to learn more about working with Angie one-on-one, she also does group classes here on Kauai if you want to come over and hang. Yes, she also does Skype (she is so experienced she can tell where your uterus is positioned by having you progress through a few different movements and stretches). And yes, she may change your endo life.