help me strengthen my core

December 17, 2007 11:51 AM

I need some very gentle core exercises.

I've been unable to properly exercise for about a year and a half, due to late stage endometriosis and surgeries. I have been on Lupron Depot for the past 6 months following my most recent surgery; my last shot was a month ago and the pain is back almost as bad as before. I'm thinking it either didn't work, or this is a side effect, or that there's something else wrong. In any case, I want to try to build up my core muscles. In my more physically fit days, I was able to weather the pain a lot better, and I feel its because my core muscles were stronger. I feel that now, since they're so weak, bad posture and lifting and moving wrong makes things worse. I can't do crunches because my lower back and neck muscles are tensed up. I can't get a massage or physio because the last time I did, it made things a million times worse because of adhesions (endo causes things to stick together inside). I'll be seeing my doctor in 2 weeks, and there will probably be an ultrasound in a month or two, but in the meantime I'm going to have to assume that my insides are stuck together again, and be as gentle with them as possible.

Are there other, very gentle core exercises I can do (besides crunches) to build a little strength, so I'm not having to pop so many pills? Excercises I can do without equipment on my living room floor would be ideal, but I could probably get a physio ball if that was the best thing. Anything that doesn't actually involve putting pressure on the lower abdomen or lower back would be best.

Also, if anyone's had experience with Lupron where it didn't work, or caused pain in the pelvic region, I'd like to hear from you as well.

Thanks in advance!

posted by Koko to Health & Fitness (14 answers total)

Best answer: i'm sure people here will have some good ideas, but you really should get a referral to a physical therapist. it is SO easy to do these exercises wrong, or ineffective. you will get so much more out of them if you have someone check your form and make sure you are doing them correctly.

that said, kegel exercises are a good place to start, and you don't need anyone to show you how to do those.
posted by thinkingwoman at 12:14 PM on December 17, 2007

What about gentle (maybe prenatal?) pilates or yoga?

There are lots of core exercises that can be done with the exercise ball, so you're right that might help.

In all three cases, maybe a video is in order?
posted by dpx.mfx at 12:18 PM on December 17, 2007

You say no pressure on the lower back -- would sitting on an inflatable exercise ball be too much strain? I replaced my office chair with one and found it really worked my core muscles -- at first, I couldn't stay on it more than fifteen minutes at a time without getting sore butt. Pretty much forces you to sit up straight and use your muscles constantly to stay upright, but it's not hard crunching like, well, crunches.

And feel better, K00k00. We're thinking of you down here.
posted by middleclasstool at 12:41 PM on December 17, 2007

Hula hooping. I have no affiliation with the company I linked to, but if you scroll down a bit they give a good description of the fitness benefits of hooping. There are many places to buy weighted hula hoops, if you Google around.
posted by infinityjinx at 12:44 PM on December 17, 2007

Take a look at the Active Isolated Stretching site. No guarantees, but two things come to mind with Mattes' work:

1. The 'active' is stretching by focusing on the antagonistic muscles, with a two-second maximum hold time. Very light pressure. These aspects reduce aggravating a situation.

2. My understanding is there are good result breaking down scar tissue. I don't know if that would apply to your situation, but there are some similarities.

Maybe try googling 'Alexander Technique,' which deals with posture in a way which may be more comfortable for you.
posted by dragonsi55 at 12:55 PM on December 17, 2007

Apologies, I blipped the Active Isolated Stretching site, try this.
posted by dragonsi55 at 1:02 PM on December 17, 2007

If walking isn't a problem (weather permitting) then try carrying one of those small (6 or 8 inch diameter) medicine balls when you walk. Move it from hand to hand, raise it over your head, twist with it, pass it behind your back if you want to get fancy.
Even without the walking, I think there are a few standing or sitting exercises you can do with them.
Good luck...hope you find something that works.
posted by rocket88 at 1:08 PM on December 17, 2007

Seconding Hooping, but adding a very gentle type of un-crunch...leg lifts. You can do these laying down, of course, but they can also be done standing, lifting the knee in toward the chest and crossing with the opposite arm--like hip-hop dancing. You can try simply sitting on the edge of a chair, then lifting the feet off the floor with your core muscles (it sounds like you know where they are...

Also, have you considered Yoga classes? A good instructor will help you find variations to get benefit without pain, and yoga done properly definitely strengthens the core!
posted by foxydot at 1:15 PM on December 17, 2007

It sounds like any exercise at all may make the problem worse, so you should really listen to your doctor rather than me. However, if you are resolved to do something, I would recommend getting a Swiss ball. Sit on it when you're working for an hour or two and see if you manage that. Lie down on it, try to balance on it, etc., just fool around within your range of comfort, and then there are reams of exercises you can do as you get stronger, just google and search youtube for Swiss ball.
posted by creasy boy at 1:40 PM on December 17, 2007

Isometric exercises? They're for building strength, and the advantages are they're easy, don't require extra equipment, and you don't move, so you aren't stirring up any tense muscles or adhesions.
posted by exphysicist345 at 3:50 PM on December 17, 2007

Best answer: Get your MD to give you a referral for physical therapy. A good physical therapist will give you gentle exercises that will build up your core strength gently and slowly, without aggravating your adhesions.

Please do not hula hoop -- if you had trouble with adhesions before, hula hooping is not (not!) a good place to begin. (And in fact is an object lesson in not getting medical advice on the internet.) Nor is pilates, unless it is a one-on-one class with an instructor who has experience working with people with medical issues. Thinkingwoman and wcitymike have it right.

This is what physical therapy is for.

Best of luck to you, and be gentle with yourself.
posted by jennyjenny at 4:38 PM on December 17, 2007

Be careful with yoga and pilates. They were originally designed for men, and womens bodies are very different. Since you already have problems, I would stay away from it.

I don't understand why so many people refer you to physical therapy, since you already said that physio made things worse (unless physio and physical therapy are not the same thing in English as they are where I live?). In my experience, physical therapists do not necessarily know enough of women's bodies, and even worse: they do not realize how important this is. You really need someone specialized in this.
posted by davar at 9:12 AM on December 18, 2007

I mention physical therapy because a good physical therapist who knows what they are doing is absolutely, and specifically, qualified to deal with this problem. There is an entire practice area of physical therapy devoted to women's health. The OP might try to find one of these therapists. Also, 86% of PTs are women.

If the OP has been to physical therapy before and it made things worse, then it is entirely possible that she went to the wrong physical therapist. But physical therapists are not all cut from the same cloth, and they do not all do the same thing.

There is a standard of education and licensure required for becoming a physical therapist that is not required for a yoga or pilates teacher, and I would not be confident that someone from one of these professions would know how to create an exercise program for someone with adhesions. Also, a PT will keep in touch with your MD and modulate your plan of care according to their instructions. When you go to a physical therapist, you get someone who is speaking the same language as your doctor and will work in concert with them to get you better.

(This is absolutely, totally, not to knock any of the fine pilates and yoga instructors out there, or pilates or yoga itself -- they're awesome. But if you've got specific medical stuff, it's a good idea to deal with it on medical terms for a while before you jump into a yoga class.)
posted by jennyjenny at 3:27 PM on December 18, 2007

Response by poster: Doc agreed I should see a physical therapist to get advice on gently strengthening my core muscles. He did an exam and ultrasound and found no new growths. However, the problem could be that there are endometrial deposits in the inner muscle of my uterus, which cannot be detected by ultrasound or regular surgery, and can only be removed by removing the uterus. Or, the uterus could be stuck to the pelvic floor again. Both conditions cause lower back pain.

The reason physical therapy didn't work for me the first time was that it was not known that my pain was caused by endometriomas. My GP thought at the time that it was muscle pain due to an old sacroiliac joint injury. Therefore the rigorous deep-tissue massage and joint manipulation that followed made the problem much, much worse.

Thanks all for your input!
posted by Koko at 8:58 AM on December 28, 2007