← The Dylan Gemelli Podcast
The Dylan Gemelli Podcast
Episode #26 Featuring "The Vagina Whisperer" Sara Reardon! The Pelvic Floor Episode!! A deep dive into pelvic floor therapy, training the pelvic floor, men's pelvic health, becoming the Vagina Whisperer, pregnancy and pelvic health, and more!!
01:11:07
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- [00:15]
A
All right, everybody, welcome back to the Dylan Gemelli podcast. So I get to interview, and I'm very blessed for this, that I get to interview so many amazing people. Different backgrounds, a lot of doctors, but people from all walks of life is what I try to do. Now, my guest today is well known, and she's absolutely amazing at what she does. But I will tell you this. When I first got introduced to her and caught her name, I was like, okay, all right, let's go. This is different for me. So first, I mean, she's a pelvic floor physical therapist, and she has done some amazing work out there with so many different people that I've had the pleasure of reading about and seeing. She's got a new book coming out that's called Floored that will be releasing June 10th that I will highly recommend. And one of her famous quotes is that she's on a mission to help people with vaginas live fuller, happier, and more productive lives. So this, my friends, is the vagina whisperer, Sarah Reardon.
- [01:15]
B
Thank you for having me, Dylan. And yes, I am the vagina whisperer on social medias. And to all of my friends, I.
- [01:22]
A
Swear, right when I got the intro, which I was very blessed to have to even get with you, I looked at that and I said, huh, okay.
- [01:30]
B
And I told my wife many different directions.
- [01:33]
A
No, but I told my wife, and I said, listen to this. And I said, how cool this was. And she said, I bet you she does exactly what you do. And I was like, well, it must be a women thing, because I had no idea. So I love it. Let's start with this, because that is a very intriguing name, and I love how you've worked it and done with it. And it. It is very. It brings people in, obviously, and it makes their. It grabs their attention. So it's very well played. But where. How did you come up with that name?
- [02:01]
B
You know, I wish I could take credit for it. So I am a physical therapist by training. I have a doctorate degree. And then I specialized in pelvic floor physical therapy. And when I was after graduate school practicing, I would get together with my girlfriends and their families every summer. And a few summers after I specialized in this field, I ended up, like, sitting in a hot tub with all of their moms talking about their bladder problems. And all of my friends said, oh, my gosh. She's like the vagina whisperer. And then when I created my Instagram account in 2017, I created it for my group of girlfriends. I was pregnant. We were all going through pregnancy and postpartum. And I just was sharing tips on social media for them to find so they could know how to prepare. And I named it the Vagina Whisper, because that's what they called me. And so it really has blossomed, you know, over the years. Several hundreds of thousands of folks following along. And I think that that growth is a real testament. One, maybe the name is funny, but two, that women really want this information about their pelvic floors, and they're not getting it from anywhere else. So it's just been an incredible journey to go from starting an Instagram account to now being a published author, talking all about the pelvic floor and the vagina.
- [03:14]
A
You know, it's a testament, too, to your work and also just your delivery and the way that I can just conversating with you, I can see the passion in what you do and the way that it resonates with people. And that's a big thing because I know a lot of really, really intelligent doctors and therapists and people, but they just don't come across like they're easy to talk to or maybe that they even care as much. And it takes some charismatic attributes, really, to connect to people, because there's. Let's face it, there's so many people that do so many different things that people look to for guidance and advice. But when somebody like you, it's a blessing to have. Just first, let me say thank you for the way that you come across and the kind of person that you are, and it just really resonates with everybody out there. And it's a testament to the following that you have.
- [04:01]
B
Awesome. Thank you. You know, and I think that that's one of the thing is, I'm a medical professional. I'm a medical provider, but I think when we start using this jargon and all of these really medical terms, people get lost, and then they can't understand what we're talking about. And so I want to meet people where they are. And the other thing is, you know, I've treated thousands, tens of thousands of women, and I. This is a really intimate part of their body that we're talking about. They're sharing things with me that they've never told anyone sometimes. And I want them to feel comfortable doing that and less alone in the process, and that I also understand it as a woman. And so I think all of those things have really just, yeah. Been able to help me connect with so many people over the years and provide them help and resources for these really kind of Intimate and often embarrassing issues.
- [04:45]
A
Well, and that's just it. The level, the problem here is the level of comfort that people will or will not have. And even to talk about things like this or get into it. And it's sad because not having that comfort level could make somebody suffer or let something drag on and drag on because they don't want to talk about it. So that's, it's a wonderful thing. Let's, let's do this first. Let's kind of start from the beginning. What kind of motivated you or drove you to get into this profession that you've chosen? And what's your background? Like, what did you study and how did this all come about?
- [05:21]
B
So I went into college. I went to Washington University in St. Louis in the Midwest. I was born and raised in New Orleans. And the first time I ever flew on a plane, I was 17 and going to college. Like, I mean, I was kind of a small town girl. And so even being from New Orleans, and I went to Washu knowing that I wanted to be a physical therapist, I said, I don't want to be a doctor. I don't want to be in school forever. I don't want to be a nurse. But I'm active, I run track, I swim, I don't want to sit behind a desk all day, and I want to work with people. And just kind of following those small things I knew about myself led me into this field. And so I was at WASHU for seven years, undergraduate and graduate school. I got a degree in psychology, and then I went on to get a doctorate in physical therapy. And while I was in physical therapy school, I had a professor who's still my mentor to this day, 18 years later, who gave us this two week lecture on women's health. Now it's called Pelvic health. But it was just talking about how a woman's body changes and how muscles influence that. Like everything from giving birth to exercise, but also just sex and peeing and pooping and periods. And I was like, I've never heard of muscles controlling those things, but it made so much sense. And then I loved understanding my own body as a woman. And then when I started kind of practicing in the field, even as a student, I said, I really love educating other women about their bodies. And I think for all of them, this light bulb would just go off of like, oh, this is just muscles. It's not like something super weird or scary or foreign. It's just muscles. And then to see them get better with just exercises and movement and Physical therapy changed their lives. And I was like, this is exactly what I want to do. And so I started eight years ago in the field, and I've bounced around to a couple different cities and states, but it's all that I've ever done. And I still practice in a clinic today, seeing women and men.
- [07:15]
A
Okay, so in terms of what you do at the clinic, then, is it all the same related type of thing, or do you do different types of things at the clinic that you work at?
- [07:25]
B
I only do pelvic floor therapy. So the way that we assess the pelvic floor, and I think that this is really the mystical part of it, is, yeah, these muscles are kind of deep in your pelvis. So when you think about the bones that we all have, like, you put your hands on your hips, and you're on your hip bones, but that's really the top part of your pelvis. You put your hands kind of in the lower front part. That's your pubic bone, and then you've got your tailbone in the back. At the bottom of that bowl of bones is a basket of muscles. And that's what we call your pelvic floor muscles. And those muscles support your pelvic organs. All bodies have them. Men and women and kids, everyone. So those muscles support your bladder, which hold urine, your bowels, which hold stool. In the male, they hold the prostate. In the female, they hold the uterus and ovaries. These muscles support growing babies during pregnancy, they support your spine. They hold in pee and poop. They help with erections, ejaculation, orgasm, sexual activity, the passageway for menstruation. So, I mean, they're so important, yet we don't talk about them. And we also don't even know they exist until we start having a problem in this area. And so that's really the story behind Florida is I wanted people to understand their bodies. I focused more on women, all on women in the book. That's who I have more experience treating. And they also just experience more pelvic floor problems than men because they have a vagina. So, yeah, these muscles kind of influence all of those things, and that's what we help with in physical therapy.
- [08:51]
A
Okay, all right. That's enlightening, too, because I didn't know this had anything to do with men at all.
- [08:56]
B
Oh, my gosh. Yes. So many men have pelvic floor issues, like, you know, pain, sexual dysfunction. It could be anything from, I mean, premature ejaculation, difficulty maintaining erections, painful orgasms, to pooping problems, painful Bowel movements, rectal pain, tailbone pain. I mean, so much.
- [09:14]
A
Okay, well, we got a lot of angles to go here. So you just flipped the script on me now. That's okay. Luckily, I can. I'm good on the, on the quick here, so. Okay. First though, let me ask you this. And, and I wonder how this relates. First of all, when do we start to see this muscle problems? Or is there some kind of degrading that goes down on there? And is it something physical that caused it? Is it diet related? Is it stress related, like the way that you sleep? I mean, break this down for me a little bit so I can understand this.
- [09:49]
B
Absolutely. So these are muscles like any other muscles in your body. They can get tight and tense. Like we maybe get in our neck and shoulders. Right? And that could be from posture, that could be from stress, could be from weightlifting. Whatever it is, the muscles respond in a way that causes tension. And maybe we get neck pain and headaches. The same thing can happen in your pelvic floor. It could be sitting with your legs crossed. It could be clenching your butt because you're stressed out and nervous. It could be holding and pee and poop for too long. It could be trauma. For women specifically, there are three times in a woman's life that directly influence their pelvic floor and make them at a higher risk for pelvic floor issues. And it's pregnancy, it's childbirth, and it's perimenopause and menopause. During pregnancy, the muscles, these pelvic floor muscles support a growing baby, and they get stretched out and weaker during pregnancy. During birth, you. They can have a tear into the muscles. They're stretched out from pushing. You can have a C section, which creates abdominal tension and scar restriction. So all of those things influence the pelvic floor. And then perimenopause and menopause. Your hormones are changing. You have lower estrogen, lower testosterone, decreased collagen. So those muscles get weaker and thinner over time. And this is why women have more issues than men, typically when it pertains to weakness or pain, because they go through these life stages that men don't.
- [11:08]
A
Got it. Okay, cool. I'm taking notes, by the way. Okay, sweet. So how do you diagnose something like this? If somebody comes into you with, I don't know what kind of, let's do this. What kind of problems do people generally come to you with? And then how do you diagnose and kind of figure this out, that it's something muscle related and not necessarily something else? That's going on internally, Whether it be a blood work, like do you run blood panels to check to coincide? How does this process go down and work?
- [11:38]
B
So typically the way that the medical system works here in the US Is that they go see a doctor. The doctor says, let me run all these tests and see if something's wrong. And then if they don't find anything, they send them to another doctor and send them to another doctor. By the time people reach pelvic floor therapy, sometimes they've gone through seven to eight physicians and they're like, all the tests are normal, the blood works normal. But like, we can't figure out why you are peeing all the time, or you have pain with urination or whatever the case may be.
- [12:05]
A
Got it.
- [12:06]
B
So my goal is that people can get to pelvic floor therapy sooner. When we see someone in pelvic floor therapy, some of the common things that we see. I'll focus on the female population is urinary leakage. So they leak with coughing, sneezing, running, jumping, laughing. No amount of leakage is normal, but any type of leakage, there's a pelvic floor component, what's called pelvic organ prolapse. When the pelvic organs aren't as supported by that hammock of muscles, they start to push into the vagina and it can feel like a bulge in the vagina, like something's falling out. It sounds pretty scary, but it's really just kind of a muscle weakness or tension issue. Pain with sex is another one. These muscles can be tight or tense, or you can have vaginal dryness that leads to pain with initial insertion, deeper insertion, or both. It can also cause hip pain, back pain, abdominal pain, constipation, painful periods. So kind of anything in this pelvic arena, the muscles can be affected. They may not be the initial cause, but they're often a component that needs to be addressed. And then when somebody comes into our clinics, it's a private session. It's not in like a big gym. Like it would be another PT session. It's one on one with a therapist, and we ask you questions about all of your pelvic floor stuff. You may be there for, you know, painful sex, but I'm asking you about pooping and menstruation and childbirth. And then we do an internal pelvic exam. So this is how we assess the muscles as inserting a glove, lubricated finger into the vagina and assessing the pelvic floor muscle through the vagina. In male bodies, we do this through the anal opening. So that's how we access the muscles to see if the pelvic floor itself is affected.
- [13:42]
A
See, this is, this is what I love about this. So when I do things, I'm programmed in the way that you are. Where. Because I deal with a lot of hormone optimization and I get a lot of people that'll come in and go to me because they come to me when they can't get fixed by somebody else. Like, you know, because a lot of even professional endocrinologists don't take the one on one time. You know, they need specialists like yourself and, and you know what I'm talking about. And they'll come to me and, oh, I'm tired, or oh, this I need t. I need testosterone, you know, I need trt. And it's like, well, let's dig in here and find these root causes of the problem and actually make sure that I'm not mistreating you potentially causing a problem or, you know, exacerbating one that may already be there. And so it's nice to know because you brought up like pain when urinating, for example. So if, if you were, if you were a person that had no idea and you went online and looked up pain when urinating or frequent urination, you're going to get this long list of things that are going to scare the crap out of you that may not even have anything to do with it. And see, I didn't have any idea as much as I think I know. Clearly I don't know that much that this was even a thing and that this could be actually the direct effect are correlated with the problem that's going on. I want to ask you then on the men's side of things because this is very intriguing to me and it's something now that I will have to think about when somebody comes to me with like a prostate problem or frequent urination problem. If you were to take a ratio or a percentage, and I know this is a difficult maybe to assess, but what percentage of like men would have this problem in comparison to women? I'm just curious, you know, I would.
- [15:22]
B
Say 70, 30, just a guess. Like I would say over the course of my career, sometimes I have men, it's 50% of my caseload, sometimes less. But I would say, you know, it's, it's typical for me to have majority female bodies and then a handful of male bodies. But I'll tell you this, I think that a lot of men experience pelvic floor issues that are Underreported. I think females for sure have underreported symptoms. But we go to see a gynecologist, we talk to our girlfriends, we go online, we kind of do the health investigation. I think that there's as much shame and embarrassment as women have around these issues. I think men also have it, and that's a barrier for them to get treatment. And oftentimes I'll be seeing a woman, the wife, and then she's like, I think my husband might need to come in. You know, and so it's. It just to kind of be, you know, make a generalization. I feel like men can have urinary issues, rectal pain, you know, abdominal pain, all these things. But it's when it affects their sexual function is when they start being like, okay, I need to get help. And it's yet then it's gone on for a really long time, and we're like, okay, now we're peeling layers of the onion for a bit before we get to the pelvic floor. But it's usually takes something pretty significant for them to say, okay, now I need to get help.
- [16:37]
A
Do you see cases where there are people that are pretty young that have this issue going on, or is it generally like a certain age range that you see?
- [16:45]
B
No, I. We definitely see young people, young men and women. So I would say in the female population, it's unfortunate because for women, we often think, look, it's after you have babies, you have pelvic floor problems, or it's when you're in menopause. But there are so many young women who have painful periods, painful sex, urinary leakage, and they don't know where to go to for help. They're not even seeing a gynecologist yet. And so they're learning about us on TikTok and social media and YouTube because they're looking for answers. Um, but I think for men, if you have an issue as a young man, it's likely not a hormone issue and it's likely not a prostate issue. Those are issues that come on later in life. It could be muscle tension. It could be which muscles affect nerves, right? Muscles affect connective tissue, they affect relaxation. So different things, like a hard time urinating or starting your stream, feeling like you can't empty completely, feeling like it's burning when you urinate, pain with sitting, pain with bowel movements, hemorrhoids. I mean, all of these things are pelvic floor related. And if you've gone to see a urologist and they've Ruled out infections and you still have symptoms, or you've taken antibiotics and you still have symptoms, your pelvic floor should be assessed.
- [17:57]
A
Wow. See, this is great because this is like another tool in a toolbox for somebody like myself to make a recommendation. If I've scanned and gone through every single component, not. Not finding any issue. And, you know, I'm. I've learned now to look more at, like, the micronutrient side and possibly, like, gut health and cellular health problems. But that's not always the question either. Some people have all of these things testing out, and then you're at a loss. And you don't know. I have never once heard about this. So that brings me into my next question. How do we get this out there? Because my assumption is, and I could be wrong, and correct me if I'm wrong, is a lot of general practitioners or doctors aren't saying, well, I don't see anything wrong. Let's send you to the vagina whisperer. So how do we. How we get this, you know, information? Or how do we.
- [18:46]
B
To be honest, you know, I think exactly the way that we're doing this, I think, you know, bringing it to people themselves, I feel like a lot of medical information, it was like gate kept behind physicians, and you maybe were lucky enough to be in a city with a physician who maybe knew about pelvic floor therapy, but it was still a last resort. Like, oh, we've done all these tests and we can't find anything. Then go. And then you've suffered for months or years. So if you have an issue with anything from pelvic pain, painful sex, bladder leakage, frequent urination, sexual dysfunction, pooping issues, I'm like, just go see one, and we'll tell you. If there's no pelvic floor component, we'll be like, sorry, we're not finding anything. But more often than not, there is. And if there's other issues, like an infection or, you know, something else more pathological going on, we collaborate with other physicians. We refer out. I mean, I work with acupuncturists, dietitians, nutritionists, personal trainers, psychotherapists. I mean, hormone specialists. Like, we are just one piece of the puzzle. I don't think that we can always solve everything, but I think we're a piece of the puzzle that's often missed. And by the time people reach us, they're like, why didn't anybody tell me about this sooner? Right now, they've suffered for months or years, and they've Their quality of life has changed, or they spent gobs of money on treatments that were ineffective. And so I think it just needs to be brought in earlier. I think medical providers need to ask the questions. I, you know, we talked a little bit earlier about sometimes people are uncomfortable talking about this, and that means medical providers are uncomfortable. And I'm like, get over it. Like, our job is to help the patient. And if you don't screen for these issues by asking about peeing, pooping, sex, menstruation, birth, you know, hormones, then you're missing a big picture here, a big piece of the puzzle.
- [20:35]
A
See, and that the older I've gotten and the more that I've worked in health and have understood that really, if you don't have your health, you really have nothing. You can have all the money in the world, you could have whatever you want, all the fame in the world, but if you don't have your health, what's the point in any of it? So there should be no embarrassment to talk about anything. If anything, you should be as open as possible with all of this. I. I've been through that, like, you know, not wanting to talk about eating disorder and problems that I faced. And I've gotten to the point now where, one, it's helpful to tell other people that so they can see that it's okay to talk about. No one's going to judge you. And two, it doesn't matter if anybody judges you because you're just trying to fix yourself.
- [21:15]
B
Right?
- [21:15]
A
So the hope is, is that people will listen to you and understand that they just need to talk about it and fix it and correct it. And people should be more mature and more caring about health than anything else. And so my assumption is, is that you have let that out to say, hey, be open about this. Come and talk to me. Get it out there so we can fix it. Because I'm sure that just like anything else, if you prolong putting this off, you could make the problem so bad that it could be far more difficult for you or anybody else to fix. Right. I mean, you want to address this earlier than later?
- [21:50]
B
Totally. You know, and I think that to your point, Juan, I mean, I am a woman. I have two kids. I'm in perimenopause. Like, I have had my own issues. And so people are like, how are you so vulnerable? I'm like, if I'm asking other people to come see me and talk to me about these really intimate parts of their life and things they maybe never told anybody, like, I feel like I. They deserve that same thing from me, they deserve compassion, transparency, vulnerability. And the other thing is that, like, people are not alone. I think so many people don't talk about these issues, and they feel like they're the only one. But, you know, I've been in this practice for 18 years. I've treated tens of thousands of patients. I tell a lot of stories in my book because I. I think it's important for people to know that, like, if you're experiencing it, somebody else likely is too. We're just not talking about it. So I really. I always say I want to normalize the pelvic floor conversations. I don't want to normalize the pelvic floor problems. And that's where I think that we really need to shift the narrative of let's talk about these things, and then we're able to find solutions for them instead of dealing with them kind of so quietly, but then not even knowing that there's help out there.
- [22:54]
A
Perfect. That's awesome. I love it. So I want to kind of talk about your book a little bit here. So it's called Floored. Is this something that is put out for men and women or just women, in terms of what you talk about and kind of get into what you're expressing in this book or what you're trying to convey and what people can expect to learn from it?
- [23:16]
B
So the full title is Floored A Woman's Guide to Pelvic Floor Health at Every Age and Stage. So it is for women, and I say it's for everyone with a pelvic floor. Because if you have a daughter, if you have a mother, if you have a wife, I mean, I get men reaching out to me, saying, I found you on Instagram. I think my wife has this problem, you know, and so they're searching. I mean, not to generalize. My husband, he wants a solution, and if he can't find one, he wants to keep searching for one. And so I see a lot of men doing that to support their partners. But it's a woman's guide. And I think one of the things I want women to understand by reading the book is that one, these muscles exist and there are things you can do to prevent issues. I think we live in a healthcare system where we're always doing damage control. We're, like, addressing problems afterwards, where I'm like, there's a lot you can do to prevent issues, whether it's you're becoming sexually active, you're pregnant, you're recovering from a baby, you're heading into perimenopause at every stage in life, your pelvic floor requires different things and I want to give you the tips and tools to take care of it. And then also, if you are experiencing a problem, there's resources in the book to help you. Like, what are the exercises to start with? How do you massage? How do you know if you're doing a Kegel correctly? How should you be sitting if you have pain? If you have pain with sex, what are different positions to try? You know, just so many things that over the years I've been practicing. This is the daily things that I tell my patients. And yet not everybody can come see Sarah. Not everybody can see a pelvic floor therapist. So how do we get this information into women's hands in a very easy, accessible and affordable way? The second part of this is I really want us to change the experience of the next generation. I have two kids, I have so many friends who have daughters and children. And they're like, I don't know how to teach my daughter how to use a tampon, or I don't know how to talk to her about sex. Or like, how should I teach my kid about how to poop properly because he's constipated. And so if we can we know better, then I think we can teach the next generation better as parents and really help them have a different experience than I think my generation or even my mom's generation had with respect to pelvic floor healthcare.
- [25:20]
A
So is this the first book that you've written then?
- [25:23]
B
Yes, and I will say right now it may be the last, hopefully not, but it was, it's a huge endeavor. I mean, it's a two year process. And I mean, I dove. I had a research assistant. I mean, we dove into the research. I looked up my old cases from over the years to have really rich patient stories. I used kind of all my old techniques and tools. I mean, everything. I mean, there were so many, so much in this book that I wanted to put out there. And I could have written a book just about pregnancy or just about menopause. I was like, we need to start just from the basics. Like, people don't even understand the basics of this part of their body. So it was a two year process. But the really cool thing is the way that I got the book deal was it was a follower on social media and she worked for HarperCollins Publishing Company. And she said, I think that what you're saying is really important and would you ever consider writing a book? And I was like, I'M going to have to think about that. I'm really busy. But I owned a physical therapy clinic in New Orleans at the time and I was building up my online exercise platform and I was like, I just don't have the capacity. So I ended up selling my clinic. And the day after I sold my clinic, I signed the book contract and so I had to make some shifts in my personal and professional life to take on this endeavor. And I still work for the clinic. I sold it to the two women who were my employees at the time and now I work for them. But it's, yeah, it's a, it's been a pretty interesting journey just to kind of follow this path. Just like you, Dylan, of like, where am I headed? You don't always know, but you just kind of go to where you're called.
- [26:52]
A
And let me shout Harper and Collins because they, they introduced me to you and they've, they've introduced me to some amazing people. And so just wanted to point that out because I'm thankful as.
- [27:03]
B
I'm thankful for them too.
- [27:04]
A
Yeah, they're really, really great. And so that's a publishing company then, correct?
- [27:09]
B
They do. And I. The imprint I'm under, kind of, which is a specialty imprint, is called Park Row Books and that's where my editor Erica is. And I've, you know, I met with this team and it was all women and they were really behind this mission oriented book and they've just been great. I mean, I have a great team. And yeah, I mean it's just wild. Literally like a cold email and then, you know, two years later you're a published author and it's just a really cool experience to kind of have gone through this and to be where I am now.
- [27:37]
A
God works in great ways, I will tell you. And it happens out of nowhere when you least expect it. And sometimes some of those messages you think you don't want to open or you think might be, they're worth a look, you can, you can tell. I mean, I know you, I'm sure when you get the followings, because I get them all the time and you get all this crap that comes in, but it's, it's always worth a second just to look at it, right? I mean, because you never know. That's, that's an amazing scenario and story. So I've obviously thoroughly looked at your website and what you do and what you offer there. I want to talk about some of the things on here. I'm going to pull it back up that I, that I See, so one you do you have. It's a, it's a membership you have on your site, then correct that people join.
- [28:18]
B
So what I. Yeah, thank you. So I. It's called the Beehive. And I started this post Covid because a lot of people weren't able to access pelvic floor therapists in person and people were working out from home and not back to gyms. And so I created online pelvic floor workout routines. And they're. Some of them are strengthening, some of them are relaxation. A lot of them are like pregnancy, birth preparation, postpartum recovery. I'm also, I just launched a perimenopause and menopause program which adds in weight, but all of it is pelvic floor focus. So it's teaching you how to contract your pelvic floor, how to relax your pelvic floor, how to modify exercises if you're having a pelvic floor problem. I'm not a fitness professional. I'm a pelvic floor therapist and I really try to stay in my lane. But I mean, if you. A lot of people are scared to exercise or they don't know what's safe or what's not, if they leak or if they have prolapse or abdominal separation or diastasis recti. So I wanted people to have a resource of how do you do this at home? And it's 10, they're 10 minute workouts, 10 to 20. So you don't need 45 minutes. I mean, if you're a busy mom, you don't have 45 minutes three times a week. Right? You maybe have 10 minutes. But I'm like, everybody does have 10 minutes. Like you scroll for at least 10 minutes a day. So if you can carve that out a couple times a week and really start working on your pelvic floor, I mean, the benefits are huge. And I've had women over the years that are like, I did this before my birth and I had the best birth experience. I had no tearing or I've been leaking for years and I'm finally able to run again. Or, you know, my mom has prolapse and I don't want to end up like her in diapers. So like, thank you for giving me resources and oh, it's very affordable. It's like $21 a month at the cheapest level. And that's important because not everyone can access, you know, in person therapy or out of network, you know, private services. So I really want this to kind of become the normal for women's. Healthcare so that they can work on their pelvic floors and prevent issues.
- [30:16]
A
Before I go further, you said prolapse. Could you just tell everybody what that is or what that means?
- [30:20]
B
Yeah. So prolapse is when your pelvic organs aren't supported well by that hammock of pelvic floor muscles. And so your bladder, your rectum, or your uterus kind of start to drop down into the vagina. You might feel a bulge at the opening of your vagina or like something's like, falling out. And it sounds scary, but it's really an issue where your muscles are tense and you might be straining or they're weak and the muscles are. Or the organs are kind of pushing through. And so by strengthening your muscles and working on relaxation, you can kind of actually relift those organs and give them more support. But it's. 50% of women who have given birth have some degree of prolapse walking around out there. And if you're lifting heavy weights and not breathing properly or engaging your pelvic floor, if you're straining with bowel movements or you're pushing when you pee, I mean, all of those things can contribute and make this. This issue much worse.
- [31:11]
A
Okay, so when you said pelvic organs, what are the pelvic organs for women, and what are the pelvic organs for a man? So that they know, hey, this, this is problem, problem area. And it could be related to this, right?
- [31:23]
B
So in the female body, your uterus, your ovaries, your bladder, and your bowels, okay? And then you also have. Your bowels are kind of connected to your colon. So any kind of digestive issue. For males, it's their bladder, their bowels, which hold stool, and then their prostate. And so. And men only have two openings. Men only have two openings in the pelvic floor. One for the urethra through the penis, and then the anal opening. Females have three openings. They have the urethra where urine exits the anus, where poop exits, and then the vagina for vaginal birth, vaginal intercourse, menstruation. So, you know, females just have more susceptibility to weakness, too, because they have an extra hole. But we see there's. That's the difference between female and male bodies, too.
- [32:07]
A
Okay, so then that would bring this question. If someone constantly is holding urine or, you know, holding too long before they go to the bathroom or whatever the case that that may be, would that potentially cause a pelvic floor floor problem for them if they're doing that?
- [32:24]
B
Yes, I See this all of the time. I see it in teachers, medical professionals, people who don't like to use the bathroom in public. Holding your bladder too long. So the normal frequency to pee is two to four hours. If you're going more frequently than that, you're, you're going too, too frequently. It's like overactive bladder syndrome, which your pelvic floor is a component. But if you're holding it longer than four hours, you can create hypertension in those muscles and then your bladder gets really full. And then when you try to pee, you can't relax. So then you try to push, you have to sit down, you strain, and you have to push in your stomach to try to get your bladder to empty. You know, there's all of these things that it can totally lead to a pelvic floor issue and it can even lead to a urinary tract infection because you're not emptying your bladder frequently enough. And then bacteria accumulates in the bladder and creates an infection. So I always tell people, pee when you have the urge to pee, like, don't over hold it. And I think people can go too frequently or too infrequently, and both of those are pelvic floor problems.
- [33:30]
A
So by holding it, you could potentially have a twofold problem by creating a urinary tract infection and creating a pelvic floor issue and did a double whammy on yourself. So there's multiple things that could happen. Okay. On top of not feeling so good while you're holding it, because you know if you hold urine too long, it can, sometimes it can give you a headache, sometimes it can make your heart flutter, sometimes it can make you like nauseous. I mean, there's a lot of things that I've seen people have or even myself when I've been like, oh, I'm driving, I don't want to stop because it's a long distance drive, for example, you know, something like that. And so that's good to know. I had the feeling that that might be the case. Here's another question. So for instance, like when I'm trained to athletes and been a personal trainer for 20 years now, I guess, I guess I'm getting older. But so one of the things that you have to be careful of is even with abs, their muscles, you don't want to over train them. If you over train them, you can potentially go backwards when it comes to your pelvic floor and you're training them. Is it wise to like do a set of your 10 minute exercises? One day, take a day off, do it again. Or can we over train those muscles? Can we under train those muscles? What's the recommended protocol? And I know that probably depends on the severity of what's there or what's not, but let's just talk about a maintenance plan.
- [34:44]
B
Yeah, this is such a great question because these are muscles like any other muscle in your body. You can absolutely over train them. You know, I had a gentleman who, years ago, I was seeing him, he had urinary leakage after his prostate was removed. After you have prostate cancers, they can remove your prostate and it can lead to erectile dysfunction and urinary incontinence. And he was doing 2,000 kegels a day. And when I went in to assess his muscles, he was. Had so much pain and spasm in his pelvic floor. And he was like, I'm sitting in a truck and I'm a truck driver, so I'm just like doing Kegels all day. And I was like, but you don't need. Just like you don't need 2,000 bicep curls.
- [35:20]
A
No.
- [35:21]
B
Right. Like, what would you say? You want to, you want to load, you want to work to fatigue, you want to gradually increase intensity. You can do heavier loads, you can do more reps, but like, you do three sets of 10 max, right? And so it's, it's about gradual strengthening, but you don't need more than 30, you know, you. But the other thing is you have to bring this muscle into function. So if you're at the gym and you're like, oh, I have pelvic floor weakness, right? Or I want to make sure I'm protecting my core and my pelvic floor. I would guide you to engage your pelvic floor. So pre contract, a pelvic floor contraction is what we also call a Kegel. Do a pelvic floor contraction prior to lifting, prior to squatting, prior to lunging. You know, contract these muscles before you load and then make sure that you're breathing. A really common thing that we see with a lot of heavy weightlifters and trainers is that they hold their breath when they're lifting heavy loads. And it's a compensatory technique and it's fine to lift heavy loads, but as a long term strategy, it will blow out your pelvic floor. I mean, you'll have hemorrhoids, you can have rectal prolapse, you can have a hernia diastasis recti, because that air is getting trapped and it doesn't have A place to go. So it's going to find the path of least resistance. So in a male body might be an umbilical hernia or a hemorrhoid. And. But in a female body we have vaginas and we have that extra layer, kind of opening of weakness. So it will lead to prolapse, urinary leakage, you know, pelvic pain, because we don't. You're not breathing while you're contracting and over time it can cause dysfunction. So you know, it's, that's a kind of an icky situation because I want women to be able to lift heavy. But I'm going, if your, your bladder contents are spilling out as you're doing it, reach your PR goal. But just know you're likely causing some pelvic floor dysfunction. Just like you may cause a muscle strain or strain somewhere else in your. But it is affecting your pelvic floor, which could lead to a more severe issue.
- [37:21]
A
And that's something to be cognizant of. I get some kickback on this, but I always teach people you have to lift smarter, not heavier. Yes, I want people to lift a good amount of weight, especially as we get older. That's not the wisest thing in the world to do because essentially as we get older and as we age, there's a bunch of degradation going on throughout our bodies, whether it's bone, muscle, joints, ligaments, tendons, all of that and all that pressure and it all applies. And there's no good or point in trying to lift too heavy and then hurting yourself and being on the shelf forever.
- [37:55]
B
Right.
- [37:55]
A
And I get these people that have kicked back of me, oh, you got to lift heavy to gain muscle. Oh really? Because I've trained Mr. Olympia athletes with 15 pound dumbbells screaming and crying. If you do it right and you do eccentric movements and teach them how to do it properly. But you know, people get this one track mind and then just like you pointed out, it can have a, a trickle down effect all throughout your body. Right. By doing things that are not necessary to do unless you're in a powerlifting competition. And I'm not saying don't, I'm not saying lift baby weights all day, but what I'm saying is do it smarter, do it wiser. And that's just. It all correlates and trickles down. Now you brought up a hernia and that immediately took me to. Is there any sort of correlation between like a weakening of the abdominal walls there that would potentially cause that weakening from a pelvic floor issue. Is that possible? Or look at it from the other way. Could developing a hernia cause weakness down there? Let's like invert these and which or both is accurate?
- [38:56]
B
Yeah. You have. The way that your brain works, Dylan, is you're really like following this track and you're. The answer is yes. It's like you're like cluing into all these things. I'm like, that's correct. So you're, you have different layers of your abdominals and the deepest layers called your transverse abdominals, that kind of wraps, you know, all the way around from your, your deep abs to your low back. And then you've got your layers of oblique abdominals and then you've got your six pack rectus muscles. Right. Those are kind of the out muscles that you have. I know you've seen yours. I've never seen mine, but I've heard that they're in there. But all that being said, that deepest layer, the transverse abdominals connect to your pelvic floor. So when you activate your pelvic floor contraction, when you contract, your deep abdominal transverse muscles contract at the same time. They work in synergy. You can't isolate them separately. So if you're engaging your deep pelvic floor muscles, your deep ab muscles are also firing. And that's actually the biggest reason that a lot of people have back pain or they can develop hernias or is because they're not activating the deep core. They're only doing rectus work or oblique work. And so before you even do any ab work, I'm like, pull your pelvic floor, your perineum, which is kind of the midline of your, we call it the taint, you know, in like urban dictionary. But the area kind of just at the base of your vagina or penis and you lift that up and that activates those deep core muscles while you're working out. The hernia is caused by not having, right, the correct pressure management, which is likely means you're not breathing well. Like it likely means you're holding your breath and that, that breath is trying to find a place to go. So it goes towards your belly button, it goes towards your inguinal area and you've got a hernia. It's also, disc bulges happen, right? That pressure from heavy lifting or poor posture has to go somewhere and you bulge a disc, right. Or you get prolapse or you get a hernia. So it's trying to find its, its outward maneuver. I would say a hernia doesn't cause Pelvic floor issues, but it's a sign of poor pressure management. And when you have that, it's like, okay, what do I need to be doing to modify it? Because you can fix the hernia surgically. And I have a lot of postpartum moms who get this after giving birth and their belly stretches out. There's so much pressure in there, it doesn't have anywhere to go. But if you fix it, there's a 50 chance of it failing and happening again because you never learn the right strategies. So to get to your point earlier about, like, you have to kind of look for what's causing the problem. You're breathing, you're lifting, your posture, your core, and that will help kind of give you long term relief.
- [41:24]
A
Okay, sweet. Good to know. All right, so I'm thinking, and because of my background, I automatically always go to diet and supplements. And I don't know if there's, if there's any correlation here at all in terms of things that we eat or things that we could potentially take to help any sort of pelvic, you know, issue, or is there a certain types of diet that could have a negative effect there and maybe not. And are there certain kinds of, you know, supplements or, or any kinds of medicines or anything that you put people on that have those kind of issues? Because, like, my mind immediately goes, oh, urinary tract infection. Okay, we got cranberry, you know, like different things. So, yeah, and then this is more of a muscle issue. I understand. But is there any sort of other things that you treat people with or recommend, diet wise, that they should be doing if they have this problem?
- [42:15]
B
Yeah, I mean, the basics are like, if you have constipation, you're at a high risk of pelvic floor dysfunction. Constipation is the number one GI complaint in the United States, and it's super common with kids as well. So if you're eating too many processed foods, not enough fiber, you're not getting enough hydration. I mean, the basics are like, you need fruits and veggies. You can get, you can take natural fiber supplements if you want. I'm a big fan of taking magnesium citrate for constipation. It's. You take it at nighttime, it makes you a little bit drowsy. But a side effect is to soften your stool and so you can have smoother, easier bowel movements. So, yeah, there is a, it's a little bit of the chicken or the egg. If you're constipated, your pelvic floor is going to be tight, or if your pelvic floor is tight, it can cause constipation. But either way, looking at what you're to able, eating is super important. On the flip side, with your bladder, some things that can irritate your bladder, you can have them. But if you have urinary urgency or leakage, you may want to just minimize how frequently you have them. So citrus juices like grapefruit juice, you know, orange juice, spicy foods, wine, beer, chocolate, anything acidic will cause more bladder urgency and frequency. So if you leak urine and you're going to go stand at a football game for hours, and you love to have beer, like just be know that you're going to have to pee a lot and you might want to be prepared to if you leak urine or something like that to have a backup. But if you, or if you have a really important meeting and you know, coffee irritates your bladder and makes you pee, then, you know, maybe hold on the coffee until after the meeting. Things like that, they're fine to have, but just knowing the effect on your body is important when it comes to supplements. So I, I mean, I take my own for perimenopause, which, you know, I take Ashwagandha, I take F oil, I take Vitex berry. I mean, I kind of take the standard ones that I think a lot of folks take. I'm actually a huge fan of CBD because I think that it can kind of have a very chill effect. And often when people have really upregulated nervous systems, they have tension in their pelvic floor. So everything from oral cbd, CBD lotions. But I also recommend CBD suppositories that you can put in your vagina or your rectum to help the muscles relax. It can also be found in some lubricants if you're using it for sexual activity. I'm a big fan of collagen because we have. Estrogen is responsible for making the protein of collagen. And when you have less estrogen, when you're postpartum and breastfeeding, when you're on hormonal birth control or you're perimenopausal or menopausal, you have less collagen. And collagen can weaken your tissues, give you less pelvic organ support and cause incontinence and lead to incontinence. So I like having, I like people to take collagen. I don't know much about creatine, so I don't comment on That a ton. But I think that there are some supplements that you can take. But it's a combination. It's like, you can't just take ashwagandha and think your pelvic floor is going to be better. Like, it's a. It's always a piece of the puzzle. But it's not just. I think our society still wants this, like, magic pill or this, like, silver bullet, and it just doesn't exist.
- [45:14]
A
No, it does not. And there is no such thing. And you have to do the work. No matter what you take. It doesn't matter. You can take. I always tell people I can. I can put you on everything under the sun, but it doesn't mean it's going to do anything for you. If you're.
- [45:27]
B
You're.
- [45:27]
A
First of all, if you're hormonally off, that's the step one, where. And then step two is you actually got to do something. I mean, it just doesn't work, you.
- [45:35]
B
Know, I mean, totally. And people like, how do you strengthen your pelvic floor? I'm like, you have to exercise. And they're like, well, do I have to do it forever? And I'm like, well, do you have to brush your teeth forever? Like, you don't have to, but your teeth will get, like, gross and you'll get cavity. So it's really a choice, you know, And I don't mean to be glib about it, but it's like, this is. If we want to take care of our bodies, we, like, have to take care of our bodies. And, you know, pelvic floor dysfunction is associated with depression, higher risk of ending up in a nursing home, higher, you know, rates of surgery. And so I'm just like, what can we do to care for our bodies in the long term? I don't want to spend gobs of money on diapers when I'm older, I want to be able to travel. I want to be able to run three miles for the rest of my life. And so how do we help keep people with a really high quality of life into our later years, which is now 40s, 50s, 60s, we start seeing our body changing so significantly. But if you have a pelvic floor issue, it can really affect that. And even relationships, like, if you can't have sex or it's painful, I mean, these can cause a lot of marital relationship, relationship challenge. If you can't have sex, you may struggle to get pregnant. I mean, the effects go so deep that I don't think we realize how much pelvic Floor issues can really influence someone's life. But that's why I'm so passionate about giving people the resources for help.
- [46:51]
A
And I would point this out with what you just said. If you actually. Because I do this a lot, where I'll actually sit down and start to do a full breakdown of, okay, so how many minutes a day do I spend doing the xyz? You know what I mean? And you'll sit there and you'll do that. And when you act put out to do something that's so minimal and so easy, and what am I doing in place of that, and is that helping me in any sort of way whatsoever to be a happier person? Am I thinking long term on what this could benefit me or hurt me? And when you start to do that and then you break it down, you go, oh, shit, like in a few minutes a day. And actually, once you develop a habit, especially a good one, you never want to miss it. I mean, you get bad habits and you. So it's hard to break. But when you develop good ones. So if I miss the gym or if I miss a day of walking or a day of cardio, I am not pleasant at all. I mean, admittedly, I'm just not. Because I'm miserable. And, and it's. I think people, if they actually, it takes a week to two weeks to get pushed through something and develop a habit. And then once you do it, you never want to be without it, especially when it's something good and it's you. You wean yourself off bad foods. Well, once you have them, after a month or two months, they taste like, you know, it's like somebody that smoked. If you stop smoking six months and then you start again, it. It'll blow you away. How gross it is. I did that with alcohol when I used to party, and then I didn't drink for a couple years, and then I did like, now I can't even have half a drink, and I just don't even want to be near it.
- [48:20]
B
Right.
- [48:21]
A
So it's just like anything else. Developing good habits is the question that I had for you that I was thinking of had to do with pregnancy. So do you start or recommend somebody that is pregnant, say, hey, be aware that this could create you a problem. Let's start working on this right now. And do you find that pregnancy can be very problematic in causing this pelvic floor problem?
- [48:45]
B
Yes and yes.
- [48:46]
A
Okay.
- [48:48]
B
Yes. When you are pregnant, that is the time that we often see pelvic floor issues arise. And we don't have Any standardized postpartum rehab for women in the United States. In other countries, they are sent to postpartum therapy, physical therapy, like, automatically. And we don't have that system here yet. But during pregnancy, your pelvic floor muscles are getting weaker over time. Your pelvic ligaments are softening and loosening, and you have less stability in those joints, which that's what our body's supposed to do. It's designed to do that. But you can get pelvic floor issues as a consequence. So I always say, you know, your pelvic floor is this basket of muscles that supports a growing baby, right? Your uterus is inside that basket. And the beginning of pregnancy, your baby's the size of an avocado, right? And then maybe the size of a papaya. By the end, it's the size of a watermelon. And so if you think about a hammock holding an avocado, it's not going to change very much. But if you think about a hammock holding a watermelon, that hammock's going to sink down, it's going to stretch out, it's going to get weaker. And that's what happens during pregnancy. Your pelvic floor gets weaker just during pregnancy. And low back pain and urinary leakage are present in over, like, 75 of pregnant moms. Unfortunately, doctors will say, oh, just wait until after pregnancy. But if you don't address it during pregnancy, it's likely to persist after the baby's born. So I always tell women, like, during pregnancy, I really recommend strengthening during the first and second trimesters. I have a whole online program for pelvic floor strengthening during pregnancy. And then in that third trimester, focus a lot more on relaxation and stretching because you need your pelvis to open up and your pelvic floor muscles to relax for a vaginal birth. We don't need super tight pelvic floors for a birth. We need relaxed muscles that can lengthen and coordinate and get out of the way for baby to come down the vagina. So if they're super tight, it's almost like doesn't allow baby to come down. So I focus a lot more on, like, yoga and breathing and learning how to push properly and different positions to push. And that third trimester and then postpartum, you should do recovery. You should do, you know, retraining, restrengthening, reconnecting to your pelvic floor and core, because it's been through 10 months of change. And then birth sometimes, which required a Surgery. So it's definitely a time. I think women need to be proactive, and we also see a lot of issues arise postpartum. And I really encourage women to get them addressed. Whether it's, you know, you gave birth three months ago or three years ago. It's never too late. I would definitely get help for the issues or read the book and kind of get started, because there's a lot that you can do, and it doesn't get better as we age.
- [51:28]
A
So I know this is a broad question, but who is your target audience then with the book and with your website? Do you have a general target audience or is it just the widest variety possible?
- [51:38]
B
Yeah, people with vaginas.
- [51:42]
A
That makes sense.
- [51:43]
B
No, but really, you know, I think that when people, like, even, you know, my Mom's in her 70s, and she's like, well, I don't know if I need this book because I'm in your 70s. I'm going, well, you're at a risk of leaking urine. You could end up in a nursing home. You pee every 30 minutes when I'm with you. Like, yeah, you definitely need this book. Or it may be a young woman in her 20s that has pain with sex, and she's like, well, I don't. I'm not pregnant, but. And I don't leak. And I'm like, yeah, but you might have pain or you're sexually active. What I really think that I tell everybody is read the first chapter and the last chapter. Those are my two favorites. I just did the audiobook recording and reread the whole book. And those two. Two chapters, I think, really sum up what's important, what's kind of total BS because there's a lot of, like, wellness industry stuff for the vulva and vagina, why we need this. And then you can kind of cherry pick which chapters you like. Like, if I have a peeing problem, then I'm like, okay, read the bladder chapter. If I'm pregnant, then read the pregnancy and birth and postpartum chapters. If I'm perimenopausal, read the menopause chapter. You know, so kind of go to what you need it for, But. But you're going to go through every stage of life as a woman, and you may be pregnant in postpartum, and then a couple years later, be perimenopausal, you know, or start having pain with sex, and then you need to read the sex chapter. So I think actually when people read it, they're going to. What I do is, I tell you what's. Normal. How often should be peeing? What should sex feel like? What is. How do orgasms work? How to insert a tampon. I mean, like, everything from the basics of your body to how should you be peeing and pooping and lifting and breathing so that you don't cause an issue. And then if you are experiencing issue, what can you do at home to start helping with it? Like, you can start these things right now. And you and I talk a lot about, like, hey, it's just 10 minutes a couple times a week. And I know some people are like, oh my gosh, I can't put another thing on my plate. But these are really small changes you can make. Literally, like just changing how you sit, when you poop, or changing how you breathe when you lift, or how to relax your muscles to pee. And all of those small changes add up to make a very big difference with your body. And so they're not big life overhauls I'm asking you to make. It's really small changes, but you have to be consistent with them and it can go a really long way for you.
- [53:59]
A
Yes. And it shouldn't just be, what else do I have to add onto my plate? It's what kind of nonsense am I doing that I can eliminate from my plate?
- [54:07]
B
Great point. Yeah.
- [54:08]
A
People will always look one way without factoring in the other way. Because there's two sides to all of this. And so people tend to their minds just go to the negative right away. I've learned to train myself to go, okay, before I say, this sucks, does it suck? What am I doing that sucks that I could replace it with? It'll make my life better. So it's an excellent point. And that's where I was going with that broad question was I was going to relate this to what I do because there's so many people that go, oh, I'm so young, I don't need to do that. Or, you know, this doesn't apply to me. And I am so firmly against that because there's so many things that you could find early, for example, that could prevent a problem later. I found a problem with my lp, which is a genetic issue, because I think, oh, I have a perfect diet. Oh, I do this and I do that, that. And so all of my cholesterol and all this, oh, it's all okay. We'll come to find out it was not. And had I not looked when I did, I mean, I could have had potentially four or five years down the road a big, big problem and caught it early enough, even though I was too young. And they'll tell you, oh, you don't need to test for this. Oh, you only need to test once for this. This is not true stuff. And so that's where I was going to drive with yours is, hey, you could prevent a problem by checking when you're 20 or working on it and catching it ahead of time. And that's why, and as a man, and I would like to point this out, too, there's things, for example, like on a blood panel, we have to have estrogen just like you have to have testosterone. But men will go, or women will say the same thing. And it's like, hey, just because this may be a direct correlation with women, as you pointed out, it's important for men. So don't just think that it's a women's thing. And I'm glad that we talked about this, because in my mind, I thought it was only a women's thing, too. And so I just would really hope that any man listening to this would say, I've got these problems. This might be it, and then come and see you and talk to you now at your clinic, is that something that anybody can just come to, or do they have to get a referral from a doctor? How does that work?
- [56:16]
B
No, in every state in the United States, you can go to a pelvic floor therapist without a referral from a physician.
- [56:21]
A
Okay.
- [56:22]
B
Sometimes insurance or the state requires you to have a physician's approval to continue. In Louisiana, we don't have that. You can absolutely just keep coming. But in every state, you can at least get an evaluation. So if you're like, hey, I'm not sure I want to talk to my doctor yet, or I'm not even sure if this problem. You can find a clinic, go to Google, ask your friends. You know, there's. You can go on social media and literally type in like, pelvic floor therapist near me or pelvic floor therapy, you know, L.A. and there's so many people who will pop up, up, so they're all over the place. And I would even say, like, go check out my blog, because there's a ton of information on there, not just for women, but it's also just like, what is your pelvic floor? What's normal to pee? How should you poo? Like, signs you have a pelvic floor issue. And so I think people can start going down these rabbit holes and then look around and actually you'll realize how many other people are seeking help as well. Or There could be a clinic down the street. So I would say at least get an evaluation and see. And then you can always try some of the things that help. You know, you can get them from therapist. You can do them from the book, whatever the case may be. You can do my online program. But I think that the biggest thing, and, you know, we talked about being proactive about health is I'm like, you get one pelvic floor and you can't replace it. If we know that it can lead to all of these dysfunctions. Like, you have to proactively take care of it and recognize early when there's an issue, because a lot of us will have back pain, hip pain, or pelvic floor problems. Like, it's not. None of us are immune to these issues. But if you have them, then I would seek help sooner than later because they can be so easy to address and so easy to overcome. Yeah, we just don't talk about it, you know, but it's what I talk about all day. And so I know how common it.
- [58:01]
A
Is, I'm thinking, because I have to go to the chiropractor so often, and I've had. I've been in there since I was 17 with my back and everything. Are there misalignments in your body anywhere, especially lower back, which I know a lot of people have, have shifts in your hips and areas like that that could also cause a problem down there that, like, say so. So for instance, when I. I broke some vertebrae in my back, and it was always, strengthen your core, strengthen your core, strengthen your core. I said, dude, I can't strengthen my core anymore. There's nothing more I can do. Is there, like, something that could be potentially out of alignment, that no matter what you do, could then cause a. Could directly affect your pelvic floor? And so you would need to address both of these. Or no matter what you do, you're not going to strengthen the pelvic floor until you get the other aspect fixed.
- [58:48]
B
Correct. So, yes, I would say that there are. There are 36 muscles that attach to the pelvis, your core, your glutes, your abs, your pelvic floor muscles, your low back muscles. So anything that is influencing one of those muscles can influence your pelvic floor. Literally, if you have a labral tear, if you have a bulging disc, if you have si. Just joint dysfunction, where sometimes there's like a misalignment issue. If your pubic symphysis is separated or kind of misaligned, all of those things will change the alignment of your pelvis and therefore change the tension and tone in your pelvic floor. So that basket of muscles may be tighter and shorter on one side or longer and weaker on the other side. And sometimes it's an injury or an episode that does something like, say, you had a back injury. But the other thing is also chronic postures and positions that we assume. So if you sleep a certain way or you. You always hold a baby on one hip, and your right side is always short and tight, or you've got weak hip muscles on one side because of an injury. So it all. All of those imbalances influence your pelvic floor. And so the way that we actually treat it's not like we go straight to the vagina or anus. It's really like peeling layers of an onion. Like, I look at your posture, I look at your back. Do you have surgery? Scoliosis, abdominal scars, diastasis, recti, A hernia, all of those things. I look at your glute strength, your hip mobility, and then I work on those things and then help kind of get closer. Peel that layer of the onion, get to the muscles and tissues and fascia externally, and then work internally. Because I could go in and release your pelvic floor muscles till the cows come home. But if you have overactive glutes and piriformis syndrome and a tight ql and, you know, rotation, then I'm like, I'm not going to get very far because those factors are still influencing your pelvic floor. So. And to your point about the core, it's like. Like, I think, again, we look at the outside core muscles, but we don't look at the deep core muscles. We don't look at the pelvic floor and the transverse abs. And I'm like, we're putting walls on a house that doesn't even have a floor like it. You literally haven't built the foundation. So oftentimes I think a lot of athletes that I work with get frustrated because I'm like, okay, let's just work on some. Some heel slides or some leg marches. And they're like, God, this is so boring. But I'm like, if you don't get the foundation, you can't. You're getting to that next level isn't serving you because you don't have that deep core engagement and support to support, like, super strong abs and upper body and thighs and all these things. So again, you kind of have to look outside and inside about what's going on.
- [61:18]
A
And that's once Again, we'll go back to it again. Addressing the underlying issue to fix the actual issue is sometimes what it takes. I'm glad you talked about the assessment. So. So let's say, for instance, I come into you and you start giving me an assessment. 1. Would you take an X ray if you think there's an issue? Is that something you do in two. Let's say that, you see, I'm just out of whack. And to. For you to work on me, I need to get that fixed first. Is that something you say, do you have somebody in house that is like a chiropractic that helps with that, or is it like, hey, you got to go get this taken care of first, come back to me, and then we can work on this. Like, how does that work when you do find these underlying issues?
- [61:57]
B
So it's in conjunction with. So if I. Somebody has kind of a pelvic misalignment or they need some kind of chiropractic adjustment, I'll continue to see them while they see the chiropractor. Because if you get adjusted but the muscles are still spasmed or overactive, then that. That displacement is going to reoccur. Like, the chiropractor is kind of putting it back in place. But if you don't fix the muscles and tissues and ligaments that are influencing that, then it'll persist. So I work on. Say you get realigned, or I release the muscles and tissues. It makes it easier for a chiropractor to adjust you. So it's very much in conjunction. I don't do pts, don't do any X rays. We're not licensed to do them. But I also. People aren't coming in to see me for a fracture. Yeah, most often people aren't coming in to see us for acute pain. We can work with chiros and physicians to get that. But I would say most often that's not what we see. What I do do, though, is I absolutely refer to a physician of, like, I think that they're. You know, I've had two women come in who have pain with sex, and when I'm working on them, they have this deep hip pain, and their hips are so overactive, and they've got popping and clicking, and I'm like, I think you have a labral tear. And then I'll refer them to an orthopedist, and they get an mri and they do have a labral tear, but the hip dysfunction is influencing the pelvic floor. So you kind of just have to have your thinking cap on is to, like, look outside the pelvic floor muscles. But we work with and collaborate with other practitioners all of the time. I think that that's a real strength of physical therapists. I think sometimes other practitioners are like, no, we're just going to do this, or we're just going to do medicine, or we're just going to do surgery where we're really thinking about, like, all the different aspects and really trying to collaborate. To do what is most supported in the evidence is to have, like, multidisciplinary care.
- [63:40]
A
That's the key. When I stopped being resistant to talking, like, I was very territorial. When I started making videos, I at, like, way, way back. Cause I was one of the only people talking about what I did. And I wasn't working with anyone. Once I put that guard down and collaborated with people and worked together with people, and I figured out how much more we could accomplish together and do this and put. You're. You're being very selfish by thinking, you know, everything and not working with others to. To fix somebody's problem. You know what I mean? So that's really a real pleasure to hear that. There's. I was probably just an outlier doing the way that I did, you know, and being such a prick. But it's really nothing.
- [64:18]
B
It's not. I mean, it's what we're trained to do, you know, like, our system is siloed. Like, you go see one person for the one thing. But I think as we grow as practitioners, like, I didn't used to work with chiropractors, and now I. All of my pregnant patients are seeing chiropractors and, you know, things like that. And so I think it's a way you kind of find. You also find the people who kind of align with your philosophies, you know?
- [64:41]
A
Yep.
- [64:41]
B
And so I think that, you know, as I practice, I'm like. Like, I don't know everything by any means. I just know a lot about a very small topic.
- [64:48]
A
Yes, exactly.
- [64:50]
B
That I can help you with. Outside of that, like, we'll find the right person for you. That's.
- [64:54]
A
I always say that I. I don't know everything. I'm just very good at what I do. But I still defer. I have mentors I defer to, that I go to for help, and I don't have an answer. I'll get you one. I'm not going to front. Like, I have them all, because no human really does. So I think that's important to. To do that as well. So when it comes to other things you offer on your website, I know you got blog posts. I mean you're constantly updating people with information and helping people. And I mean, do you, you're constantly coming up with new methods, new teachings and anybody can come and listen to you or watch you. Right? I mean, right. Is that free for everybody?
- [65:32]
B
So on social media, my handle on Instagram is the Vagina Whisperer, where you can just. I have so much information on there. And then, um, I also have my website, thevaginawhisper.com has all my blog, which is totally free. I have a bunch of free guides for everything from birth to pelvic floor, you know, relaxation for painful sex, for perimenopause, just, you know, resources for folks. And then we offer online consultation. So if you do want to meet with somebody one on one, it's a really easy way to do that. And then of course the membership where people can have kind of at home pelvic floor training programs and you take a quiz so you, we kind of know what you need help with and help direct you down the path. So all of that is free except for the membership is paid, but it's super affordable. I mean, somebody's like, I'm like, it's the cheapest program is $21.
- [66:18]
A
It's so cheap.
- [66:19]
B
And I was like, the other day I went and you know, my kids wanted Chick Fil A. I'm like, I just spent 50 bucks at Chick Fil A. What kind of economy is this? You know? But it's like you, when you think about what you spend money on, I'm like, this is your health. And as you mentioned, like, this is, is the probably the most important thing that we can take care of. You know, we do live in a system where I'm like, you have to be the advocate for yourself. Like, solutions are not going to fall into your lap. Physicians are not going to always ask you the right questions and lead you to the right person. Like, you have to really dig and fight and advocate for yourself because it's just the way that it is, you know. And so I really encourage folks, if they think they have a problem or they're experiencing one, to like check out the website, buy the book, take the quiz, whatever it is, but just, just start somewhere, just make one change and I think you'll realize that again, like these really simple things can go a really long way. And I'm also like, I want to have great sex until I die. I don't. I Want to run forever. I want to work out forever. So, like, why would I not do the things to help me be able to do that? And, you know, I'm in perimenopause right now, and I think that there's a lot of doom and gloom around kind of this stage for women, but I really see it as like a Runway. I'm like, okay, I've got the yellow lights flashing. I'm like, you need to strength train. You need to eat better. You need to take care of your body. You need to strengthen your pelvic floor, you know? You know, like, just, like, we take care of our skin externally. Like, take care of your insides, too. And so I really look at it as an opportunity to, like, I get this warning signal before my hormones completely shift. Listen to them, like, be proactive and feel in control of your health instead of feeling like it's controlling you.
- [68:02]
A
Absolutely. Do you do any, like, live speaking? Do you do that anywhere or.
- [68:07]
B
No. I mean.
- [68:09]
A
Judd.
- [68:10]
B
Not yet. I mean, you know, I love this topic, and I. It's like just a body part to me. It's like an ankle. It's not that big of a deal to work with it and talk about it, and I'm just really appreciative to be able to collaborate with folks like you who are open to sharing this information with their communities and not making it weird or awkward. But, like, hey, let's talk about this because. Because, you know, people need to know.
- [68:32]
A
I think it's weird to not talk about it because it's a problem. I mean, really, you should. And I'm not just saying this because you're on here, because I just don't do that, but you should be talking and speaking. I'm sure that all of these conventions and places would be thrilled to have you to talk about something like this. It would be very beneficial and very helpful. Just something to consider, to add to your. Add to your already stacked plate.
- [68:59]
B
But no, it's really, you know, when people are like, where did you come up with these ideas? And I'm like, oh, I didn't. People asked. People said, will you write a book? Will you do a post about this? Do you have a blog about that? Do you offer home workouts? You know, and so it's really like, I just kind of listen to what people say, and if I'm able to do it, I'll do it. And I think it's really, you know, the strength of you and me. It's just like, if you listen to what people are saying like. Like, they'll tell you what they need, and if we can help them, we'll do it. And so it's just been a real. It's been a real honor, to be honest, to literally throw up some Instagram posts in 2017, and then here I am later, you know, just really loving this work and being able to kind of just improve the healthcare of people and their pelvic floors has just been a real honor. So it's. I'm having a blast doing it.
- [69:49]
A
Well, you could say this for yourself. You are the only vagina whisperer in existence. I can guarantee that. I really, really appreciate your time. I learned a ton today, and I really didn't expect to have three fourths of this conversation, so it's even better. And I think that this is going to be so enlightening for so many people, and I think it's going to really, really make people, one, more comfortable and two, more awareness. So those two things right there are some of the biggest hurdles that we have to overcome is teaching people and getting their comfort levels. And I think. And I truly believe that we were able to do that today. And I just thank you again for your time and really for your efforts and your willingness to talk about all of these things.
- [70:41]
B
Thanks for having me, Dylan.
- [70:43]
A
Absolutely. All right, everybody. Well, that wraps up another episode. I hope everybody enjoyed this and learned a ton from it. It. Stay tuned for plenty more to come. Dylan Gemelli and the vagina Whisperer signing.