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I want you to say the next words out loud 3 times…
EARLOBE , EARLOBE, EARLOBE
KNEECAP, KNEECAP, KNEECAP.
VAGINA, VAGINA, VAGINA
ANUS, ANUS, ANUS.
For even the most unreflective person, I think they would notice a difference in their internal responses whether it be physical, or cognitive when they say the last two compared to the first two words. Maybe you will notice an increase in heart rate, blood flow to the face, feelings of embarrassment, laughter, awkwardness, fear, discomfort, shame or even irritation at the exercise.
This is obviously a conditioned response that some would say is healthy and warranted as the words anus and vagina, along with the words penis, testicles and breast or areolar, are associated with areas of the body that are more sensitive on every level (by that I mean emotion, cognitive, spiritual and cultural). I am not denying this and please don’t take from this piece that I am trying to downplay the regard I have for these sacred areas of the human body. This piece is about deconstructing or exploring some of the psychosocial/emotional and behavioural scaffolding that supports some of the potentially preventable physical states that I see and treat in my practice as a pelvic health physiotherapist.
I work in the area of women’s and men’s pelvic health. It’s interesting talking to physios and other health professionals and even friends and family about my work. Many physios have said to me, ”I won’t go near the pelvis,” or, “I just can’t look at you the same now you’re doing that work!”. When I first moved into this area, these responses made me anxious, but that anxiety fuelled a fire. The fire that burns strong in me to continually promote pelvic health, and to take on a quest of educating everyone to normalise this anatomy, the processes associated with pelvic health, and maybe go a step further and not just normalise, but actually bring joy to the area. I firmly believe that can help women’s and men’s overall health. In a deep conversation with a mentor in physiotherapy, a point was made that if you were truly responsive and aligned with your pelvis, you possibly could be the most enlightened, joyous person in society. In the current paradigm, we would not accept this kind of person (an example would be farting in public, we accept it in kids…or do we?).
Here are some of my thoughts on the area.
This can start in childhood: we are told pretty early that playing with our anus, vagina, penis, testicles, is wrong, yucky, smelly, foul, and generally, we get into trouble. Even as a baby, the tone of our parents, when they have to change a nappy, is often different and somewhat concerned. Even the best mums and dads will show micro gestures of disgust at a poo filled nappy. It’s interesting; I watch my two Labradoodles smell and lick each other’s anuses daily, and they really enjoy it. I find myself telling them off like a reflex…like it’s the most disgusting act ever…why? It could be building their gut microflora in a perfect way!
Obviously, playing in poo is an infection control nightmare; I am not suggesting we promote this. I am a massive supporter of basic sanitation. However, are we aware of how deeply these emotions of disgust are associated with pelvic processes from an early age? Do we need to be mindful of this? I’d say yes. Displaying sexual movements such as hip thrusts or “humping”, which is a basic unconscious reflex, is often laughed at, made fun of, or discouraged. I have even had people in my pilates classes who worry that doing a bridge is too sexual…why are we worried? After a certain age, we are told that displaying our sexual organs is wrong, not accepted and we will get in trouble for it. If our privates were to be displayed in public, we would be shunned and made fun of. I remember as young as five years old, having a dream I went to school with no undies on, and it was like a night terror! I woke in total embarrassment.
I believe this emotional learning can have an effect of overall tonicity of the pelvic floor and lower pelvic region. A freeze effect due to fear and concern that we will do something wrong with this region. I theorise that this is the start of sexual and pelvic repression over the lifespan. On top of these effects, if you throw any type of trauma associated with this, whether it be sexual shaming, sexual abuse, repeated infection in the area, pain in the area, or perceived dis-figuration, you can only imagine the psycho-emotional and therefore physical associations that would associate with this. We then get to a certain age and make a baby in our pelvis and push it out through the pelvis…I mean, does the shame and lack of relationship with our own anatomy have anything to do with why our Caesar rates are so high? Why don’t we as a society teach women deeply about the birth process and how to care for themselves after?
I want to make a point, too, about our current medical management of sexual dysfunction. Through my education I have seen how amazing this management can be, but there is still so much backward practice. Mostly because, as a society, we are still not okay with the area.
Benefits of empowered sexual activity include:
- Improves pain and immunity
- Improves mood
- Improves healthy weight management
- Improves self esteem
- Improves WELLNESS AND HEALTH
When I quiz my orthopaedic clients post-operatively, they leave hospital with exercises, precautions for movements, but no mention of when they can have sex, let alone how. Why have we forgotten that this is an activity of daily living? At least weekly or monthly! We instruct people how to safely dress, and transfer in and out of the car, and how to prepare food, but sex…um, nah, they’ll work it out…great! This contributes to more awkward, fear-based avoidance.
All these factors can contribute to creating an area that is, for want of a better word, ‘shut off’, and can contribute to much dysfunction, including:
- Sexual pain
- Inability to orgasm
- Inability to develop an erection
- Inability to enjoy sex
- Inability to defecate well
- Development of many flora-based dysfunctions
- Decreased self-esteem
- Contributes to relationship problems
If we step back in time, our predecessors who introduced chairs and sitting toilets thought they were doing the right thing to become more civilised, but they didn’t know how this could possibly affect the dysfunction of our perineum. Squatting that is done across the lifespan in Asia is an amazing position for opening the pelvic floor. It’s a perfect position for defecation as it releases tension in the puborectalis, but for the western world this was, and for many, still is seen to be disgusting or just impossible, as we don’t allow our kids to learn to maintain a full squat.
Possibly, prior religious pressure, societal norms, and issues with hygiene, meant that humans could not respond to their pelvic needs adequately. A lot of this has changed. There is a lot more space to apply love, acceptance and nurturing to the pelvis, and we can start to change this for the next generation. What I have seen helps: love and acceptance of your own pelvic anatomy, bringing touch there, bringing heat there, engaging in shameless sex, understanding and enjoying your own biome and your partner’s (this is obviously aligned with finding good health), being able to deep breathe, deeply rest and deeply relax the pelvic anatomy.