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Tidbits on the knee: Don't forget PREVENTION!
PREGNANT WOMEN: OBs are closing birth canals up to 30%. See the simple
PROOF in PS2 below. Squatting allows the birth canal to OPEN the "extra" up to 30%... But if your knees are weak, REMEMBER: you don't have to squat to allow your birth canal to open the "extra" up to 30%... For simple instructions, see the very end of this post... TIDBITS ON THE KNEE: DON'T FORGET PREVENTION! "Tidbits on the knee...evaluation and treatment...Closed-chain exercises (foot on the ground): With the patient standing, feet facing forward, positioned at the width of the pelvis, squeeze [contract] the gluteals and slowly flex the knees to 30 degrees and return to full extension without locking the knees.4 It is an excellent beginning exercise..." --Warren Hammer, MS, DC, DABCO http://www.chiroweb.com/columnist/hammer/index.html OPEN LETTER Warren Hammer, MS, DC, DABCO Norwalk, Connecticut Warren, Don't forget PREVENTION of knee problems. After living in a squatting culture, elderly Chinese men showed LESS knee osteoarthritis than elderly American men. [Zhang et al. 2004] Then again, elderly Chinese women showed more knee osteoarthritis than elderly American women...but this was after a living in a squatting culture! Wouldn't it be cool if more of our elderly could rise from a full squat! Sincerely, Todd Dr. Gastaldo PS1 Your instructions for exercise in injured/ailing knees ("slowly flex the knees to 30 degrees") remind me that Americans are advised not to fully flex their HEALTHY knees! This in turn reminds me that failing to squat/fully flex knees entails failing to fully flex HIPS. People in squatting cultures are known to suffer far less hip osteoarthritis. Who knows - maybe less hip osteoarthritis has something to do with the fact that they fully use their hips? Just a thought (that some MDs - and this DC - have been speculating about for years)... PS2 PROOF that OBs and CNMwives are routinely closing birth canals up to 30%... First, the fact that semisitting and dorsal close the birth canal is simple biomechanics. See Gastaldo TD. Letter. Birth 1992;19(4):230. Here's my source for the 30% figure... "[T]he outlet increases with moulding by approximately 20-30 per cent." --Russell JGB. Moulding of the pelvic outlet. J Obstet Gynaec Brit Cwlth 1969;76:817-20. NOTE: In 1973, Ohlsen verified Russell's 20% figure on Borell and Fernstrom's 1957 intrapartum x-rays. Ohlsen pointed out that the authors of Williams Obstetrics were claiming that the pelvic diameters *don't change* during delivery (!) - so the authors of Williams Obstetrics decided (erroneously) that dorsal delivery widens! Interestingly, early last century, J. Whitridge Williams, MD, the original author of Williams Obstetrics demonstrated MASSIVE amounts of change in pelvic outlet diameter change at-term - and the just mentioned 1957 intrapartum x-ray study accorded with the average amount of pelvic outlet diameter change Williams found clinically... See: http://home1.gte.net/gastaldo/part2ftc.html Jason Gardosi, MD, director of the British National Health Service/NHS West Midlands Perinatal Institute/WMPI states the grisly biomechanics of the semirecumbent delivery position (semisitting): "...the weight of the mother is in part taken on the sacrum which is therefore pushed upwards, thus decreasing the antero-posterior diameter of the pelvic outlet..." http://www.wmpi.net/reviews/oe/oe_shoulder_dystocia.htm The funny thing is, Jason Gardosi, MD also *recommends* semisitting (closing the birth canal) - or used to! "The second stage...You might want to remain in bed with your back propped up with pillows...As you push, try to let yourself 'open up' below..." http://www.preg.info/book/chapter11.htm NOTE: Jason Gardosi, MD and his fellow British OB pal Malcolm Griffiths once got me censored from an international OB/GYN listserv - but fortunately not before two of my posts were archived thereon: http://forums.obgyn.net/forums/ob-gy...9707/0128.html http://forums.obgyn.net/ob-gyn-l/OBGYNL.9707/0153.html Anyone interested in some entertaining obstetric reading, check out Jason's 1989 Lancet "randomised controlled trial of squatting" - where nobody squatted... See Sarah Key's huge balls (also: Kids can SQUAT motionless for hours)... http://groups.yahoo.com/group/chiro-list/message/2084 MORE PROOF According to the Merck Manual: "When shoulder dystocia occurs...the mother's thighs are hyperflexed to increase the diameter of the pelvic outlet..." http://www.merck.com/mrkshared/mmanu...er253/253g.jsp WHY are OBs and CNMwives (nurse midwives) waiting until the head is out and shoulders get stuck before giving the baby maximum pelvic outlet diameter? WHY are OBs and CNMwives forcing babies' heads through birth canals senselessly closed up to 30%? WHY are OBs and CNMwives KEEPING birth canals closed when babies' shoulders get stuck? (Merely hyperflexing the thighs does NOT get the woman off her sacrum. This is BAD McRoberts maneuver. ON A POSITIVE NOTE: Gardosi et al.'s WMPI site (quoted above) recommends a version of GOOD McRoberts if the shoulders get stuck... http://www.wmpi.net/reviews/oe/oe_shoulder_dystocia.htm) LADIES: HELP PROTECT YOUR VAGINAS... OBs and CNMwives are slicing vaginas (euphemism "routine episiotomy") - surgically/FRAUDULENTLY inferring everything possible is being done to OPEN birth canals - even as they CLOSE birth canals - up to 30%! See Criminal medical CAM at Hawai'i's John A Burns School of Medicine http://health.groups.yahoo.com/group...t/message/2256 Sorry to be repetitive but... WEIRD: In 1993, the authors of Williams Obstetrics published the correct biomechanics at my request but they left in their text (in the same paragraph!) the "dorsal widens" bald lie that first called my attention to their text. The "dorsal widens" bald lie was created when Ohlsen informed the authors of Williams Obstetrics in 1973 that they were still claiming that the pelvic diameters *don't change* at delivery! ALSO WEIRD: Before Ohlsen stimulated their "dorsal widens" bald lie, the authors of Williams Obstetrics were ignoring Borell and Fernstrom's 1957 RADIOGRAPHIC demonstration that the diameters DO change - and this MANY years after (way back in 1911) J. Whitridge Williams, MD - the first author of Williams Obstetrics - clinically demonstrated 4cm of AP outlet diameter change! For details: See my Open Letter to FTC at: http://home1.gte.net/gastaldo/part2ftc.html SIMPLE INSTRUCTIONS PREGNANT WOMEN: It is EASY for you to allow your birth canal to OPEN the "extra" up to 30%. Just roll onto your side as you push your baby out - or deliver on hands-and-knees, kneeling, standing, squatting, etc. BUT BEWA "Midwives...encourage...semisitting." (closing the birth canal!) --Yale CNMwifery Prof. Helen Varney. Varney's Midwifery. Sudbury, MA: Jones and Bartlett. 4th ed. 2004:839] Some MDs and MBs will let you "try" "alternative" delivery positions but will move you back to dorsal or semisitting (close your birth canal!) as you push your baby out! If your baby's shoulders get stuck OBs and CNMwives will KEEP your birth canal closed! Yale CNMwifery Prof. Varney (just cited) writes: "In the event of...shoulder dystocia...the woman should be in a lithotomy position..." (p. 839) Lithotomy position keeps the birth canal closed! So does semisitting! Talk to your CNMwife or MD or MB about this TODAY. (For further details see "Criminal medical CAM," URL above.) CNMwives/MDs/MBs: If you must push or pull - and sometimes you must - first get the woman off her sacrum - off her back/butt. Thanks for reading everyone. Sincerely, Todd Dr. Gastaldo |
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