Ep. 19: All Things Pelvic Floor w/ Bryanna Wirth, PT, DPT

The episode I know you’ve all been waiting for - the pelvic floor! It’s slowly making its way into becoming a common household name, but there is still work to do. Maybe you’ve never heard of the pelvic floor, maybe you were told all you need to do to help your pelvic floor is just do a bunch of kegels, maybe you’ve been having symptoms you didn’t even know could be connected to the pelvic floor, or maybe you’re a regular in your pelvic floor physical therapist’s office - either way, this episode is for you. It’s PACKED full of incredible education on what the pelvic floor is and what it does, what to expect from a physical therapy session, when you might want to consider seeing one (and spoiler alert - it’s not just after you’ve had a bunch of babies), the connection between your nervous system and your pelvic floor, and we even cover some common misconceptions about the pelvic floor. It’s everything you didn’t know you needed to know!  

Bryanna Wirth is an incredible wife and mama to two and the owner of Cultivate Pelvic Floor Therapy here in Bryan/College Station. Check her out for all your pelvic floor needs! 

Thanks for listening!

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Want to learn more or take my in-person course? Reach out at allisonsroose@gmail.com

Let’s build a foundation that lasts - for you, your future babies, and generations to come.

Transcript

SPEAKER_00 0:01

Welcome to Foundations for the Childbearing Years with Alison Roos, the podcast equipping married couples with empowering biblical and practical guidance for preconception, pregnancy, childbirth, and postpartum. I believe this is a transformative season of life, and the best time to prepare for it is long before you ever see those two pink lines. Think of this like premarital counseling, but for your childbearing journey. If you want to step into parenthood with wisdom, clarity, and Christ at the center, you're in the right place. Let's jump in. Hey everybody! Welcome back to this episode of Foundations for the Childbearing Years. Today is super fun because I have a really fun guest with me, and it's one of my dear friends and also my pelvic floor physical therapist. Don't know if that's breaking hip-up by telling everyone that. I guess it's fine if I say it. But Brianna Wirth, she is amazing. She's here today. Um, I asked her if she could come on and talk to us about pelvic floor, everything pelvic floor-related. She is amazing. And I know that the pelvic floor, I think, is is more well known now than it has ever been, probably, which is awesome. Uh, but I also know that especially for people who have not yet had babies and kind of dove into that world, they may or may not have really heard much about it. Or if they have, they just have heard about Kegels, or that you pee yourself after you have a baby, and maybe that's normal. I mean, I don't know. Um we'll see. And so yeah, we'll see what she says. So I thought it would be cool to do an episode about this because I before I had my first baby in 2019, I somehow was just found something about the pelvic floor and took a little class from this one girl that I knew from church. Um, and she like taught me how to breathe properly for my core. This is when I was pregnant, I think I said that. Um and I feel like doing that, I still knew virtually nothing about it, but I at least had a grid for what it was and that it was going to be impacted by my pregnancy and that I needed to do some things to help it. It was kind of like all I really understood, and I was like, okay. And I've and ever since then, I have done, I've gone to see a pelvic floor physical therapist in between every single baby that I've had and during some of my pregnancies that I've had. And I obviously don't know what would be going on with my pelvic floor had I not done that, but I feel like I'm in a really great place after having four babies and hope to stay there. And I I feel like it's largely, if not entirely, because I have like taken care of my pelvic floor um and been mindful of it and gotten help when I've needed it and not just like ignored symptoms and things. Um, and so it's something that I feel passionate about, even though it's not I I obviously don't know half as much as you do. So I'm excited to hear from you today, and as someone who is more of an expert and uh it really is like your deep, deep passion. So all that to say, would love to hear who you are, tell us about your family a little, and then how did you get into this? Yeah, and what's your business, all that?

SPEAKER_01 3:27

Yeah, okay, super grateful to be here, first of all, um, with my star patient who's been who's been so consistent with pelvic floor therapy. Seriously, though, she's just taking it very seriously, and I appreciate that as her therapist. But um, and I just love this podcast. It's so rich. Um, y'all need to listen to all the episodes. I wish I had this when I was pregnant with my first baby, especially the breastfeeding one. Man, that was really good. Shout out good stuff, shout out to that one. Um, okay, but my name is Brianna Worth. I'm a pelvic for PT here in College Station, Texas. Um, I'm married to Thomas. We have two babies. Um, my son is about to turn three in September, and my daughter just turned one, which is crazy. So sad and so happy. Um, okay, how I got into pelvic floor PT, I'm gonna try to keep it concise. But basically, going into physical therapy school, I thought I wanted to do pediatrics and I was super envisioned for that. And then we had one lecture on pelvic floor, and I was like, wow, I did not know this existed. I didn't like even as a PT student, I didn't know these muscles existed, I didn't know there was a whole like niche PT for that. So I um shadowed her for a little bit and immediately fell in love. Loved how you just get to walk with in her case, she just worked with women, but get to walk with women through these very vulnerable things and get to walk with them through like this whole journey and get to know not only their like what's going on, but them as a person. We have to address so many aspects of their life to really address pelvic floor. So I really love the holistic care of the pelvic floor therapy. Um yeah, and another part of it was which sounds super like crazy, but this was already like eight-ish years ago, but no one had told me that sex doesn't have to be painful until I learned about pelvic floor, like pelvic floor PT. And I just thought that was crazy growing up in the church, and we could go into purity culture and all that, but personally it just like either wasn't talked about or like friends were like, Oh, it's gonna be painful, and you just have to push through. And so when I hear it's not supposed to be painful, I'm like, gosh, I need to tell everyone about this. Like, tell them get a billboard people should not just be pushing through pain or walking in shame and guilt because they can't enjoy this part of their marriage. Um, and so I really felt envisioned for that just to be a safe place for women to come to to find solution and not just kind of live in this pain and just not great sex life. So um, and then from there, obviously, I've loved growing in knowledge of pregnancy postpartum since I've had babies, and I could share a lot more, but I'll st I'll stop there.

SPEAKER_00 6:21

That's perfect. I forgot to say at the beginning that we will be talking about intimate details of our bodies and sex and all those things, so just uh FYI, I forgot to say that before we were getting into it, but uh maybe don't play this around small children. Um and just a caveat or not caveat, but I don't know. Whatever you just said is like pelvic floor therapy is relevant to everyone, to all women um and men, I think. Yes, right? Pelic floor through children, yeah. Okay, yeah. We're like specifically mostly gonna talk about how it's connected with pregnancy and birth and all that, but we will there will also be bits and pieces where we touch on uh seasons outside of that as well. I just wanted to clarify that. Okay, love it. I love that you're passionate about it, and that is so true that it you get into like such intimate details of people's lives that you're you start getting into so much more than just like let's work on these muscles, you know. It's like okay, we need to address like emotional things or trauma or yes, who knows? I mean, so many things probably come up.

SPEAKER_01 7:36

It's a big puzzle, and yeah, we're looking at all aspects of life your daily life, your stress, your past trauma, everything you just said, um, daily habits, um, what you're eating, what you're drinking, how much you're drinking, your toileting habits. We we try to look at the whole picture because pelvic floor can be influenced by everything.

SPEAKER_00 7:55

Love that. There's a specific way that you should poop everyone. So go talk to your pelvic floor therapist about that. Um okay, so can you tell us what exactly is the pelvic floor uh and what is like what does it do?

SPEAKER_01 8:14

What is it for? So the pelvic floor is a group of muscles that runs from your pubic bone all the way back to your tailbone. It should sit like a hammock or kind of like a trampoline at the bottom of your pelvis. Um it's responsible for supporting your organs, so your bladder, your uterus, your rectum. For men, they're prostate as well. Um it's you um the pelvic floor works to um help with bowel emptying, bladder emptying, sexual function. Um, it it is engaged with your core. Um, it really does a lot for us to support us and also with pressure management. Um yeah, that's kind of like how the pelvic four works and what it does.

SPEAKER_00 8:55

I remember when I was learning about this in 2019 from that girl, she told me to picture it like a soda can.

unknown 9:02

Yeah.

SPEAKER_00 9:02

Like in your body, it's like there's a top and a bottom, and then it there's the thing that wraps around the whole Yes. Anyway, that's how I've always pictured it in my mind.

SPEAKER_01 9:10

Yes, that's a great analogy because when you kind of dent the soda can, something's gotta give top or bottom. Usually it's the bottom, yeah.

SPEAKER_00 9:18

Yeah, so tell us how does the pelvic floor play a role in pregnancy, birth postpartum kind of seasons?

SPEAKER_01 9:25

So during pregnancy, um, the pelvic floor is constantly adjusting to the growing baby, um, along with your core, your hip muscles, glute muscles, everything surrounding that baby, it's kind of working in tandem with what's going on. Um, and it's also really trying to support baby, but also um like adjust to all the relaxing that's going through your pelvis um and trying to maintain strength and mobility. It's it's doing a lot during pregnancy, always adjusting because your your body changes day by day. Um, and then with birth, the pelvic floor is really just trying to get out of the way. We're trying to lengthen the pelvic floor to make space for a baby to come through. And then postpartum, it's really just working on healing and adjusting to a new center of gravity. Your posture dramatically changes postpartum. Um, and so it's kind of working to heal from like the trauma of birth, just like the physical trauma of birth, and um managing new pressure. Um yeah, it's just and hormonal issues, um, or hormonal changes rather. It's adjusting to all of those things. So just in the healing phase, postpartum.

SPEAKER_00 10:37

Yeah. So crazy. Yeah. Just it has so much to do with it. I'm like, how did we go so long with just no one knowing about this or like caring about it or doing anything about it? It's wild.

SPEAKER_01 10:49

Yes, it feels so it does so many things, so it's hard to like be broad about it. I like want to list everything it does, but I'm trying to not do that.

SPEAKER_00 10:58

Yeah, I mean, you can sure you could talk about it all day. Um, okay, so with maybe let's think about someone who has not, since this is geared towards people before they ever have kids. What um is there any benefit to that mom or future mom, that woman, married woman, whatever, even a single girl? I don't know who's listening to this. But like, what what benefit is there for them in seeing a pelvic floor therapist? Like, would they want to wait until they have some kind of symptom, or is there any benefit to doing that just as a prerequisite to getting married or having babies?

SPEAKER_01 11:37

Yeah, I think I mean, I'll I think every pelvet for a PT would agree that we would love to see everyone preventatively. Um, but obviously the reality is most people come in when they have symptoms. Um, so common symptoms might be like pain with your gynec gynecologist exams, your vaginal exams. Um those should not be painful. Those should not be painful. It might be uncomfortable. Okay. But yeah, if you have pain with the like a pap smear or a vaginal exam with your gynecologist, um, that's probably one indicator, like, mmm, something might be a little off.

SPEAKER_00 12:13

Okay, that is very good to know. Yeah. Take note.

SPEAKER_01 12:16

Um and then um other symptoms. Do you want me to list out like a bunch of symptoms? Yeah. Okay, yeah, that'd be great. Um, but you could have even like urinary leakage, just some some women might have like, oh, it's just happens a little bit when I laugh, even though they've never had babies, they've never experienced like anything crazy like that. Um, constipation, chronic constipation could definitely be a big symptom of pelvic fore dysfunction, any sort sort of pain, pelvic pain, tailbone pain, SI pain, um, and then um like pelvic for heaviness, bowel incontinence. There's so much that could be directed towards pelvic for dysfunction. Um but what was the main question again?

SPEAKER_00 12:58

No, that's so helpful. I mean, I think that I actually have a friend who had tailbone pain. Like I think she had an injury. And like for a decade, she uh just lived with tailbone pain and then in pelvic floor therapy during one of her pregnancies or something, had finally had like major breakthrough with that.

SPEAKER_01 13:15

Yes, tailbone pain, that's always one of my questions I ask at the first visit is if you've ever had a an injury to your tailbone, even if it just seems minor, like I fell off the steps when I was eight years old or something like that. Um, it can significantly change how the muscles in the back are functioning if they're too guarded or too tight, and that could be pulling um the pelvic floor back or tightening in the back, and then also changing how pressure is going down into the pelvic floor.

SPEAKER_00 13:43

Crazy. Yeah, that's so fun. I just love that our bodies like are they want to heal themselves. Like there's so there's just like sometimes you need a little bit of assistance, but it's like okay, and when you when you find like more of the root cause of something, it's like okay, we could actually not live with this crazy thing that we've been dealing with for forever. Yeah, I love that. But I think my question originally was why would a non-pregnant, non just pre-pregnancy woman want to go to the pelvic but go see a therapist?

SPEAKER_01 14:17

And I feel like you Yeah, I was gonna say too, if if you are having even minor symptoms like that little bit of leakage or that little bit of pain or that little bit of whatever, um, it could be kind of signaling to a bigger issue, um, which could be beneficial to kind of tackle before you have babies and maybe it becomes a bigger issue. But I also want to say too, it's never too late to get pelvic for therapy. A lot of women come in, they're like, I didn't come in earlier. Am I gonna be ruined? And that's not the case. We can still work with you. And even if you've had six babies and it's been 10 years, we can still do it.

SPEAKER_00 14:49

Do you feel like those scenarios, does it tend to be more challenging, or is it really just individualized? Like for some people, they'll see change and symptoms pretty quickly, even if it's been years.

SPEAKER_01 15:01

I mean, yeah, it's definitely individualized. It depends on to how um consistent you are with like doing your homework. Yeah, your homework. Allison's great at doing her homework.

SPEAKER_00 15:11

I if you have a type A, I'm a firstborn like perfectionist personality, then you it'll be easier for you to keep up with the exercises.

SPEAKER_01 15:22

Every time you came in, I was like, how are the exercises going? You're like, I'm doing them every day. This is how I feel. Like, great. Wow, this is star student.

SPEAKER_00 15:30

Well, honestly, I think it's because I got educated about it before I had a baby. I mean, I was pregnant when I learned about it, but I was like, wait, I didn't know that you could not pee yourself when you're 70. I just thought that was what everybody had to do. So I was like motivated ahead of time. I had vision. I was like, wait, I can do something about this now so that later in my life I'm not having to deal with X, Y, and Z. And so I feel like that's part of why I even just want to put this out into the world uh because I'm like, I want all the women that I know to like to know that as well. I feel like it's motivating to do the exercises and you know, just not sorry if y'all can hear the screaming baby in the background. Um, but yeah, it's it's motivating when you can have a vision for your future that's not filled with um common or what is it, common but not normal symptoms that you hear that people have.

SPEAKER_01 16:29

Yeah, and even if someone walks into pelvic floor PT, which I've had this at least a handful of times and they have no symptoms, they're just like, I just want to get a gauge of what's going on. Um, it can just be highly educational for them, um, just to know what the pelvic floor is, how it should function. So that way they it can be on the radar if something is wrong. Right. Um, they know, okay, this is just my body telling me something is wrong and I know who to go to or I know the resources that I have already. Um, and especially for the women who I don't know if you're gonna get into this, but like the women who are maybe going to get married, they've never had sex before. Um, there's a lot of discussion we can have about like what what does it look like to prepare for intimacy? Um, is there any anxiety behind that? Can we talk through that? Um, I mean, I can give a whole page of like sex position. I can like get as much seatl as you want or as little depending on the personality. Some personalities just want to know like medically kind of what their pelvic for is doing, and they don't really want to get into um certain things they don't want to be nervous and they maybe address that later. Um, but yeah, there's just so much education we can give, which usually I feel like women want to be more educated rather than less.

SPEAKER_00 17:38

Yes, um that's been helpful with any nervousness, yeah, whether that's about the first time you're gonna have sex or giving birth. Like we just want to know what's coming and how can we prepare.

SPEAKER_01 17:49

Yes, yeah. And yeah, we had I have met with a few women too, even just before they get pregnant and um just wanting kind of a baseline. I always say it's just great to get a baseline, what's going on that way we can also compare um when you are pregnant and postpartum, kind of what where we want to be.

SPEAKER_00 18:06

Yeah, so helpful to have that to look at. This is where I was and here's where I am now. I um yeah, I had that on here of like I always encourage women before they get married. Like I I think it's pretty common knowledge or at least common advice to go see a gynecologist before you get married. Perhaps mirror, yeah. Yeah, like just get everything looked at down there. And I'm like, okay, but you're only doing like I don't know, I would honestly say like a third of what you should be getting looked at down there or something when you go see a gynecologist. It's like, yeah, that's helpful, it can be helpful. You can discover a lie. I know lots of people who have ha who have benefited from doing that. But I feel like I wish I had gone to a pelvic floor therapist before I got married and had sex. Like it just feels like um I don't know, it feels like this well kept secret that it should not be.

SPEAKER_01 19:02

And there's just a lot of unknowns that I feel like once you know you're not as nervous and the nervous system has such a big influence on the pelvic floor. So if your nervous system's a little bit more regulated into going into marriage or going into pregnancy, your pelvic floor will be happier for sure. I love that.

SPEAKER_00 19:19

Yeah. So good. Okay, so before you uh get married, if you're listening to this, find a pelvic floor therapist. Yeah. Uh it's a great idea. Okay, so let's uh talk a little bit into like just about pregnancy. If if someone is listening to this and they are already pregnant, what is something that she can be doing now to like support her pelvic floor? I mean, I guess the best thing is go see someone. Yeah.

SPEAKER_01 19:52

I mean, yes, that obviously I'm a pelvic four PT, so I'm always gonna say it's a hundred percent worth it to just go get checked by your pelvic four therapist. Um, the earlier the better, especially kind of starting in second trimester. Um, we can kind of get ahead of some things and guide you through exercise, yes, guide you through what's going on with pelvic four, any current symptoms. We can address that and kind of set up a plan going forward into um pregnancy and preparing for birth. We do a lot of education on um just labor positions, push prep, a lot of things. And a common thing that people think is, oh, I need to wait for a symptom to arise, but you don't actually have to, and you don't also need a referral from your doctor. Usually, like I would say 99% of the pelvic for PTs should just be able to take you if you just call them. But yeah, so you can just go ahead and do that yourself. Some people are just always, especially with your first pregnancy, you're just waiting for your doctor to just tell you to do every single thing, but you don't have to, you can just do it. Do it, yeah. Um take charge, take charge. But uh, besides like going to pelvic 4 BT, I think really connecting to your breath is something really huge and that helps you connect to your body as a whole. So many of my first-time pregnant moms, they just haven't been connected to their body and especially their pelvic floor. So kind of helping them learn how to correctly breathe in a way that helps their pelvic floor move a little bit better is like life-changing for them, and they're like, I didn't know my pelvic floor moved like that. Um, but yeah, just kind of being more body aware is super helpful. And then I'm always gonna say this, but addressing like how your nervous system is functioning during pregnancy um is always going to be helpful.

SPEAKER_00 21:36

What would like what would they how would they go about that?

SPEAKER_01 21:39

Yeah, that's a good question. Um first of all, just kind of assessing like I do am I always stressed? Am I always clenching something in my body? Am I is my body super reactive to stress? Um, your pelvic core will always kind of follow suit with that if you're like always clenching your jaw, clenching your butt, um clenching your ass. Your inner thighs. I'm like, am I clenching my butt right now? I'm doing that right now. Um, I'm always like just clenching my upper traps, bringing my shoulders up to my ears. So kind of just being overall body aware is like the first two sessions of pelvic four therapy is we're working through a lot of that. And so if you're kind of already aware of what your body is doing and your habits, you're gonna be doing great.

SPEAKER_00 22:24

Love it. That's so helpful. I was gonna say that earlier, I forgot that I I do feel like um the body awareness thing has been huge outside of just addressing symptoms. It's like I actually can feel I don't I'm not always aware of it, but I can I can like intentionally relax my pelvic floor, which is so like before I mean, yeah, if you don't know what that even is, it's like how would you know how to do that?

SPEAKER_01 22:51

Right. And so if you don't know how to relax your muscles, regardless if it's pelvic floor or not, um, a PT should be able to kind of help you with that. Yeah. And give you a good toolbox for nervous system regulation and talk about breathing techniques, talk about like just body regulate. There's so many different things for a nervous system toolbox that I might give someone or have people try to kind of help with that too. I know that's a big kind of like yeah phrase right now. Nervous system regulation. Yeah. Um but yeah. But breathing, breathing is a huge part of that. It's huge and correctly breathing, right? Yeah, breathing into your diaphragm, not just all kind of neck breathing, right? Um, which we tend to do when we're stressed, is all in our neck and shoulders.

SPEAKER_00 23:30

Mm-hmm. Yeah. I love that. Those are great tips. Um, how do you feel about someone like finding a YouTube video of like how to I just know people have done I know friends that are like, I'm not gonna go see a pelvic floor therapist. I found some exercises on YouTube. Like, are you like, ugh, I don't love that? Or is that like, okay, well, it's better than nothing, you know?

SPEAKER_01 23:54

Yeah, I, you know, I feel like about 80% of my clients are like, well, I tried this first and it got me like halfway there. And so I think it's always a great start. There are great resources out there. Um, obviously, I can't keep track of who everyone is. There's so many fitness influencers, and there's also great Pelvic 4 PTs that have YouTube videos too. So um I would say it's better than nothing, yes. But the hands-on approach I think is like so helpful for most people because they in their brain they think they know what they're doing, and then um I'll like have them touch their stomach or kind of like their pelvis in a certain way while they're doing certain things, and they're like, Oh, that's what it's supposed to feel like. I PTs should really help you feel what you're supposed to be feeling while you're doing something, so that way it's it makes sense with your brain, yeah, and it's not just you like kind of blindly going through something that makes sense.

SPEAKER_00 24:47

So helpful, yes. So it's like great. If you want to Google something, yeah, what would be uh a red flag if somebody's watching a video on YouTube? This we're going off script here. I know watching a YouTube video and it's like the pelvic floor therapist on there or the fitness instructor starts saying what and then you're like, ah, I would not keep uh following their advice.

SPEAKER_01 25:09

I mean, I think we're about to get into this too later, but if they are saying like clench your butt with everything or kegel with everything, or just saying and kegel to the beat. I don't know. If I'm hearing those type of like intentional squeeze certain muscles to try to activate them, there's a time and place, but to like exercise your glutes, you shouldn't have to always think about clenching them, stuff like that, where I'm like, okay, there's overclenching going on, and usually women tend to be overclenchers in general if they're already having pelvic voice issues. So um that would be my red flag personally, but if I still love a bunch of I'm thinking of one fitness influencer right now who I love, and she still does tell you to squeeze your glutes occasionally, and I just you know block it out, and I still do the extra.

SPEAKER_00 26:02

It's not like everything they say is wrong, but that is like okay, maybe we shouldn't be doing that so much. At least personally, maybe maybe just go ahead and go into the Kegel thing, like while we're here. Um that feels like I said earlier, if people have heard of pelvic floor, they've probably heard the word Kegel.

SPEAKER_01 26:18

Yes, so it's a big kind of debate. I feel like in pelvic floor PT world, you could do a whole podcast about this, and I've listened personally to hours of content about this because it's just it's such a it's a big thing people like to get in arguments about. But personally, I fall into the I don't love prescribing Kegels. I can probably count on one hand people that I've told to do Kegels outside of my office. Yes, I will help them learn how to do it. I will test them, I will test the pelvic floor contraction, but sorry, I'm getting ahead of myself, but basically, Kegels is right now what we think of Kegels is like an isolated contraction of your pelvic floor. Way back when Mr. Kegel, Dr. Kegel, uh who discovered or started implementing the Kegel exercise, did implement the pelvic floor contractions with other things like lifestyle changes, postural changes. And fun fact, it was actually not Dr. Kegel, it was a lady before him that actually started doing this, but it's her name is Margaret Morrison, but it's not named the Morrison, it's named the Kegel. So, anyways, history lesson. Of course, a woman discovered it first, but um, anyways, so that was his version. It was a little bit more holistic than what we've made it to be. Um, so about like maybe 15-20 years ago, I think a lot of people just latched on to oh, let's just keagle all the time and that will fix everything. And let's come up with um devices that help you keagle and just help you just continually continually clench your pelvic floor. And the reality is that it's just pelvic floor is not a one-size-fit fits all in general, and the pelvic floor just doesn't work like that necessarily. The pelvic floor, yes, should contract, but it should also relax, it should lengthen, it should um yeah, that's what mine has a hard time with.

SPEAKER_00 28:15

I I do not need to do more kegels, is what I learned through going to do like a hands-on pelvic floor therapy. I was like, okay, kegels are not it, because that is like the classic OB advice, you know, is kind of like for a pregnant. I remember, I remember literally hearing, I don't know if I was told this or I've just heard of people being told this, but it's like, okay, every time you're at a stoplight, just do kegels. You know, like as while you're pregnant, as like a way to almost prepare your pelvic floor. It feels like the the in my mind, what they're saying is like this is almost like a workout for your pelvic floor. You need to like lift weights or something, like how you would strengthen your arm muscles. You need to do some kegels to strengthen your pelvic floor, but then it was just like, yeah, blanket prescribed to everyone and then left at that.

SPEAKER_01 29:04

Right. Yeah, it's it's so much more nuanced than that. Yeah. It um your your pelvic floor should function with your body, and it is a very anticipatory muscle. So when you're you when you're contracting it, yes, you are like working those muscles, but you're not always working on the reactionary or the anticipatory part of that muscle. And so um I find that it's just usually not super helpful to just tell people to do key goals, or if they are doing key goals, sometimes I would say like at least 50% of the time they're not doing it right, or they have like a weird relationship with their breath with it. So I'm not a fan. Um, there are public four PTs that really do work on it and they find success, but for me, I was also just trained to to not like that's not my first focus. I look at a lot of other things first, yeah. Um, but yeah, that's my short answer.

SPEAKER_00 29:57

I guess I'm trying to think is anything else I would say about that other than No, that's great. I think that's helpful. Like it feels like something that at least when I've come to see you, and we can talk more about like what does kind of a session look like, but like it's something that you will have me do to make sure that I know how to do it properly. It's like a test almost of like how is my pelvic floor functioning or do I know how to um what's the word contract and then relax, yeah, versus something that I need to be doing all the time to help with something. I don't know. That's how it has felt to me.

SPEAKER_01 30:34

Yeah, and when I when a lot of pelvic floor PTs are testing this, you do test on your back, but usually symptoms aren't while you're on your back, you're moving, you're grooving, you're doing exercises, you're chasing your kids. Um, and I mean there is a standing test, but I which I think I've done with you. I don't know. Sorry, I'm not trying to reveal all of it. No, it's fine. I don't mind. Um I can't remember, honestly. Um, I do that pretty frequently. So there is like a little bit of a way to test with movement, but um, you know, sometimes people like don't know how to contract, but they don't have any leak, they don't have any like the typical symptoms that you would think of a weak pelvic for. Um but yeah, doing a lot of kegels can tend to also hurt people in the long run. It just kind of shortens the muscles and can cause a lot of pain and some other symptoms in general. So we need full length of our muscles in order to be able to contract, which is why I focus a lot on like the mobility and the coordination of the muscles before I'm just like asking you to work on squeezing. Yeah, I love that.

SPEAKER_00 31:40

Yeah, okay. Um I'm just having the thought. I feel like when I talk about anything related to pregnancy or birth, I'm always telling people like you want to think about before you pick a provider, or before you decide where you want to give birth, or before you just any of these decisions about birth, decide if you want an unmedicated. I'm like, think about what are your values, what is important to you, what kind of person do you want to work with? You want to trust them. All that to say, the thought that I'm having is that I feel like I hit the jackpot with you as like a pelvic floor therapist because I honestly didn't think about or even know what to think about of what kind of pelvic floor therapist do I want, or like, because like you said, I'm not in that niche world that you're in of listening to all these hours of podcasts of pelvic floor therapists debating things. So you see kind of like, okay, there's this type of pelvic floor therapist, and there's the ones that focus on this, and the ones that are coming from a more holistic place, and like and all that to say, I'm just it's cool to hear you talk about like w your almost like the foundation that you're coming from, or like your philosophy around like pelvic floor therapy. I honestly have not even thought about that until this very second that, like, oh, every pelvic floor therapist has a different, probably like, you know, a way that they approach it. Um well, thank you for saying that. And so I I am like, I I was thinking about that because I'm like, that's helpful for people to look for that when they're looking for a pelvic floor therapist.

SPEAKER_01 33:15

Yeah, it I always say too, it's like finding a counselor or yeah, your OB is something. You want to um really connect well with your pelvic 4BT and you can always switch. I've had yeah, many people yeah, just talk to me about like coming from different clinics or like where they moved from or whatever, and just the differences and how what they've enjoyed, and um some of it, a lot of it can be like personality too. I tend to not be like super loud in your face. I try to be super calm, and um I feel like that's helped some of my clients, and some clients might want like a like a loud, boisterous person. Um anyways, but yes, I think fitting personality and um yeah, you can totally ask your pelvic four PT kind of what their philosophy is on Kegels. And I do think though, more more that more so than not, pelvic 4 PTs are landing on pelvic 4 has to be a holistic thing. You're not just gonna work on Kegels, even if they do a little bit, they're hopefully not doing that the whole time. And if they are, then then I would say maybe that's a slight red flag if they're not addressing anything else.

SPEAKER_00 34:21

But yeah, yeah. So good, so good to think about. Um, okay. Let's I I'm I'm thinking about my walk me through the basics of like a session, what that would look like, and I'm feeling like that's a humongous question because it just depends on what you're coming in for. So maybe let's I'm gonna try to pick it in. Pick, or you can pick. I don't know if you already had something in mind, like of how to explain to someone just generally, here's what might happen when you come to see a pelvic fluorotherapist or come to see you specifically because you don't know what everyone does. True.

SPEAKER_01 34:52

Yes. Um, I would say I I like to talk about the first session. Okay. Um, with a lot of people who are like, what is what what even goes on in that room? Right. What are you gonna do to me? What are you what's gonna happen? Um so we honestly talk a lot the first session, which hopefully you remember. I'm going through a lot of your medical history, a lot of if you've had babies, your birth history, your um menstrual cycle symptoms, um, how you eat, how you poop, how you pee. We're looking at all the habits. Um, we are looking at exercise, stress levels, past trauma. We're talking through a lot of different things, and a lot of questions I bring up, hopefully they are familiar with based on like the intake paperwork I have them do. So they're kind of already thinking about those things. And then after we ch chat for a really long time, um we go into kind of a big assessment of how your body's moving, um, looking at some different strength things depending on kind of what symptoms are currently, and um doing some mobility tests, doing some postural assessments. I don't know if I said that already, um, looking at how you're managing pressure. Um, there's a lot of different like body movement things that I have you do, like just in general, standing in front of me, looking at your posture, looking at how you're breathing, and then also I'll have you get on the table for some specific muscular tests as well. Um and then at the end, we usually do the pelvic floor exam, or maybe not at the end, but part of the first session is the pelvic floor exam, which most pelvic floor PTs kind of go thoroughly through what that's gonna look like, why we do that, what is what we're gonna find. And for anyone that's super nervous about that part, I always always say from the get-go, it's totally optional. I've treated actually quite a few patients without ever looking at their pelvic floor doing the vaginal exam. Um, sometimes that's just feels like very off limits for people. Totally understand. It definitely gives me more information, but um, I never want that to be an obstacle for some people, especially if they've had trauma, because again, pelvic floor is part of a whole system. I can usually see other things going on in their body that might indicate why they're having certain symptoms. We can address those first. Um and then I can also go into how they can maybe treat their own pelvic floor if they feel more comfortable treating themselves. Sorry, I went into a caveat on like pelvic exam or no pelvic exam. But yeah, I love that. After the pelvic exam, we go into just talking through a lot of habits. What I would ask them to be aware of, change, whether it's like bowel habits, bladder habits, pressure management, um, different habits with urge, um, lots of different things, maybe recommendations on lube. There's so many things we could talk about and then give them a lot of exercises to go home with, and we kind of go through those and make sure they're understanding that um before they're sent off. But that's in general the first session, and then the second one and third and fourth, they are just very individualized. Yes, very individualized based on what we did the first session.

SPEAKER_00 37:57

But I love it. Can you go into more detail like about the vaginal exam part? Like just so people, if people are like, I don't know what you're talking about, what are you gonna do? Like, is it just you look in there? Are you putting something up in there? What are you doing?

SPEAKER_01 38:10

Yeah, so it's not your typical like OB gynecologist exam. I'm not using a speculum. I am using my hands to assess the function of the muscles. So we're assessing, yes, if there's any pain or tenderness, we're always looking at that, but really assessing how the muscles are working. So assessing strength, mobility, coordination, um, pressure management, if there's any signs of prolapse, but I assess that externally and internally with my gloved hand. Um, I'm always telling people what I'm doing before I do it. I always ask them, are you okay to continue? Um if there is a lot of pain, I do talk about that ahead of time of like what the pain threshold is for us. We might not even get to the full exam. We're not gonna push through too much pain. Um, that's just for me personally. I try not to kind of go above and beyond with the pain because if that's why they're there, I don't want to kind of re-enforce that brain message, that interaction with the pelvic floor is painful. We're trying to mitigate that as much as possible. But um, anyways, just testing different muscles through like palpating or hands on the muscles and asking them to contract, relax, going through all the different layers of the pelvic floor. Love it. So helpful. It's not that scary when you actually do it. Yeah, it's nothing like every time when it's scary for someone, they're always like, wow, that wasn't as bad as I thought it would be.

SPEAKER_00 39:33

Yeah, so true. Um okay, that's so helpful. That's kind of generally what you could expect if you go see someone. Um let's see. What uh I think I'm gonna well, let's do this one. Okay, so like what would you say to mom? This mom, she's had a couple kids already. She's trying to exercise and keeps peeing when she jumps rope or when she sneezes, and but she doesn't have any like really anything significant, no like obvious prolapse, no pain with intercourse, but she's just she's having some trouble peeing. So she's kind of like, I don't know, is it worth it? Should I just keep living my life? It'll be fine. I'm probably fine. Like, I feel like that's what I hear a lot. It's like someone at the gym is like, oh yeah, I have to go to the bathroom every time after I do the jump rope. And I'm like, or every time before, make sure you're fully empty.

SPEAKER_01 40:29

Yeah, totally get it. I think, and yeah, it's funny when I'm whenever I'm at the gym too, people will look at me when they say those things. I'm like, you do you, girl? They're like, I'm not judging all of you, it's okay. I'm just a mom right now and also trying to be active. Um, but no, I would say I totally get it. When you're a mom, especially, like you cannot prioritize everything in your life. Um, and that's just a fact. And so, but on the flip side, usually just a little bit of leakage here and there can over the years turn into bigger things, not to be scary, but it could just be a little signal like, hey, something's off. And again, kind of like what we said before, the sooner you address it, the sooner things will um get better, but also the sooner you're more aware of like what could be the root. When a lot of symptoms kind of pile up on each other when I see people in the clinic, it just takes a little bit longer to kind of see, okay, what is the root going on? Um, whereas if you dress it earlier, you are just more aware of your body, how it should function, and kind of implement those things earlier. But um, if you're a busy mom and you're like, How am I gonna do this in my life stage right now? Um I would just say evaluate kind of like what your priorities are in life. I think we all have priorities, we all make time for things. Um, and definitely try if you are gonna do pelvic for BT, just know that it is a commitment. Um, and like even talking to your spouse or kids or whatever, like what would it look like for mom to follow through on this commitment to help her in the longevity of taking care of her kids? Um yeah, there's a lot that I could do or go on with that.

SPEAKER_00 42:10

But yeah, I love that. I think that's such a great point. Like, um, what are your priorities and then being committed to it? Because it's like it's probably not gonna just be like you go one time. Right. Yeah, and then you're good to go after that.

SPEAKER_01 42:23

Yes, I would love to talk about that. Yeah, go there. Or I can give you a lot to work on. I can give you a lot of like, okay, this is where we're at, but having that expectation that it's like a one and done appointment is just not the reality. Usually it it takes many appointments, but I also don't want that to be intimidating for people, even if you can only come in like once every few weeks or something. I always try to work with that, even if it's just a little bit here and there, and then communicating maybe between appointments, giving you a lot to work on between appointments. Um, the practice might be slower, but it's better than nothing. Right. Um, a lot of moms come in, they're like, I cannot do weekly, or I cannot do twice a week, or whatever. They have this thing in their mind that like this is what PT is. And a lot of public four PTs are super flexible with what schedule, finances, everything looks like to make it work for you, your family, everything. They want it, this should be a peaceful process, not like an added stress.

SPEAKER_00 43:26

Yeah, that's so good. Um, yeah, it's just making me think about like postpartum in general. I feel like we often um are just expected, moms are expected to kind of just like get back to life. Like, you know, just get back to it, get back to your normal life, and you're like, okay, I guess that's what everybody's doing, you know. And I I just think it's so helpful. Like, I like telling people what I'm doing about my pelvic floor, or just like being open about it and conversation. conversation even with other moms that like yeah this is something that I've done I don't know I guess like I've been you know probably eight times at this point not eight sessions but like I've gone to like that many different yes um whatever I don't know how to explain that I've just gone to see someone lots and lots and lots and um I feel like normalizing that is helpful for people because it does feel like our needs especially if you're just peeing your pants a little bit here and there you're kind of like okay I can live with that it's fine like there's way bigger fish to fry um but I I do think yeah just again going back to that like bigger picture vision for our lives and the longevity of even our sex lives or our you know or just wanting to have more children or wanting to not have to buy adult diapers when we're in our 50s 60s 70s whatever like I I want that for us you know and it starts now like I mean again not in like a scary way it's not again like you said you can always do something about it but I if if at all possible the proactive I just love being proactive about decisions and health stuff and thinking about the the long term benefits.

SPEAKER_01 45:11

Yeah and the more people are aware the more they are being proactive which is fun to see in the clinic too.

SPEAKER_00 45:16

Yeah that's so great um I guess while we're on the topic of postpartum um then I'll go back into my question about birth but what are what are some common mistakes that you see people make in the postpartum window?

SPEAKER_01 45:33

Maybe we've already hit on a couple of those and like how can we how can we best support our pelvic floors postpartum yes okay so it's hard to I I hate to say like mistake but um okay I think maybe just we can call it something else.

SPEAKER_00 45:50

Just like a no I don't want people to be I don't know. It's not like a shame thing.

SPEAKER_01 45:54

So like you did this wrong you're a failure we're not saying that at all just like or we just don't even know maybe yes you know it's just feels normal and I feel like a lot of people are waking up to like anti bounce back culture, you know I think one of the biggest things is just not respecting the healing process of being freshly postpartum and being like I have to be doing all these activities. I have to be cleaning my whole house I have like so many have to's for moms. I think it's just moms carry such a big weight of that in postpartum or even they're just like this big identity shift especially with first baby they want to feel maybe an ounce of who they were maybe before baby. So they're like I'm just gonna do everything like normal how I was doing how I was doing it before. And so I think that can cause um just a few issues with some of the pelvic four healing and I mainly see that or just like mechanical issues like holding your breath while you're lifting like just not being aware of what your body's doing is one of the bigger mistakes I guess you could say of just trying to bulldoze through life and then like six months later you're like wow I've been in pain for so long and I should probably address this. That's the main thing just not respecting the healing time I guess.

SPEAKER_00 47:08

Yeah that's a great one. I'm I agree. Stay in your bed ladies um okay um going backwards to giving birth what are your thoughts? Well any thoughts really about uh uh pelvic floor and birth but then specifically thoughts on coached pushing yes and how that's I feel like I've just heard or seen things about that being not great for the pelvic floor. I don't really know.

SPEAKER_01 47:37

Yeah okay so I'm assuming when you say coach coached pushing you're talking about in the moment like a woman's like someone is like telling you like hold your breath bear down while I count to 10 they call it purple pushing or whatever any of that. Yeah so um I feel like women especially second third time moms they come in and they get so frustrated when they talk about when they were pushing out their baby and all of a sudden everyone's yelling at them to push in a certain way or they're not doing it right and they just have never practiced it but they it's like such an intense moment and then all of a sudden you're getting this new coaching that you've never heard before never experienced before you've never practiced this before. So I would say the the beauty of Pelvic4 PT is we can educate you on the different types of pushing what feels best for your body specifically how to practice when to practice we give you a lot of feedback in session there's again many different types of pushing and different positions to push so we kind of go through those but we really emphasize too like in the birth space um and research shows that when moms feel empowered to push how their body is wanting to push in the moment that leads to less tears less like pelvic floor trauma um so we try to really emphasize that like there's not necessarily one super correct way of pushing obviously we want to limit the purple pushing especially if your body's not feeling like it wants to do that or your body's not ready to be pushing um but yeah I I get frustrated with my moms when they're like I don't even know what this means and people are just telling me to do this.

SPEAKER_00 49:18

So we really go through that and practice it with them which is I was gonna say my own personal testimony to that is I did that with you before my third baby. So I've already pushed out a couple of babies but we practiced like how to push in a way that felt like supportive of the pelvic floors like how I always phrase it when I'm telling someone about it. And I don't know but that that birth um if y'all listen to my recent birth story episode she just fell out of my body I didn't my body did it all by itself I didn't really do anything. It was like virtually pain free and I don't know if that's why but I was like that was amazing like and I really felt like even though I had pushed out babies before that was the first time like in that session with you that I was like connecting to my pelvic floor while I was thinking like while I was I wasn't pushing out a baby but you know while I was like simulating that experience um I don't know it was so helpful. I always tell people that I'm like you guys should really try this out really just practice this it's awesome.

SPEAKER_01 50:22

It really is cool and it's empowering too to know when you are in birth and you like feel that urge to push or you feel your body wanting to push and being able to partner with that instead of being like a lot of people say it feels like it kind of takes over or they feel like out of control.

SPEAKER_00 50:37

And some people it's the opposite they feel very in control and whatever everyone's so different but yeah yeah that's really cool.

SPEAKER_01 50:44

Some women I will say too not to be like devil's advocate but some women do like feel more natural with like a purple push or like a total goddess push and so recently I've been trying to change my wording in sessions with that just so people don't walk away from their birth like I did pushing wrong because I purple pushed that is not the case your body wanted to push like that partner with your body yeah um and it yeah it's really an issue when it's like you're coached to do it and you don't want to do it. It's too early natural you've been purple pushing for four hours like that's there's there's an issue with that.

SPEAKER_00 51:17

And you will will you see like that cause pelvic or you don't know I guess if that's what caused it but like I just see it feels like surely if that's what's happening like that specific scenario that's gonna be not good for the pelvic floor.

SPEAKER_01 51:31

It's just it is a lot of pressure for the pelvic floor to manage and um it's also just exhausting for women to do that. Yeah but every birth is different. You can't say no birth caused this and this cause that's exactly um you can never know. Yeah yeah which that made me think about when you were saying the thing about tearing um how is that connected with pelvic floor even in recovery and stuff after a tear yes so um and this is this is why we go over so much during the pregnancy period of how to take care of your perineum during pregnancy how to get like the nervous system ready for that stretch because it's not so much that we're stretching everything out to be stretched and fully stretched it's to get the nervous system ready so that way when you are pushing your nervous system is partnering with your body and not freaking out and clenching your muscles because that can um sometimes cause more tearing but anyways um what was the question?

SPEAKER_00 52:29

Well sorry just a question about that so you typically if someone's seeing you during pregnancy and maybe is it specifically on the first baby or any baby you're you're kind of helping and coaching them to like do some perennial like massage and stretching pre-birth.

SPEAKER_01 52:44

Yes pre-birth and sooner than what like your typical OP might recommend which is that 34 35 weeks um I would say that's kind of like pretty late in the game to start realizing oh my nervous system hates my perennium being touched. So we we tend to practice second that's so helpful.

SPEAKER_00 53:02

It's helpful to hear that explained as like we're helping you connect with your pelvic floor while this part of your body is being stretched and pushed on. Instead of because yeah I think I've always heard it talked about as like you're stretching it out so that yeah the baby can come out easier or something which I've always been like that doesn't make any sense to me because it doesn't do that.

SPEAKER_01 53:22

Yeah the vaginal opening is meant to stretch and then come back. So it's yeah I mean you are stretching a little bit and if you do have past scar tissue you're trying to like maybe break that up a little bit like from a previous tear. Yes. Um but yes um so and then does I guess if you have a tear is that a reason that is you should maybe go see a pelvic floor therapist or not necessarily um I I would think so just to kind of check the status of scar tissue everybody has kind of a different way of scar tissue formation in their body um is it like super restricted or did it heal in a way that it does help your pelvic floor still move freely if it's stupid super restricted I would definitely want to work on that postpartum making sure scar tissue's moving more and making sure it's not restricting pelvic floor movement. But yeah I would say if anyone has a tear and it's it is pretty typical to have a tear even just a minor tear your first birth and that's totally okay. It doesn't mean you did anything wrong. Yeah I would say just definitely go check with the pelvic for PT see if there's anything you can do especially if it's causing any issues with inner course or anything like that.

SPEAKER_00 54:31

Yeah. It's good to know um okay we've got a few more and then we'll wrap this up what is diastasis recti?

SPEAKER_01 54:41

Is that how you say it diastasis diast I always say I think I always say diastasis. Okay but diastasis is also I don't think there's a right way to say I never know that's I've recently just been saying DRA because I just don't know what I want to say what A stand for um abdominisis rectus abdominis abdominus abdominal abdominis oh gosh now I don't know the acronym it's okay someone Google it um but so what is that diastasis recti. Yeah how is that connected is the separation of the connective tissue between your abdominals and I know y'all can't see me but I'm like touching my belly I'm such a like hand mover um the separation of that connective tissue called your linea alba and it's just everyone has that separation because you're growing a baby. You have to have some sort of separation to grow a baby something's gotta give um and so it also um like postpartum you're looking at that separation yes but you're also looking at kind of the back of the person why is it still separated um it could be towards the back like your tight um external obliques your um restricted thoracic spine that can all still be pulling on those abdominal muscles if you still are having a crazy separation so before even like working on the core contraction which can help with that separation a little bit we're working on what is restricted maybe in the back from any like postural changes throughout pregnancy kind of getting that back in order so that way the core can come back together nicely and also function correctly with your body. Nice.

SPEAKER_00 56:17

Hopefully that made sense yeah so it's like sometimes it's possible that whatever separation you have there will kind of mostly be fine on its own. And then sometimes it will not kind of close up as much as it should and you'll need to get some extra help.

SPEAKER_01 56:35

Yes and I would say too even if you technically don't have like that finger separation, you know how that your OB or your provider will probably test you above and below your belly button and at your belly button um you still might have some of those like postural changes still pulling on your core. It almost feels like when you put your fingers there it's kind of deeper which can still indicate that you probably need to still address some postural things and how your deep core is activating to further kind of make everything work again correctly. Yeah if that makes sense.

SPEAKER_00 57:07

Yeah it's like there can be deeper issues going on than just what you see when you do a crunch or something.

SPEAKER_01 57:12

Yes we're not always just looking at the separation I want to I want to see how everything's functioning with each other especially if you're looking at some people have no separation but they still have like crazy rib flair and then their upper abdominals like just won't come online with certain movements and um anyways I'll try not to connect to yes it's just all connected.

SPEAKER_00 57:32

Gosh this is why you just need to go see Brianna or someone like Brianna if you live somewhere else because it's like there's just so much that probably feels feels over my head and feels over everyone's head that does not know about all this but it's like that makes sense you know we just we don't know what we don't know and um it's just helpful helpful to hear. Okay what about if you have a C-section? Should you do you do you need pelvic floor therapy?

SPEAKER_01 58:01

And she knows the answer. Yes so you're still carrying a baby for nine ish months and your pelvic floor still adjusting to all of that new pressure management everything all the postural changes you're still going through all of that um I st I think that's such a funny thing that people say like oh my pelvic floor it's fine but your pelvic four doesn't just bounce back because you now don't have a baby in you and you it didn't come through your vagina you know like they also cut through seven layers of tissue to get that baby out.

SPEAKER_00 58:32

That's part of your pelvic floor.

SPEAKER_01 58:33

Yes your pelvic floor and your core are so connected if one is not working correctly the other one usually does not know how to function and they're just like help me. So um we usually have to work a lot on getting the core to be activated correctly again. But um besides that like looking at the scar tissue how is that scar healing? Do you have pain do you have numbness sensitivity? We work a lot on scar mobility making sure none of that scar tissue is restricting your core because again we need muscles to fully relax and fully contract. So pelvic four needs to do that and core needs to do that. If scar tissue is kind of clenching everything together making everything tight then we can't fully relax to fully strengthen so in my brain it's like okay we still address everything that we do normally postpartum plus extra first C section. Right. So yes that's my answer.

SPEAKER_00 59:23

Yeah I don't know why I don't know how that became a thing of like oh I didn't have a vaginal birth so I I have no pelvic floor issues or something.

SPEAKER_01 59:31

I don't know maybe people don't actually think that but I feel like I've heard that I have too uh okay great um okay are there any other just like kind of like that like common misconceptions about the pelvic floor that come to mind that we haven't hit on yeah I would say kind of the theme that we've already been talking about is pelvic floor PTs they don't just look at your pelvic floor we really try to take a holistic view we're looking from ground up head down seeing what could be influencing pelvic floor um a lot of the times pelvic floor is like a victim to what's going on up and down the chain so we're really taking whole person view um I always just get so many comments when I'm looking at people's feet they're like why are you looking at my feet? I'm like it matters she gives me exercises for my feet it matters and um even like all I'm always trying to learn I'm doing a bunch of continuing ed on rib cage um positioning and breathing and everything everything fixed pelvic floor. Also a funny one is yes men do have pelvic floor and they do usually they a lot of them do have issues and they're not usually aware of them or a lot of wives just out their husbands and they're like my husband spends an hour on the toilet what do I say like well he should probably go see a pelvic floor PT if it's actually an issue or if it's just a habit. I don't know. Are there like guy pelvic floor PTs?

SPEAKER_00 1:00:55

Like what who do they go to?

SPEAKER_01 1:00:56

I'm sure surely someone out there do you do this?

SPEAKER_00 1:01:00

I don't know.

SPEAKER_01 1:01:01

Yeah I I right now only treat women I have treated men in the past through some of my clinical rotations but um right now I just treat women but there are a lot or not a lot there are a few people in town that treat men and they are all women there are men like men themselves that RPTs that also treat pelvic four I would say that's on the rare side right now. But yeah men can see a pelvic four therapist too and usually it's gonna be a woman but okay cool.

SPEAKER_00 1:01:28

Yeah good to know tell your husband uh that that's probably a pretty common misconception is it like men men don't they don't need this they don't have a pelvic four usually I feel like they're just in denial they're just like no I'm fine.

SPEAKER_01 1:01:44

Yeah but when you do work with men they are so motivated to get that under control that they improve so quickly. Whereas moms are like juggling not that dads aren't but moms are just their priority list is different. And so anyways it's just funny working with men they're like all right how can we get in and out of here quickly I want to be done with I want to be done now.

SPEAKER_00 1:02:04

So funny can you share any like fun success stories or no?

SPEAKER_01 1:02:11

Yeah just in an I mean anonymous way yes anonymous for sure I thought about this one so long because there are so many fun ones I love getting texts from people after birth or just in general life stuff updating me on symptoms but one that always comes to mind is I was working with a first time mom who um she's just nervous about birth like everybody and she rocked her pushing phase so well she pushed that baby out in 20 minutes and wow it was like record time. But it wasn't like traumatic record time like her labor itself wasn't fast. It wasn't one of those like fast labors she still did she just did all the work to really connect with her body and feel confident with pushing and so much so that even her midwife later came up to me and told me how cool it was to see her like a first time mom push out a baby like that. So that was awesome and that's like mainly props to her she did great and she did all the work to do that. Um and then recently I just I just thought of this because I just got the text I think the other day um a mom was texting me how she was able to play baseball with her boys without urinary leakage which is just so sweet. She has young boys and she is super active but it it is like embarrassing when you're trying to do these things and you're having urinary leakage it but to not be able to not have to think about that I think is just so freeing and so yeah that's just a sweet text that I got that she was able to do that.

SPEAKER_00 1:03:36

I love that I love that it's like you put in the work for a while and you really do have to think about it. You really do have to like do your exercises I have a reminder on my phone that comes on every day you know doing your exercises but then for that to be the the outcome is like now I don't have to think about this anymore.

SPEAKER_01 1:03:52

Like I don't have to you can live life and enjoy life and be well that's not have to like wear a pad everywhere you go or whatever you're doing. Yeah waste money on the adult diapers yeah let's not do that.

SPEAKER_00 1:04:04

Yeah or just be like anxious every time you go to have sex because it hurts and it's not fun or whatever. It's just like it's so encouraging that we can there's hope and you can do something about it and I'm so thankful for that um okay those are amazing.

SPEAKER_01 1:04:22

Uh anything else anything you're like I wanted to say this anything you want to leave us with before we um I again we might have I kind of went over this but nervous system plays a huge role in pelvic four so just being aware of that is great. But secondly um you like having a daily bowel movement is so influential for the pelvic or people don't feel people don't think about how often they poop but it matters people it really does matter so many of my patients recently we just get them on a regular bowel movement and like 90% of their symptoms go away.

SPEAKER_00 1:04:57

So do everything you can take wait tell me more about this we have to we have to spend two minutes on this. Because I feel like I've heard that in the health and wellness space is like you should be pooping every day or multiple times a day or whatever just because that's that's what's healthy for your body but how is that like how do you help someone?

SPEAKER_01 1:05:16

Yeah and some people even are like what goes in what should come out you should be pooping three times that's what I've heard right um which I don't necessarily hold people to that but basically um so for my clients that like recently I've had a few people deal with tailbone pain and they're only pooping every two to three days and then they start pooping every day and is that just from doing pelvic floor exercises? A little bit of like yeah pelvic floor exercises getting mobility back to the pelvic floor especially the back of the pelvic floor maybe getting more space in the back of the pelvis um maybe looking at some lumbar thoracic mobility all that yes but then also addressing diet and if they're taking magnesi what what a magnesium supplement supplement might look like in their daily life obviously that's very individualized. But looking at diet and um water people drink water um a lot of my drink your water need to drink more water shout out and me too I'm I also need to drink more water. But yeah working online habits and exercises that is so cool. I honestly have not ever heard that or thought of or just paying attention some people just don't even think about it and then they just are like oh I have the urge let's go and then they have a daily bowel movement and they're like I feel great now oh like they could have been doing it all along.

SPEAKER_00 1:06:37

Yeah they just didn't know just classic like I got I'm too busy.

SPEAKER_01 1:06:40

I'm too busy for that or mom you know moms like you convince yourself I don't have time for that but you you really do have time. Usually I mean I'm not gonna say all the time but sometimes just let the kids scream just let the kids scream for like one more minute two more minutes maybe and have that bowel movement feel better. Or especially with prolapse like if we get we didn't even get into prolapse. Yeah I know that's so much yeah but pooping is really influential for prolapse symptoms too okay wow this is so educational I love this you're amazing this is so helpful I'm sure there's so many other questions that people have if a question popped into your mind you should call Brianna cultivate pelvic floor therapy everybody just google it and get on her website get a consultation yes right is that what they do yeah you free 15 minute consult I think almost every pelvic floor PT does that's FYI so don't be afraid to reach out to somebody they will they do we want to help you we're like there's no like embarrassing questions oh my gosh yeah thanks TMI we love this so much we talk about it in social situations too so we're just itching to talk about pelvic four but yeah everywhere you go people are like hey can I can I have a quick quick question you know or literally the other day we're at a we're at a little hangout and somebody's like could you do a little pelvic exam real quick I'm like sure do you have gloves first of all but yeah no we um love to hear from people or even if you're just asking questions in general we always have time um but yeah cultivate pelvic for therapy um five stars oh thank you thank you for the live review great absolutely well thanks for being here this was so helpful for having me that's it for today on foundations for the child bearing years if you found this helpful be sure to follow the show and send it to a friend who's preparing for this season too see you next time