The Livy Method Podcast - Let's Talk Pelvic Health with Registered Physiotherapist Erin Degagne - Spring/Summer 2024

Episode Date: May 8, 2024

In this Guest Expert episode, Gina talks pelvic health with Registered Physiotherapist Erin DeGagne.You can find the full video hosted at:https://www.facebook.com/groups/livymethodspringsummer2024Topi...cs covered:Introducing Erin Degagne, Physiotherapist - Pelvic Health Specialist Pelvic health - not just for those who have given birthDoes this apply to you? - signs and symptomsIncontinence - an issue for both males and femalesSolutions to explore - the importance of being assessedKegels, yes or no? - understanding tension in pelvic floor musclesPelvic health issues - signs to watch forActionable steps - what you can do if you’re experiencing these issuesUrinary urgency - when we need to go and when we don’tMen - this information is important for you too! Bowel movements - exercises and techniques for healthy bowel movementsKegels - everything you thought you knew and what you didn't! Incomplete urination - why you can’t empty your bladderStress - connection to tension in pelvic floor musclesCoffee, alcohol and more - bladder irritants and their affectsOrgan prolapse - signs and symptomsHormones - how they affect our pelvic healthConstipation - is it a symptom of pelvic health?Weight loss - does it impact pelvic health?Improving pelvic health - treatment options Where to find Erin Degagne  www.lakecountryphysio.com or on Instagram @squats.and.coffeeIn Canada, find pelvic floor specialists in your area at www.pelvichealthsolutions.caTo learn more about The Livy Method, visit www.ginalivy.com. Hosted on Acast. See acast.com/privacy for more information.

Transcript
Discussion (0)
Starting point is 00:00:00 I'm Gina Livy and welcome to the Livy Method podcast. This is where you'll have access to all of the live streams from my 91 day weight loss program. With a combination of daily lives, guest expert interviews and member stories, there is something new almost every day. Miss the morning live? Want to re-listen to one of our amazing guest experts? Well, this is the place. This podcast is hosted on Acast, but it's available on all podcast platforms, including the one you're listening to right now, Spotify, Apple,
Starting point is 00:00:31 and Amazon Music. going to have this ability to now reframe. Allow yourself time throughout the day to stress the fuck out. The thoughts and the feelings and the behavior cycle can start changing. This is probably going to be a conversation that you didn't know you needed to hear and have today. Joining me is Erin Degagne. She is a pelvic health specialist physiotherapist, and we are talking pelvic health. Welcome, Erin. Hi. Hi. Nice to see you again, Gina. So Erin is no stranger to the program, to the Living Method. She's been in the group before talking about pelvic health, but we have a lot of new members as always. And so why don't you do a little bit of an introduction? Just tell us sort of who you are and your passion for pelvic health.
Starting point is 00:01:29 Let's talk about that. Sure. So I have been a physiotherapist for 13 years, but I took the pelvic extra courses probably 12 years ago now. So it wasn't something that was interesting to me initially. But I just, my mom actually needed to see a pelvic floor physiotherapist and there was no one around this area. So she asked, you know, look, why don't you go and do this? Initially, I thought like, that's crazy. I don't want to be doing this. I took the courses and I was just amazed at all of the information that's available that we as women and men just have no idea about even as a physiotherapist, I had no idea about all of these muscles in my pelvis, how they could be contributing to bladder issues, bowel issues, and so many other things. So and then I just became passionate about sharing this information, it was just shocking to me that we didn't have access to this information, how many people were suffering. And then once I started treating patients, I realized how effective this treatment could be. And just wanted to help people right to know what they can be doing, how to advocate for their own health, how to, you know, fix these issues that
Starting point is 00:02:35 don't need to be something that goes on for your entire life or later in life, even it's not something that just automatically happens because you get older. It was shocking to me the first time we had this conversation, like how many people were excited about the conversation, needed to have the conversation. Of course, that's why we are back having the conversation. Interestingly enough, I was at a symposium on Friday, which was women and innovation and in health. And they had the futurist there from Deloitte and she was talking about how pelvic health is going to be such a big thing that they really need to do more research on. And more and more people are going to realize like a lot of their health issues are tied into their pelvic health. So when we talk about pelvic health, I, and I've been talking about this and promoting you, it's not just for women who gave birth. It literally is for every body. It's
Starting point is 00:03:26 an issue that men are going to want to tune in and listen to it well. So when we talk pelvic health, what does that mean? What does that mean? People listening today who know nothing about pelvic health, why do they need to know about this? So as a pelvic floor physiotherapist, what we're doing is assessing the muscles in and around your pelvis. So I brought my pelvis actually. So if we take out your bladder, it's right behind your pubic bone here. Then we have your uterus, vaginal wall, if you're female, if you're not, then you don't have that. And then your rectum is right at the back. And then all of these muscles in here are your pelvic floor muscles. And so it's like a sling that is holding up these organs helping with bowel and bladder function helps to pump fluid out of your pelvis. The issue is, is that these muscles kind of get ignored because they're in a sensitive area,
Starting point is 00:04:15 right? No one probably even knows that they're there. Most people aren't doing anything about them or even talking about them. But they can really contribute to so many issues, pain included, right? So hip pain and back pain, any bowel or bladder issues, heaviness. And this can be before pregnancy, after pregnancy, during menopause, things tend to kind of creep up and become an issue. And for men as well with prostatitis, any prostate issue, cancer, but also just with increased urinary urgency, like having to go to the washroom more often affects men and women. Okay, so that's a
Starting point is 00:04:52 big one. I think that's sort of where people start to learn maybe they might have some pelvic health issues when they start drinking more water and they're like, I have to go to the bathroom all the time. Look, it's normal when you start drinking more water that you have to go to the bathroom more often. With the detox process, you're going to the bathroom more often as well. Um, you know, trying to jam your water in at night, it's going to have you up at night, but what, what, what are some of the, what are some of the signs and symptoms that there, there might be some pelvic health issues that you have? Sure. So some of the, if you have, if you're having any urinary incontinence, so that would be like loss of urine with like a cough, sneeze, jump, anything like that, or urinary urge incontinence.
Starting point is 00:05:30 So like you're feel like immediately you have to run to the bathroom. You don't have you can't say like, oh, I'll just go later when I get home. Like, you know, where every bathroom is. You pee when you get to Walmart. You pee when you leave Walmart. If you're waking up more than once at night to pee, that's a problem. Even if you're increasing your water intake, again, initially, it takes time for your body to adjust.
Starting point is 00:05:53 But eventually, that should even out and you should only be waking once. And then during the day, like five to eight times going to the washroom is a normal amount. And you want to make sure that when you go, you're actually emptying enough. So we typically say like counting to six seconds while you're peeing, that would give you if it's more than six seconds, that means okay, you actually had to go. But if you're going to the washroom all the time, and there's just like a little dribble there, or maybe three seconds of pee, you probably didn't actually have to go, it's a sign that there might be something else going on. Or if you have difficulties starting and stopping, like if your urine stream stops,
Starting point is 00:06:28 starts, or it's difficult to start it initially, it could be an indication of something else going on. Okay. Where do we start with this conversation? Is that the majority of issues? Is that incontinence? Is that the biggest one? Should we start there and then break them all down? How do you suggest we get into this conversation today? Sure, we can. There's just so many things that are contributing. But yes, incontinence is very common. One in three women experience some sort of incontinence, one in nine men, but only, you know, one in 12 actually seeks help either because they don't have the information or they just don't like know where to go, right? They are they're embarrassed, they don't want to talk about these things. Yeah, you know, it's understandable, like the
Starting point is 00:07:15 the exam for a public physiotherapy exam is typically doesn't always have to be but an internal like vaginal or rectal exam. And so I understand that it feels like an uncomfortable thing to have to do. But if it wasn't a fixable problem, like, I wouldn't be doing this, like, it's, it's really something that can be helped. And so if we can get over this, like hurdle around being embarrassed, or, you know, not wanting an internal exam, it can really help and get rid of these other embarrassments, right? Of having to wear pads for your entire life or having leakage every time you go somewhere, right? Yeah. I mean, that's why I could imagine that's why we're not going. Also, probably just because
Starting point is 00:07:57 we've been taught to just deal with it. Like it happens when you have children, it happens when you get old, it happens, you know, through menopause. Like just deal with it. It's a thing. It happens to the point where I think a lot of us joke about it. We laugh. We pee. We jump.
Starting point is 00:08:14 We avoid trampolines. Like, great, we don't fucking go on trampolines unless you want to pee your pants. Like I think this is something that we've just learned to live with, right? My family doctor says, oh, it's normal. You deliver three children naturally and now you've gone through menopause. That's it. And no, no further help. So this is, this is like, I mean, we're going to talk about other things, but this is like
Starting point is 00:08:37 this, this is where I love this conversation. Just like you're old. Oh, it's normal to gain weight. Oh, it's menopause you know you're gonna have that tire around your belly just deal with it it's how it is fuck that shit so there is actually stuff that we can do so let's say i've had i've had four kids yeah um i even had a prolapse prolapsed uterus which is a whole other thing um peeing my pants was, you know, that's the norm for me, right? Um, laughing, jumping without just standing, coughing, peeing my pants.
Starting point is 00:09:14 So there is something that you can do about that. Of course, people are going to talk Kegels and we have learned from you. That's not necessarily the way to go. So what can we do about the fact we're peeing our pants? Okay. So, I mean, if you have access to see a pelvic floor physiotherapist, I know it's not accessible to everyone. It's not covered, unfortunately, through OHIP. It is covered through your regular physiotherapy benefits if you do have that. But if you could see a pelvic floor physiotherapist, the thing is, is that we don't know what's happening inside your body,
Starting point is 00:09:41 because we can't see these muscles. So until you've had an assessment, it's difficult to give, you know, blanket exercises to everyone, because, unfortunately, we have no idea, like, it would be like me giving you knee exercises without ever having seen you, right? Seeing how your knee moves, see what's happening in there. So the reason to have an assessment is that we can see what's happening in these muscles, is there tension, which is probably, I would say 90% of the patients I see. And it's, I mean, it goes against kind of our general understanding of what's happening. You assume that because you're having leakage, these muscles must just be weak, laying there not doing anything. But 95% of the time, like it's not, that's not the case, there's tension in there. And so then the muscles cannot function the way that they
Starting point is 00:10:24 need to. So if you can picture, you know, you're here, and then you have to cough or you sneeze, and these muscles are supposed to contract, but they're like, we can't do anything else. Like we were at our absolute limit here. And then you're having leakage. And so if you're just doing Kegels, trying to strengthen these muscles without knowing if they're actually weak, which, again, they're just regular muscle. It would be like if your arm all of a sudden got weak, we would be very concerned about something happening. These are just muscles. They don't just get weak. Oftentimes this tension is building and that's what's causing the issue. So where's the tension coming from? It is a little bit like, because you think weak muscles, that's why I can't hold my pee in. Weak muscles from having a baby, weak muscles from whatever.
Starting point is 00:11:06 But where, where's the tension come from? Is that just from being, is it from being stressed? Where is that coming from? Posture? What is that? What is that about? It's probably like a multi-layered effect, right? So these muscles, they attach from your pubic bone to your tailbone, but these bones don't
Starting point is 00:11:22 move. So it's easy for tension to build in there because you're not stretching the bones around like you would, you know, moving your neck, moving your arm, moving your leg. So the tension can build over time. So it can start as early as childhood, right? Any sexual traumas that tends to be something that can start some tension, any injuries, so back injury, hip injury, even your foot, if you injure your foot, you're walking differently, these muscles are going to try and compensate. Then if you have a pregnancy or a delivery, if it's traumatic or not, it's still a lot for these muscles to be supporting your baby for nine months, and then going through the trauma of a delivery. And then
Starting point is 00:11:59 you're like running around taking care of a baby and not taking it easy, right? Our society is very stressful. Regular stress will increase the tension. Like if you have anxiety, if you're stressed, if you're, you know, nervous, worried, all of those things, especially in women tend to hold quite a bit of tension in your pelvic floor in the same way that you would hold tension in your neck. And so that can kind of build over time. And then menopause tends to kind of, if you're already have all of this tension, and then you think all of a sudden, I'm in menopause, and now I have all of these issues. It's probably not just the menopause, it's been building over the years and menopause just kind of like pushes it over the edge.
Starting point is 00:12:38 Pushes over there. What are some other signs of pelvic health issues besides the incontinence? So any pelvic pain, so pain with intercourse, hip pain or back pain that's not resolving like in a normal amount of time, six to 12 weeks, or if you're having treatment and it's not going away. Yeah, urinary urgency. So if you're like rushing to get to the bathroom, urinary frequency, like we talked about waking more than once at night, any pain with intercourse, if you feel heaviness vaginally, that's typically a sign of prolapse that you were talking about, Gina. So if you feel like something's falling down in your pelvis, that's a sign of prolapse. And typically could be either tension in these muscles, and then they're just failing by
Starting point is 00:13:22 the end of the day, so they can't hold the organs up. Or it could be weakness that they need to work on endurance with those muscles. Or if you're having pain with urination or bowel movements, constipation, there's so many signs. But and this this this this goes for men as well, would their signs or symptoms be any different? So typically, so with all of these other things that I discussed, like the men are less likely to have incontinence, but it is possible. So they could have have leakage, pain, like pelvic pain, testicular pain, or pain like rectal pain, with bowel movements is often a common one. Typically, it's symptoms of like a prostate issue. So it feels like you're
Starting point is 00:14:05 sitting on a golf ball, right? If you have increased prostate, like if your prostate is inflamed, that's how it feels. But pelvic tension mimics this same feeling. So the two often are confused for one another. But yeah, typically the same hip and back pain we see a lot of men for that kind of hasn't resolved. Okay, where do we go next with this conversation? Do we want to dive more into what do you do if you find that you can't hold your pee? What do you do if you're having pelvic pain? Where do we go with this?
Starting point is 00:14:37 Yeah, such a big conversation, my goodness. But yeah, well, let's talk about some like actionable steps, what you can do if you have any of these symptoms. What can you be doing outside of like getting an assessment? Great. If you can't do that, there's other things that you can do if you have any of these symptoms, what can you be doing outside of like getting an assessment? Great. If you can't do that, there's other things that you can do. Right. So like you talk about, Gina, you want to make sure that you're drinking enough water. Unfortunately, because if you're peeing all the time, your initial instinct is kind of to be like, well, I'll just stop drinking water and then I won't have to pee. But unfortunately, what happens is when your urine is more concentrated in your bladder, it's a bladder irritant to the lining of your bladder. So it's sending the signal like, oh, there's so much urine in my bladder because it's so
Starting point is 00:15:14 concentrated. So go pee more often, right? It's sending the signal that you have to pee more often than you should. So make sure that you're getting your water in. It's kind of a myth that like, oh, if you just stop drinking, you know, you won't have to pee as often. Yeah. Make sure that you're not straining with like trying to get urine out or straining with bowel movements. So really work on constipation, either having a squatty potty or working with your family physician about why you're having constipation, whether it be we talked about like on the program as well with magnesium can be really helpful. But that straining all the time puts a lot of undue pressure on your
Starting point is 00:15:52 pelvic floor muscles. And some other things are if you have a chronic cough, you want to address that that's a lot of tension in your pelvic floor. So we see a lot of people who are doing great, and then they get sick, coughing, coughing, coughing, those muscles contract as hard as they can every time you have a cough. So that can really increase tension in there. But if there's things that you want to be doing around the house, a mindfulness practice or or breath work can be super helpful just to get those muscles to relax. So your diaphragm and your pelvic floor really work in conjunction to kind of work as this pump through your abdominal wall. But if we're always doing this upper chest breathing, which most of us are doing all day, your diaphragm, your diaphragm
Starting point is 00:16:36 never drops down. So when it drops down, it forces all of your pelvic organs to drop down and it forces your pelvic floor to relax so that it's not just staying tight all day long, right? And so if you can do even 10 deep breaths before you go to bed, you're not going to bed with all of this tension in your pelvic floor. Oh, okay. With nocturia, so waking up at night, if you're waking up more than once at night, there's a bunch of things you can do. So legs up the wall 30 minutes before you go to bed is a great idea for everyone really because we all hold extra fluid in our in our legs through the day just with gravity bringing everything down but then what happens is you go to bed and then your
Starting point is 00:17:15 your heart can really process all of this fluid much better when it's not working against gravity so then it's creating all of this urine processing all this fluid and then you're waking up at night to pee so if you can do it 30 minutes before bed legs up the wall your body can kind of process that fluid you pee before you go to bed um and then that kind of helps eliminate maybe waking up two or three times in the night um part of it is a habit as well like you wake up and you think oh well you know i don't i'm already awake i might as well pee so that i don't have you wake up and you think, oh, well, you know, I don't, I'm already awake. I might as well pee so that I don't have to wake up again later to pee. But really the bladder should be able to hold enough urine to just pee once at night. Yeah. It's in your brain, right? I do this.
Starting point is 00:17:55 So I've listened to you from past conversations where I would be like, oh, I should go because if I don't go, then I'm going to wake up. And then I like, then I wake up and I think, oh, I should go. I'm awake anyway. And then I did kind of re I trained myself to be having to go. And it's almost like a trigger. And so now I'm like, no, I'm fine. I don't need to go. I, I, I lied there. And I learned this from, I think you said, if you, if your pee is shorter than six seconds, so if you're going and you're not peeing longer than six seconds, chance. So you didn't have to go in the first place. So that was a gate. It took a while for me to be able to actually train my brain to be like, you're going to be fine. You're not going to wake up five
Starting point is 00:18:33 minutes later. And then even when I wake up in the middle of the night, now I will say to myself, you know what? Nope, you're good. You don't have to go to the bathroom. And then I fall back asleep. And then I'm still amazed that I do that. I'm like, holy shit, I didn't actually I actually fell back asleep. And I didn't pee my pants and everything was fine. So it does take a while to to try to train your brain into like not being afraid that you're just going to wake up or not be able to get to sleep if you don't pee. Yeah, so it's really like a two pronged approach, right? We want to work on releasing tension or strengthening these muscles, whatever's happening with them. But also our central nervous system is a big part of it. So your body's whole goal is to protect you. And so if you've had leakage out in public, or you've had, you know, this urgency where you felt embarrassed, anything like that, it's working overtime to try and protect you. So it's sending this signal sooner than it needs to protect you. So you don't pee your pants in the middle of the store, right? So getting the signal, okay, go pee here, you see a bathroom, there can be triggers as well,
Starting point is 00:19:32 you pull into your house, your body knows you have access to a bathroom, your urgency goes up. Or you know, you see a bathroom or you're running water all of a sudden. And now I have to pee again, because your body's like, okay, go now. So you don't pee later, like it's going overboard. So we want to retrain your bladder to get that part to calm down. Because even if we release tension, if it becomes a habit, you're waking up five times a night, your body just thinks, oh, she needs to empty her bladder five times a night. So we'll wake her up for that. So like you said, try and go back to sleep. If you're laying there for more than five minutes, and you're like, I really have to go like, just get up and go pee. That's okay. But work as you can to not be going more often than you need to. Yeah. Because you can be in the car, you know,
Starting point is 00:20:13 you're in the car and the next bathroom isn't like, I don't know, 64 miles away. And then you have to pee so bad. And then all of a sudden you're just like, yep, no, I'm good. I don't have to pee anymore. And I'm like, what, how is that even possible I thought I was gonna pee my pants five minutes ago and now now I'm fine and big part of that is in my head oh my god I don't have a place to go what am I gonna do yeah okay all right what else so urinary urgency like you're talking about is really how your bladder is working with your pelvic floor muscles and your brain. So let's say normally your bladder would fill to like 75% full, send a message to your brain that says you have to pee, you look around, you know, you're in the car, no, I don't
Starting point is 00:20:54 have time to pee right now. I'm in the car, there's no bathroom available, your brain should send a message down to your pelvic floor muscles to contract. So when your pelvic floor muscles contract, this is all happening without you knowing, but then your bladder says, okay, no, not time. And it relaxes. But if your pelvic floor muscles can't contract, so either there's weakness there, or there's tension, they're here, they're like, no, we can't contract to tell the bladder, it's not time it thinks, oh, I didn't get the signal. She's on the toilet. So it's just a big muscle, it starts to contract. That's when you're like, oh my gosh, like, why all of a sudden do I have to pee so bad? Luckily, if you have, you know, decent pelvic floor strength, you can stop that for your bladder doesn't just empty right there
Starting point is 00:21:34 in your car. But it's really stressful. So you're holding these muscles as tight as you can, that's creating more tension. Maybe you make it to the bathroom, but your body says, well, that was very stressful. We don't want that to happen again. So it lowers that line so that now it's sending the signal that you have to pee when your bladder is only half full, right? And it's sending it stronger than it was before. It's trying to protect you, but it goes way too far. And then you're, you know, getting the signal, like you have to pee day and night and the signal is so strong. And then you get to the bathroom and you're like, there's nothing even here. Like that should not have been such an intense signal. Like as if my bladder was about to explode. Right. Yeah. Okay. I want to take a minute because there are people who are asking
Starting point is 00:22:14 questions. How long do you keep your legs up on the floor? What the heck is a squatty potty? Also, so we have some men listening and here's what I want to say. This conversation, if you missed it, is also very important for men. Same with the hormone conversation, also important for men. So if you think that you are a man and this conversation is not relevant to you, you are absolutely incorrect. And I think this is a big problem with men and their health. They think, well, I don't have hormone issues. I don't have pelvic health issues because it's like, you know, cause women, yeah, we talk about, you know, okay, you got to get an internal exam and you got to do this. You got to do that. It's just, I mean, that's a huge issue
Starting point is 00:22:54 that men don't think that this conversation is relevant to them. Um, I don't want to necessarily get into that. I just want to make that very clear with this conversation. I mean, with all the conversations that we have, some are going to be relevant to you. Some are not going to be relevant to you at the end of the day. This one I think is relevant to everybody. How long do we hold our, this conversation is making me pee. So the legs up the wall, right? That's to relax the pelvic floor muscles. How long are we holding the legs up the wall for? Like five minutes. It doesn't need to be long. And I'll post a video. I did a whole like legs up the wall routine for before bed. You can be doing stretches in that position. You can do your deep breathing, your
Starting point is 00:23:33 10 deep breaths in that position. Yeah. Five minutes. Like you can do longer if you want, but it doesn't need to be that long. Okay. What about the squatty potty? What the heck is a squatty potty? Squatty potty is just like a, you can use anything. I mean, I know what a squatty potty is. I know what it is. It could be a stool. It could be... My kid uses a garbage can. Yeah. It could be your garbage can. Pull it over from the side, put your feet up on there. The goal is for your knees to be higher than your hips. It just changes your anal rectal angle. So it makes it easier to have a bowel movement. So you're not like straining and pushing against,
Starting point is 00:24:06 because we weren't meant to sit at 90 degrees and go to the bathroom, right? If you can picture going to the bathroom in the woods, like you're squatting right down. Yeah. Okay. Yeah. My kid does this all the time. She has a squatty potty, but only in one of the bathrooms.
Starting point is 00:24:20 And then she's always, there's always a garbage cans in front of the toilet. It makes me freaking crazy. But yeah, she's, she's, she's, she's, she's, she's, she's, she's fine. Can we talk about those Kegels? So yes, we should be doing them. Shouldn't be doing them. Is there a right, right and wrong way to do them? Like what's, I know you should go see your, your therapist, but yeah, I would say benefit in them. I would say there can be, um, but I think it's way over prescribed, right? Probably everyone who's listening has been told at some point, Oh, do your Kegels. You should be doing Kegels for those who don't know what it is. It's just a pelvic floor contraction. So contracting these muscles, the truth is, is that these muscles, they don't need to be that strong. You know, you've heard of like the Benoit balls are like really strengthening these muscles so that you have this like tight vagina. Like it's just not that serious.
Starting point is 00:25:12 And that's not what it is anyways. Right. So these muscles, they don't need to be that strong. They need to be able to stop your urine. They need to be able to support your organs, but they don't have to be able to lift anything. Right. So if you, if we know that you have weakness, so if you've had an assessment, and they said, yes, you do
Starting point is 00:25:31 have some weakness that we need to work on, then great. Otherwise, like if you haven't had an internal exam, I would say it would be way more beneficial for the majority of people listening to just don't just stop, just don't do them. Because a you have no idea if you're doing them properly, right, which 95% of people who I assess are not doing them properly. And B, you don't even know if you have tension, then you are making the problem worse, right? You're, it would be like if you had a hamstring injury, and you're running every day, trying to make it better, they need to be released, right? What about those machines you sit on? they're like, Oh, like, you know, they even have like, they have like, like not stores,
Starting point is 00:26:11 but places you could like, like little pelvic health gyms you go to. Yeah. This was the question I got most of all. And you know, I don't want to discount what it is. So I, I don't, the problem is I don't see people who are successful on it because they wouldn't come and see me if they had had no problems. Right. But yeah, here's my issue with it. If they're not doing an internal exam at the place that you're going to, then definitely I would not be going there because they have they have absolutely no idea what's happening with your pelvic floor. And then this machine what it's doing is artificially if you can picture like a dog, remember those Dr. Ho machines that would like
Starting point is 00:26:47 contract and give you abs? Yeah, yes. It's, it's the same thing as that, except for it's contracting your pelvic floor, like 10,000 or 20,000 times. Again, that's not functional, like there's no need for your pelvic floor to ever contract that many times. And but let's say let's say there is someone who just had weakness, because there are people who I've talked to who have had benefit from it. And I think that that's great. Like, I don't think that's terrible. I would go to a place that does an internal exam, make sure that you don't have tension, like there are reputable places that do that. The problem is, is that it's extremely expensive. So it's like two to three thousand dollars i believe um yeah and so you know if i'm if i was just i was gonna sit on my washing machine i'm just gonna
Starting point is 00:27:33 just okay so if you if you have the means and you wanted to try it i would go to a place that does an internal uh exam otherwise just go see a pelvic floor physiotherapist. If you do have weakness, they can teach you how to do a proper contraction. And if you don't have tension, then you're not risking a spending $3,000 and then having nothing happen, which is unfortunately who I see a lot of or making the issue worse, right? Yeah. Okay, I get a question here. I often get the urge to pee normal urge urge. Then I go to the washroom and hardly anything comes out. Sometimes this goes along with feeling bloated. Is this a sign of retaining water or something else? Or is this pelvic health? What is that? Any idea? Yeah, it could be tension, right? So you're going, it's sending that signal that you have to pee when your bladder only has a little bit of urine in there. So it feels like your bladder is really
Starting point is 00:28:24 full, but you get there, there's not that much there. That's problem number that could be number one. The second thing could be that your urethra comes down like this. So your pelvic floor muscles are here. If they are very tight, what happens is you go to the bathroom, when your bladder is full, you can push past the amount of tension that you have here, because there's a lot of pressure in your bladder. But as it gets lower, there's not enough pressure left in there to push past the amount of tension. And so it stops. And you think, okay, you know, it feels like there's still some in there. But like, I don't know, it's not coming out. And then you stand up, sometimes you have a little bit of dribble on the toilet seat, that's urine that's trapped from the bottom of your bladder to your
Starting point is 00:29:01 pelvic floor muscles. And then you stand up, and you relax, and then that dribbles out. So you want to work on some deep breathing, get those muscles to relax. You could see a pelvic floor physiotherapist release some of that tension. But there's other things that you could do. If you're sitting on the toilet, you can do what's called a double void. So you pee, never contract your pelvic floor muscles while you're peeing. So sometimes people will be like, oh, I tested to see if I could stop my urine stream. Like, don't do that. Don't do that. We can talk to do that. That's what you do. No, because the problem is your pelvic floor and your bladder are supposed to work in opposition. So you're peeing, your pelvic floor is supposed to be relaxed. Your bladder is contracting. If all of a sudden you contract your pelvic floor,
Starting point is 00:29:45 your bladder thinks like, Oh my gosh, what's happening? You know, it's stressful on the whole situation. It's just not, they're not supposed to be contracting at the same time. But what you can do is empty your bladder when you think you're done. Even if there's some still in there, you can do a contraction on the toilet. Once you're done peeing, contract those muscles, relax, which I'll explain how to do in a second, relax, and then try to empty the rest of what's in there so that then you're not just filling from like here to here all day long going to the washroom often. Okay, you want to show us how to relax those muscles since we're talking about it? Sure. So if you're sitting and you're doing we're going to do
Starting point is 00:30:19 a pelvic floor contraction, a Kegel, if we want to call it that. So for women, you want to think about a ping pong ball at your vaginal opening. For men, you can think about a marble at your rectal opening. Okay, so you want to think about nothing should be happening outside your body, no one should be able to tell that you're doing this. If someone else is in the room with you, they don't know what's happening. So you're going to think about pulling that either that ping pong ball inside of your vagina or the marble inside of your rectum. So think about pulling that either that ping pong ball inside of your vagina or the marble inside of your rectum. So think about pulling that up kind of like an elevator. Another way to think about it is stopping your pee. So picture that you're peeing midstream,
Starting point is 00:30:55 and then you're trying to stop that, that stream, right? So you can do the contraction, and then you want to relax those muscles. And so it's not a bad thing to do periodically through the day. If you're, you know, you notice your shoulders are up here, you can do a contraction so that you can locate the muscles, not to strengthen them, but just to locate them so that you can relax them. I keep thinking about the marble. I'm doing the marble thing. Why am I doing the marble thing and not the other thing? Is that, is that a, that's totally fine. You have a rectum too. So different cues work for different people. And most of the people, most of these pelvic floor muscles are posterior.
Starting point is 00:31:30 So like behind your vaginal opening, right? So most of them are at the back. So oftentimes even women get a better contraction thinking about the rectal marble thing. This is weird, truly. So how often do we, really? But I mean, I get it. It's like, it's muscles, right? And because we just live such stressful, like non-movementy kind of normal lives these days. How often am I doing this?
Starting point is 00:31:57 I wouldn't do it that often. Like just if you notice that you're holding tension, right? Like if you notice that you're holding, so this is a Kegel, this is what they want you to do a hundred times when you're at a stoplight, right? It's not necessary. Um, but if you feel like you're, you know, stressed, like it would be the same as doing it, taking like a deep breath, doing a contraction and then just relaxing those muscles. So you're stressed, you're, you're stressed, you're stressed. So like if you right now, I'm super stressed. I got a lot going on. So my neck is like fused. My shoulders are tight. You know, I'm just like, ah, so would it be safe to assume that if that is going on stress there, I have stress everywhere. Yeah. You likely guaranteed, Gina, you probably have pelvic
Starting point is 00:32:43 tension. Does this orgasm come in? Do orgasms help with that? Like, is this the whole point of orgasms? It seems like there's gotta be a point. I mean, not that it's not enjoyable and fun, but like, is there, does that help? So what happens is these muscles do contract during orgasm, right? So they're part of your sexual function, but if there's tension there, that's when you can have either pain with an orgasm or just difficulty relaxing pain with intercourse for sure is tension in your pelvic floor. Like that's what I mean, outside of another issue. But yeah, like it's so connected, right? If you're having if you have all this tension, and these muscles can't contract the way that they need to,
Starting point is 00:33:22 but doing more Kegels or strengthening, like that's not going to increase, like improve orgasm. Like, no. What about having more sex? Does more sex help with relaxing those muscles or is there anything to that? It depends. Like if sex is painful, I would stop. Like if it's painful at all, or you're having discomfort, I wouldn't push through that. It's not like going to loosen things up. It's going to create a real negative association, right? Would masturbating help? I don't know that it would help because you're not really stretching out the muscles, right? Unless it's a if it was a strength issue, maybe that would help. But I don't think so. Like I think you you know, the muscles are being worked all day long. You lift something up, they're
Starting point is 00:34:05 contracting. You cough, you sneeze, they're contracting. You are walking, they're contracting, like they're working all day in the same way that your neck muscles are working to hold your head up all day, right? Like they don't need anything else. Yeah. Too much like fuck off. I'm tired. I don't need to have sex. I'm already stressed out. I'm like, no, I'm done. They got it. Okay. What else? I saw a question about coffee. Coffee is an irritant. It is. So there are quite a few bladder irritants. If you're having a lot of issue, like if you're peeing 13, 14 times a day, it might be worthwhile to take out some of these bladder irritants to see if that helps in the short term. But it doesn't mean that you need to cut these things out forever, right? So I would never tell you to give up coffee. I love coffee.
Starting point is 00:34:55 But if you if if it's really interfering with your life, how many times you're going to the bathroom, then it might be worth cutting things down. So coffee, alcohol, acidic foods, so like tomatoes and spicy foods, that type of thing. Carbonated beverages, artificial sweeteners, which you shouldn't be having anyway on this program, but that kind of thing can be irritating to your bladder, smoking. But yeah, so there are things, but I wouldn't say that's the be all end all. Like if you're having these issues, the problem isn't that you're having, you know, tomatoes, likely there's other issues, but this might just be adding one extra time going to the bathroom a day, which can be really, really annoying if you're already going 12 times a day.
Starting point is 00:35:40 Yeah. Okay. Louise is talking about how she doesn't have leakage, but her pelvic floor is falling. Been doing some pelvic floor exercises. They've not really helped. Should she see a pelvic physiotherapist? So before we get into that, I'm going to assume yes. But what would that be? Like I had a prolapsed uterus, so literally it fell out. Like I could see it on the outside, fell out. But how would we know that our uterus is falling? What would be the sign and symptom of that? So you typically so there are some women who I see who just they can't feel it, right? They can't feel that it's happening until it's like outside of their body, right? But what happens is it's not that anything is falling out. it's either your bladder, or your uterus, or your rectum, that's falling into your vaginal wall. And so what you're seeing externally, you don't have to freak out, it's not like, oh,
Starting point is 00:36:33 my bladder is going to come out of my body. It's the inside of your vaginal wall that's just being pushed by either your bladder, your uterus or your rectum. Okay. And so it could be it could be a multitude of things, it would be good to see someone because it could be that the muscles are weak, it could be that there's a lot of tension, and they're just fatigued. So typically, with a prolapse, it's worse by the end of the day, worse with jumping worse, if you're walking or standing all day worse, if you have constipation issues, because you're really pushing everything down all the time. So it's good to assess what's happening, I wouldn't just be doing Kegels because that might not honestly help at all.
Starting point is 00:37:09 It might be making things worse, fatiguing those muscles even more quickly than they already are. Okay. What about hormones? What's going on there? So as we go through menopause and our estrogen levels decrease, it really affects a lot of things in our pelvic region. So it affects the strength and thickness of our vaginal wall, right? And the lubrication of that vaginal wall. So that's why you end up with dryness vaginally or pain with intercourse, as well as increased risk of prolapse.
Starting point is 00:37:42 So because this wall isn't as thick as it used to be, there was a nice shelf here for your bladder to sit on. As that tissue thins, then either your bladder or your uterus can drop down a little bit further because there's not as much support there as there was. The other thing that affects is your lower urinary tract. So it does affect your external urethral sphincter. And so it's the same thing. It's not as thick, not as strong as it used to be. So it's more common to be experiencing urgency, frequency, incontinence, and prolapse as you go through menopause. But that doesn't mean that you should just live with it, right? Yeah. There's a lot of things. Yeah.
Starting point is 00:38:26 There's a lot of things that you can do. Likely, it's a combination. Like it's almost never just menopause. It's either you had other things happen. You have this tension. You have other injuries. There's other things that are contributing. So we can really reduce it by reducing all of those things.
Starting point is 00:38:41 If we do all of that and you're still having issues, you can ask your family physician for vaginal estrogen. So hormone replacement therapy orally hasn't really been shown to help with any urinary urgency or incontinence. But vaginal estrogen, it's just like a cream or a pill that's, that's that's, uh, applied vaginally that can really help with that tissue health. So it could be help with lubrication so that if the skin feels irritated or is bleeding or is dry and cracked, um, with the thickness of that vaginal wall, so it can help with prolapse. And then it does help with, uh, urinary stress incontinence as well. Wow. Okay. Um, what about, I mean, a couple more questions. And then I want to get into when
Starting point is 00:39:26 to seek help, just cognizant of time, constipation and weight loss. So let's do constipation first. Is constipation something that can be addressed by, is it a symptom of pelvic health and can it be addressed by physio for that? Yes, for sure. You would never think of that. You would never, well, maybe that's not the thing. I should let you answer first. Yeah, so it totally like I see people like most people who come in, have something right, either constipation, or they have been really loose stool. And these things can really be affected by tension in your pelvic floor. So around your at your anus at your the bottom of your rectum here, your pelvic floor muscles are there. So if they're tight, what happens is, normally, let's say your bowel would fill. And then if there's no tension here,
Starting point is 00:40:09 when you have to empty your whole bowel just empties. But if you have tension here, your bowel fills up. And then as you're emptying your bowel, there's not there's too much pressure here. So it stops maybe only empty half, right. And so then this stool is sitting in your bowel for a lot longer, and water is excreted from it, it gets harder, and then more is filling up. So you're only ever emptying like little bits, like if you're only having, you know, a couple little like dry round pieces with your bowel movements, then you know, you know, you're probably having constipation. But as well, if you're having diarrhea, really loose, watery stool, sometimes that can be the only thing that can get around all of this hard stool in your bowel. So releasing tension
Starting point is 00:40:50 in those muscles can help you to fully empty. But there's obviously a lot of other things that contribute to constipation or bowel issues. So you want to make sure you check with your family physician about all of that first, but it really is connected. Yeah. I mean, let's just take a minute, hot minute and just remind people that if ever they feel like something is off, checking with your healthcare provider, definitely the way to go. But that's one thing you never think constipation, right? I'm constipated, eat more leafy greens, have more fiber, drink more water, all those things. You don't think that it could be tied to your pelvic health. Okay. What is, what about the impact of weight gain and weight loss, Erin? I mean, here we are, we,
Starting point is 00:41:23 you know, we're taught, that's what we're talking about. So how does this conversation factor into that? So increased weight, especially around your abdomen can put more pressure, obviously, on your pelvic organs on your bladder. And like, it's more literally more weight for your pelvic floor to be holding up, right? So those muscles are just working harder than they need to. So of course, losing weight will help take some of the pressure off your pelvic floor. But again, like I don't want any of these things to be a barrier for anyone to seek help. Like, oh, I'll get help once I lose my weight. Like I see women and men of all sizes who we can address their issues. Weight is just a small part of it. All of these are just small little parts of the puzzle. And so obviously helping in all of these different ways can help, but none of them is the
Starting point is 00:42:10 whole issue. And none of them are as a reason to just, oh, well, you know, I'm overweight, so I'm going to have this issue or, oh, well, I'm going through menopause. I'm going to have this issue. No, they're all just small pieces of the puzzle, but it does affect your bladder function, heaviness, all of those things. Okay. Just quickly, your thoughts on Eurospot, Perry Fitthrow, and UriLess. I don't have a clue what any of those are. That's the machines you're talking about. Yeah, you sit on the machine, it does 20,000 Kegels. Again, if you really want to go and you have the means to go, I would make sure that you research the spot, make sure that they're reputable, that they're doing an internal exam before you would ever get this treatment. But honestly, if you're willing to spend $3,000, like spend $130, go see a pelvic floor physiotherapist and they will be able to do the same thing for you. Okay. Let's get into that. Cause again, this conversation, all of our conversations with our guests, I mean, we could go down the rabbit hole and maybe one day we will
Starting point is 00:43:08 go down all the different rabbit holes of these conversations with our guests. Not enough time in 91 days. But this is sort of about, it's about bringing awareness. It's about that. Maybe what you are dealing with is more than just drinking more water and having to go to the bathroom. Maybe, you know, just, this is what this conversation is about. It's about bringing awareness, trying to educate and inform and empower people to really understand what's going on in their bodies and to be able to take the appropriate action if needed. Maybe it's doing some exercises on their own. Maybe it's going to their doctor. Maybe it's seeking out a physiotherapist. Okay. So, I mean, I'm going to ask you when to see a doctor, maybe it's seeking out a physiotherapist. Okay. So I mean, I'm going to ask
Starting point is 00:43:47 you when to see a doctor, but I mean, I think we covered that. Anything else to add? Yeah, you should see your doctor if you have any of these issues and mention it to them, talk to them about seeing a pelvic floor physiotherapist. But if you have anything like a really big change in urinary incontinence, like if all of a sudden your bladder's emptying just when you stand up or you're having blood in your urine or you're having pain with urination, anything like that, like anything at all, you should be talking to your doctor about this.
Starting point is 00:44:14 You don't need to be embarrassed. There's things that can be done, but yeah, advocate for yourself. It's okay to share all of this information with your doctor. It's not too much information. It's what's happening with your body and it's an important part of your health picture, right? Yeah. Someone said you answered questions I didn't even know I had. Yeah, this is I said, this is the conversation
Starting point is 00:44:32 you didn't even know that you needed to listen to. Hopefully, you're not having any of these issues. But if you are, hopefully, this is give you some great insight to that. So how do people find of course, everyone is going to want to know where to find you. I know you're local here, Canada, Ontario in a real, yeah. Um, and we will definitely put your, well, I'll ask you for your, well, your contact information. You are at Lake country physio. Oh, that sounds so lovely. It is www.lakecountryphysio.com. Um, and I know they can follow you on Instagram. I'll give you, I'll give them, well, okay, there we go. The team is very quick. Squats.n.margs, squats.n.margs. And you're also, you also, uh, did the programs. You're always sharing great tips, great recipes, by the way. So people want to follow you over there as well. How would people who are in Hong
Starting point is 00:45:25 Kong or New Zealand or in the US or anywhere else in Canada who don't have access to you, where do they start with this? Is there like a pelvic physio directory? What do they do? Go to their doctors? What do they do? So in Canada, you can go to pelvichealthsolutions.ca. They have the website up there now. It has a great resource to like find a local physiotherapist in your area. By no means does anyone have to come and see me if they don't live in my area. But there's so many great well trained physiotherapists on this site. And then if you live outside of Canada, yeah, I would I would talk to your doctor, they probably have something similar. I don't have a list of all of those resources, but I could look into it for you if you had questions. But yeah,
Starting point is 00:46:09 I would talk to your family physician. They should be able to point you in the right direction, hopefully, or just look for like a pelvic physiotherapist who's accredited, who's been, you know, well-trained in your area, wherever you are. Great. Well, Erin, thank you so much. I really appreciate you coming on and having such a passion for health wellness, really understanding how hard people in the program are working to make change. I mean, that's one of the things I love about all of our guests. This is such an important conversation. Like I said, the first time we had it, I was wowed. The more I look into it, it's a really systemic issue in the sense that we're just being blown off men and women when it comes to this conversation, or we don't think, you know, we
Starting point is 00:46:50 don't, we don't even, we're not even knowledgeable enough to know that there could be something more going on. And this is why I love having guests like you on. So thank you for taking the time for us today. Thanks for everyone who is, uh, joining us live and watching and when listening, what, if there was one thing you wanted people before we go one thing you want people to know about pelvic health, what would it be? I would say like, everyone that I end up seeing afterwards says, Oh, that wasn't as bad as I was expecting it to be. Right? I think people come in and they're very nervous to have an internal exam. Like what is the person going to think? I don't care at all about anything happening down there. You know, like, you don't have to be nervous about it. It's not weird. It's not like a sexual thing. Like we're just assessing muscles
Starting point is 00:47:35 inside your body. And there's so much that can be helped. So I would just I they do a much better job of this in Europe. So they, as soon as you have a baby, or as soon as you have an issue, you see a pelvic physiotherapist, but we're very like, you know, we're very private in our culture, which, you know, is okay. But I think it's okay to be talking to talk to your friends about it. Probably half of your friends are experiencing the same thing that you are, and no one's talking about it. Yeah. And then yeah, just don't worry about about coming in. It's everyone says, Oh, that wasn't as bad as I thought it was going to be. So if that helps at all. All right.
Starting point is 00:48:08 Well, we're talking about it and that's what's important. We're talking about it. All right, Aaron. Thank you so much. Everyone else. Thanks so much for joining us today. Uh, we'll see you next time. Thank you.
Starting point is 00:48:18 Bye.

There aren't comments yet for this episode. Click on any sentence in the transcript to leave a comment.