How Your Pelvic Floor Affects Athletic Performance and the Musculoskeletal System | Pelvis Party

Welcome back to the Pelvis Party! We are thrilled to have Joel Luedke, Manager of Clinical Operations at Olmsted Medical Center, to talk about how your pelvic floor affects the musculoskeletal system and your overall athletic performance.

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Transcript

SPEAKER_03 0:00

Before she'd even take a full exam on them, she'd go work on this muscle, trying to get it to relax and release a little bit. And those eight or nine would stand up and go, Oh yeah, my pain's gone.

SPEAKER_00 0:09

Wow.

SPEAKER_03 0:10

Just by doing that specific soft tissue work and then obviously adding in some stretching and other things.

SPEAKER_02 0:23

Hi everyone, welcome back to the pelvis party. My name is Becky Montpellier. I am the owner of Rochester Local, and today I've got two guests with me. My first guest, obviously, you already know, co-host Britt Strum from Olmstead Medical Center, the department of marketing. And today we have Joel Ludke with us. He's the clinical operations manager for a lot of different departments. Why don't you tell us which departments they are?

SPEAKER_03 0:46

So mostly the musculoskeletal ones. So that includes orthopedics, podiatry, sports medicine, pain management, and then somewhat adjacent to that, athletic performance.

SPEAKER_02 0:55

So a real desk job, you would say, right?

SPEAKER_03 0:57

Just sitting there and spread out across the entirety of Rochester and soon to be Oatana.

SPEAKER_02 1:03

But that is a lot of um areas for you to focus on. What is the overarching topic of everything that you cover?

SPEAKER_03 1:12

I mean, really, when I sum it down to the musculoskeletal department, that's what it is. It's the aches and pains, the joints, bones, muscles, all the way through. So you can look at from the athletic performance perspective. Trying to work with patients that are generally healthy or at least working their way towards their vision of health, to then being able to provide those services from the non-surgical and sports medicine, uh, different options there, collaborating with physical therapy and other ones to then orthopedics, where if we're heading down a trend of potentially a surgical intervention, similarly with podiatry, a lot of options there. And then tying pain management into it, um, some of the issues that potentially go along with the spine and other areas that might not be able to be seen in those other departments.

SPEAKER_02 1:58

Got you. So you're a real skeleton guy, then I suppose, here, right?

SPEAKER_03 2:03

Coming up as an athletic trainer by education and profession, yeah, that's pretty much what my focus has been.

SPEAKER_02 2:09

Right. So on our podcast, uh, a lot of the topics that we cover are women's health and and our pelvis, pelvis area too, right? So I think a lot of what we want to talk about today is really uh how important is our pelvis in terms of our musculoskeletal structure to our overall health now and as we age when thinking about perimenopause and menopause.

SPEAKER_03 2:38

Yeah, so when people talk about the core, a lot of people think about just like the abdominal area, you know, all the abs and everything, the obliques that go into it. When we look at it, um, particularly from a performance standpoint, really it's from your hips to your shoulders because it's that transfer of everything that occurs from the lower extremity all the way up through your upper extremity, your hips are essential to that. And with that, obviously your pelvis and everything that goes along with it. And there's so many muscles that crisscross and go from the pelvis down to attaching to different points on the leg that they can really have a big impact on just everyday ability to not have discomfort or things like that. But also when we talk about potential performance, whether that's you're a weekend warrior, you know, trying to run a 5K or trying to then perform at your highest level.

SPEAKER_02 3:28

Sure. Um, so we we think a lot about um our desk jobs, people that have desk jobs. And we hear a lot about you know, we we all fill out that form the doctor, how many days are you sedentary or whatever? You know, how many days are you up and active? And obviously over the last you know, 10, 20 years, it's all about getting the steps in because you want to be not having that sedentary lifestyle. And that has often been the most associated with sitting at the desk. But you were just telling me something really interesting to me is that we have to be really careful about our musculoskeletal structure and alignment with how often we sit at a desk. And it's not just about being sedentary, but it's about making sure you're aligned.

SPEAKER_03 4:17

We talk a lot about looking at different, especially from the athlete side, but it applies to the everyday person of what's your kind of general pelvic tilt? So you can have a posterior pelvic tilt, you can have an anterior pelvic tilt to just make it an oversimplified analogy. Yeah. Do you think of your pelvis like a bull, which is it essentially kind of is in structure, we want that to be level.

SPEAKER_01 4:37

Level.

SPEAKER_03 4:37

We don't want it tipping forward, we don't want anything to spill out the front, we don't want it tipping back. Well, what can happen is a lot of people will get pulled into anterior pelvic tilt.

SPEAKER_00 4:46

Okay.

SPEAKER_03 4:46

And the big cause of that is there's a huge muscle, kind of a combination of muscles called the ileosoas. It runs right down the front of your hip and it goes and attaches to the upper part of your leg bone or your femur, but then the other part of it actually goes and attaches to the five lumbar vertebrae you have in your back.

SPEAKER_00 5:03

Uh-huh.

SPEAKER_03 5:04

So if that muscle gets shortened or gets tight from sitting, shortened tight, when you stand up, it's going to be pulling on some place. And odds are it's not going to pull your femur forward. So you're walking like a V. It's going to start pulling on your lower back and pull that into an exaggerated curve.

SPEAKER_00 5:23

Okay.

SPEAKER_03 5:23

So when that happens, then all of a sudden everything starts tipping forward. So you're getting this constant pain and pressure on your back because this these muscles are pulling so tight on it.

SPEAKER_00 5:35

Yeah.

SPEAKER_03 5:35

So you can try and walk upright. Our bodies are amazing at adapting until they don't want to anymore, and then it lets you know about it. So I know going remember going back to one specific soft tissue course that I went to, and this lady who did this technique worked with a lot of farmers. She said eight to nine out of ten of them would come in from sitting in their tractor all day with little back pain. Yeah. Before she'd even take a full exam on them, she'd go work on this muscle, try and get it to relax and release a little bit. And those eight or nine would stand up and go, Oh yeah, my pain's gone.

SPEAKER_00 6:07

Wow.

SPEAKER_03 6:08

Just by doing that specific soft tissue work and then obviously adding in some stretching and other things. So without having to go down this super in-depth way, it's something to take a look at. And so that's one aspect of that you can take a look at it. But then tying into the back side of that is well, what muscles counteract that ileosoaz muscle? Well, it's really your glute muscles.

SPEAKER_01 6:29

Okay. So it's the same thing as your hip flexor.

SPEAKER_03 6:31

Your hip flexor and psoas, yep, same thing. Exactly. And then if we want to get super technical, there's one more of your quads that also acts as a hip flexor. But if you're focusing on one, you're gonna get both. And so ultimately you're taking care of that issue. But then just to go and try and work on the other side, your glutes can actually help with your alignment as well. Well, if you're sitting down all day, you're not using your glutes because they don't have to do anything. You're just sitting on it.

SPEAKER_00 6:56

Right.

SPEAKER_03 6:56

And so by engaging those and making sure that they're strong and engaged, that can also help with some of that pelvic alignment to help just make everything a little bit more balanced, counteract. You can even feel it if you were to stand up and just do a little squeeze. You can essentially feel your pelvis rotate a little bit over the top of it. And so that's something that can be a very easy focus on as well to help counteract that and kind of maintain balance, if you will, within the pelvis.

SPEAKER_02 7:24

This has been like I'm already just like swimming with information, such such a good topic to c for us to cover. Um, and I think I my follow-up question to that is okay, so as someone in their mid-40s, approaching, you know, kind of some different phases in my life, perimenopause and menopause, how how do I need to be prioritizing my pelvic health in terms of my, you know, skeleton and my muscles around that area?

SPEAKER_03 7:54

As much as it's a part of my job, like I don't like to, I don't spend the time enjoying working out as much as I used to. Like I was an hour and a half, five days a week in the gym kind of guy. If I can force myself to do three times by 45 minutes a week, I'm winning at this stage in my life. But trying to find something where you're helping to at least engage those muscles to do the work to make sure that we're keeping them strong as much as we can. And that doesn't have to be going into the gym, loading up a bunch of the weight on the squat bar and you know, doing back squats. I mean, there's plenty of options if you like hiking, getting on some sort of hilly terrain where you're essentially having to engage those muscles to help push you up the hill, walking on a treadmill with an incline can do all those things, but even some simple and kind of prehab, more like lower intensity ones uh with some bands around the knees, you know, they're all hip bridges, glute bridges is what we utilize them a lot, can do a lot to help just keep those things engaged while then also focusing on some basic hip flexor stretching. Okay, simple Google searches, YouTube videos to help just stretch that area out on the front could potentially help with a lot of those aches and pains, discomforts that you might get with that.

SPEAKER_02 9:10

I've got two follow-up questions. Like I said, I've got I'm like all excited. Um the first would be it sounds like you know, this you don't have to like head to the gym or invest in fancy equipment. These are things that you can do at home with a Google search about hip flexors and even like engaging your, you know, your um glute muscles, thank you. Um when you're out and about, you can just walk around. Sorry, I'm like so excited, right? I'm like losing my train of thought. Um but then the other thing that I wanted to bring up is um when you reach a certain age, you start hearing all about perimenopause and menopause and these sorts of things. And the big thing that we're all hearing right now is lift heavy, lift heavy. Women of a certain age should start to lift heavy. And I think that's just but why is that? Why do we have to start focusing on that now as we're heading into perimenopause and menopause? Why do we need to strengthen our car? Why can't we just focus on cardio? Like are these sorts of things?

SPEAKER_03 10:15

You know, with the changes that come along with it and all the hormonal changes that happen, your ability to maintain muscle mass decreases, and that happens to all of us as we get older. That's just a natural part of it, and just with all the changes that women go through that can accelerate that or make it more. And then coming along with that, you could look at things of how that changes bones and the ability to for those bones to stay strong again, happens as we all age, impacts females more. So some of that lifting heavy is putting enough stress back through that system.

SPEAKER_00 10:49

Uh-huh.

SPEAKER_03 10:50

And I use heavy in quotes, and there's a lot of decent options that you can go along with that to help come combat that essentially. So if you your bones will always adapt to the stress you put on it, uh-huh. And so it can be very counterintuitive. I've worked with a lot of cross-country runners in my career, and we would actually have them do a modified version of a deadlift. We would do it with a hex bar, which just sounds like that. It's a hexagon. Yeah, it's a lot safer movement than a traditional deadlift, or we would use different machines. Well, part of that is we are trying to load stress through their bones in that specific group because they're prone to stress fractures, very lean females may not be having their menstrual cycle, which then throws in a whole new wrench into their game. Right. But if we can put some of that stress through, we can get those bones to remodel and hopefully prevent those injuries in the future. And it's similar on the other side, as you get older, if we can continue to apply those stresses, we can get some of that adaptation and hopefully limit any of those potential negative things that could happen with age and all the other changes that are occurring.

SPEAKER_02 11:53

Great. Yeah. Check plus, now I just gotta do it, right?

unknown 11:57

Right.

SPEAKER_03 11:59

The best workout program is the one that you can figure out how to follow. I understand that one in my core. Yeah, for sure.

SPEAKER_01 12:05

Speaking of that, how important is it to have like guided programs with a trainer versus finding an app or starting to build weight on if you're weight training or just using simple dumbbells or like um what are they called?

SPEAKER_02 12:22

Bands. Yep. Right?

SPEAKER_03 12:24

Yeah, one thing that we talk about a lot from the athletic performance standpoint, and that's been this throughout my entire career, is you can find a workout anywhere. Yeah, you can go anywhere and get a workout.

SPEAKER_00 12:33

Right.

SPEAKER_03 12:34

Having a program is a different process, and that's not something that everybody can do or everybody does as safely as we would like it to be seen from our end. And so that's where the importance of a coach, a personal trainer, where now it's the progression. Because we even dealt with this with athletes. Like, if you're not writing down what you did in terms of weights and reps and whatnot, you're probably just gonna load up the same thing over and over. And then it loot your body loses the ability to adapt to that. So that's where we look at from speaking more from the athletic performance standpoint, is we're probably not gonna have you do the same thing for more than four to six, eight weeks at the most, because we want to adjust that stimulus so your body adapts and then we can build on it and go to the next step. And that's the importance of a program. Or if you're able to find a program online, write down your weights, write down your reps. Because if you're starting to get easy, it's important that we increase that weight or mess around with the reps in order to then hit that next actual stimulus to get things to occur. So there's plenty of good things online, but there's also plenty of things where again, it's just anybody can come up with a workout, but actually establishing, hey, this is what our plan is for this amount of weeks, here's our next step, here's our next step, and then just progressing it from there is I think where you really find your value in getting those services.

SPEAKER_02 13:58

Right. I think you know, social media there's a lot of pressure on there to have a plan and have a program. And I think um, you know, that can certainly be helpful when you have a busy life and you don't want to like ooh right research all of that themselves. But then I think, wow, 50 years ago no one was doing any of these programs and plans, and 75 years ago, and how did our ancestors, you know, how'd they build muscle mass? So then you know, I think okay, yeah, right. So we can take it, we can take the pressure off of us to have those um that perfect program.

SPEAKER_03 14:36

Yeah, and none of it has to be fancy.

SPEAKER_02 14:37

Yeah.

SPEAKER_03 14:38

For most people, especially if you haven't done a lot, like the basics will get you so far. Um, that's something, again, just trying it back to other parts of my career. I spent a lot of time working in the division three college. And we found that when we returned to the basics with a lot of our teams, in particular our football team, like we didn't do anything fancy, we didn't have all the bells and whistles, but we got really good at the basic movements, yeah, worked on building that strength, and their ability to perform just took off. Awesome. It w we didn't have anything overly fancy, and that would be the same thing I would say for people. Like it doesn't have to be fancy. And if somebody's selling you one, you have to have some certainty. No, I just not to start off. You have to hit a certain level, and that's usually pretty far out there before you might need that to hit your next level of advancement.

SPEAKER_02 15:30

Yeah, and accessibility is so important, right? Do you know, like not everyone can afford you know the fancy equipment and a program and stuff like this? So it's just starting where you're at. 100%. Well, this has been a super informative episode. I am going to ensure now that I'm for sure doing my weightlifting.

SPEAKER_01 15:51

Um, Britt, do you have anything else to add? Uh, we talked about sedent being sedentary. I'm curious from an athletic trainer's perspective, how often would you recommend if you're sitting all day at an office desk, whatever, getting up, moving your body? I time is a commodity, right? I don't have time to get up every 15 minutes and walk 10 minutes.

SPEAKER_03 16:11

Sure, sure.

SPEAKER_01 16:12

What would you say?

SPEAKER_03 16:12

The sit the sand desks and everything are a great option if it's something that people can do because it gives you the option to stand up and you know just fidget around and move a little bit there. But you know, somewhere in like you had mentioned that 15-20 minutes, even if it's just standing up, stretching, like you get that natural inclination, even when you get out of bed to just stretch everything. Yeah, it's your body telling you something that it just needs to get out and move. So it even doing a minute worth of those stretches, you know, 30 seconds each side just to help loosen up your anterior hips, perfect. And then if you can do something where you're getting around a you know, five, 10-minute walk every hour or whatever it may be, also hugely beneficial. Um, I don't remember all the details of a specific study, but they went in, they looked at what they call exercise snacks. And it was essentially that during the day, you know, whether it's able to just go up for a walk or if there's a stairwell at your house or at your work that you can go up and do three to five minutes of just something in there, that cumulative effect over the day actually showed some really good changes for your metabolism to just build that up, but it wasn't the time commitment of peeling that off. So um, I can dig up that study again. It's in the tea if you want to link through it. But they yeah, referred to it as exercise snacks. Yeah.

SPEAKER_02 17:26

That's I mean, and that's achievable, right? That's something that's achievable. Or if you just like sit and you know, have weights in your office or something like that, or my watch tells me when to stand. I don't know if anyone's gonna. Yeah, well, like I said, this was a really great episode. So thankful to have you on. Um thank you for tuning in to join us. If you are interested in more pelvis party, you can stream the podcast anywhere where you listen to your podcast.