Interview with Deborah Bowes
about her Pelvic Health and Awareness program and workshops, March 2008
Interviewer: How did you come to develop the health and awareness program for the pelvic floor?
Deborah Bowes: Many years ago when I had incontinence, I was doing Kegel exercises, and they weren't helping. I was unable to dance, or run of jump without leaking urine. And traditional ways of doing Kegels exercises, you know, contracting the pelvic floor hundreds of times a day, just didn't have any effect.
Interviewer: What's different about your program?
Deborah Bowes: My program is different from traditional Kegels. With traditional Kegels, you try to exercise the pelvic floor and isolate it from the rest of your musculature. What I discovered was that the pelvic floor doesn't work in isolation - like all the rest of our muscles it works in a whole coordinated system. That the other parts of the system also have to be included in the exercise portion in order to get full strength - and full use of the pelvic floor.
Interviewer: So, what other parts of your self do you use?
Deborah Bowes: Its been found with research that the muscles of the pelvic floor system include the abdominals, especially the transversus abdominus, the deep muscles of the back, the diaphragm, some of the muscles of the hips - plus the muscles of the pelvic floor itself that supports the organs. And all of those muscles, that whole system of support, has to be coordinated, they have to work together to contract when you need more support.
Interviewer: Are these the 'core' muscles that we hear mentioned a lot these days?
Deborah Bowes: That's right, these are the core muscles that they work with in Pilates and similar approaches. When you need more support for walking, or jumping or balancing or dancing, you need to be able to have the support of these muscles, and then when you want to eliminate that whole system has to be able to relax a little bit in order that the organs can do the work of elimination.
Interviewer: So, the program is not just about elimination?
Deborah Bowes: That's right. We all think about the pelvic floor: 'Oh, its all about getting rid of things from your body'. It also has so much more to do with our everyday movement: with the ability to walk powerfully and walk with good balance; the ability to stand one leg; the ability to lift your laundry basket. The pelvic floor holds the organs inside the pelvis… and it supports the work of the hip joints and the work of the spine also.
Interviewer: Would it help with back pain too then?
Deborah Bowes: Yes, it can decrease back pain, because when the deep muscles of the back are injured they will stop working so they can heal. Then, what happens is, another part of the system has to work harder because the system has lost the support of the back muscles. So for example, the pelvic floor muscles can then become over contracted. Muscles are only strong if they can both contract and relax: get short and get long. When muscles are over-shortened for too long, they get weak.
Interviewer: It says here you are Physical Therapist?
Deborah Bowes: I've been a Physical Therapist for 33 years.
Interviewer: And also a Feldenkrais Practitioner. What's that?
Feldenkrais Method is a method of learning about yourself, of learning about all the habits that you have - many of them movement habits. Many of the ways we move are also reflected in how we think, in how we sense ourselves, and how we feel ourselves. In Feldenkrais Method we teach people how to pay attention to themselves to discover new ways of moving. In applying the Feldenkrais Method to the pelvic floor, I have used the principles of movement exploration so that women and men can discover for themselves how to improve the entire system of the pelvic floor.
Interviewer: So you mentioned women and men. How do women benefit and how do men benefit? I wouldn't have thought men would be helped so much by this.
Deborah Bowes: Both women and men benefit because they have the same system I have been talking about! They both do the ordinary activities of daily life: they have to breathe, they have to eliminate, they have to support their spine, they have to walk, and they have a sexual life. And when you integrate the whole system, and co-ordinate the whole system, then all those activities become better.
Now the pelvic floor specifically is also involved in more kind of private functions.
For women, especially older women - women after menopause, or women after having given birth, or maybe there's been some kind of trauma - often the pelvic floor muscles are weakened. Not just that are, not just that area is weakened, but the whole system is weakened, and they need to exercise the system so that pelvic floor can be strong enough to keep the stuff in when you want to keep it in, and flexible enough to let the stuff out when it needs to get out. And for women, having more control over the pelvic floor can also help them gain or regain improved sexual function after giving birth, as they age…
Men have a particular issue with enlarged prostates. For enlarged prostates, if you have more ability to relax the pelvic floor men can be really helped both in elimination and in sexual function.
Many people have trouble with the pelvic floor also because the pelvic floor responds to stress. And many of us have a lot of stress in our lives! That makes the pelvic floor tighter and the breathing more difficult, so for both men and women to relax that whole area will help with the body's response to stress.
Interviewer: And after prostate surgery?
Deborah Bowes: Certainly after prostate surgery. After any surgeries to that area: prostate surgery, hysterectomies, abdominal and back surgeries of any kind. Any time the muscles are touched or cut, they stop working for a while and then that can become a habit. People need to be able to wake the muscles up again and use them in a coordinated fashion. So these exercise have helpeda lot of people post surgery to move better and feel better.
Interviewer: How do people benefit? What do they feel from doing this program or workshop?
Deborah Bowes: People always feel more relaxed. They feel stronger. They feel more balanced. And for issues of incontinence or difficulty in starting to go - they are able to control the urine, stop leaking, they are able to have more time between. They are able to go to the bathroom less. They are able to spread that out and not have to find a toilet every hour of their life! Many people also report greater endurance for waking… and less pain. Anyone who has pain walking usually has less pain.
Interviewer: How many times have you taught this workshop?
Deborah Bowes: I have been developing the program since 1996 and I started teaching this workshop in 2000 - so for the past 7 years. I've taught the workshop about 4 times a year - so about 30 times. Several hundred women and a few dozen men. Women are more open.
Interviewer: I was going to ask about that, you are talking about personal stuff, so how does that go in the workshop?
Deborah Bowes: My approach is that it is all about our bodies - its your anatomy, and its nothing to be shy about or ashamed or nervous about. It's a natural function. And if these functions don't work your life is seriously affected. My approach is to be respectful, and humorous, and informative in a way that allows people to be in the workshop without having to disclose more than they would want to. And I am always available for questions privately in the breaks if anyone has a particular issue they would rather not discuss in the large group. However mostly I have found that people are quite open and are craving this kind of information. As I have taught the workshops more I have learned more and more how important pelvic health, and awareness, is in each person's life.
Interviewer: Thank you very much.
Deborah J. Bowes, 2008