73. The Truth About Pelvic Floor Dysfunction, Prolapse, and Bladder Leaks in Midlife, with Patricia Linderman

Are you a woman over 40 feeling anxious about bladder leaks when you sneeze, laugh, or jump? You’re NOT alone — but you don't have to just live with it. In this episode of Mind Your Midlife, certified health coach and Pfilates instructor Patricia Linderman joins me to break down pelvic floor health, the reality of prolapse, and the real muscular mechanics behind why we leak and how we can stop it.

What You’ll Learn:

✔ How your core acts like a "can" and why deep, three-dimensional breathing is like taking your pelvic floor for 10,000 steps 

✔ Why a tight pelvic floor can cause just as many problems (like pain and cramping) as a weak one 

✔ Practical steps to properly perform a Kegel using the "rolled-up towel" method 

✔ What women REALLY need to know about the "partner muscles" (glutes and inner thighs) that turbocharge your pelvic floor strength 

✔ How to use "bracing" to prevent leaks in the exact moment you are about to cough or sneeze 

🎯 OMG Moment:

A shocking reality check: There are more incontinence pads sold in the United States than menstrual pads. Even more staggering, serious incontinence is one of the primary reasons women are forced to enter assisted living. Leaks might be common, but they are an indication of muscle weakness, not an inevitable sentence of aging.

Take Action Today:

• Connect with Patricia at fierceafter45.com and explore Pelvic Floor Pilates at pfilates.com 
• Listen to the episodes on breathwork and on talking to your doctor
• Choose ONE small step to build your mind-body connection this week, like taking three deep breaths without hunching over your phone 

Why This Episode Matters

Midlife is a powerful turning point. We are often sold the message that pads and surgeries are our only options. By understanding how to train this hidden muscle group just like we train our shoulders or biceps, we reclaim our bodily autonomy and our quality of life.

Take a little bit better care of yourself in midlife.

Grab your Vitamin G pixie sticks for detoxification and wellness at cherylpfischer.com/vitaming.

Transcript

Why Pelvic Floor Health Matters

Cheryl Fischer 0:00

Today we're going to be talking about something that we don't talk about very often. And that is pelvic floor health. Now, don't move on to another episode. Stick with me because this is pretty life-changing stuff. And I don't know why we don't talk about it more. And I believe it will be that for you. So if you have had a baby, you have been told about Kegel exercises. Or maybe even you haven't had a baby. I think we all know what those Kegel exercises are, but we don't do them, or we don't know how to do them, or we don't know why we're doing them. And we just figure that as we get older, then incontinence and various other things are just what's gonna happen. But what if that's not true? Let's talk about it. Welcome to Mind Your Midlife, your go-to resource for confidence and success, one thought at a time. Unlike most advice out there, we believe that simply telling you to believe in yourself or change your habits isn't enough to wake up excited about life or feel truly confident in your body. Each week, you'll gain actionable strategies and oh my goodness, powerful insights to stop feeling stuck and start loving your midlife. This is the Mind Your Midlife podcast. Your pelvic floor is your

Meet Patricia And Her Approach

Cheryl Fischer 1:31

muscles, basically at the bottom of your ab muscles, part of your core. And my guest today is going to explain that to us really well with a visual that will make a lot of sense for you. And it's not something we like to talk about, but it is something that creates for us, if we ignore it, creates for us some issues and symptoms that we don't like, especially as we hit midlife and beyond. So my guest today, Patricia Linderman, is a certified health coach, personal trainer, functional aging specialist, and is a teacher of phyllades, which you're gonna hear us talk about. That is a pelvic floor training method developed by a Eurogynecologist. She is passionate about sharing simple ways to reverse the effects of our sedentary modern lifestyle and transform our health. I'm excited to talk about this because it is not talked about often enough. So welcome, Patricia.

Patricia Linderman 2:35

Hi, Cheryl. I'm so happy to be here with you. So important. I'm so happy that you do this, Cheryl. Well, thank you.

Cheryl Fischer 2:43

And we actually, uh if you're listening, I'll tell you, we met years ago. And I I'm not even sure I remember how, but we are in the same local area and got connected through some way or another. So I love that we're able to do this. Yeah, awesome. Okay. So today we are talking about the pelvic floor. And if you are listening, you knew that already from the title.

Symptoms Are Common Not Inevitable

Cheryl Fischer 3:11

You know what you're getting into. But let's start with what are some common symptoms or some common issues that women will recognize?

Patricia Linderman 3:22

Yeah, sure. I'm so glad we're talking about the pelvic floor. And yeah, it does seem like a topic that we don't necessarily bring up all the time. And I think that's something we need to we need to rethink because the pelvic floor is a muscle group in our body. It's like our shoulders or our arm muscles, and it's just as important. And you asked about what people might experience. Well, there are lots of things. The pelvic floor, just like any set of muscles, can get weak over time. And then that leads to the common problem of leaks. And uh that could mean just leaking when you jump. Like sometimes young mothers discover it for the first time at the trampoline park. But um, then it goes to when you might cough or sneeze or laugh or exercise or so on. And there's also the latch key phenomenon when you need to use the bathroom, but you're getting home and you're turning the key in the lock, and things start happening that you don't want. And then even uh, yeah, we're we're talking about this part of the body. Like you might even notice that you pass gas when you cough or something like that. These are things that are not necessarily part of normal aging. They're common and frequent, but they're not inevitable. They're an indication of weakness, and in fact, they're considered a form of incontinence. So if you have leaks, you know, this is the prequel to incontinence. And uh I got just two facts about incontinence. One is that there are more incontinence pads sold in the United States than menstrual pads.

Cheryl Fischer 5:06

Oh my gosh. Oh, yeah.

Patricia Linderman 5:08

And then two is that more serious incontinence is one of the primary reasons that especially women enter assisted living. So if this is the but this is the kind of thing that we can prevent by focusing on our public floor health and just with a few simple routines like how do we take care of our biceps and our shoulders,

Marketing Myths And Medical Gaps

Patricia Linderman 5:30

and and we we can do this, we can do this ourselves.

Cheryl Fischer 5:34

I have been seeing, I've been watching a show on Amazon Prime, and I don't have the version without commercials. So I it forces me to watch the commercials, and I keep seeing commercials for incontinence pads. Yeah. I'm kind of ignoring it, but now that we're talking about this, it sort of feels like it seems that this is inevitable. And so we better know what we need to buy because it's definitely gonna happen and we just need to deal with it. Like that, I feel like is the message that's coming towards us.

Patricia Linderman 6:06

It is the message, and the companies that sell the pads are perfectly fine with that message. So those of us who are in the field of health really need to give a different view. And I didn't know that myself until I got the special training that I have now. Like I was just as I had no idea. Even though I've trained as a personal trainer and a health coach, my training didn't have to do with the pelvic floor until I took a specialty uh certification. Right.

Prolapse Urgency And Core As A Can

Patricia Linderman 6:36

Yeah. So just quickly back to some other things that people might experience, frequency and urgency of going to the bathroom, overactive bladder, they have a lot of components. A lot of factors affect these, including like what are you drinking and your habits, and but but pelvic floor weakness can have something to do with that. Prolapse is when our organs, it could be the uterus, the bowel, the bladder, start to sag downward. And it is very, very common. A lot of women don't realize that they have it or they have the early stages of it. And what's happening is these organs are just not being supported by the muscles and the connective tissue in this part of the body, they start to sag downward, and people may not notice it until they feel a really heavy bulge or something that's interfering with our exercise. But it's something that we can actually help prevent or help prevent it from getting worse with exercises for our pelvic floor. And then incredibly, we think of our core, right? We always thinking about our core and we think about our ab muscles. But the pelvic floor is actually technically the base of our core. So we can think of our core sort of like a can, and our abs are going all the way around, and then our pelvic floor is the base of that can. And so pelvic floor strength and stability helps give us core strength and stability, which we tend to start to lose, and also affects our balance, even. We have that core strength and stability with a well-toned pelvic floor, we've got better balance, which we all want.

Cheryl Fischer 8:21

Yeah, you know, you're right. We we all want a smaller slash flatter stomach. We want balance. We know that that's core muscles, we focus on the abs. Nobody says anything about pelvic floor being a piece of that at all.

Patricia Linderman 8:39

No, no, no. See, we're cutting new ground, we're breaking new ground here. We're on the cutting edge.

Cheryl Fischer 8:46

Now, quick question for you related to that. Yeah, if we're working on strengthening our core, is there some side benefit that helps the pelvic floor as well?

Patricia Linderman 8:57

Absolutely, yes. This is a two-way street, and that's part of the good news that we're gonna share today.

Cheryl Fischer 9:02

Okay. Okay.

Patricia Linderman 9:03

So if we think of our can, our core is like a can, pelvic floor is the base of it. Our ab muscles are connected to our pelvic floor through the connective tissue and muscle connections. So actually, when we brace our abs, our

Breathing Diaphragm And Core Stability

Patricia Linderman 9:20

pelvic floor braces too. So they are related, they coactivate. And when we brace our pelvic floor and we do kegels, sometimes our abs will brace too because they're working together. They're friends in the body. And the pelvic floor has other friends. So thinking of our can again, the top of the can is our big breathing muscle, our diaphragm. So when we breathe deeply in and out, which unfortunately we sometimes don't do because we're hunched over, but if we breathe deeply in and out, it actually transfers that pressure to our pelvic floor and it starts to just gently go up and down with our deep breathing. And that brings blood flow and muscle tone to our pelvic floor. I say deep breathing is like taking our pelvic floor for her 10,000 steps a day. Breathing is essential, and breathing helps us with that core stability too, because it makes our can stable and not all crushed the way we might be leaning over our phone or our keyboard.

Cheryl Fischer 10:22

Yeah, very good point. And if I may go on a tiny tangent for a second about breathing, I will put a link to an episode in the show notes where I talked with a breathing specialist. And it was, I don't, it makes me feel silly to say this, but when I talked with her, I realized that like why it matters that you take a deep enough breath that your stomach expands as well. Because lungs aren't in the stomach. So what is going on there? And she was explaining your lungs are expanding and that's pushing the diaphragm. And now you're kind of continuing that. So making it even more important for us to realize.

Patricia Linderman 11:03

Yeah, absolutely. I I love that you're gonna link to that because this breathing, the deep breathing, is um it's a great way of taking care of your pelvic floor, believe it or not. And also, a lot of women, one thing I didn't mention yet is over tightness. A lot of women have over-tightness in the pelvic floor, and that can translate to pain during sex and the feeling you have to push to pee and even cramping. I know a woman who went to the hospital because she had really hard, really painful cramps in that part of the body, and it was pelvic floor tightness. So that deep breathing, when we when we inhale deeply and the diaphragm goes down, the pelvic floor actually goes down, which is the relaxation phase of our pelvic floor. So that deep breathing is really the first line of defense if you're dealing with a tight pelvic floor. So that's awesome. I want to say one tiny more thing about breathing. So we do think about expanding the belly, and that's true. The uh diaphragm presses

Three-Dimensional Breathing Explained

Patricia Linderman 12:05

downward, transfers force to the abdomen, pressure, and the belly expands. But we really also, it's possible to breathe and just your belly expands, and that's not optimal either. What's optimal, they call it three-dimensional breathing, that your whole can expands. So you might notice your ribs expanding out to the side and even out to the back. And that's the real optimal breathing that reinforces our core stability and uh helps our posture, can help ease back pain. The woman I learned this from, Janice Matek, she cured her back pain, was terrible back pain, was cured by proper breathing. And then she became a teacher of breathing. Wow.

Cheryl Fischer 12:50

It is wild to think just breathing in and out. We have to do it anyway. And just doing that differently, I mean, it's amazing to think what effect it can have. Yeah.

Patricia Linderman 13:01

It it really is. And then, but we can do a simple test. Like when you like right now, you can pretend you're hunched over your phone to look at it and try to take a deep breath. Like you can't do it because we're hunched over it. We're kind of squishing our can. Yeah. And you can't do it. And that's how we spend a lot of our day. And we're we're staying alive, but we're breathing up high in the chest, which is not optimal for our bodies. It's not optimal. It's it's a stress type of breathing. And what we're talking about today, the pelvic floor, it's not doing our pelvic floor any favors.

Cheryl Fischer 13:35

Wow.

Patricia Linderman 13:36

Have we covered a lot of the symptoms or are there more? We did cover the symptoms, but I just wanted to hint to why we have these symptoms. Because yeah, we use our pelvic floor, you know, we go to the bathroom, right? Why does it get weak? Well, it's our sedentary lifestyle. So that ties in with the breathing. Like we're not doing our deep breathing, we're not necessarily challenging our abs in daily life.

Cheryl Fischer 14:02

Right.

Patricia Linderman 14:03

And then the pelvic floor has two more friends in the body that are very important: the glutes and the inner thighs. So it's a cliche that if someone has to use a bathroom urgency, urgently, they're like squeezing their inner thighs together. Well, there's a reason for that because the inner thighs coactivate with the pelvic floor, and so do the glutes. But what's

Sedentary Life Glutes And Inner Thighs

Patricia Linderman 14:25

happening with us, our modern people, we're sitting on our glutes. And even when we walk around, we're not necessarily activating our glutes. And the same with our inner thighs, they're just sitting there. So our pelvic floor is missing out on this muscular stimulation. But then the good news is it's super easy to add that back in. So, what I teach people to do is you're doing your kegels, which we'll talk about in a moment, and then you can just squeeze a squishy ball or a cushion between your inner thighs, as you do, your kegels, and it turbocharges them because you're activating those muscles. And it's also great for your body in general.

Cheryl Fischer 15:06

Yeah. Inner thighs are just a problem area as well for so many women. So, all the better that we can do a bit for them while we do this. Yeah, I love it. Yeah. Interesting. Okay, so also one more question for you. How does it happen then that some people have this lack of muscular strength in the pelvic floor, and some people have an overly tight pelvic floor? Do we know why that difference happens?

Patricia Linderman 15:33

Sure. Yeah. You know, they're not visible, but they're muscles. So think about our shoulders, right? Our shoulders can be weak, often they are. Our shoulders can also be tight. And they can be both. They can be both weak and tight. And why does that happen? So, weakness, think about our shoulders is, you know, maybe we're not pushing and pulling with our arms very much, and they've just gotten weak. And then tightness, why do they get tight? Well, it could be our habits, our posture, our way of holding ourselves. It could be that we have stress or we have trauma and it's caused our shoulders to become shoulders up by the ears, yeah. Yeah, up by the year. I can wear mine like earrings. It's crazy. So we all understand that. And the pelvic floor is really exactly the same thing. So it can get it

Kegels Done Right Step By Step

Patricia Linderman 16:25

gets weak through underuse and underuse of those partner muscles, and it gets tight from too much sitting, posture, trauma, stress. So uh it's it's all very logical. And the really interesting thing, you know, with our shoulders, what would we do? What would we do? If we have weak shoulders, we know what to do, some pushing, some pulling, maybe resistance bands, right? But what if we have tight shoulders? What do we do? Well, we might go for a massage, we might use our own massage tools, we might go to a physical therapist, we might investigate like why are my shoulders tight? Is it my habits, my posture, my stress, my trauma? And we can do the same thing with the pelvic floor. There's actually pelvic floor physical therapists who specialize in this area of the body, and they're able to do like specialized massage or even teach you. And there are specialized massage tools you can use for this part of the body. There's a whole world that people are not aware of that can really help their quality of life.

Cheryl Fischer 17:30

That's amazing. Yeah. And it's kind of sad that we're not aware of this. And all these symptoms that you've described are things that people definitely deal with very commonly. Yeah.

Patricia Linderman 17:42

Right. There are 200,000 surgeries approximately per year in the United States for prolapse and incontinence. And the doctor who trained me, Dr. Bruce Crawford, says that most of those could have been prevented if people would do exercise simple exercises and help their pelvic floor. And sadly, a lot of those, up to 50% of those surgeries have to be repeated because they're just not very good. You know, they'll put a, they'll put like an artificial mesh in your body to uh substitute for your pelvic floor support. And that just doesn't work so great. So really starting wherever we are, however old we are, training these muscles, we can prevent a lot of these problems. But yeah, people don't know this.

Cheryl Fischer 18:35

Yeah. Well, that's why we're here, right? That's why we're here. Yeah. Okay. So then that is the perfect time for us to talk about what we can do. Because I think every woman has probably heard of kegels. Yeah. And tried them at whatever point we were told to, and then maybe stopped doing it or couldn't really figure out how to do it and got annoyed. And so let's talk about what we can do, and maybe it's that, and maybe it's other things as well.

Patricia Linderman 19:04

Right. Kegels are really important. They were invented by Dr. Arnold Kegel in the 1940s,

Isolate Don’t Overuse The Glutes

Patricia Linderman 19:10

and he was also a surgeon, saying, like, wait a minute, we can prevent some of these surgeries if people do these exercises. So basically, it's an isometric squeeze of your pelvic floor, like it's a voluntary contraction of your pelvic floor muscles. But a lot of people aren't doing it right or aren't doing it optimally, let me say. So let me coach you through it. We can do it anytime, anywhere. So uh Dr. Crawford, when he trains people who've never done a Kegel, he'll put a rolled-up towel on their chair. And this is true for men and women. Men have pelvic floors too, that also really contribute to overactive bladder, erectile dysfunction when they have weakness. Uh it's serious too. It's really very, very equivalent. But you and I are women, so I'll mention female anatomy. But this is really true for men as well. So he puts a rolled-up towel and you're sitting on it on a chair like you're straddling a horse.

Cheryl Fischer 20:09

Okay.

Patricia Linderman 20:10

And then he says, Lift your vagina off the towel. So you can just do that right now, just lifting up off the towel and see, just notice what happens. And then you hold it for a few seconds and then let it relax. All right. And the relaxing is just as important as the contraction, just like any muscle. You wouldn't hold a bicep curl and keep it there and keep it there because we don't want to cause more tightness. Right. We want to contract firmly and then we want to relax. So I coach my people to like imagine it's sagging down to your knees and so relaxed.

Cheryl Fischer 20:49

I have to say one sec. When you said that, I immediately I used my glutes. And I assume we're not supposed to do that.

Patricia Linderman 20:56

Right, right. Okay. Good, very good question. But I was going to say that tensing and relaxing, if you don't notice a difference

Contract All Three Openings

Patricia Linderman 21:05

between tensing and relaxing, it could be that you're just not tuned in yet to this part of the body, but it could also be that you have this tightness because you're not able to relax. So this is something to tune into. But also, yes, absolutely, Cheryl, we want to tune into what else is happening in the body. So yeah, you started using your glutes, and there's nothing wrong with it because glutes are your are your pelvic floor's friends. So you're you're not doing something bad for your body. But we really want to get so we can isolate. We want that mind-body skill that we can isolate the pelvic floor. So it's something to work on. You can tell the glutes, like, go hang out by the pool, right? Go, you know, hey glutes, not your job right now, and see if you can do it without the glutes, because we really want to tune in. It's this mind-body connection, it's really important. Um, There's the strengthening piece, but the mind-body piece is just as important because that's what helps prevent the leaks. Because often as we get older, and I mean after 30, we're getting older, right? We our our nerve connections just start to slow down a little bit, like if you're trying to thread a needle or something. It's just a little harder. And so we want to reinforce those mind-body connections. And that's what's going to if we need them to be quick and responsive so we can prevent those leaks. So we really want to isolate the pelvic floor, but you might notice that your abs also brace and you really can't help it. That's okay. That's okay. According to Dr. Crawford, some women are like just squeezing their glutes and they're not actually compressing their pelvic floor and they think they're doing a kegel, but they're not. So we really

Habit Triggers And Rehab Volumes

Patricia Linderman 22:50

want to feel that lifting. All right, what else do we want to feel? The pelvic floor stretches all the way across your pelvis, from the front to the back, from the side to the side, and it has three openings in it, not just one. Men have two, but women have three. So when we pull up and contract our pelvic floor, we actually want to contract all those three areas. We want to contract around the urethra in the front because that's where leaks happen. We want to contract that. We want to contract around the vagina because that's the middle of our pelvic floor. And we want to contract around the back too. Like I've had that problem, past gas when I cough. Like nobody wants to do that. So we want to really contract it all, lift it all up, and then let it all relax. That's a true Kegel. And people say, How long do I need to hold it? Well, think of a bicep curl again. How long would you hold it? A few seconds, you feel that muscle working, and then you can let it relax.

Cheryl Fischer 23:49

Yeah.

Patricia Linderman 23:49

Yeah. Okay.

Cheryl Fischer 23:50

That's helpful. I don't think I've ever heard it explained quite that clearly. So that's helpful. Yeah.

Patricia Linderman 23:55

Oh, good. I've been explaining it a lot and spreading this information. And one other misconception that I'd like to mention, sometimes people have the instruction, stop the flow of urine, to um get them started with a Kegel. Like that's a feeling that you can tune into. But then people take that and they say, well, then I'll do it in the bathroom, you know, when I'm urinating and I'll stop the flow of urine. But Dr. Crawford says, don't do that. We want to train our body to work automatically the way we want it to work. We don't want it to stop in the middle of urinating. And also by stopping and starting, we could introduce bacteria or something. Anyway, that's not the time to do it. But the good news

Bridge Squats And Ball Squeezes

Patricia Linderman 24:40

is we can do Kegels like anytime, anywhere. Stop lights. To make it a habit, you can associate it with something, whether it's stoplights, commercials, conversation with a boring, you know, relative, whatever might be a might be a trigger for you.

Cheryl Fischer 24:56

Yeah, I I love that. And that's what I do a lot with my coaching clients to train them to stop and pay attention to how they're feeling, is to have some sort of a trigger, like when you're going up and down the stairs or when you first sit down at your computer. So, hey, when you first sit down at your computer, you could do this too. Exactly.

Patricia Linderman 25:13

It's booting up, you know, it's it's updating, right? Ooh, do some kegels. Great chance to do some kegels. And then if you if you're doing rehab, pelvic rehab, which is another pet peeve of mine, right? Because any other part of the body, if you have trauma or you have surgery, you get rehab, right? But with the pelvic floor, if you have childbirth or surgery or sexual trauma, nobody's giving you rehab. Like, wait a minute. It's just like go do some kegels. That's unfair. But the standard for rehab is to do 70 a day, 7-0 kegels a day. If you've had, you know, you're trying to rehab uh from a situation, 70, which you can do. You can totally do 70 kegels a day. But that's why this muscle squeezing can really help us because it really turbocharges our kegels and uh makes them more effective. So we don't have to do 70 a day. So if you do something like squeezing the cushion or the ball between your thighs and you do it 10 times in combination with the Kegel, then uh you can do that twice a day, and you've basically covered your needs for the day. Okay, that's good. That's good because 70

Find The Muscles Without Bearing Down

Patricia Linderman 26:30

is pretty daunting. 70's daunting, yeah. But the other thing is you're probably there may be something in your life that you're already doing. Like maybe you're already taking a yoga class or uh you do squats or something like that. If there's if you're doing anything that involves your abs, your glutes, your inner thighs, you can just add your kegel as you do the contraction. So if it was a squat, you just add it as you're standing up, as you squeeze your glutes and you squeeze the pelvic floor at the same time, and then you let it relax as you go back down. One absolutely wonderful exercise for the pelvic floor is when you do bridges. So if you have, if that's part of your exercise routine or you're willing to put it in, you know, you lie on your back and you just lift up your glutes from the floor, and you don't have to lift them up a lot. You can just kind of curl up your tailbone or you can lift up more. And then as you live, as you squeeze your glutes, you can squeeze your pelvic floor. And then you for an extra bonus, as you do your bridge, you can put a ball or a cushion between your thighs, and you can squeeze your inner thighs at the same time, and you're getting the inner thighs, you're getting the glutes, and it's just super good for your body. You just add your kiggles to that. Maybe you do 10 repetitions, that's it. Super easy. And then we mentioned prolapse when the organs start to sag downward. Well, if you're doing a bridge, those organs are upside

Bracing To Prevent Cough Leaks

Patricia Linderman 28:00

down, so they actually pull deeper into the body. For so for somebody who's starting to have prolapse, this is the bridge is the recommended exercise. So it just has so many bonus benefits. You're kind of using gravity to help you. Yes, yes, uh-huh.

Cheryl Fischer 28:16

Yeah. I like doing bridges, and I do bar, and that's something we do at almost every end of every class is do bridges for a little bit of time. So yeah.

Patricia Linderman 28:27

Well, there you go. So from now on, you're just gonna add that pelvic floor squeeze to this bridge that you're already doing.

Cheryl Fischer 28:33

Yeah, perfect. Perfect. Yeah, yeah.

Patricia Linderman 28:36

And you, you know, squeezing something between your thighs, if that doesn't fit into your, you know, your class, don't do it. That's okay. These are just extra bonus things. Okay.

Cheryl Fischer 28:46

Now, what about someone who when they when they try to do this, they're kind of thinking, I I can't feel anything happening. I don't even know what muscle I'm supposed to be moving. Yeah. If they keep trying, does it get better typically?

Patricia Linderman 29:02

Yeah, I think so. It's a mind-body thing, like trying to move your little finger all by itself. You know, the first time you do that, like it's totally impossible. But then you can practice, you can tune in. So there's some tricks to it. So I do like the tactile feeling of that rolled up towel.

Cheryl Fischer 29:18

Yeah.

Patricia Linderman 29:19

So you're not probably actually lifting off. There's not airspace there, but you do have that tactile feeling, like, where am I supposed to be lifting? And so you kind of lift off the towel, and then you can also exaggerate a little bit in the other direction. So as you relax, you you can give not really a push, but you can ease downward. And so then you can feel like a spreading and a relaxing as you ease downward and then you pull back up, and then then you should notice a difference. And then, aha, that's what I'm going for. But we want to avoid the real pushing, pushing

Listen Advocate And Get Support

Patricia Linderman 30:00

like we're having a baby. That's called bearing down. And some women do that actually when they're when they're bracing like to lift a heavy object, they actually push down on their pelvic floor, and that's something to avoid because it can make prolapse worse. Ah. So, what we want to do is is just ease it down when we're relaxing. Okay. And we want to pull it up. So there's also, I have so much to say. So there's down and there's up, and there's also a middle position that's called bracing. Just like you brace your abs, you can brace your pelvic floor, which is kind of pulling it, sort of gathering it uh from side to side into the middle. Um, and this is a really important skill to stop leaks in the moment. So if you know you're gonna cough, and in fact, we can cough on purpose. We can just go, and you know, this is a good thing for the mind-body connection because if you cough on purpose and you keep your pelvis relaxed, you're gonna feel your pelvic floor kind of trampolining down there. So this is something to tune in. It's like cough on, so do it right now. So relax your pelvis, relax everything, cough on purpose. Tune in. Yeah, something happening? Yeah, I do. Yeah, exactly. And so that's going up and down, and that's where a leak might happen. So, what we can do is we can brace those muscles, kind of gather them inward. And here it's okay to squeeze your glutes or whatever you need to do. Brace them in and then cough again. Try it right now. So brace those muscles and then cough again. Yeah, different. You feel less, right? Yeah.

Cheryl Fischer 31:43

Yeah. Yeah. That's a good exercise for somebody who's kind of confused as to what they're supposed to feel at all, I think,

Resources Pilates And Fierce After 45

Cheryl Fischer 31:50

right? Yeah. Exactly.

Patricia Linderman 31:52

Right. Yep.

Cheryl Fischer 31:53

Okay. Okay. So that's great. I think that's gonna help a lot of people. Are there other things that we should talk about that women should maybe be doing? Or have we covered it?

Patricia Linderman 32:03

Oh, I think just having this good relationship with your body and it's a two-way street. Like, we want to brace when we're gonna leak, and we also need to listen to our pelvic floor when she's talking to us. Like, sometimes we ignore that signal that you have to go to the bathroom and like, yeah, don't bother me, don't bother me. And that can make things worse. So we really want to have a caring two-way relationship with our pelvic floor, even though it's hidden away. It's super important to our quality of life, and it is not shameful. It is private, but it is not shameful. And I think we should be able to speak the words. We should be able to say vagina and urethra and anus and talk to our medical providers about anything that's going on because there may be something going on that you can do something about. It's not inevitable part of aging or childbearing.

Cheryl Fischer 33:01

Yeah, that's a good point. And I actually am gonna link in the show notes another episode where I talked with I talked

One Takeaway Mind Body Connection

Cheryl Fischer 33:10

with a PA about how to talk to your doctor. And we were focused on perimenopause and menopause. We weren't focused on this, but the theme being talk to your doctor for real. And if they brush you off, no, come informed and say, You can't brush me off. Like we need to talk about this. Yeah.

Patricia Linderman 33:28

Exactly. Like when I went to my uh gynecologist last, I said, Well, how am I doing with prolapse? And she said, Oh, nothing unusual for someone your age. And I'm like, Okay, but what does that mean? So yeah, so often the providers aren't bringing this up, they're not going into detail about it either. So we need to speak up, advocate for ourselves and each other.

Cheryl Fischer 33:53

Yeah, absolutely. Absolutely. Okay, so Patricia, tell us where can people find you to learn more about what you do or maybe connect with you?

Patricia Linderman 34:02

Yeah, two places. So my own personal practice is called Fierce After 45. And I mean all the way after 45. And you can find me on the web, fierceafter45.com, or on Substack, where I have a blog, Facebook, Instagram. But also I'd like you to check out Pilates, because that's the certification I have. So it's like the word Pilates, but it has an F after the P. So it's pelvic floor Pilates. So, but it's nowhere near as complicated as regular Pilates, but it's basically Pilates-based

Closing And Ratings Request

Patricia Linderman 34:40

because we're talking about the core, right? And and and intentionally activating certain muscle groups, it's Pilates-based pelvic floor training. And that's where I have my certification. So Pilates.com, they have some free resources. There's a video teaching you the exercises, and there's a directory of practitioners, including me, that uh can help you out. Okay, perfect.

Cheryl Fischer 35:04

Okay, so then my last question is I feel like always uh people are listening to a podcast, including me, while we're, you know, folding the laundry or driving or doing the dishes or whatever. So we can't remember everything. What is the most important thing that somebody listening should remember from this episode?

Patricia Linderman 35:24

Yeah, I just having that relationship with your pelvic floor. Like do a Kegel right now and just remind yourself that in the bedroom, the bathroom, our core stability, our balance, this is a muscle group that's hidden away, but it's just as important as every other muscle group in our body. So just to remember to include it in your wellness repertoire.

Cheryl Fischer 35:47

Yeah, absolutely. It's not something that we should ignore. It's not something that's weird to focus on. Absolutely. Love it. Well, Patricia, thank you so much for joining me. This has really been fun.

Patricia Linderman 36:00

Thank you, Cheryl. Yeah, I always love talking to you.

Cheryl Fischer 36:03

I'm gonna emphasize again, you heard Patricia say this a few times the mind-body connection. I mean, I'm gonna say it. You know I'm gonna say it. This is mind your midlife, our brains and the beliefs and and ways we look at the world that are saved deep in our subconscious brains, are running our lives, influencing our decisions. We talk about that a lot. Today we're talking about how paying attention with our brain, with your mind, matters when you're doing these pelvic floor exercises and just in general when you are exercising. You may know that one of my favorite ways to exercise is bar class at Pure Bar, and they will occasionally say, remember, mind, body connection, pay attention to the muscle we're talking about. Actually think about it, feel it, focus on it. That is what Patricia means, and it is powerful. Whenever you hear somebody talk about mindfulness or mind-body connection, we can we can simplify it down to this. Be in the moment and think about what you are doing. Or maybe it's think about who you're interacting with or think about what you're trying to achieve, whatever it is. In this case, today's topic, think about what you are doing. Focus on it with your mind, feel it. It matters, especially with these pelvic floor muscles that we tend to either just ignore or almost hide from as an issue that we don't want to deal with. So I hope that this episode has made a huge difference for you. I know it did for me. Go check out the episodes we mentioned. They'll be linked in the show notes as well. And Patricia's information, of course, will be there. Now, if you're listening on Apple, I would love for you to go to the Mind Your Midlife page, scroll down to where you can see how to rate and review, tap the five stars, and take just a quick minute to do a couple sentence review. Tell us what your favorite episode has been, or tell us what you like about the podcast. It tells the app to show this podcast to more people, and that is amazing. And if you love Spotify, you can tap the five stars on Spotify as well. Thank you so much for doing that. And remember, midlife is our time to take just a little bit better care of ourselves on the inside and on the outside. Just a little bit better care makes a huge difference.