Episode 82: Pelvic Floor Pain & Core Dysfunction: Why Kegels Aren’t the Answer w/ Lauren Ohayon

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• Joe Gambino
• Joe LaVacca

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Summary

In this episode of the Beyond Pain podcast, hosts Joe Gambino and Joe LaVacca welcome Lauren Ohayon, a movement teacher specializing in pelvic health. The conversation explores the often misunderstood topic of pelvic health, addressing common myths and misconceptions.

Lauren shares her personal journey with pain and how it has shaped her approach to teaching. The discussion emphasizes the importance of holistic approaches to pelvic health, including the connection between pelvic health and overall well-being, practical tips for optimizing pelvic health, and the significance of embodiment in movement.

Listeners are encouraged to seek help when needed and to understand their bodies better.

Takeaways

• Pelvic floor health is often misunderstood and under-discussed.
• Kegels are not the only solution for pelvic floor issues.
• Education is key to understanding pelvic health.
• Personal pain stories can shape professional practices.
• Holistic approaches are essential for effective treatment.
• Movement and breath are crucial for pelvic health.
• Embodiment helps individuals connect with their bodies.
• Pressure systems in the body affect pelvic health.
• Seeking help early can prevent long-term issues.
• Community support can empower individuals to discuss pelvic health.

Transcript

Joe Gambino (00:00)
Welcome back into the Beyond Pain podcast. I am one of your hosts, Joe Gambino, and I'm here with our other host, Joe Lavaca. You can find us both on Instagram at joegambino.dpt for myself and at strength and motion underscore PT for Lavaca. Their podcast is on YouTube as we were just discussing cups of Joe underscore PT and podcast on Instagram Beyond Pain podcast. And today

We have a special guest with us, Laura O'Hayan. She is a long time movement teacher who specializes in pelvic health. Welcome to the show.

Lauren Ohayon (00:33)
You called me Laura again.

Joe LaVacca (00:34)
Yeah,

do you love Lola?

Joe Gambino (00:35)
Oh no,

no, I could have swore I said, Lord, I was even staring at a man, my brain somewhere else, somewhere else.

Lauren Ohayon (00:39)
Yeah, I know. I know. It's funny how everybody wants to laura me.

Usually they try to make me Irish and not Jewish with my last name. So I'm pretty excited that the adventure is in my first name here.

Joe Gambino (00:52)
Yeah, for real, I got the last name, but I can't get the first name. That's impressive for me.

Lauren Ohayon (00:55)
It's okay.

Joe LaVacca (00:56)
Yeah, and Lauren, now I can

only hear your name with an Irish, well, Hayden, like a little flair to it. Now that's going to be stuck in my brain forever.

Joe Gambino (01:00)
Yeah

Lauren Ohayon (01:05)
And the cognitive dissonance is hilarious because I teach a lot in the United Kingdom and people are like, your last name is really interesting. And I'm like, well, that's because I'm Jewish and not Irish. And that's why you're seeing a dark olive looking person, not blonde and blue eyed. Yeah.

Joe Gambino (01:23)
is apparently named Laura on this podcast. apologize again. Man, man. Well, Joe knows I have I have problems with intros to the show. So here we go. It just continues.

Joe LaVacca (01:26)
Right, exactly.

Lauren Ohayon (01:28)
It's fine. Don't worry about it. I'm over it. It's fine.

Joe LaVacca (01:36)
Yeah, we were on a streak

Lauren Ohayon (01:37)
So was on purpose.

Joe LaVacca (01:37)
of one, I think, starting last week where Joe got through the whole thing without messing up a hashtag or an underscore or something like that. So ⁓ we just reset it. It's like the big board behind you, know, days since our last incident, we erase it. We just draw the number zero again and now we're rolling. But Lauren, you're in Miami, which ⁓ I'm hoping has some nice, beautiful weather. It looks beautiful there as always. So.

Joe Gambino (01:40)
Hahaha! ⁓

Yeah.

Yes, yes.

Joe LaVacca (02:05)
What's it like in Miami right now? us in for all the people who are suffering in the winter climates.

Lauren Ohayon (02:11)
I mean, that's why I moved here. I traded intelligence for beauty, right? Like New York is like, you know, anywhere north of, I feel like north of Jacksonville, things get incrementally more intelligent. But ⁓ Miami's beautiful. I love it. It's beautiful. And I can dress like this all the time. ⁓ And I do not miss seasons. People are always like, don't you miss cozy seasons? And I'm like, no.

Not at all. Hate them. Nope. Not interested.

Joe LaVacca (02:42)
Yeah, and like you said,

your attire can always be consistent. We know you have a really wonderful movement practice, virtual space. Why don't you just intro the listeners into that? Tell us a little bit more about what you do and how you do it in the beautiful Miami landscape down there.

Lauren Ohayon (02:48)
Yes.

Yeah, so I actually don't really work in Miami, but I do live here. I am a long time movement teacher. I started ⁓ doing yoga in my 20s and I was ⁓ at NYU studying to be a journalist and then was like teaching yoga on the side, loved it a lot.

Took a year and traveled the world and everywhere I went, I could make a few bucks teaching yoga in the youth hostels. I'd be like, hey everybody, yoga out in the grass at 9 a.m. And people would always show up, it was really fun. ⁓ And so I kind of just started teaching more and more.

And now I teach a lot more. It's been 25 years that I'm teaching movement. I've since trained in a variety of other movement modalities. And I started working much more in pelvic floor health about, well, I've done it for years, but I would say really consistently about 20 years ago, because I had my first daughter 20 years ago.

And so it's that sounds crazy to say I'm like how did I have a child 20 years ago?

I feel like I was still in India, but I wasn't. I was having a baby in Brooklyn. And ⁓ I started working a lot more. I had three kids in three years. ⁓ And I just started working, being much more curious about the pelvic floor because we have one and it's a thing to be interested in. And the kind of mythology around it was fascinating to me and kind of the stories and in the yoga world and the Pilates world that I was deeply

kind of more invested in. It was just fascinating to hear the contextualization of the pelvic floor. ⁓ And I felt like everyone had it all wrong. was my mission to re-educate everybody. So I became, I was like, I'm gonna just kind of get out there and talk about the pelvic floor in a different way. Actually, in my early days, I pissed off many, many, pelvic floor therapists.

⁓ PTs, physical therapists. Yeah, it was like, who's this woman with no PT credentials saying that Kegels are bad?

Joe LaVacca (05:13)
That's okay, we're used to being pissed off about something.

Joe Gambino (05:15)
Yeah.

Lauren Ohayon (05:21)
or not the right way. And so yeah, I've just and I have an online program. Now I kind of, you know, put my work online, do trainings online. That's kind of the background of what I do and who I am. I was really lucky. I got online way before COVID. I got online 10 years ago in 2015, and created a whole kind of universe online again, way before COVID. So like, I know that everybody and their mother now has online programs. I was really lucky that I got into it so many years ago and have a

really ⁓ quite a large audience, which is quite nice.

Joe LaVacca (05:55)
Yeah, you mentioned the online programs and ⁓ I've been fortunate enough for you to have sent me a few people and I think it's a lot more than that ⁓ because everybody that has come to me or seen me speaks about the community, the support, ⁓ you specifically, your personality, how welcoming everything is and how straightforward things are. So how you tailor anything. So I think ⁓ you're doing yourself a little bit of justice there. You've really created a wonderful platform, wonderful community from the people that I've heard from.

So you're doing your thing. And then like you even said, now you have education too. So what courses are you now offering on your platform as well?

Lauren Ohayon (06:33)
Well, have my, like, so the thing that I rolled out 10 years ago is a 12 week program called Restore Your Core. And like really shortly after, and a lot of people, there were some people in the yoga community who took my course because they needed it.

And then they were like, teach people how to do this. This work that you do is really different. It's not quite yoga. It's not quite physical therapy. It's not exactly Pilates. Don't know what it is, but it makes a lot of sense. Do you train in it? So I now teach a professional training as well, ⁓ where people, I have a lot of physical therapists who take it, occupational therapists, just kind of learn a very different way into the pelvic floor. And ⁓ so those are like my main courses.

Joe Gambino (07:05)
.

So we have typically two starting questions. One is ⁓ how you take your coffee. The other one is how your pain story and how it may be impacted what you do today. But before we get there, I'm actually just curious, because you mentioned like mythology behind pelvic health. You know, people get it wrong. So from a other, what you've seen maybe for both from clinicians and from just like the patient side of things, what are some of the biggest misconceptions people have around pelvic health?

Lauren Ohayon (07:49)
Well, I think we have to start with the fact that the pelvic floor is under discussed, under minimized. And then when it is discussed, it's like, ⁓ your pelvic floor is probably not strong enough. Therefore, you should just go home and do things to strengthen it. And the obvious thing to strengthen your pelvic floor is why don't you squeeze it 50 times in a row? And when that doesn't work for you, which it won't, it's not the system that's wrong, it's your body.

And ⁓ you're a woman? This is just what happens. Welcome to being a woman. So I would say that we live in that kind of, it starts with the fact that nobody is talking about their pelvic floor. In fact, multiple males have said to me, I hate to ask this question, but do men have a pelvic floor? And I'm like, you do. And actually, I'd like to tell you that your pelvic floor looks almost identical to a female pelvic floor. So behind every penis is actually a vagina. ⁓

which is not what a lot of people want to hear, but it's kind of true. I know, you kind of have a vagina. I know, you kind of have a vagina.

Joe LaVacca (08:53)
There's the hashtag for today's episode.

Joe Gambino (08:59)
So the perfect quote for Instagram there. We got it.

Lauren Ohayon (09:00)
And so I am, yes, there you go. You will be banned

if you say the word vagina on your Instagram. I have learned that multiple times. Clitoris is especially hot as a banned word. ⁓ So yeah, I think that like a lot of people with pelvic floor dysfunction don't know where to start and they start with kegels. And I think that the assumption that, that,

Joe LaVacca (09:12)
Ooh!

Joe Gambino (09:20)
Mm-hmm.

Lauren Ohayon (09:25)
when something is not working efficiently, that the assumption that it needs more of a specific type of strength, it's a false equivalency. And I think that it has, and I think that women, I'm gonna just talk about women, because that's the population that I serve most, although I do see a lot of males these days.

that women are not given a handbook on their body to begin with, right? We're just kind of like thrown into all the different changes that we go through. We go through so many different changes in our life, right? Like we are not given information about any of it. So again, I think that when something goes wrong with our pelvic floor, because it's in the area of shame,

it's even harder to try to get support around it. And again, there's a lot of medical gaslighting from unfortunately doctors and physical therapists. And I think that physical therapy for women is changing a lot, but it was heavily based on the perspective of Kegels is the approach.

And I have now worked with hundreds of physical therapists who tell me this all the time. They're like, that's what we were taught. When there's a problem, give them some Kegels and go in there and do some manual release. Neither of those are very effective.

Joe LaVacca (10:40)
Right. It's so similar. And

it's so similar to what Joe and I have spoken about on the podcast, even with the physical therapy limitations in general. If you have a problem, it's probably because, you're just not weak enough or you're not strong enough, rather. Right. We have to get you stronger. We have to do these isolated exercises. We have to keep everything contained. ⁓ you know, don't worry about anything else in your life. You know, your sleep, your activity level, your nutrition, your recovery, your relationship. You know, none of that stuff matters. It's just

Lauren Ohayon (11:09)
Your childhood.

Joe LaVacca (11:10)
Exactly. It's just your your glute med or your QL or your quad or your soleus. That's the crux of all the things that is wrong with you. So it is very similar to or interesting to hear how the similarities go from space to space. And I think part of that might be just because it's easier for clinicians to be reductionist in their thinking and not think outside the box. And I think that's what a lot of our conversation today is going to help people do. So I'm really, really excited for it.

Joe mentioned that there was another question though. We need to know how you take your coffee. yeah.

Lauren Ohayon (11:44)
My coffee?

Do I tell the truth? ⁓ I love that we never know if it's the truth. I was hijacked by the you need more protein trend until I...

recused myself from it very happily. However, I had a moment where it did hijacked my critical thinking skills and I thought I needed to dump it into my shower and every other part of my life. So I started putting a scoop of it in my morning coffee. I know like off like who F does that? I did it.

Joe Gambino (12:09)
Thank

Joe LaVacca (12:20)
⁓ okay.

Lauren Ohayon (12:25)
And then because it was so repugnant, I needed to add honey to it. Ugh, what a way to kill coffee. ⁓ And then to offset all that, I of course put a lot of copious amounts of either cream or half and half, whatever I have on hand.

So it's revolting, but it's the very first thing I drink in the morning, because it makes me feel like I'm somewhat trendy, which is important to me, apparently. And then later, when I have my second cup of coffee, it's just like straight up coffee with some cream, and it's really delicious. And I'm like, thank god it's not that protein bomb.

Joe LaVacca (12:59)
It's more like a soup. Sounds like a soup at the end of the day.

Lauren Ohayon (13:02)
It's

revolting. like, why? I don't know why I'm doing this, but I don't adhere to the protein obsession for the rest of the day. I mean, I do try to get some protein, because Joe Lavaca has told me I need some to eat more if I want to get bulk more. ⁓ So yeah, it's like cottage cheese for me the rest of the day, but the morning is disgusting protein powder in my coffee.

Joe LaVacca (13:18)
Just a touch more. Just a touch more.

Well,

the bros really appreciate your sacrifice in the morning for sure. I will tell you that, Or else why do it? Or else why do it?

Joe Gambino (13:34)
Yeah.

Lauren Ohayon (13:37)
I'm gonna live longer.

Joe Gambino (13:40)
Yeah.

Lauren Ohayon (13:42)
I won't age and

my bone density will be perfect if I do that.

Joe Gambino (13:47)
I feel like at that point you should just dry scoop it and just chase it with the coffee and then finish the second cup. Yeah.

Joe LaVacca (13:51)
⁓

Lauren Ohayon (13:51)
That's actually not a bad idea. would probably kill me before I got to the coffee though.

Just choke.

Joe Gambino (13:59)
All right, well, let's move to your pain story because it sounds like where we're going to go back towards, you know, you having the three kids and how that might've set things up, but maybe we'll go in a different direction. So I'm curious what kind of ⁓ go deeper into your story and what kind of led you down more of the pelvic held rabbit hole and how it's kind of impacted what you do today.

Lauren Ohayon (14:20)
Yeah, mean, I, you know, there's like correlation and then there's causation, right? I was always a super mobile, flexible mover. I was a dancer, I was a gymnastic person. And so I was always very movement and like loved bending my body into deep shapes.

⁓ And when I was in my 20s, got a lower my first lower back injury I herniated Between like I don't know. I can't remember. It was like how many discs got herniated? Probably since birth they were all herniated, but who knows so a bunch of shit got herniated and I was told by you know, the very Amazing surgeon that I should have surgery immediately because I was already like showing all sorts of signs of like

like nerve damage and blah, blah, blah, blah. I was like 22.

So my Jewish mother was like, you are not having surgery. She kind of came and wherever I was living, found me and it took me a year to actually get back. Like it was a really serious injury. I was bed bound for three months and ⁓ took me a year to really kind of stop limping. I had a lot of like limping. I was very antelgic in my pattern. So I got very curious at the time.

had

a cousin who was like, you should read this book by John Sarno. It's amazing. And I was like, I'll read anything. And at that point, I was kind of like, I was like, I don't think I can teach another yoga class until I really learn everything there is to learn about the body. I just need to know everything. And I'm like a forever learner. So while I was healing in that year, I took ⁓ like a

Pilates teacher training course, I read John Sarno's books, ⁓ and I will say that when I got to like, before I finished chapter one, 98 % of my pain was gone, which was amazing. So most of my pain was gone, but I was still like limping and antalgic.

but I still was out of pain. And so I was like, oh, there's something there, but I need to really understand all of it. So I just started studying a lot of anatomy and biomechanics and all of it. I just took probably more courses than most PTs take. I just took every anatomy course I could find. I wanted to understand the back, the spine, the this, the that, the core, the pelvic floor. I was just interested. So that's my pain story. then within a year, I was fine.

Yeah, I was fine. And my back never gave me an issue until four years ago, where I was in a chiropractic office. And I was and he gave me an adjustment and my disc fragmented. And it was another four month pain story, which culminated in a microdiscectomy. ⁓ And

I'm now doing amazing and Joe has been a huge part of my rehabilitation and I'm so grateful to you for that Joe. Joe Lavaca, to give credit.

Joe LaVacca (17:25)
They're not joking, you know,

not the other Joe.

Lauren Ohayon (17:28)
Okay.

Joe Gambino (17:29)
I

mean at this point just call me John, know just make up a name for me since I've botched yours a couple times so.

Lauren Ohayon (17:29)
Yeah, that's right.

So, and so that's my pain story. ⁓

And it heavily, heavily, heavily influenced my work. It continues to. But I will say that ⁓ it's not like my pelvic, my focus on pelvic, I had three children in three years and I really didn't have any pelvic floor or core issues. And I think it's because my rebellious nature, I refuse to ever do one Kegel. I was like, there's no fucking way you're getting me to do something that feels barbaric. Like nothing about that is pleasurable. It's not fun. It's not enjoyable. It's barbaric. So I'm not doing it.

be a better way. Like, I don't prime my arm to open the door. Why am I priming my pelvic floor to do its job? How about I keep the whole system lubricated and working and functional and like a chain working? That just made sense to me. It didn't make sense to me. So I think that like part of what really helped my pelvic floor in all the pregnancies back to back, I had three vaginal births.

unassisted, unmedicated at home, basically. So, well, my first one was actually in a hospital. I think part of that was because I really refused to listen to, I mean, I think there's so many reasons why, right? We don't know. There's just too many options of why did I get lucky in that department. ⁓ But I never had pelvic floor and core issues post-birth, but I've...

We could, one could call, like, I don't know if you would call what I have chronic back stuff, but whatever, long-term back shit could also be a core, defined by some people as a core issue. Not defined by me as that, but other people might call it a core issue. I wouldn't.

Joe LaVacca (19:18)
Yeah.

I love hearing your story, Lauren, ⁓ and thank you for sharing it. And I think that when you compare the first time you had your back pain, very similar experience, it sounds like to what you were suffering from about four years ago when we met. However, the first time life was a little bit different. You leaned on your mother, your relationships, you were able to sort of quote unquote, fix this yourself over the course of a year.

Now we flash forward, it ends up that the surgery just seemed to make sense for us at the time. So much of this was mechanical, so many movements were blocked. And it actually had me start to think about what you were saying about the pelvic floor just a few minutes ago when it comes to a lot of the stigmatization for women, the fallacy of that you just need to get everything stronger. So the thought that popped into my mind was,

Lauren Ohayon (20:03)
Mm-hmm.

Joe LaVacca (20:19)
often are you actually seeing a split like that? Where can you determine with assessments or what you learn women who maybe actually just need more strength and women who maybe just need more support and how do you approach those two maybe lenses or roads differently?

Lauren Ohayon (20:41)
That's a good question. You're always so philosophical. ⁓ I think that because we are so complex that you can't go wrong in offering both. And that for most people,

Most people, like, I think that injury can happen to everyone. That's the thing, right? So I think that, the mechanism of why is less important. I think the story of why is cool. But the mechanism of why is less important. And when we can just hold space for what I believe that everybody could use a little dose of all of that.

Everybody, everybody could use like their mommy to lean on and everybody could, you know, everybody could use. And so when I'm working with someone, I want to hear their whole story because I think that a lot of people also, when they come to you with an injury, they're not conditioned to talk to you about what happened in their childhood, right? Or like they're not conditioned to talk to you about how they feel about their life right now. You're like, how are you feeling? I'm good. Like, are you really good?

How are you sleeping? How is your relationship? What are you stressed about? What's happening? So I think everybody needs to take account of it. We need to hold space for everybody's stories. But do we need to shift blame and wonder, like, this, is this, like, what is, what's, you know, what's happening here? I don't think it always matters.

Joe LaVacca (22:25)
Yeah, and I think too, to your point, ⁓ least, you know, again, something Joe and I have mentioned is that with the whole stories of pain, I think a lot of people now have pushed so far in one direction where, your pain's always psychological or it's all in your head. ⁓ You know, you just need to, you know, keep moving. You're going to be fine. And like you were saying, holding just space for people to tell their stories can be some of the most validating things.

And then at the end of the day, yeah, a lot of treatment might look the same. You know, it just might be how you're educating people. You know, the sort of context you're giving them to, you know, perform some restore your core with the idea of mindfulness involved. And that might just be enough to shift someone where someone else can think, OK, cool, I'm stabilizing all these muscles and someone else could just be thinking I'm bringing healing to the area that I need it the most. But they're sort of doing a lot of the similar things. So I think that's sort of like what your point was.

Lauren Ohayon (23:25)
think also that ultimately our clients don't give a shit why it's working. They just want it to work. We love to nerd out about what was it that helped them. But I think that ultimately they don't really care. I will also say that, I don't know if you remember this, Joe, but when I was in the... So my last back injury that happened about four years ago left me unable to extend my hips. So I was literally walking around like this.

for four months, this was my antalgic position. was revolt, mean, revoltingly awful to see. I could not extend at all. And I had no pain. So I had no pain for four months, even though I was literally beyond hunched over, because I had so much hope. I had so much hope that like my last injury, just give it time, give it input, give it, you know, and...

And one of the places that I sought support from was the John Sarno community that now refers to themselves as TMS. And like I did an hour session with this guy who has zero credentials, but 30,000 YouTube videos and his own recovery from pain story, which is fine. I'm totally fine with that level of credential. Like I'm okay with that. You don't need to be like a DPT.

But he literally tried to convince me that it was all in my head. And it was really shocking because the minute I had the surgery, I could stand up, my pain was gone, I was fine. And so like I really, part of me was like, why didn't I have surgery three months ago? Like I just spent four months because I wanted to give it a chance, right? I wanted to give it the four months to resolve itself. But my pain started four days before I had surgery.

And it started because I freaked out. I flew to France to teach a retreat in a wheelchair, and it was just too much. Like getting out of my house, thinking I could teach a retreat. I was literally in the retreat house, crawling, like crawling around teaching my next class. It was the epitome of ridiculous. And my students who've been with me, many of them, for 20 years on retreat, they were like,

Joe LaVacca (25:41)
You

Lauren Ohayon (25:42)
why aren't

you having surgery for this? And I'm like crawling up the steps and crawling into the yoga room and they were just looking at me like, what's happened to you? So I called the surgeon. My mom had like a, my mom had an in with a surgeon and he's like, I can operate on you in four days. I got on a plane that night.

That's when my pain began, was when I got to France and I had to teach this retreat. I hadn't had pain. So it's interesting what you say. My first back story, I actually had a lot of pain until I read the Sarno book. That pain went away and it just took me a year to heal. This pain was no pain. I was totally antalgic. I was totally hunched over. I could barely move. But I really wasn't in pain. I could sleep at night. I wasn't on painkillers. I was fine.

I was just stuck. I was like just stuck. And then my pain came the night I said to my mom, I want to die. I called her. I was weeping into the phone. I was like, mom, I want to die. She was like, no, you want to get on a plane right now. I have a surgeon waiting for you. And I did.

And I had a great surgical outcome. People are always like, don't have surgery. It'll be worse. Really? I can tell you about the workout I just did this morning that Joe scripted for me. I'm doing great.

Joe LaVacca (26:59)
Well, we're yes, we love doing that.

Lauren Ohayon (27:03)
It's just

layered.

Joe LaVacca (27:11)
Right, right. And one of the things that we wanted to ask you too, I think kind of builds off of this then, and it's probably true for both men and females, but it just seems that it takes so long for men and or women to find treatment. So why do you think that is? And maybe what can men and or women look out for to kind of look out to get help sooner?

Lauren Ohayon (27:40)
think if you're under this idea that this is just what happens to you as you get older, you're not going to go get help for it. then when you go, so many of my clients tell me that when they go to their doctors with concerns about their pelvic floor, this is what they're being told, including my male clients. Maybe you should go see a physical therapist for that.

I specifically, the surgeon called me yesterday about my husband's ACL recovery. And I said, ooh, I can't remember when I was like, you know, a lot was happening at the hospital on the day of the surgery. We're now day two post-surgery. Is today the day he's supposed to start flexing his knee? And he was like, I have no idea.

There we have it. This is like Miami's leading surgeon. The Miami Heat and the Dolphins all use him. He's got like signed shirts. We are all so much in the whole of what we do, right? These surgeons, and he's phenomenal. don't necessarily, I mean, I feel like I do expect them to know the answer to that question. That feels like a...

question you could answer. It wasn't the surgeon, by the way, it was a surgical resident. But I was like, maybe you should go find the answer to that and remember it. I didn't say that, but I wanted to. But I was like, this is why it takes so long, right? If you're a woman and you're going to get a surgical consult about your uterine prolapse, and the doctor doesn't even understand the basic mechanism of what you can do a day post surgery,

When it's like the basic function, what do we expect? This is the baseline. This is where we're at. So I think that like what takes a long, like I think with the pelvic floor especially, whenever I teach a group of women and I'm like, X amount of women have pelvic floor dysfunction, the floodgates open and everyone's talking about their pelvic floor issues.

But like 10 minutes earlier, no one was willing to admit they had a pelvic floor issue. But the minute I'm like, I'm sure almost everyone in here has one, so just somebody talk about your pelvic floor issue. One woman will raise her hand and be like, okay, and then the whole room, and it erupts. Suddenly we go from zero people in the room had an issue to basically 99 % of the women in the room want to share their issue.

We're not like, you know, there's just not this like invite to talk about these issues. It's embarrassing to a lot of people. And when people continue to say things like, do you have pain down there? I'm like, fucking defying down there. Do I have pain? The nurse at the hospital was like, to my husband, if you don't pee, I'm gonna have to put a tube up your pee pee. I was like, by pee pee, you mean his penis? Literally the floor went quiet. You're in a hospital where people can't say the word penis? Just.

Tell him it's a tube of his penis. Why are you using this word, peepee? There's no such thing in the human body called peepee and weewee and yo-yo and shmo-shmo stop using stand-in language for body parts. So I think, you know, I always joke. like, I just want people to be more clitoral.

Joe Gambino (30:52)
Hahaha.

Lauren Ohayon (30:53)
know, like a little more clitoris-y would help. And I think that clitoris-y, that's what I wanted to name my book, but it's taken. I think that clitoris-y leads to self-advocacy. Like when you feel safe enough to talk about a body part like it's no big deal, then you feel safe enough to start asking help, not the other way around.

Joe Gambino (31:12)
Mm-hmm.

Lauren Ohayon (31:17)
So we need to start with education. We need to start with people feeling safe in their bodies. When you feel safe in your body, you'll go get help for your body because you feel safe in it you want to protect it and you're at one, like you're one with your body.

Joe Gambino (31:30)
That's I think that's a very fair point. What do you think for somebody who maybe is in that boat so to speak? What would be your advice for them? What kind of like I feel like there's also a lot of people who don't even understand that like pelvic floor or something they can work on or go seek help for so what like if someone's listening to this what should they you know, maybe they don't even know they have these symptoms where should they be thinking about like hey, maybe this is an actual problem for me and

where might they go to reach out to get the support they need.

Lauren Ohayon (32:02)
Yeah, and I think that like, ⁓ I think that if we can rebrand the pelvic floor as your core, like how about we just lump those two together? Then there'd be a lot more incentive to get help or maybe seek understanding. But I think that also understanding that like there is this canister system in your body and it starts with your ribs and your breath. ⁓ but the ribs are connected to your spine. So actually our spine is involved.

Right, so now we're talking like ribs, breath, right, because it's a pressure system. This canister is managing pressure all the time. So if you're experiencing something in your pelvic floor at the base of the system, how about we start looking further afield up the system to see what else we can optimize, right? A lot of people are really constricted in their breathing, right? Their ribs don't...

They're belly breathing. the, like so many places that I see, the fitness world talks about belly breathing and I'm like, why? Your diaphragm is in your ribs, like up here. Your heart sits on your diaphragm. Like it's that high up and it attaches your diaphragm to your spine. Like why are we talking about the, like people are like, breathe into your diaphragm. I'm like, why are you touching your belly when you talk about the diaphragm?

Right? So there's all these people doing all this movement in their belly. And when, if you try it, if you actually try to do nothing, but move your belly on your next in-breath, the only way to do that is to lock your ribs down. There is no other way to do that. You have to close your ribs and lock them. You have to immobilize your ribs to move your belly. That's how most people breathe. Now they do it for whatever reason. One of my daughters has very large breasts. Maybe...

The large-breasted people do it because their breasts are large. They want to hide. Not my kids, of course. They walk around very proud of their large breasts, right? But every day I'm like, ⁓ they're so beautiful. Let them out. But most people are ashamed of their breasts. it starts with that. Or you walk into a porta potty and it smells like shit and your body doesn't consult you and it just helps you survive the 45 seconds you need to be in there.

Joe LaVacca (34:01)
You

Lauren Ohayon (34:19)
Well, what if your life smells like shit, right? Your life is a porta potty, which all of us at some point in our life go through a porta potty moment. Our body creates these patterns to cope. And that coping is usually a constriction of that core canister. So we're just really used to constricting our core canister. And I think that the more you squeeze your core canister, the more you're like,

you over pressurize your pelvic floor. And the more you over pressurize your pelvic floor, the more tight and tense it can be in response because your body is smart and it's adaptable and it's adapting to that load that's like excess load on your pelvic floor. So it starts tightening up in response to all this pressure. I mean, the simplest thing you can do when you're thinking about your pelvic floor is how can I optimize intra-abdominal pressure, which is very nerdy sounding, but like,

instead of thinking about like localized treatment to the pelvic floor in the form of contract release, contract release, how about we think about getting the pelvic floor to be responsive and adaptive again, by creating mobility and opening through the rib cage, the breath, again, changing this pattern from belly breathing into more thoracic breathing, right? And spine mobility. So, you know, I think the first thing is like understanding that if you're having like,

any sort of pain with intercourse, pain post intercourse, pain with orgasm, difficulty to get to orgasm, ⁓ even low back pain, deep hip pain, pressure in your vagina, feeling of just like totally disconnected from your perineal area, which is males and females. You know, those are signs of possibly over pressure, leaking. I mean, the whole thing, like if you leak any amount,

It's actually not that normal, but it's common. And let's have a look at your pressure system. It could be that the structures are in fact more weak, right? Like especially for women going through menopause, like loss of estrogen can lead to a less, the muscles get weaker. But that doesn't mean there's nothing you can do about it. And that doesn't mean that Kegels are gonna solve your problem.

So I think like what are the symptoms? Well, all the like continence systems, all the sexual and pleasure symptoms, but looking further afield, we can also see that like deep glute pain, deep hip pain and low back pain can often also be a reflection of the pelvic floor or the pelvic floor and core being way too pressurized. Like the pressure is just accumulating there and we see people gripping through their low back.

but when you grip in your low back, you have to grip in your pelvic floor. Like they are that connected. They're that connected. So, you know, a lot of women who've been like, who wear like ⁓ shapewear, I know, sucks to fucking suck, all this, like leggings that squeeze you, shapewear, postpartum, they're putting on these binds and corsets, like the pressure's gonna go somewhere. When you lock down the center of your body,

We have to expect that the pressure is going to go somewhere. And so again, people might be feeling it in their low back and not want to believe that their pelvic floor is involved because they're not leaking when they cough. No, your pelvic floor is most likely involved when you are bracing through your back, when you are tightening and tensing. So I would say that even people with like tension responses, like just really held in anterior tilt or held in a post tilt, just held in a position

where there's not this fluidity through the spine, we can expect that the pelvic floor is in a state of overpressurized. Does that mean they're gonna have symptoms? No, they might not have pelvic floor symptoms, but when you optimize the core canister, you optimize the pelvic floor. So in my programs, I don't actually ever talk about the pelvic floor. We don't do any Kegels. We just optimize the core, the spine, the breathing, the ribs, the mobility of that canister, and the pelvic floor is suddenly taken care of. It just starts.

doing its thing.

Joe LaVacca (38:35)
Yeah. And hearing you explain that Lauren, it makes a lot of sense than how these sort of issues or opportunities around the pelvic floor can affect movement of the wear in the body, know, mid back, hips, right? And then if we start to extrapolate that a little bit more, well, now we're kind of looking at maybe global patterns. We're talking squats and deadlifts and gait and all these other different things. And we know that you have sort of worked with ⁓ Dr. Diana, who's been a guest on the show. ⁓

Dr. Courtney, who's been a guest on the show. And it sounds like this optimization of the pressure system or, you know, kind of bringing yourself back to breath is a kind of sort of a big swing from maybe what people are thinking with kegels and strengthening and clenching. Right. So that's such a great tip for people to walk away with and sort of understand that it's not always about adding. Maybe it's a little bit more about subtracting.

And I don't have to get this manual input, which I also probably think is relatively uncomfortable for men and women to think to treat this. You know, I have a little bit of this opportunity to do this on my own. So I was wondering, like either again, like through your studies and your research and your working and experience working with Diana and Courtney, ⁓ if bringing maybe breath or controlling pressure through the system, are there one or two other like tips that

we can share with listeners to help them also optimize this pelvic health.

Lauren Ohayon (40:10)
Yeah.

I think that, I I loved the work I did with Courtney. Courtney Conley, as you know, you both know her, Dr. Courtney. Yes. ⁓ I think that...

Joe LaVacca (40:22)
I've heard of her.

Lauren Ohayon (40:32)
It's impossible that any pattern in your core, which is your pelvic floor, is not probably also a reflection of what's happening down the chain. Now again, does it mean that it's a dysfunctional pattern? No. I hate the word dysfunction. I love to think of the body as just an adaptation, like a ⁓ series of patterns that form because we're all so spiral and the way the body moves is like.

absorbing force, right? Like we absorb force, we offset force, right? Like shock absorption and force. And so there's no way that the feet are not involved in that. And I think that sometimes it's really hard for people to access their core and pelvic floor.

And one beautiful way in is to start accessing your feet. And it's not about, again, it's not about like, my god, no wonder you have a prolapse. You've been wearing heels your whole life. We should never make a client feel guilty about their life choices and create these, well, this is why this is happening. But.

It's more like, okay, maybe it's triggering to access, maybe you're struggling, like there's a disassociation here in your core and pelvic floor. How about we play with your feet a little bit? And then people are like, my God, I never noticed I had flat feet.

Right? Okay, cool. Cool. You have flat feet. Doesn't mean anything's wrong with you. You're not broken. How about we reintroduce the arch a little bit and see what that's like? And then they're like reintroducing the arch and then they're noticing like, my legs are rotating as I reintroduce my arch. Yeah, that's cool. Did you know? Did you know that as you rotate your legs, it actually creates a rotation up in your pelvis? Like, did you know that we could actually do these five exercises for your feet and create really positive outcome in your pelvic floor?

I think we need to assume that anytime we're creating three-dimensional movement from the feet to the head, and it's intentional and mindful, it's going to affect your pelvic floor, right? You don't need to lay in your bed and do 50 Kegels. You could actually just play with your toes a little bit, rotate your legs a little bit, do a little bit of internal-external rotation. How about that? I do think that for people who are really suffering with a pelvic floor injury,

Some more isolated work on like, let's dial in on your breathing mechanics, not because there's one good way or bad way to breathe, but when we do different, change happens. So just do different. So dialing in on patterns is useful because it's a different input. So like, yes, it's fun to be curious and like move three dimensionally and like be flowy and move your toes and play with everything, but also isolating out skills. Like skills are fun. Learn some skills with your body.

your pelvic floor will likely benefit from that too. But if you really do have a pelvic floor injury, seeing somebody who works with the whole body and does like the work, pelvic floor whole body work is a great idea as well. Like integrating feet to pelvic floor, to core, to breath, through the spine, the ribs, the arms have something to do with it, the shoulders, right? Like you got to kind of...

get everything doing a little bit of movement in a lot of places is a great idea for the pelvic floor. A little bit of movement in a lot of places really, really helps the pelvic floor. And unfortunately, a lot of our clients have a lot of movement in just a few places. They don't have a little bit of movement in a lot of places. that's kind of like how, when I assess a client, I'm like, where are they really good at moving? ⁓ what's kind of stuck?

And I've seen thousands, I mean, I have over 15,000 people subscribe to my programs and we hear amazing success stories every day and it's all done without Kegels and it is integrating like the feet all the way up. So I send people to Courtney Conley all the time. When I feel like I think you could use a little bit more skill work in your feet, let's hone in on what's happening in your feet a little bit more, see if that helps up the chain.

Joe LaVacca (44:50)
Yeah, super interesting. So I don't think people were expecting to hear like breath and footwork. And I like what you said about a little bit of movement in a lot of places. Again, I think all that stuff seems very, approachable. And I hope listeners are able to kind of take away a few bits of that. So that was great. Thanks, Lauren.

Joe Gambino (44:52)
Mm-hmm.

Lauren Ohayon (45:09)
Thanks. Yeah, I got in big trouble like when I first started on my soapbox about the pelvic floor. I was like, why are you looking at Kegels? Why aren't you looking at breath first?

Joe Gambino (45:12)
Yeah.

Lauren Ohayon (45:22)
And now I see all sorts of pelvic floor therapists talking about breath and the role of the pelvic floor. But like back then, this is like going 20 years ago, I was like getting all over Brooklyn, pelvic floor therapists were like, we don't recommend, do not, she's like talking about the breath and you should be doing your kegels. And I was like, no, you should be optimizing your core canister and looking at your breathing patterns. They did not like that. Now it's very, very widely accepted.

Joe Gambino (45:26)
Yeah.

I always think like ⁓ with anything like a holistic approach is always the kind of like best way to approach things. So I mean nothing works by itself in a sense. But I'm curious I mean I know you have you know you kind of work globally and that helps the public floor but have you seen

Lauren Ohayon (45:52)
But back then it wasn't, yeah, it's quite.

Joe Gambino (46:11)
Maybe any specific examples where you kind of go through all that and you have to like specifically like target strengthening through the pelvic floor, whether it's Kegels or some other ways to kind of get that area stronger in a sense.

Lauren Ohayon (46:19)
Mm-hmm.

Absolutely, but I would say that my way of getting people's So like I work in a kind of a different way. I first make sure that people are Mapped to their pelvic floor. So like it's really easy with your hand, right? Like you can see your hand and feel your hand and I could even tell you with your eyes closed I could talk about all these scenarios and you would know exactly how your hand would feel in that scenario Pick up a glass grab a baseball. Whatever it is. Pick up a pencil pick up some

been cold, you know, like you don't need to do it to actually. Now we talk about the pelvic floor and people, it's like a blank. There's zero since the no, no mapping, no point of reference, no ability to describe what it does when it does what it does. Like what does your hand do when your hand does what it does? You know, you feel, you have a knowing on multiple layers of your brain. Pelvic floor, people are like,

I don't know, I can stop my pee if I have to. I can do that. That's like their frame of reference. Think about that. And so, and it's partially is because it's not a hand, it's not a leg, it's not a swinging limb, right? It's not appendicular, it's axial. So that changes things, but yet, axial, you can do a lot of cool shit with your spine.

I could talk about your spine cat and cow, roll over a ball, do a Roman schmoman, and you know, like you can embody that without doing it. You can have, and you can have this sense on multiple layers of your brain. You can feel it, you can taste it, you can see it, you know how your spine feels in that shape, you know how your spine feels against the bed, you know how your spine feels against the block, that's.

a lot of knowing, that's a lot of like GPS happening. People have no GPS to their pelvic floor, none. And then we're like, let's work on strengthening it. And they're like, okay, my PT told me to squeeze my pee mid pee. I'm like, okay, can you wag your clitoris? And they're like, I don't even know, no, no. And some people are like, I don't even know where that is. Right, so it's like.

Can you move your clitoris? Did you know that your clitoris has this function that it can move, it can nod? Nope, didn't know that. Did you know that your tailbone can move? It's not a big movement. It's not huge, but your tailbone can move. Hello, there are a bunch of muscles attached to your tailbone. It moves. Right, so now we've got from the front, clitoris can move. From the back, tailbone can move.

How about we get that happening? That's an amazing key. Like better than a Kegel, right there is accessing that. How about your sitting bones? Did you know that your sitting bones, you can actually widen and narrow them depending, like get people moving from their sitting bones, lie on your back, narrow your sitting bones, that's gonna pull you into a post-top.

widen your sitting bones, that's gonna anteriorly tilt you. But I'm not using that language. I'm not saying posteriorly tilt your sitting tailbone, your pelvis, no. I'm dropping people into the bones of their body. And so I love to drop people out of instruction, vague instruction, contract this, squeeze that, and more into feel your anatomy.

Right? And it gets you into the same muscular action without speaking muscle to someone. There are multiple ways to bring someone into a muscular action without ever mentioning squeeze, tighten, lift, and lengthen. And it's awesome work. So my curiosity is to get people embodied. Like when you feel your pelvic floor in those three dimensions, you've got the sitting bones, I've helped you feel your sitting bones, I helped you feel your tailbone, I've helped you feel your clitoris.

I do it for the ASIS too. I have a whole embodiment on the ASIS. Feel them as you tuck and tilt, sagittal plane movement, rotational movement. I bring people into their pelvis so it becomes like this 3D experience. When you have a 3D experience in your pelvis, it never leaves you. You are now like, it's this, it's your hands, it's your fingers.

Joe Gambino (50:38)
Mm-hmm.

Lauren Ohayon (50:49)
powerful. Why do we not give people this? And it's like what Courtney does with the feet, right? I'm sure people who do work with Courtney suddenly feel like their feet have like Botox or filler, not Botox, filler. They've been filled up. They're like alive. They're like, whoa, feet, cool, right? We do it.

Joe LaVacca (51:01)
Thank you.

Lauren Ohayon (51:08)
so automatically with our hands, but not our feet and not our pelvic floor. So like Courtney is doing that with people's feet, I'm doing that with people's pelvic floor. And I think that the way that like, again, the way that most people have taught other people about the pelvic floor is this binary muscular action. But we have to understand that in a part of the body that most people are disconnected to, why are we asking them to squeeze? How the fuck do you know what they're doing? How do you actually know that they're doing what you think they should be doing?

Just because you say squeeze, one person can go posterior, another person can go anterior, someone else can go to their belly, another person can just grip their jaw. How about we bring them into their pelvis as a 3D operating system? We give them some instructions about how to operate that system. And now instead of them being like directed, they are the direction. You become.

the vehicle that's driving on the road. Like you become that object. You are no longer looking at it from the outside of your body, trying to wield power over it. And there's something incredibly powerful about being that embodied in your body. It's...

Joe Gambino (52:17)
Okay.

Lauren Ohayon (52:23)
agency, if you want my opinion. It's really special. And so that's my work with people. When you ask me, like, do I ever give like Q, yes, I want people's pelvic floor doing its thing. But I also know that like, A, when I bring them into like the embodiment of it, that's helpful. And B, when again, we can see what's disrupting their core from doing core things, and what's disrupting their spine from doing spine things, and what's disrupting their breath from doing breath things.

When we reintegrate those patterns, the pelvic floor is being, it's being narrated by the core. The core is the narrator of the pelvic floor. And the pelvic floor is the shock absorber of like the ground beneath it. So the pelvic floor has this amazing job. It's a conduit and a composer.

It's very interesting. it's, you know, dropping into the energy of the pelvic floor, dropping into the action of the pelvic floor is way less about squeeze and release. It's way more about like conduct, receive, conduct, transmit.

And I think that we're just not used to connecting to a muscular space that way, because we're used to squeezing and lifting and pulling on our muscles. We're not used to like what the pelvic floor does is just not those things. It's not an appendage. I love it, as you can tell. It's fascinating. I find it. Yeah.

Joe Gambino (53:42)
Yeah, I actually really, yeah, I love that approach.

I think, you know, even like Joe and I have talked about this, we're like, just like, if we just go to the core, if you don't have like spinal segmentation and all these things, right, like your core is not going to be able to do the job that you want. So I love this approach of like, can you get your pelvis to move on your femur and kind of disassociate and create the movement around all those areas to get the muscles to do what you want. And when you start to take a more...

movement-based approach and less of this like you need to just activate this muscle. I think you can get people to respond very differently and more effectively in my opinion.

Lauren Ohayon (54:18)
And then they're curious, because they're like, my task is to do something interesting with this body of mine. My task is not, again, an instruction to follow.

Joe LaVacca (54:31)
Yeah, the embodiment piece was terrific there, Lauren. Thank you for that connection. Because if you don't feel comfortable or you feel anxious or you feel worried or you feel afraid or you feel shameful, you're going to move and interact differently. And I think you did a wonderful job highlighting that for us. So thank you. If people want to work with Lauren Ohayan, not your sister Laura, where do they reach out and find you?

Lauren Ohayon (54:49)
Yeah, thanks.

My nemesis.

Yeah, so the best way is like probably whatever social media or my website restore your core. People are always shocked like I answer all my own emails. Like if you shoot me an email, it's me answering. are always like, I can't believe it's you responding. I'm like, yeah, I answer my own emails. ⁓ So like, you know, I'm accessible and I answer all my own Instagram messages. You can find me there, restore your core, the website. ⁓ We have, you know, a support button there. Yeah.

I'm around.

Joe LaVacca (55:30)
Do we drop your

Instagram? What was your Instagram account so that way everyone knows or just remind them?

Lauren Ohayon (55:33)
It's the Lauren

O'Hayan. So the and then Lauren O'Hayan.

Joe LaVacca (55:39)
Yeah, you had to put the the in there because people were calling you Laura. So you had to be like, I'm the Lauren. I'm the Lauren.

Lauren Ohayon (55:43)
Yes, that's right. That's right. I'm the Lauren.

Yeah, that was a decision I made many years ago and I today I would probably take out the the but I'm happy to honor the former the the former stages of my development as well.

Joe LaVacca (56:00)
Joe, any other thoughts or questions for

Lauren before we let her go?

Joe Gambino (56:04)
No, no, thank you for coming on and sharing your thoughts and experiences.

Joe LaVacca (56:09)
Yep, Lauren, that was wonderful. ⁓ We love you listeners. We love you, Joe. We love you. And thank you all for tuning in to this week's Beyond Paid podcast. And don't forget to come back next week for another exciting episode.

Lauren Ohayon (56:09)
Thank you.