Healing From Within: Secrets of Pelvic Health with Dr. Hannah Strom

Did you know that your body holds onto stress in ways you might not even realize?

In this episode, we sit down with the incredible Dr. Hannah Strom, founder of Awake Pelvic Health, to explore the powerful connection between our nervous system and pelvic floor. Hannah takes us on a journey beyond the physical symptoms, revealing how deep-rooted stress, trauma, and anxiety can manifest in our bodies.

We dive into topics that are often left unspoken but are vital for true healing. From the surprising link between the vagus nerve and chronic pain to the importance of men’s pelvic health and how these issues can even affect children, Dr.  Hannah sheds light on the path to finding freedom in your own skin. Whether you are navigating postpartum recovery, chronic pain, or simply want to understand your body better, this conversation offers a holistic roadmap to feeling safe and at home in your body again.

Tune in to discover how peeling back the layers of your nervous system can lead to profound, lasting relief. Healing is possible, and it starts with understanding the beautiful complexity of your whole self.

Connect with Dr. Hannah here: www.awakepelvichealth.com

In this episode, we cover:

• The vital connection between the pelvic floor and the vagus nerve
• Why pelvic health matters for men, women, and children
• How stress and trauma manifest in the body
• What to look for in a holistic physical therapist

How's My Nervous System Quiz

How's My Nervous System Quiz     I 

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Transcript

SPEAKER_01 0:45

Good morning and welcome to the Find Your Peace podcast. I have my friend Hannah Strom here. She is a doctor of physical therapy and the owner and founder of Awake Pelvic Health. So I'm really excited to have her here today. So thanks for being here, Hannah. Yeah, thanks for having me. I'm excited to chat and dive in. Yeah. So tell me what got you into pelvic health when you were in physical therapy school.

SPEAKER_00 1:10

Yeah, so you know, it's kind of interesting. I think my journey, like the pieces were in play prior to PT school, and then that was kind of the catalyst. Um, but I, you know, never had intentions of becoming a physical therapist. That wasn't like this lifelong goal that I had.

SPEAKER_01 1:27

Yeah.

SPEAKER_00 1:28

I yeah, I um started when I in in my undergrad education, I became a yoga instructor. I I got all these yoga certifications. I started teaching classes and fell in love with um just instructing movement and helping people in their body. And I was so interested when people would come up to me with, I have this pain, this problem, this thing. And I just wanted to know more. I wanted to figure it out and be able to go beyond just, yeah, the yoga, the yoga world. So got into PT school and eventually we ended up taking a class towards the final year of PT school in pelvic health, both men's and and men and women's uh pelvic floor health. And that was like this entire just world opened up because it took all of these pieces I already loved movement, breath work, nervous system, um, pain issues, yeah, and putting it in this much more um kind of unique sphere of helping people with problems that they don't typically talk about, you know, just in their day-to-day lives. And I love being able to help people navigate through through challenges that are maybe really um manifesting in their lives as a big problem. I wanted to be able to dive into topics that felt really uncomfortable for people to share and help them feel more confident and comfortable in their bodies and learn that, yeah, within that sphere, we can help women who are pregnant, women who've given birth, women who are going through menopause, um, men who are struggling after prostate cancer, kids who are struggling with chronic constipation. I mean, it kind of goes across the whole board.

SPEAKER_01 3:12

And why do you think so, in in my own home, you know, we had some of those issues going on and went to the the regular doctor several times looking and seeking answers. Um, and we're really not given any information on that. Why do you think that is?

SPEAKER_00 3:28

Yeah, you know, I think I think there's a lack of general education. I mean, even most physical therapists aren't really given this education on pelvic health when it's it is just another, another muscle group in the body, just like your biceps or your glutes or your shoulders, right?

SPEAKER_01 3:46

And a pretty major, a pretty major one that's in charge of a lot of things within our body, right?

SPEAKER_00 3:51

Oh, yeah, yeah, like major, major functions, right? We poop, we pee, we, you know, do things all day with our pelvic floor and don't even realize it. Right. And so to me, it's like that should be maybe one of the first things we all learn about and understand about our bodies. And so I don't know, I think it's just it's attached to a lot of things that are more taboo from things like pooping, peeing, intimacy. Um, you know, it's it's not things that we just talk about all day and and lack of education across the medical sphere.

SPEAKER_01 4:19

Right. I love that. Yeah. Okay. So one of the things that I've learned along my journey is how important the pelvic floor health is in relation to the vagus nerve. So for those of you that are listening and aren't sure what the vagus nerve is, it's it's the major nerve that connects your brain to your nervous system, right? So if it's not functioning properly, your nervous system is probably gonna be a mess. So I talk about the vagus nerve a lot, but one of the things I've learned along the way is your pelvic floor can be directly tied to that. So why don't you just touch on that for me, Hannah?

SPEAKER_00 4:51

Yeah. So I'm gonna kind of take a little journey through this a bit because I too love, love, love the vagus nerve. And we often weave it in a lot of vagus nerve hands-on techniques in our clinic. Like we'll literally do work on people's bodies that help help stimulate the vagus nerve, help get it to wake up and work better. Yep. But there's this kind of an interesting um study that was done. I can't remember the name or when, but um, our pelvic floor is so intimately connected to our nervous system. And a lot of the folks that we work with are struggling with things like chronic pelvic floor pain issues, tension problems, bowel or bladder dysfunction, pain with intimacy, all sorts of just not fun pain-based disorders and issues. And there was this study that was done where there they had women sitting in a room. I think they had like EMG sensors or something on their pelvic floor muscles, watching scary videos and different, you know, sensing different muscles in their body. And what was found is that the pelvic floor like went into this like gripping tension pattern before any other muscle group in the body. So it responds intimately to um stimulus in our lives, stress, anxiety, um, fear, uh, nervous system upregulation. And so we can have these chronic tension pain patterns that are manifested out of a nervous system dysregulation problem. And as a pelvic floor physical therapist, that that works from a much more holistic lens, meaning I'm not just like, hey, this muscle is tight, let's poke at it, let's massage it, let's make it better. Going deeper, peeling back the layers to really understand, but why, why is it like that? Why has it been like that for five, 10, 15 years? What is the root cause that has that has created this pain problem, this manifestation it is today? And usually it's like once we start digging in, having more conversations, peeling back those layers of these like deep-rooted nervous system upregulation issues that maybe came from childhood, came from young adulthood, whatever, some big traumatic event in someone's life, that's when these problems arise. And so, um, and it's not always that dramatic, right? It can be these slow build issues that build over time. But what I found is the majority of the time, we have to, we have to go into the layer of the nervous system. It is not just about stretches and yoga positions and breathing and hands-on, you know, massage work. It's yeah, it's the nervous system. That's that's what's gonna help us move forward. And so if we can teach our clients to have like very tangible strategies and tools, like certain breath work techniques, vagus nerve hands-on techniques to the neck, to the belly, um, you know, mindful, progressive muscle relaxation, different meditation options, like so many, those are just like a couple of the wide breadth of tools we have, but we have to go to the vagus nerve. And the other really cool thing I like to educate my clients on is the pathway of the vagus nerve. So sometimes I'll even take like a like a long um theraband or a wire, yeah. And I'll be like, it starts here, kind of up at the the base of your skull, right? Comes down the side of your neck, and that vagus nerve then goes to your heart, to your lungs, and all across your genus. Every single major, every single major organ it touches. Yes, it touches everything, right? And so, and so if we think about like if you have a lot of cranky neck tension and your gut health isn't super happy, you're not, you know, having you know, healthy uh bowel movements, right? The whole thing, like that, those are little signs of vagus nerve dysregulation. Yes. And so we have to go into treating that vagus nerve from the top all the way to the bottom. And because we're physical therapists, our clinic prioritizes hey, we know that that's probably a problem. So let's let's do techniques in clinic. There's a lot of cool things we'll do with you on the table, um, working around the tissues of your neck, your shoulders, your sternum, um, gentle manual therapy or manipulation to the GI organs to help bring blood flow to that vagus nerve. And it's amazing when you start doing some of this work. I'll just see my clients. It's like, it's like they just take this deep exhale. It's like they soften, like like something.

SPEAKER_01 9:41

But their whole body just like lets go of that bracing.

SPEAKER_00 9:44

Yes, yes, exactly. That full body bracing. And if you're constantly in this brace across your whole system, your pelvic floor is going to come along for the ride in that. Like it's going to not be happy. And and that's where I, as a physical therapist, you know, my my very base baseline training was, you know, treat treat the tissues, treat the bones, treat the joints. But it's like, that's like layer one. Yes. We have to dig deeper. What's happening at the nervous system? If we can go there through our hands-on treatments, through the tools we provide our clients, that's when we can start to get to that longer-term resolution.

SPEAKER_01 10:23

That's so good. And I don't know about you, but like I do a lot of those same things. I just have a different approach. But like where a lot of my clients come to me is when they've had trauma, right? They've had that severe trauma and they've tried, you know, talk therapy, they've tried other types of therapy, and they're like, I just can't let it go because we know that the body holds on to everything. The physiology holds on to that trauma. And so I love what you're saying about all the layers, right? Because it's not just a physical issue, usually when you're having pain, especially when it's been long-term chronic pain. You have to involve the nervous system in order to just really peel back that so good. So let's talk about one of the things I've heard you talk about before is men's pelvic health, which is just absolutely women's pelvic health is not talked about enough, but I've never heard men's pelvic health talked about until you talked about it. And I'm at that age where, you know, I have a handful of friends that have been experiencing prostate cancer. And so talk about men's pelvic health for just a moment.

SPEAKER_00 11:24

For sure. So, you know, our our pelvic floor muscles are really like the the actual muscle tissue is pretty much the same across men and women, right? We all have a pelvic floor, but then things change from kind of the the genital space and all of that. Of course, there's there's differences there. But long story short, anyone that has these muscles can have a problem with these muscles or anything connected to them, right? So for men, right, just just like women can have a bunch of problems, they can also experience a wide variety of issues. So, some of the the most common things that we see in our office that men come in for, um, one of them is you mentioned prostate cancer. That's that's a big one. So a lot of men, I mean, usually we see that in kind of the older population, but we can have younger guys who unfortunately experience prostate cancer as well. So that prostate organ needs to be removed. And during that process, in order to remove that tissue to make sure we get the cancer out, um, the uh individual can start to experience a lot of urinary incontinence and leaking because that prostate helps kind of guard the urethra from leakage. And then a lot of erectile dysfunction issues because of the damage to some of the nerves to that erectile tissue. So um there's a lot of things that we can do in our office to help with different pelvic floor strengthening, breath work exercises, um, things like that. It goes much more in depth than that. But yeah, long story short, to help men kind of reclaim their lives again, because it can be very um, you know, very damaging emotionally, actually, um, after that kind of experience. I mean, you had cancer and then all of these repercussions afterwards that you have no control over. Um, some other common things are um, you know, chronic constipation issues, straining problems, testicular pain. I mean, something that a lot of the men we see, you know, they're not telling anyone. Sometimes even their own spouses or partners don't even realize the extent of their pain. Um, and things have been ruled out medically. Um, and so it's it's usually a combination of nervous system, tissues, and muscles that are tight and angry. Um, usually once we start to dig beneath the surface, there's some type of trauma pattern that happened at some point. Um, believe it or not, a lot of our male clients are police officers, military or like high-level executive type folks who are dealing with a lot of stress in their life.

SPEAKER_01 13:54

That actually makes sense to me.

SPEAKER_00 13:56

Exactly. And a lot of these things are manifested and born out of that. Right.

SPEAKER_01 13:59

Um, people don't realize how much stress they hold in that pelvic floor, right? So when you're constantly under stress, then it starts to manifest out and have deeper chronic issues. Yeah, so good.

SPEAKER_00 14:12

100%.

SPEAKER_01 14:13

What about women? So let's talk about women. So most of the time, women are not educated at all on pelvic floor health until after childbirth. But I know that there's all kinds of other things that can be happening long before that. That's just when symptoms can tend to get, you know, chronic or people start to do things about it. So talk a little bit about women's pelvic floor health.

SPEAKER_00 14:33

Yes. So for women, you know, I like you mentioned, a lot of times the conversation is born out of, oh, we I had a baby, right? Now I'm having all these issues. But if we just set that aside for a second, our pelvic floor is interconnected to so many other um aspects of our body and our lives and our movement. And so for people who've never had children before, we, you know, we help people who have been struggling with things like tailbone pain, endometriosis problems, um, chronic constipation and bowel health disorders, low back or hip pain that's never been resolved because we're not tapping into the root cause of why that's even showing up. And usually it's some sort of pelvic floral nervous system issue. And so those are just kind of a list of symptoms and problems we we help with, but that's like children or not, like you we can have all sorts of issues throughout our entire lives. Right. Um, and then of course, you know, we've got our pregnancy postpartum sphere. Um, women who are pregnant, I mean, man, your body is changing so much from trimester to trimester. There are things that we do, even if people aren't having pain or symptoms, to help you prepare your body for birth. So hands-on body work, birth prep exercises, mobility drills, things that you can do to set yourself up for success for birth and postpartum healing and helping women rebuild their strength and confidence and healing after having a baby. I don't think we give enough attention to just how much that um impacts our, I mean, every aspect of our life.

SPEAKER_01 16:14

It really, really does. Um, another issue I want to talk about is um when I first started learning about pelvic floor health, I was stuck in the middle of my chronic health issues, right? And what I would have is I'd have a neck and shoulders that were totally braced and inflamed. And what surprised me is after trying chiropractors and all these other things, and I would get temporary relief, somebody finally said, It's actually your pelvic floor because your pelvic floor is so weak, your neck is having to like take over and hold the weight of your core. Um, so talk about that a little bit because I had migraines for years until I got help with that area.

SPEAKER_00 16:51

Totally. So, you know, just imagine, even in your mind right now, your your body being stacked, right? So you've got your feet, your pelvis, your spine, your neck, and then your head. And there are tissues around your core canister. So think about your hips, your glutes, your deep core, your pelvic floor. That's what we call your core. It's like this whole system of muscles, it's not just your abs that need to be doing their job. It's like the middle of your body. Yeah. And if there's something happening at one of those muscle groups, like your core is really weak. And again, that could include your pelvic floor, your back, your hips, your glutes, all of those things, other parts of your body are going to have to compensate for that. You're gonna have to take over that um the work that those other groups aren't doing. And so a lot of times we will see, and this is why as pelvic floor therapists, at least at awake pelvic health, my clinic, we're not just pigeonholing our attention into those muscles. We do work with people, for example, with chronic headaches or migraines, upper back problems, foot and ankle issues. They've never had resolution. And so what we're looking at is that whole body system, because it's probably something up or down the chain that's actually the real root problem that is causing these chronic head-neck issues or what have you, right? Yeah. And so then we can look at, okay, how are those muscle groups of your pelvic floor actually working and doing their job? Oh, they're not. Let's go there as we continue to work up and down the chain, if that kind of makes sense.

SPEAKER_01 18:27

So good. I love it. Okay, talk about bed wetting in kids, because I know a lot of sensory kids, a lot of kids that are just struggling to regulate. And we're seeing so many of those as these COVID babies are getting older, um, even more so than we ever have in the past. Talk about that a little bit and how that all can be connected.

SPEAKER_00 18:46

For sure. So I will say my expertise is not in pediatrics, but we do treat feeds at my clinic because we have a couple providers who are just absolutely brilliant, but from a just kind of a very basic level foundation. Um, when we when we think about kiddos and bed wetting and pelvic floor issues, usually it's not like, oh, my kid has a weak pelvic floor, right? Right. It's typically there's there's more to the picture, such as um, you know, helping, helping educate parents on daily habits, hydration, food intake, constipation problems. So if a little kiddo is having bowel issues or constipation issues, that's going to put a lot of pressure on their little bladder. And they're not, you know, they haven't quite learned, you know, really true like deep body signals like adults hopefully have. Right. And so when we're looking at kids that are that are kind of chronic bedwetting, and sometimes we've even treated um, you know, peds who are in in their teens with this issue. And so what we really do have to look at is this very holistic pie of kind of like any sort of past trauma stuff that's that's playing a role. Nervous system upregulation, um, hydration and nutrition habits, movement, bowel health, right? All those pieces to the puzzle are are what we need to look at to figure out why is that happening. So it's usually not like just a one root cause problem. It's like multifactorial.

SPEAKER_01 20:23

Right. And I don't think people associate pelvic floor health with kids at all. Um, I just know in my own home that that was a big issue. And until we address the pelvic floor, you know, the bed wedding didn't stop. So it's been life-changing for our family. So I'm just super thankful for that. Any last thoughts about pelvic floor health and nervous system regulation that you want to share?

SPEAKER_00 20:47

Yeah, you know, I just, I'm sorry, my voice is getting a little scratchy. I, you know, I think I just want people to recognize that that this the the the issues that can come up with someone's pelvic floor is it's it's not weird. A lot of these things are common but not normal. And if you've been dealing with with some type of chronic pain pattern, some type of thing that you're like, wow, I, you know, I I've been dealing with this for a long time. I finally want to get some resolution that there is there is help out there and there are solutions for you, and that it's not something you just have to live with. So that's kind of the message I'd like to get out there.

SPEAKER_01 21:26

Yeah, that's so good. And so awake pelvic health is located in Woodbury, Minnesota, but I know I have um listeners all over the world. Um, so if somebody's looking for a pelvic floor therapist that's not local to our area, Hannah, what would you say the things to look at? Because I've been to several, right? And they they're not all the same. So what kind of things would you say they should look for if they're looking for a practitioner?

SPEAKER_00 21:50

Yeah, yeah, exactly. Just like any medical provider, everyone is different. So the things that I really encourage folks to to look at and ask questions on before they head on in is, you know, how long are visits? So I really do believe that a good full hour at least is important so we can look at all of the different pieces to the puzzle. Is that person, um, do they have a specialty in pelvic health, or is that just kind of like a little thing they do on the side? And do they believe in and treat from a holistic whole body lens? Meaning if you're going in with a problem like urinary leakage or incontinence, are they just looking at your pelvic floor and maybe doing some biofeedback or something like that? Or are they looking at everything up the chain from how you're breathing, how you move your body, what's happening in your foot and your ankle, you know. Is your nervous system? What's your stress look like? Like all of those pieces are important. So those are the things that I would be looking for.

SPEAKER_01 22:50

That's so good. That's so good. Well, thank you so much for being here today. Um, if you want to connect with Hannah, I will put her contact information in the show notes. So feel free to do that. Um, I just appreciate your time and I appreciate the work that you're doing, it's super important.

SPEAKER_00 23:04

Yeah, thank you. And likewise, yes, thanks so much.