Peeing Your Pants PostPartum? - Common, but Not Normal Pelvic Health Issues with PFPT, Lynn Schulte

*This episodes includes discussion of intercourse and pelvic anatomy. 

Understanding Pelvic Health: Common but Not Normal Issues Postpartum

This episode features a conversation with Lynn Schulte, a pelvic floor physical therapist, who addresses common postpartum issues like leakage and painful intercourse. Lynn stresses that these issues are common but not normal and discusses the importance of working with a pelvic floor physical therapist for recovery. 

The discussion covers various topics, including the impact of childbirth on pelvic health, the importance of proper alignment and muscle activation, and the need for holistic trauma care. Lynn also highlights the significant difference between common occurrences post-pregnancy and what is normal, and encourages listening to one's body and seeking proper care instead of normalizing these issues.

More from Lynn: 

CenterForBirthHealing.com (for mothers)

InstituteForBirthHealing.com (for practitioners)

IG @InstituteForBirthHealing

FB Group: InstituteForBirthHealing

Youtube: InstituteForBirthHealing

Lynn will be conducting in person trainings for practitioners in Australia in August. See the above website for details. 

00:00 Introduction: Common but Not Normal

00:24 Meet Lynn Schulte: Pelvic Floor Physical Therapist

01:00 Understanding Postpartum Issues

02:11 Lynn's Journey and Expertise

03

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Transcript

 things that are common, but not normal, like it is common for women to have leakage after pregnancy, but it's not normal. That's not what we should be expecting or accepting that our bodies do. 

 pain with intercourse is common, but it's not normal. And you do not need to listen to your doctor and just give it time and drink more wine.

 📍  friends, I'm sure that little snippet probably got your attention.

My guest today is Lynn Schulte. She is a pelvic floor physical therapist, and this is the type of conversation I have wanted to have for so long, because as you just heard in that clip, having leakage, having quote unquote accidents postpartum is really common, but it's not normal. It's not something that we should be accepting and

working with a pelvic floor physical therapist, if that's something that you're dealing with

is what will put you on the path to recovery  and dryness. And it's not just leakage my friends.

We're just gonna dive in with the TMI, but we are talking about painful sex. We are talking about

feeling like your pelvis, your hip area, just never came back to normal post birth, and that's whether you had a vaginal birth. Or a C-section. So Lynn and I jump into all of it.

As someone who is a anatomy nerd, I had a field day. I am sure you will be able to hear my. Absolute enthusiasm with the different topics that we discuss.

 I tried to make sure that whatever we were talking about, you didn't feel like you needed to have a kinesiology degree to understand. So everything is broken down in a way that regardless of what you know about your body in different terms. Hopefully we've put it to where you can absolutely understand it.

As always, if you have any questions, please feel free to send me a message. So let's go on and get into the rest of the conversation that I have with pelvic floor physical therapist, Lynn Schulte.  📍   

So you're a Physical therapist a pelvic floor physical therapist. 

Yeah, I just mainly work with pregnancy and postpartum women to, so I'm a pelvic health physical therapist and I specialize even more and niche down to pregnancy. Postpartum is my main population that I work with. Yeah I'll occasionally see other moms that need healing work, but the majority of my clients are moms. So I appreciate you having me on to  help moms know more and more about this work because there's stuff that I've discovered that nobody else is talking about.

And when you address it,  everything gets so much better.  Yeah. Other people are just putting band aids around it versus actually addressing the actual issue that's going on in there. And so I just am trying to get the word out, let people know about it. Yeah. 

You're coming to Australia in August. Huh. To teach. To teach. You're doing two different locations.  And people can find that on the website, which I'll put in the show notes and then you have. ongoing things through the website so people can do  learning with you all the time.  

But that is mainly for practitioners.

. There is one course that is mama specific, but,  I want to just let moms know about it so that they can be reaching out because I have trained in Australia before. So there's a couple of therapists around that know about my work.

And, after hopefully in August, we'll have even more and people are taking it online as well.  I just want moms to understand they're not crazy. If you're not getting better, this is why, , because doctors and everybody else is Oh it's in your head.

Or so I hate it. And especially, I talk a fair amount about, I talk about pelvic health in general, but  things that are common, but not normal, like it is common for women to have leakage after pregnancy, but it's not normal. That's not what we should be expecting or accepting that our bodies do. 

No, not at all. Not at all. So yeah, that's a good message to get across. Thank you. I should have clarified. , your courses at the Institute of Birth Healing are mainly for practitioners. But through your socials and stuff, you also do a lot of educating just so moms in general can. Better understand like that, like what's common, but what's not normal, right?

Right. Yeah, I do. I would just, I want to train the practitioners and then, but I also want moms to know about this so they can find those, so I'm like trying to do both. And then in my clinical practice, I still work with moms as well. And if anyone has any trauma related to the birth, we can work on that via zoom.

Okay.  Yeah, because I know that's a big one. I was quite lucky with my birth. It was an unplanned c section, but I don't feel like it was traumatic. 

Yeah. Versus, 

it is, it's all about perspective, right? Because me and someone else can have the exact same experience.  And my perspective  shapes out one way and their perspective shapes it another.

Let's dial way, way back. So you're a pelvic health physical therapist. How did you get into working specifically with moms and this demographic? And.  Focusing on pre and postpartum 

let's see when I moved from Seattle to Boulder, Colorado in 2008. I had to start my practice all over again. 

And there was a maternity store that was offering classes or having professionals come in to give classes to moms. And so I went to her and I'm like, what do moms want to know? And she goes bellies.  Everybody wants to do what, wants to know what to do with their bellies after birth, because it's, they get really stretched out and depending on how much weight you've gained, they can be a little soft and mushy after having a baby.

And then there's also an issue called diastasis recti where there's a separation of your abdominal muscles that can contribute to that. I call it, the class I taught was how to lose the pooch for good. Because it's, sometimes that diastasis can create and make it look like you still look pregnant, even though, you've given birth 678 months ago and then also the lengthening of the abdominal muscles, the way the baby, the way the abdominal wall has to expand to carry a baby, the lower part of your abdominal wall doesn't get as stretched out as the top part near your ribcage and So that and then because that upper part doesn't get as stretched out, those stay stronger.

And as our body needs stability, we need to create stability when we're moving and lifting things and carrying babies. And so that top part starts kicking in more to help stabilize us. And that lower part just it's taking a break. That's not coming to the party and we really need to rehab that and restrengthen that lower belly to bring it back to the party.

Like I call it like it gets turned off and I put that in quotes because it's not yet  turned off, but it's lazy and it does. Want to come to the party. And so we need to turn it back on. We need to actively consciously think about drawing our belly back up and in a way where the lower part draws in before the upper part.

And yeah,  just want to add two,  two things. One, we're not talking at all about weight. It's literally your core being stable and able to hold you. And when you talk about drawing the belly in, only because, so as a movement teacher I see people misinterpret this all the time. And if people aren't familiar, I just want to clarify as we go through the conversation.

You are talking about utilizing your pelvic floor and your lower abdominals in a way that's more like creating an internal corset and it's not sucking in because I see a lot of people who think like it's sucking in but that's just exacerbating the problem.  

Yes. Yes. You need to actively engage and draw back the lower belly. 

And when that lower belly like stays lazy, that can contribute to somewhat of our pooch postpartum and again, mom's always but what do I do with this? I say, Draw in your belly, contract your abdominal muscles as best you can, and then now pinch all the skin and fat because that's on top of a contracted muscle that is skin and fat that needs diet and exercise, but the muscle layers underneath all that, and that is what can be strengthened and really that, that transverse abdominus muscle, which attaches from the spine all the way around to the front.

Is just a length and muscle. And so we need to draw it back. And I like doing end range contractions with that.  Shorten the muscle because if we have muscles that are, the muscle fibers are meant to overlap and then they contract and that's how they tighten. But if we've over lengthened it, then it has a harder time overlapping in order to strengthen and it's, that's why your belly is sticking out further than it has.

It's not because of the excess skin and fat. That belly is just that the muscle is lengthened so that for me, the best way I know how to link shorten a lengthen muscle is through end range isometric contractions. And so you can do that with the belly by just drawing it back in as, as far back as you can and then trying to go tighter.

But it's really important that you do get the pelvic floor muscles to kick in first so that you're not, when you're drawing back, you're not actually putting pressure down. Like the whole canister of your abdomen from your diaphragm up top to your pelvic floor down below is a canister. And if you press too much at the top, all that pressure goes down at the bottom.

Yeah. That pressure comes from the bottom to the lower bottom abs and back up and in. So that we keep the pressure away from the bladder and the uterus.  

And that's what I think so many women postpartum, because we all turn to social media and you'll see snippets of things. And a lot of the times either I struggle to say the word practitioner.

I'll just say the person making the content. Okay. Doesn't adequately or properly explain. And so it just leads to this, like getting misconstrued. We want to avoid putting pressure downwards on the pelvic floor, especially in the case of prolapse, but in general, as you said,  and I think too, right. 

And I think a lot of women because I know like I had a baby who just would not be put down and obviously as she grows and gets bigger, she's almost four and she still very much wants to be hold. I'm aware of this stuff and I still have developed. Compensatory like positions to where, yeah, like my hips a lot of the times I'm trying to be really aware of it.

But I noticed I did it a lot, especially when she was little and I was wearing her like 24 hours a day. My hips would sit forward so that then I'm trying to offset. Because then my center of gravity, if you will, doesn't become just my torso. It's her body and my torso. So you shift backwards, which then allows, not in a great way, your lower back to have more curve.

And this lower abdominal area inadvertently gets a lot of pressure. A lot of pressure, yes. And pushing forward, yeah. And your body over time learns these holding patterns.  And so what you're doing through your work is teaching people how to rewrite.  These holding pattern, 

right? And their habits, which habits are hard to break and you can't break them unless you become aware of them.

And so I just invite anyone listening in when you recognize that as, Oh, this is a habit, please don't get down on yourself. Don't go, chew yourself a new one just because you found yourself in this more. Challenging pattern or strategy just recognize and go, Oh, there I am and change it because we're not meant to be robots.

We're not meant to be statues. We're meant to live in this fluid body of ours. Thank goodness. Right? Yeah.  And we want to just make sure, especially after having a baby and after the changes in tissue length pressures and scar tissue, whether we've had a cesarean birth or tore during childbirth, those structures.

And if a baby came out vaginally, there's a lot of downward pressure through the pelvic space, and there's a lot of lengthening of tissue. And so we just want to help that tissue to be able to recover in its more shortened, healthy position. And if we're doing these patterns from the get go and we're spending.

80 percent of our day in these patterns where we're increasing pressure down,  that's not going to give our body and tissues the ability to heal in a shortened, healthier, more supported way.  And so we want to help. postpartum women who've had babies to find positions where there's less pressure down on their bladder, their palate, their uterus, their bowel.

And we want to work in a way that gives, evens out the pressure in that canister 

and 

give support to the tissues that need healing. Your uterine, some of your uterine ligaments lengthen 400 times their normal length. It's incredible, but at the same time, it's Like that means there's a lot of recovery to have  exactly.

But, in the other thing that blows me away that I don't know if many women really get this because you can't see it after your placenta detaches from your uterine wall, it leaves a dinner size plate wound. In there  and that needs to heal. If you had that wound on your thigh, would you be running around and picking up your kid and driving it all over the place and being out and about? 

No, you'd have your leg. Elevated and on a couch, probably, or sitting in a chair and resting it so that it could heal. And that's truly what needs to happen. Some cultures have it right in that they surround, newly postpartum women with community and support, and they really don't do anything for 30 to 40 days. 

Which I think in my head,  it's so foreign that it sounds unachievable, but really, it is what we should be doing.

It's, our bodies recover better when we give it the time to do and I have  a colleague over in Russia, who's I think five or six kids, but on her fourth kid, she took a 30 day Recovery time, and she had her family wait on her.

She didn't do anything. She just stayed in the bed, near the bed and around the bed. We talk about 555 5 days in the bed, near the bed, then around the bed. And she just really took it easy for 30 days and she's my recovery was so much better.  

And I think to like, not to get on a whole side quest about broken healthcare systems, but it is also, it just has to be said that there are.

So many women like especially in America, that do not have that privilege, that literally have to get back to work two or three or four weeks later, which just speaks to how absolutely wrong the system. Yeah, absolutely. It just speaks ridiculous just to how wrong the system is  that women are forced.

to do it. So we won't go on that side quest because I feel like we could probably both just  both end up crying. Absolutely. Right. Yeah.  

But I think, what I do want moms to just recognize is the need for their body to recover,  their body to heal. And part of that is resting and I, and you do it to the best of your ability.

And if you have family, if you have friends in the area, have them make you meals, have them like, and here's the other piece that needs to be worked. on for moms is you have to open up your ability to receive.  Yeah. And ask for help. But that's receiving the help to  receiving and then being able to ask for help is two issues that are really big.

And most women that they have a hard time doing both of those things. And so I, I just think that. stepping into motherhood is a huge opportunity for us to learn how to ask for help and then learn how to receive it as well. And one, and those of you that are lucky enough to have partners in your life it's also another time to allow your partner in to support you.

Better and to support you more and to recognize that there is a daddy style and there is a mama style and there is okay. It's okay that they are different and you need to let dad figure it out and do it his way and it's okay. The baby's going to adapt. And it's important that baby and dad have that connection and that relationship and you don't try to do it all because that's just going to lead to more burnout and more rift in your relationship as you start to get a little bit what's the word I'm looking for?

You're going to burn out and not like your partner as much.  

Yeah that's In my own relationship, part of my struggle of not voicing all of my needs early on and being a control freak.  That's another big thing for women, isn't it? Oh, it's so hard. But it meant that, and I'm the primary carer, so it probably was going to happen this way anyways, but I am.

100 percent the default parent. And so then it adds to my burnout and a bit of resentment towards my partner. Not for anything that he hasn't he's not knowingly doing anything despite me,  but it's I understand that my daughter, I'm the one that she wants.  Yeah, more often than not. 

I would encourage everybody to watch nurtured first on Instagram social media They talk a lot about they show how dads can counteract that, you know by just saying I know you want mommy I want mommy too, and there's a way To, to handle that instead of just giving in and, making you be the default parent all the time, there are ways for dads to step up.

So that, that's one thing. The other thing is the control piece. And I really just want people to understand is and I found this in myself as I was raising my kids is that I, when I was controlling my kids, it was because I didn't want to feel something. And my, my youngest never, I live in Colorado where it's normally, in the wintertime it can get below 30 degrees Fahrenheit.

So I'm not sure what that is. Very cold. It's cold, but my son would never take a jacket to school in the wintertime and he would go in t shirt and shorts.  And so I, I had many fights with him at the door saying, here, take this. And he'd be like, no, I don't want it. I don't want it.

And I realized as I was trying to force it and control him to take the coat that I realized that, oh, I didn't want the teachers or parents to think I was a bad mom because my kid didn't go to school with a coat.  And as soon as I recognized that within myself and realized, I don't give a. Crap what other parents say I tried and my kid is choosing not to and natural consequences is gonna be  You know the it'll help teach him, right.

And he never took a coat, never. And like in that is his responsibility to take care of himself. And, so understanding that I didn't want to feel something was the reason that. I was trying to control him. And when I realized that, oh, wait, I'm okay with that feeling, then I stopped trying to control my kids.

So please, if you are a control freak, get to the root cause of what is it that you're trying to control and what are you trying to avoid feeling?  

Yeah, I know. That's a lot of it for a lot of people. For me, a lot of the, um, instructing my partner to do certain things a certain way is, again, being the primary carer and understanding her preferences, but like you said,  they're going to have their own dynamic, and he needs to figure it out, and they, and you've probably witnessed this with your kids, and with pretty much any kid you've ever been around, they are different with one parent, Right. 

Then the other.  Yeah, there's different expectations. Because of the relationship that has been built from each other. And that's okay. Yeah, and that's the hard part to I guess get your head around. I did want to ask. Pelvic health wise. So a lot of the moms listening are neurodivergent in some ways and a very common co occurring condition with that is EDS or Ehlers Danlos or some type of hypermobility.

As we look at pelvic health and like specifically this pre and postpartum, what are some considerations someone with EDS should be thinking about? 

In the pregnancy stage of EDS. So if you're pregnant and you have EDS the hypermobility along with the relaxin and the hormones that are softening things make you even more loosey goosey and.

So it's just important to try to a couple of things that you can do is to try to stay as strong as possible working on strength. Your muscles are going to need to become your major stabilizers because your ligaments. Are basically turning off in a way. Yeah.  So the more you can do strengthening and do strengthening bilaterally so that you're not putting excessive strain on one side than the other side.

So if you're doing lunges, just do a bilateral lunge. Don't do single leg lunges. Try to do what you can you bilaterally with things. So what left legs do and right leg should be doing at the same time. To just minimize, try to keep things as balanced as possible. And also that goes with like you're sitting and you're standing.

So if you're used to crossing your legs over, I would avoid that. Like what, when you're sitting, whatever your left leg's doing, your right leg should be doing to just try to keep yourself as balanced as possible. And then when you're standing to avoid standing on one leg, we tend to shift all our weight.

And then that's just, you're just setting yourself up for creating more of these asymmetries in your pelvis during that timeframe. So really just be aware of your habits and try to change them as best you can. Strengthening is really good. There's a great book out there called Relieving Pelvic Pain During and After Pregnancy, and this is symphysis pubis dysfunction can be a big problem with laxity in the pelvis and she talks a lot about symmetry and there's some exercises in there that you can do to try to create symmetry.

A lot of people with EDS tend to have hyper, hyper extension of their knees. And so if you stand up and you hyper extend your knees, That causes internal rotation of the femurs, which causes increased compression of the symphysis pubis joint. So learning to stand with a slight bend in your knees and a slight external rotation in the knees can help try to balance out the pressures in your pelvic space to avoid that excessive pressures anteriorly on that symphysis pubis joint.

And if people don't know, like they might've heard this in pregnancy classes. So the area you're talking about is where the Hip bones, essentially the pubic bones come together at the front of the hips, which some women get where those are going to be pushing into each other and causing pain. Some women get where that's going to be starting to pull apart too much and cause pain.

Either way, it's uncomfortable. And then the other thing that we see commonly is at the back at the sacrum. So the backside of the pelvic bones in the hip area, that triangle, that's another area. But what you're talking about is everything at the front. Just in case people aren't familiar with the terminology.

The hyperextension. So when your knees bow backwards  internal rotation, so your knee caps are actually facing each other almost, that need positioning of the legs. And so if you can just keep a slight bend in it and just rotate, use your muscles. to rotate your kneecaps.

So they're facing forward. That's going to help balance out the pressures in that pelvic ring because it's a ring of bone. It's made up of four, three, really three separate bones. We call them different parts of those bones, but the sacrum is the triangle in the back. And then there's a big bone on either side that come together in the front with your symphysis pubis and your rectus abdominis muscles attach into it in the front at the bottom there.

So your bladder sits right behind it. And so depending on your sense of laxity it really can cause a lot of problems with it either being compressed too much or being pulled apart if you do a lot of unilateral, like I would avoid side lunges.  Like slipping in your legs, slipping out can cause a lot of symphysis pubis problems and with, as far as like managing that, a lot of people are going to tell you to keep your knees together when you roll over and move, but but that may be helpful for some, but it may be more helpful for you to keep your knees apart because your knees apart is actually more stabilizing to the pelvic bones.

And so sit like a man and see if that helps. And roll over like a man with your knees apart and see if that helps. Okay. So that's pregnancy during labor. When you have EDS, if baby can get into a really good position, your births tend to be quick. Because everything's already just Ooh, loosey goosey. 

I read on out. And so you just need if baby's not in a good position, then it may take more time. And so I really encourage everyone to work with a pelvic floor physical therapist or someone who's been trained by me. They know how to address. the structures of your pelvis. They know how to assess your uterine mobility and ligaments to make sure there's no tightness.

That baby during pregnancy should be able to move left, right and be all over your belly and not just being held on one side. If it's being held on one side, that's a sign of a restriction. Your uterine ligaments are not allowing that baby to get into a different position and that's going to cause baby to line up a little crooked.

which may make it more challenging for it to come through. So we really want that baby's head aligned right on top of the fundus. And that is done with the uterine ligaments. Getting that assessed to getting some help and support with that is great. Spinning babies is another awesome resource for people if they're not, if they don't have a provider near them, do some of the three sisters, the three balancing exercises that they talk about.

That can be super helpful. And then just be prepared if, baby is lined up, your birth may go pretty quickly. So I hate to say that because then people are really like, they're going to be disappointed if it's not quick, there, there is the Goldilocks of birth like just right too fast, traumatizing to the body and too long is traumatizing to the body.

So, you don't want to wish for too fast of a birth. A lot of the moms that I see, they're like, Oh yeah, my birth was really fast. And I'm like, did it feel too fast for your body? Because our body processes things 10 times slower than our mind.  So our mind is like, Oh yeah, baby came on out. Okay.

Labor's over. But your body was like, what the hell just happened to me?  It's like still stuck back in that labor because it was like, Oh my gosh. I liken it to a bullet coming out of a gun. Sometimes that's how it feels for birth when it is too fast. So with EDS that's something to think about is that birth can be relatively quick and then the postpartum recovery again it's back to strengthening and One of the big things that I want everyone to understand is after a baby has come on out, the bones of your pelvis do have to widen for a baby to be born.

And so your sit bones that you're sitting on are get pushed out to the side. Your tailbone gets lifted backwards and that opens up your pelvic. outlet. And that's how a baby comes on out. And sometimes, especially on those babies that are O. P. So ox put posterior or they came through asynclinically, meaning crooked.

It took a lot longer. Maybe baby got stuck or, it was a really hard. You push for over two hours. That's a baby that did probably most likely didn't come through very well that could excessively widen your pelvis and then the bones just have a harder time coming back to their original position.

So I'm pointing this open birthing pattern in the pelvis that we have that the bones can get stuck there and depending on it's my hope and dream that every day.  pelvic health, physical therapists will ask postpartum women's, what position were you in when you gave birth because that mechanically what forces did your pelvis experience?

So if you if you gave birth and standing, but you had one leg. Bent up and on a stool maybe or something that leg that was bent up that sit bone is going to be more pushed out to the side from the baby's head. A lot of women are given birth on their backs with their legs supported.

But if dad was more eager than the nurse, now we've got this torque and twist happening in your pelvis as your baby's coming on out. So if you are giving birth, make sure that. Your partners whoever's holding your legs that they mirror each other to keep the leg Metrical as possible as you're giving birth Please don't be on your back if you can avoid it because the sacrum needs to lift Backwards in order for a baby to come on out and if you're laying on it Then your entire pelvis has to lift up in order for baby to come on out So it's just more challenging and you're actually bait your baby.

You're pushing upwards so being in all fours position or tall kneeling is my preferred method of birthing because it allows the pelvis to be free. Sacrum can lift backwards freely.  Easy peasy. Sometimes mamas need to be on their side. And so I don't like telling anyone that it, one position is bad because you may need that one position in order for baby to come on out.

The key is to find someone who can work with you afterwards to know how to get your bones back into their. proper alignment afterwards so that your muscles can function better and you can recover quicker. So the, if you're sidelining that top side the ischium, the top part of the bone is going to get pushed out more because the bottom side is anchored.

So it can't move. So the top side has to move more. So there's dynamics that. As physical therapists, we should understand and know how to approach those bones because the pelvic floor muscles attached to those bones. So if you have these, your sit bones are wide and if anybody is sitting and yeah, I just feel cattywampus a little after, I feel a little crooked or after sitting, one side might be more out to the side than the other, your sit bones that we're supposed to sit on should be even.

Once out to the side, you're going to feel like, yeah, I just don't feel even when I sit anymore. Your tailbone has to look backwards for birth and that's called sacral flexion. And if you have a hard time laying on a hard surface after birth, your tailbone is stuck in sacral flexion. If you're laying on your back and it feels hard and it feels uncomfortable, your tailbone is just stuck in sacral flexion.

I have a free course on my website. For practitioners to learn how to mobilize the sacral flexion pattern and release it from the body so that you can help your clients get out of pain better. and I think it's important to, this is why it's important to see a practitioner because  for someone laying on their back, if it's uncomfortable.

It could be that depending on how you gave birth, and it could also be if someone has like an anteriorly tilted pelvis in general, and they feel like laying flat on their back is,  doesn't suit their body, like they feel better with something under their knees or their knees bent a little bit, that's something else that also a practitioner can help with, but determining which is,  But a sacral flexion causes more of that curve.

So it's going to accentuate that as well. Yeah. And, a practitioner will know how to mobilize and assess to see what it is that is actually causing the problem for you. So I just, not many practitioners, unless they've studied with me, they're not looking for these issues. in the pelvis.

They're just addressing your pelvic floor muscles, but your pelvic floor muscles are at the effect of your bones. So your bones really need to be addressed first, and then there's less work for your muscles to have to do. And the other thing that I find intervaginally is that As that baby comes through the pelvis, it's like it rearranges the furniture in there.

Like your bladder gets smushed off to a side. I can find the cervix anywhere in there vaginally. It should be nice and centered, but it can be off to one side. It could be pulled back. It could be poking into your bladder, causing you to feel like you have to pee all the time. Like that cervix can be anywhere after birth. 

When I, get the bladder back into place and release the cervix ideally is like a pinata in your vaginal space. It should be able to move 360 all around and up and down. And up and down is so important for thrusting with intercourse. So if you have someone who pain with intercourse is a very big complaint after childbirth. 

Hi baby. And there's two issues with pain with intercourse. One is insertional pain, and that is that your pelvic floor muscles, maybe scar tissue from the episiotomy or tear that you had, doesn't allow the pelvic floor muscles to expand for the penis to come in. So that's one issue. The thrusting issue is the cervix can't move.

It's like hitting a brick wall in there, and that cervix may not be able to move if we've had c section scar. So if you've had a C section and now you have deep thrusting pain, you need to release your C section scar tissue. And I have a video on YouTube on how to do that. You can do that yourself or you can go find a practitioner who knows how to do that for you.

To free things up so things can move around in there for you. A lot of times you just get in there and free it up and then now you're able to have intercourse and not have any pain., pain with intercourse is common, but it's not normal. And you do not need to listen to your doctor and just give it time and drink more wine.

That's their answer. Oh my God.  I know, right? No, dude, go get help, go get support so that you can free this up quicker. I had one mom came to see me who she had given birth and she tore and she had given birth at home. So the midwife sewed her up and she then a couple of months later was having pain with intercourse.

So she came to see me. And when I went to evaluate her Oh, she went to her doctor's Oh, you have scar tissue. Go see someone. So she came to see me and our vaginal opening should be around circle with the tissue is like around circle. When I went to evaluate her, it was a round oval side to side. 

And when I found that it was like her tissues were B were being pulled apart. by her sit bones being too wide. So all I did was take my, I just brought those bones back together and then she had a circle again and she had a little bit of scar tissue at eight o'clock. But that's not what was causing the pain with intercourse.

It was that her muscles were being pulled apart from the bones being out of place. And so that's just it's something for you guys to just know that a lot of times with pain with intercourse It's one session and I've got everybody happy again and husbands love me partners Love me because it's okay go do your homework.

You gotta go have sex check this out  

I think a lot of people miss understand working with a practitioner that they think it's going to be months and thousands of dollars worth of visits. But sometimes it really is like quite simple little just making adjustments and it might be one, two visits and you're done.

Yes, some things do require multiple visits, but not always. 

No, and that's how I, my practice. We're one to three visits with most of our postpartum moms and a lot of that. It depends on what's so important after birth and you can appreciate the same with your movement practice, but getting the core automated.

That's the big, that's the end goal for me with my clients is to make sure that their core, your pelvic floor and your lower abdominal muscles are pulling up and in. Okay. with everything that you do. So when you're laughing, coughing, sneezing, we've got that contraction up and in. And so as long as someone has that core activation, like a lot of times I talk about a continuum where on the right hand side we have someone who's newly postpartum and nothing's turned on.

Everything's stretched out. Everything's a mess in there. We know as baby comes through, it rearranges the furnitures and we know kids never put anything back where they belong. We need to go in there and help get things back together again. But once we do that, then we can get the muscles turned on in the working.

And that's like the first step is that, a lot of women that I see that maybe 20 percent of their muscle fibers can actually come to the party at the start of a session. And after I teach a protocol in my online and in live courses and my postpartum course, a protocol on how to get things back into place.

And that allows the pelvic floor muscles to just function so much better. I am. Constantly amazed every day I work with postpartum clients from where we start to where we end in less than, really the internal part is only 15, 20 minutes long and I can get 20 percent of the muscle fibers to 80, 90 percent of the muscle fibers in that 15 minutes.

And so we can just make so much change and now we've got things they can actively work, but you have to think about it. To make it work here to the left side where it's automating and it's commenting on its own. So if everybody were to just, if you're listening to this and you're sitting down, you're not driving a car and just stand up, notice what you use to stand up and then sit back down and then really exhale and engage your pelvic floor and pull your lower belly back as you stand up.

And notice the difference. And that's the main test that I have my mamas do to see if they're automated. Because the majority of them, when they go to stand up, they're not using their lower abdomen to make it happen. They're not using their pelvic floor to lift their butt up off the chair. And so that's one thing.

One of the exercises I have moms do is just lift your butt an inch off the chair and back down. Just an inch up and down and with that, you should be pushing through your feet, but getting your pelvic floor to engage to make that happen. And that should be drawing in your lower belly to help boost you up to standing.

And so that's part of that automaticity that should be happening each and every time you stand up without you thinking about it.  

But it's all repetition, right? It's the same as when I was early postpartum and I was holding my daughter and I was compensating and leading. I was doing that every day.

So that's repetition, building that pattern to get out of it. I've had to do repetition of mindfully breathing. And I think that's a good test that like your stand a lot of people can do. If you are  being, if you're breathing. And the first thing you feel is your lower rib squeezing and your belly is still relaxed, then there's a disconnect between  what's supposed to be happening, right?

Right.

Yes. And so what we want is the pelvic floor to initiate and that draws lower belly in and rib cage stays more relaxed. Although, when we breathe in, we want the ribs. to expand. And then as you exhale, they come in gently, but we want the lower belly to come in more before the ribs do. Yeah. Yeah, there's a lot of nuance to it.

When you're so right, Sam, people on the internet and social media are just like, Oh, just do this.  But there's like all these things tied into it and it's not easy peasy. Oh, just do this because you've really got to get this core foundation working well in your body and getting it activated all the time for everything that you do to have good pelvic health for the rest of your life. 

Yeah. 

And I have, I've had the thing that always stands out to me, this is like a slight side quest, but it, I think it also talks to the culture change. Thank God we're even talking about pelvic health and pelvic floors now. I, I always laugh in my movement classes because I talk about  pelvic floor, like anything else, like your hand, like your, I just am, we're constantly talking about it.

And I have a mix of, yeah. From 20 year olds to 65 year olds, men, women, whatever. But I was teaching a class one day and I had a mid fifties women, woman, dead serious ask me, do men also have pelvic floors?  Because she had only ever heard it in the context of talking about women.  

Wow. 

And her age up until very recently, you had a baby.

It was expected you were going to have leakage after pregnancy, after birth. And that's just how it was. And you just had to suck it up and deal with it and get some panty liners, because That's what everyone expected. So I'm so glad there's people like you out there changing the culture and educating people.

But I also, you might've had a baby 10 years ago, 20 years ago, you can still heal  and recover.  

Yes, because a lot of it is changing the strategy. So the leakage that's happening is because your rib cage is overpowering your lower belly. So when the rib cage squeezes tightly, like Sam was saying, all that pressure goes down on the bladder and it causes a bladder to leak. 

And so we need to change that and contract the pelvic floor and pull in the lower belly, protect the bladder before we pressurize up from above. And if we're, like sneezing or jumping on a trampoline or whatever, and you get a little leakage, it's because your pelvic floor cannot contract and hold everything in the way it's supposed to.

It's just sitting there like hanging out. Not really. And I tell you Sam, after like when I've had so many women who've come into my practice and their pelvic floor is like, it's just frozen. It can't. It can't. Function, it can't contract. And some of that is the bones are too far apart.

Some of it is there's a trauma response in the body from the birth because irving can be traumatic, everybody, it's okay to recognize that and it goes from small T trauma to capital T trauma, where it's like capital T trauma, it's traumatizing, but that small T trauma, it's like that can still be just as impactful in our body.

And it just causes to me, I feel it in the pelvis, like everything is frozen, like the pelvis has gone and it's holding its breath. The pelvic floor muscles are frozen. They can't contract again. And so Getting that to  be able to soften, to melt the thaw of the freeze and to get the bones back together, get the organs back into place and then get those muscles to turn on again, that is what's going to help us to save ourselves for the rest of our life because you may not have any issues I think about my poor aunt who is now 80 plus years old, and I saw her, gosh, 20 years ago, and she doesn't live near me.

So when I saw her, she had zero contraction ability of her pelvic floor muscles. And and she was that she, what she's who helped me to realize that this open birthing pattern. Lasts in our body forever.  I was finding it in my 20, 30 year old women that were in my practice. And I saw her when she was in her sixties and she had the same patterns in my postpartum mamas.

And I was just like.  Wow, your pelvis is still like stuck in this birthing pattern. It's stuck when you were 30. You had a 42 year old son at the time.  So for 42 years, her pelvis has been stuck in this open birthing pattern. She had, and then she didn't even get into the details because we were running out of time, but she was like, Oh, horrifically traumatic first birth. 

And. And her body has been stuck like that forever and now and she's a massive warrior can't sleep at night. Like energetically, our pelvis is a container. It's a bowl. It helps hold our energy. And hers was like wide open, flowing, fully, no containment of her energy whatsoever. And now she's 80 years old and is completely incontinent. 

Yeah. And that's what happens. This is absolute worst case scenario, but that is what happens when you have this small issue that compounds and compounds. And years later,  that's the end result.  Right. And that's what my goal is to train more practitioners so they can help moms to recover more fully.

So  80 years old.

If someone's looking for a practitioner,  what should they look for? What should they, like, how do they find someone who is, because there are a lot of people, especially now that pelvic health and pelvic floor understanding is growing, there's a lot of people who claim to know what they're talking about who don't really.

They do know certain things and it's, pelvic floor physical therapist knows about the muscles and knows about stress incontinence and all that. What you want to do is go to my directory on my website and we'll give you a link that'll be in the show notes and you can see if there's anybody nearby you.

So that would be my first stop is like try to find someone who has trained and with me and understands these principles that I've shared with you today. so that they can help you in this way.  What you're going to find if you go to just a traditional physical therapist is they're not going to be addressing the bones.

They're not going to be addressing the organs internally like they need to be to help facilitate this increase in strength for your muscles. So it just, It might take longer, it might not, you might not get as fully recovered as, you'll still learn good stuff, you'll still learn good principles, but if, if you're going to someone and all they're doing is biofeedback, run. 

Because, it's, to me, when I look at these postpartum moms and they have 20 percent of their muscle fibers working of 100 percent of them, and you go try to do biofeedback, it's like hitting your head against the wall to get rid of a headache. Only those 20 percent are going to try to get stronger, but they really can't because the whole thing can't function well.

So you really need to find someone who can help manipulate the structures and the tissues so that they can function better. in the body. And and so that's, go give someone a try. But ideally, someone who's trained with me first, because they'll know all these things to look for. And you'll get a hopefully a much better outcome with your therapy.

And then if you can't find a pelvic floor physical therapist, tell them to take my courses so that they can treat you better. Okay, that's what I want you to do. My courses are offered online and also live in person. But they can learn everything online and still be able to help support you. 

And through your directory, you have obviously everyone who's done training with you, whether that's online or in person, so that you, like you said, you've come to Australia before.

I do have a lot of listeners in America, so you have you've traveled globally and done training. So it's not just people in Colorado. It's not just people in the States. You have worked with people globally, so they'll be able to find someone hopefully  in their area ish. Yes. 

Yeah. Unfortunately, my directory only has over 200.

students and I've trained over a thousand. So I don't have everybody in there unfortunately but we're doing our best to try to get our students to put their names in there so I can connect moms with people who know what I'm talking about here. Another place to go is I have a Facebook group, Institute for Birth Healing Community, and there's a lot of practitioners  in there that you can reach out or.

Go on social or go around into, Facebook groups and ask is, has anyone trained with Lynn Schulte? Has anyone taken any courses from Institute for Birth Healing and see if there's, what response you get there, but really asking your therapist, do you know this information, please go take it.

And then I'll come see you would be an awesome way to encourage more practitioners to learn this material. Cause it's just too darn effective, Sam. It's.  Oh, and it's so important!  It is. I know. I know. That's why I'm so passionate about getting that this word out. I want mobs to understand more of what's happening with their body.

It just, it drives me nuts that there's therapists out there that don't, that are not addressing the bones and then telling moms, Oh, it's in your head. Oh, that pain is in your head. And it was like no, it's not. It's actually a functional thing happening with your bones that hasn't been addressed. Like they don't recognize how these bones can be moving. 

And so they're not looking for it.  And once they learn with me and they understand it, then they start seeing it in everybody and they start getting so much better results with their clients. We're growing, we're getting more practitioners trained each and every year. And it'll happen.

My, my goal is to have trained practitioner in every city and state in the world  to know this. 

I love that. That's such a good goal. I also I have to, I think of red flags when looking at practitioners. So obviously you said someone who's just doing biofeedback stuff. What are a couple of other kind of red flags when someone is looking at a practitioner  that they, if this is something that's coming up, they're like, Oh, okay.

Maybe not. 

Yeah. A couple of things. One is that, you'll know that your practitioner is not concerned about your pelvic bones, that they don't ask what position you were in when you gave birth. Okay. They're not addressing the bones. And then the other thing is if they're doing intravaginal work and it's painful and they're not respecting your pain,  run.

Yeah. When we're doing intravaginal work, there should be no pain. And if it is painful, that practitioner, needs to learn more. Because this is a very  area. It's a very, it's an area that has experienced a lot of, has had a lot of experiences in, in the world and a lot of them not very good ones.

And so if seeing a pelvic floor therapist is adding to that and not. detracting from that, to me that's a big red flag. So if you don't feel comfortable with that pelvic floor therapist, if they're creating pain in you and not respecting your pain, that to me is another red flag. And I just don't believe we should be creating pain.

Now there is a difference between a burny, stretchy, okay level of pain. Like we need to work with some tissue, but if it is like painful and it's making you clench and tighten up your entire body, that's not okay in my world. I do not like creating pain and I teach that we should never create pain when we're doing intravaginal work because it's too sensitive of an area. 

And I think too, then on the flip side of that, as a patient, communicating that, like communicating all of the sensations to your practitioner so that they can understand what you're feeling and not just going into it going, okay I heard someone say that this might hurt. So I just have to like, suck it up. 

No I do not. I no, we should never have to grin and bear it and please know if you're having intravaginal work done by any provider, you are in control. You tell them when you're done. If it's uncomfortable and you're not enjoying it, tell them to stop and go find someone else and know that there is a different way that there is a better way that can, it can be done in a way that doesn't have to create.

Yeah, I love you say that also on the website that you don't have to grin and bear it. And I think that's so key because I think with so many things we're taught that, but especially with health and recovery, unfortunately that has been the kind of messaging for so long. And  I think that we're learning better now.

I hope that we're learning better, but it really does mean that like the practitioners as well as. The patients need to understand that's not okay,  right? 

And, if you're a practitioner, if you're a patient, you haven't listened to this. You don't know any better. You don't know any differently.

And I'm just here to tell you that there are practitioners out there who know how to treat your body with respect, know how to teach your. Treat your tissues with respect, and if you're doing intravaginal work that, respect needs to be utmost and paramount for that and, my number one rule for I have two rules that I hammer into my students head is that's respect the tissues and don't create pain and so that's, I feel like, too many women have had too many things happen in their vaginal space, and there's a lot of trauma and a lot of disconnect for women, and birth is a very disconnecting experience.

It's so intense and so overwhelming that a lot of people are actually cut off from connecting into that pelvic space. We need to, the very first step, and this is a more advanced level skill, is to help get someone connected into their, and get rid of the block, because there's a block usually around the belly button, that they can, we can only work from up here, and like they're just disconnected from the bottom half of their body, and if someone's disconnected, we shouldn't be doing intravaginal work with them.

So I want to work at that level and help them reconnect into that area. And usually there's trauma involved in it. So working with the trauma first can help make the treatment less painful. And to me, like a painful C section scar, if you don't want to touch your C section scar or it's super painful to the touch, those are two signs that you have trauma being held in those tissues. 

So a lot of practitioners will talk about trauma being in your nervous system.  I think it's both trauma's response in our nervous system, but it's also being held at the tissue level as well. And it needs to be addressed in both areas, not just from the nervous system level. That in that work, that trauma work, if you've had a really traumatic birth that can be done over zoom does not need to be done in person.

So if anyone's interested in that, you can schedule a session with me via my website center for birth healing. com. We can set up an online session.  Amazing. 

Yeah, I think a lot of people don't realize.  especially with C section that it still can create a lot of these issues. I think people only think if it was like an emergency, really high stress C section, but in general it can.

And it also depends on your surgeon. Some of them go in there really slapdash and don't take as much care as they should, putting everything back together. And even sometimes like. know me, for example, I had one side that was tighter. And I could feel it from as soon as I got out, and I know, then, thinking about fascia and thinking about how everything works,  I know the surgeon was standing on my right side, my left side was tighter, and I'm like it makes sense.

As he's doing the sutures, he's pulling that and it's getting tighter. And tighter. 

Yeah, it's sometimes it's either the side they stood on or the opposite side that they stood on that's tighter, but there's always one side tighter than the other when it comes to a c section scar. And and c section scars need to be mobilized.

They need to be  moved around. Three issues that can come from c section scarring is bladder frequency because the bladder can't expand. It's hitting scar tissue and that's sending the signal to the brain. You get in there and release that scar tissue and your bladder can fill up more. The deep thrusting pain with intercourse that I talked about earlier is another issue.

And then back pain back pain, the uterus sacral ligaments. It's attached from the sacrum to the back of the uterus and the front of the uterus is where they cut into to get the baby on out. And so there's usually because of that tightness on one side, it pulls on things which is pulling into your back and then your sacrum can't move as freely.

So we need to get in there and release that C section scar. And a lot of times that like for you, that's, to have that pulling in that pain right away is one thing, but some people don't have any issues till 10, 15 years down the road. And then they started. problems and nobody's thinking c section scar by then. 

So I had one client that came to see me and she was five years out from her c section and she had excruciating pain right after the surgery from after the c section and she went on to have two other surgeries. They did two exploratory surgeries trying to see if they could find the pain and it was trauma.

She was traumatized from the first birth and she came to see me five five years later in pain and in one session the pain was gone because we addressed the trauma.  

Yeah. So I 

want people to know that trauma, the trauma response in the body can be responsible for pain. So not all pain is physical. So the trauma response can have all your tissues Okay, but you still have pain and unless you deal with the trauma response in the body, then the pain won't let go.

Sometimes the tissue gets really tight, like a really tight C section scar or a thick scar  can be very painful.  And that painful part of it, and there's trauma stuck in there. There's something about that birth that needs to be healed in order for that pain to go away. 

It reminds me very much of Basil van der Kolk's work, his book, The Body Keeps the Score, which it sounds like you're probably very familiar.

Yes, I am. Yep. Yeah.

If people want to work with you, everything's through the website. I'll obviously put that in the link in the show notes. Bye. If people want to work, you said  telehealth, they can do for trauma work with you on the patient side and then you have for practitioners through your website, they can do self guided learning, or they can come to one of your in person learnings that you have.

So it's Institute for birth healing dot com.  is the educational platform for practitioners to learn this type of work. The center for birth healing. com is my clinical practice. And that's where you should go to find there's a form that you can fill out and we can connect and try to set up a time to do a zoom session, to do the healing virtually.

And just so you guys all know, it is. Center with the E R. So C E N T E R for birthing. com,  not R E like the, you guys, don't you guys do R E? Yes. Yep. Yeah. Yeah. 

So I'll put it all. I'll make sure that's all in the show notes. Yeah. And on Instagram, 

Institute for birth healing is the main one for so for Instagram and YouTube. I also have a YouTube channel Institute for birth healing. 

And if people are in the Boulder area, they can come work with you in person as a patient. 

Yep. I'm in the Denver and Boulder, Colorado area.

So I have two practice locations. That I can see people at 

amazing. I appreciate you spending the time and offering all of your knowledge. I feel like I could talk to you forever because I am so passionate about  helping people understand pelvic health and that what is common doesn't have to be normal and we can heal things no matter how long ago trauma happened.

Yeah. So important. So important. Thank you, Sam, so much for your work and this out to the world and allowing me time and opportunity to share with your audience. I'm so appreciative.