The Livy Method Podcast - Pelvic Health with Erin Degagne - Spring 2025

Episode Date: June 18, 2025

In this episode, Gina sits down with Registered Physiotherapist and pelvic floor specialist Erin Degagne for a candid chat about pelvic health—and why it's something everyone should care about, not just women who've had kids. From interrupted sleep and frequent bathroom trips to back pain and constipation, they uncover how pelvic floor dysfunction quietly affects daily life. You’ll learn why random Kegels aren’t always the solution, how simple habits like walking or deep breathing can support better function, and what urge delay really means. Plus, Erin shares practical tips you can try today to get more in tune with your body. This is a must-listen if you’re tired of discomfort being your norm—and ready to take that first step toward real change.Where to find Erin:Instagram: @squats.and.coffeewww.lakecountryphysio.comYou can find the full video hosted at: https://www.facebook.com/groups/livymethodspring2025To learn more about The Livy Method, visit www.livymethod.com. Hosted on Acast. See acast.com/privacy for more information.

I'm Gina Livi and welcome to the Livi 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 relisten 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, and Amazon music. This is an opportunity to become curious. To learn some things. How do we help you feel less overwhelmed so you can continue on your journey? Keep believing in yourself and keep trusting the process. Just be patient.

What does your pelvic health have to do with weight loss? Actually a lot more than you think. Every time I have this conversation with our guest today, Erin Degagne, I'm fascinated. It's so interesting. The first time I had it, and I time I have this conversation with our guest today, Erin Degagne, I'm fascinated. It's so interesting. The first time I had it, and I know I say this, every time you were on, my mind was blown. And this conversation is not just for women

who've had babies and pee their pants when they laugh and think that's an ongoing thing. It is for every one, men, women. Everyone can deal with pelvic health issues. Like I said, my guest today is Erin everyone, men, women. Everyone can deal with pelvic health issues. Like I said, my guest today is Erin Degagne, who is a pelvic health physiotherapist. Hello, hi. Hi, Gina. Nice to be back.

Are you ever surprised? I mean, this is what you do and you have a passion for, but are you ever surprised by this conversation? Yeah, it's always surprising. New things every day. I'm seeing patients every single day. So we're always getting new questions, new things on the horizon, a lot more talk about hormone replacement therapy, menopause, that kind of thing. But I'm still surprised by how much people don't know about their bodies, how much they're

not getting the information that they need to be able to do what they need to do to help themselves out. Well, I do have to say, I don't know if it's through my conversations with you, but I am noticing more and more people are starting to talk more freely about pelvic health. Yeah, like our culture over here in North America is like pretty private, right?

In Europe, this is just like a normal thing that happens. You have a baby or you have an issue, you have a surgery, you go see a pelvic floor physiotherapist. Here we're a little more private, but I do notice a lot that the younger generation are like telling all of their friends, any young women that I see are like, oh my gosh, I told my mom, I told my aunt. Whereas older women tend to be a little more nervous to come in and they just have, they don't think anyone else has this problem because they weren't, aren't really talking as much

to their friends about it, but it is improving. So that's good. Well, it's interesting because we had a post in the group on pelvic health and women were talking about how they had like just back pain or pains and didn't know what the cause was. Their doctor sent them to a pelvic health physio. It made a world of difference.

Like we don't really associate back pain or aches and pains with our pelvic health. Let's get into this conversation. What is the difference for men and women? I wanna make that very clear because this conversation is for everyone off the top. So both men and women have a pelvic floor.

So it's just these muscles that attach from your pubic bone to your tailbone. They help with bladder control, bowel function, pumping fluid out of your pelvis, sexual function, and to support your hips and pelvis. So everyone has a pelvic floor. We tend to hear more about it around women just because after childbirth,

the pelvic floor is more affected. But both men and women have tons of issues with their pelvic floor, and like you said, it can lead to back pain, hip pain, tailbone pain, abdominal pain that isn't explained, and that kind of gets passed over because you just think it's something mechanical that's happening in your back itself,

but we see a lot of men with low back pain that's just not resolving, and they tend to hold a lot more tension in their pelvic floor as opposed to having weakness. And then also with prostatitis or having a prostate removed with prostate cancer, we see a lot of men for pelvic physiotherapy with that as well. But they're up in the night peeing all the time too. Well, I was just going to say, so sort of how this conversation comes about, and I just

thought it was just going to be about more frequent trips to the bathroom. Obviously when you're following the Libby method, you are drinking more water throughout the day. But, you know, it could be that all those trips to the bathroom are more than just you drinking more water, because that should subside. Once you get hydrated, no one's asking you to drink more than you need. Once you get hydrated, that frequency should start to decrease. But if you're still noticing you're going to the bathroom quite often,

there could be some underlying issues there. How would someone know if they have pelvic health issues? So there's a bunch of different signs, but yeah, if you found that, okay, now you're doing the program, you're drinking more water, and all of a sudden you're up peeing more than once at night, that's not normal. Again, maybe a couple weeks in, that's normal.

Your body's adjusting to this new, like a couple weeks in, that's normal. Your body's adjusting to this new, like you're finally hydrating yourself, great. But then that should subside once a night is normal. Zero is great once it's considered normal. Anything more than that, not normal. So that could be a sign that something's going on with your bladder itself, like check with your family doctor, or it could be something with your pelvic floor. And then during the day, if you're always thinking about when you're going to pee next, where the bathroom is, if you're having to plan trips around when you can access a bathroom, that kind of thing, that's a sign.

If you're having any pelvic pain, if you're having any pelvic heaviness, if you are having any leakage, so urine leakage or stool leakage, obviously that's a sign that you have something going on with your pelvic floor. But again, you want to check with your family doctor first if everything else has been cleared. See a pelvic physiotherapist because there's so much we can do for this. I know it seems like something that's just normal as we age, but no, like it's a totally fixable problem that should be dealt with and not just left. Well, I'm glad that you mentioned that because, you know, I grew up around women who laughed, who peed when they laugh. We joked about, I even joked about my kids had a trampoline

at one point. I'm like, I can't get on that trampoline. I peed my pants. I just thought it was my due because I had four children and that was just what was gonna happen with me. And I think we laugh about it, we joke about it, but it's actually not, it's normal in the fact that it affects so many women,

but it's actually not a normal thing that we should just sit back and accept. Especially that going to the bathroom multiple times a night, I know through conversations that I've had with Erin, a lot of that is just habit. I wanna make sure that I can go to sleep because I had sleep issues. And I think, oh my goodness, I should pee

or I'm not gonna be able to sleep. Or I'm lying there, I'm like, okay, do I have to pee? Do I not have to pee? Let me go just in case. And in fact, I was just basically training myself to get up multiple times throughout the night. How do we, and then also menopause, that's a big conversation.

We're awake at three o'clock, we're going to the bathroom. What do we and then also menopause, that's a big conversation, we're awake at three o'clock, we're going to the bathroom. What do we do about that? What's not you said one time a night, but how do we know it's the way we've trained ourselves or is that part of pelvic health or is it just something structurally with our body and our hormones? Yeah, so it could be either, right? So it could be that you have all this tension in your pelvic floor and that's sending this signal to your bladder to say that you have to pee more than you do. It's kind of a protective mechanism so that you don't have leakage. So it kind of get your central nervous system kind of goes

overboard trying to protect you. So it's sending you the signal that you have to pee all the time, even though like your bladder should be able to hold the amount of liquid that you've drank before bed, unless you're like guzzling water before bed. So you want to taper your drinking before bed, but I never tell people toling water before bed. So you wanna taper your drinking before bed, but I never tell people to stop drinking by like a 6pm or something like that. Just slow your drinking down.

You wanna try and drink the bulk of your water at the start of the day, and then just slowly be drinking through the day. And then there's a couple other things that you can do. So if there's medication that you take that does affect like any diuretics, things like that, that can affect you having to go to the washroom at night. You can talk to your family doctor about that. You can maybe move them around so that you're not

taking them right before bed. And also we tend to hold a lot of fluid in our lower body, especially if you're up doing a lot, you're exercising or you're just, you're sitting a lot through the day. You're not, your legs are down, right? And so you tend to kind of hold a lot of fluid there. And then when you lay flat, your body is processing all of that fluid. So then you have to pee. And so if you can lay down with your legs either up the wall or elevated in some way about half an hour before bed, that can allow your body to process some of that fluid, pump your ankles, and then it can you can go pee before you go to bed. And then you start doing that multiple times through through the night. There's a bunch of things like you want to deal with other sleep hygiene things too so that you're not waking up because like you said sometimes you wake up and you're like well I might as well just pee because I don't want to wake up again later if I have to pee so don't do that for sure but if you're not waking up multiple times in the night for other reasons like you've been on your phone right before bed or whatever then that will will help as well. But if you find that you wake up once, the first time you wake up,

go pee, that's fine. The second time you wake up, I would roll over, try and go back to sleep. If you're laying there for more than five minutes and you're really thinking like, oh no, I really have to pee, get up and go. It's not worth staying up all night, but try and retrain that because unless there's something else happening with your bladder, you shouldn't need to be going that often. And then how long should we be going to? Like, does it, like if I just, I get up and I'm sitting there and I'm like, do, do, do, do, do, do,

it's taking forever or not very much is coming out. What's normal there? So normal is more than six seconds. I find with patients that I see who are doing GINA, which is a lot, they are often really well hydrated. So it's more than six seconds. Like this data is on like normal people who are probably super dehydrated. But if you're going pee all the time and it's like three seconds or it's a little dribble,

you feel like you really need to rush to get to the bathroom. And then you get there and you're like, oh, like, I felt like my bladder was about to explode, and then I got there and that didn't feel like enough pee. So less than six seconds, it's probably a sign that you do have pelvic tension, your blood or your bladders not fully emptying. So we need to look into that. I want to get into that with Aaron, because I think some of you might be surprised that she keeps talking about bladder tension and we assume that if we keep peeing ourselves it's because we're all loosey goosey down there. Before I get to that though Erin, I want to talk about what about during the day because

there are people talking about how the nighttime, whatever, it's during the day which is affecting my life. That's, and the adult diaper industry is one of the largest growing industries out there. There's more and more on the shelves. Obviously, it's a real issue. So what's happening when we have to keep going during the day? So what happens with urgency? If it's feeling like you have to rush to get there or you stand up and then all of a sudden, oh my gosh, you have to pee, you're running to the bathroom. So normally your bladder, when it fills up to let's say 75% full, it sends a message

to your brain that says you have to pee. You look around and you're like, I don't know, I'm out for a walk. There's no bathroom here. I don't want to pee right now. Your brain sends a message to your pelvic floor muscles. They contract. So you don't know any of this is happening. They contract.

That sends a signal back to your bladder that's like, not right now, she's on a walk. Your bladder relaxes, you pee when you get home or whatever at a more convenient time. But if you have pelvic floor tension, which is often the cause of this urgency or frequency peeing all the time, then your pelvic floor gets that signal that, oh, she's on a walk, but it's so tight already, it can't contract to send that signal back to your bladder to say like, not right now. So your bladder thinks, no signal, time to pee.

So it starts to contract. That's that feeling like of urgency, is this like, oh, I'm starting to pee. Luckily, most people have decent pelvic floor strength, right, otherwise, every time you stood up, you'd pee your pants, or every time you stood up, you'd pee your pants or every time you, you know, walking you pee your pants. So you can stop that but you're rushing, rushing, rushing, rushing to get to the bathroom. Sometimes you make it there. Sometimes you don't make it there and you have a little bit of leakage

on the way we call that urgent continents. And then when that happens, that's a really stressful thing for your for your body. It's it's thinking, okay, I don't want to have leakage in front of my co workers. I don't want to pee my pants on the street. So let's fix that. Now let's lower that line under your bladder. So now we're going to send the signal to her when we're 60% full and often stronger signal as well. So it feels super urgent. You get there, you're like, oh, I could have waited. Right. And unfortunately over time that just gets worse because these pelvic floor muscles, if they're tight, they can't be released through a normal stretch because your pelvis

is just this pelvic ring of bone and it can't move apart to stretch those muscles like you would stretch your leg or your neck or whatever. What about small bladder? Is that a thing someone just uses? I just have a small bladder. Is that actually a thing? So it is a real thing that can happen. It's so rare.

And I think that it gets overused, right? If you think, oh, I'm peeing all the time. I just have a small bladder. Like unless you've had a cystoscopy or an ultrasound done that shows that you really do have a like a smaller than normal bladder, like that's probably not true. And it wouldn't create urgency. It would just mean that, you know, you had to pee more often,

but it would still feel pretty normal, right? Like your 75% full would still be like, oh, I have to pee, but like I'll wait till later. And then, you know, if you wait long enough, of course everyone has urgency. But if it's urgent all the time, that's not probably a small bladder. Okay. I want to get into what we can do about it

structurally, but what about things like coffee, alcohol, stress, are there any things that's making it worse that we could do that can make a difference? Yeah, so there are things that are bladder irritants. It doesn't mean necessarily that you have to stop drinking these things or having these things, but if it's really affecting your life

and you haven't figured out what the problem is, it wouldn't hurt to kind of cut down on these things or having these things, but if it's really affecting your life and you haven't figured out what the problem is, it wouldn't hurt to kind of cut down on these things to see if it's just less irritating to your bladder. So yeah, coffee, carbonated beverages, spicy foods, acidic foods, smoking, artificial flavors and colors, like that kind of stuff, is irritating to your bladder lining. Does that mean that I'm not gonna drink coffee?

Like, no. But if you're already peeing like 12 times a day, maybe don't have three coffees a day because that's really going to increase that. Well, Erin's Instagram account is called squats and coffee. So she's not about to stop drinking her coffee. So let's not worry about that. Okay. Let's go through some of the common issues for men and women, urinary urgency, urinary frequency, nocturia, waking up at night to pee, bowel issues, constipation,

bladder irritants. Let's talk about, let's move into constipation because we don't think, we're not thinking of pelvic health as I don't think that of constipation is of pelvic health, but people do deal with constipation. So when people are following a program, they can have bouts of loose bowel movement, especially when the scale is moving bouts of constipation for periods of time, any changes in their diet and whatnot. But when do we know that our constipation is a real issue and due to our pelvic health? So again, it's often like multifactorial, right? It's not often like, oh, it's just this pelvic issue that's causing it, but it doesn't

help in the same way that pelvic tension, if you have, you know, painful periods is making your pain. So the painful period maybe is caused by endometriosis, but then the pelvic tension on top of that is really making it 10 times worse. So same with constipation. If you're already a little bit constipated, a you're probably sitting on the toilet pushing for long periods of time, that's really hard on your pelvic floor. And so then when what happens is you end up building up this pelvic tension, either because you're like trying to hold things in or it can be with IBS as well, or looser bowel

movements, like if the muscles are trying to hold things in all the time, they can get fatigued and then they get tight. And then what happens is so there's less space for the stool to leave the bowel, right? So you have to wait what ends up happening is like, so let's say this is your bowel here, okay, it has to fill with stool enough that it can push past the amount of tension that you have right at your rectal opening through your pelvic floor.

So as it gets full, full, full, okay, perfect. Now it's full enough, it can push past this tension, but then it comes down, you're not fully emptying your bowel because as it empties, there's not enough pressure left in your bowel to push past the amount of tension that you have. So then you have this stool

that's staying in your bowel for longer, it loses more water, it's hard again, and it's just like vicious cycle of never fully emptying your bowel. And then the opposite of that is that if you have really loose stool often, it's that it's way more difficult to stop, right? If you have diarrhea, or if you're having loose bowel movements all the time, once, you know, if you get sick, and it happens a a couple times your body can handle that. But if it's every day you're having this loose stool your pelvic floor muscles have to work so hard to stop fluid versus like a solid stool that those muscles get really fatigued and then they just can't do it anymore and that's when you end up with with stool leakage or like full

loss of control of your of your bowels which can be terrible and scary right but there's things that you can do to kind of fix all of that. What can we do? Okay, should we keep a pee poo journal? Like, like, if someone has constipation issues, and it's pelvic health related, and they also assume that their urinary issues are also like would they also have urinary issues? Can you have one without the other? You can have one without the other you can have one without the other

but oftentimes like most people most Women have some sort of pelvic health issue right whether it's leakage or urgency frequency pelvic pain heaviness And then yeah most people with a bowel issue same thing. It's probably been there for a really long time We don't do a great job of diagnosing and treating bowel issues And then, yeah, most people with a bowel issue, same thing. It's probably been there for a really long time. We don't do a great job of diagnosing and treating bowel issues, unfortunately. And so then it does end up causing tension, which then trickles over into bladder issues as well.

But would the fact that we're so sedentary and sitting at our desk all day play a role in that? Yeah, for sure. So walking is a really great way to get your bowels moving. If you do feel like you have constipation. So going for like a 10 minute walk after each meal. Great way to get things moving so that it's not just like sitting in there. There's no blood flow to your pelvic area. Making sure that you are drinking enough water, staying hydrated. Super helpful obviously for constipation. Doing some deep breathing. Most of us are doing kind of this upper chest breathing all the time.

But your pelvic floor, so your diaphragm is here and your pelvic floor is right below. So when you're taking a deep breath, your diaphragm drops down to allow your lungs to fill with air. It forces your pelvic floor down to relax. But if your diaphragm's never dropping down to fully fill your lungs, then you're never getting a full relax on your pelvic floor, so it just stays tight all the time. And it's a lot harder to get things moving through your bowels when that's not happening. Yeah, because we're always just shallow chest

breathing. We're never actually breathing in a way that we're... We actually have to like sit down and practice it. And you're not really thinking about... You're thinking, okay, it's helping to relieve our stress, but we're not thinking about what's happening for pelvic health. Yeah. And you want to think about relaxing those muscles. Most people are holding tension in the same way that you hold tension in your neck. You might catch yourself like, oh, I'm clenching my butt or like I'm clenching my pelvic floor just with stress and anxiety. So if you can get a hold of that in some way, breathe breath work, yoga, whatever you like to do

to get those muscles to relax so you're not just holding this tension all the time, that will transfer over into bladder issues, bowel issues, all of those things. Well, I was just thinking what you said there, because tension in your neck, when you have tension in your neck and your shoulders are tight, that gives you a headaches,

it makes you feel nauseous, tired, it messes with your shoulders, and it goes down into your neck, when you have tension in your neck and your shoulders are tight, that gives you a headaches. It makes you feel nauseous, tired. It messes with your shoulders and it goes down into your back. And it's just, you don't feel motivated to do anything. And then your mood is affected and then you're hungry. You're not hungry. And is that just happened at the opposite end basically? Yeah, it's very common to have the two together.

So if you have neck tension, which most of us do, you probably have pelvic tension, which most of us do, right? It's a very common, common thing that we're holding this tension, right? And in the same way, it can refer to like hip pain, back pain. So those things often get mistreated for so long. Like I do regular physiotherapy as well. I'll see a patient for hip pain for a long time. And I'm thinking, you know, this doesn't make sense. Your hip moves really well, but we release tension externally, and then it just comes back. And often there is this missing piece of these internal muscles that are really, really tight that have been there. That tension has been there for years, whether it's from an old injury when they were young or a trauma in their past or stress or whatever surgery could be anything.

It's time for today's podcast sponsor and this is a company that I can feel good about. It's Bombas. Did you know that socks are one of the most requested items by organizations supporting people experiencing homelessness? Yeah, socks. The thing most of us take for granted every single day. That's why I love Bombas. They make the most comfortable socks in the history of feet. Seriously, once you wear them you'll never go back. And for every pair you buy in Canada, they donate a pair to someone who really needs it. Same goes for the insanely comfy underwear and tees, which just so happen to be the most requested items by shelters. So far, Bombas has donated over 150 million clothing items.

That's not just doing good. That's doing real good. But let's talk about how they feel. Every sock, slipper and tee is made from the softest, dreamiest materials. The underwear, effortless, the t-shirts, they're going to be your new fave, and the socks, game changers. Especially if you're working out, walking lots, or just love a cozy vibe.

They even have compression socks if you're into recovery mode like me. And the best part, Bombus has 100% happiness guarantee. Meaning you can return, exchange anything, anytime, no questions asked. So if you wanna feel good and do good at the same time, just go to bombus.ca slash livi, use the code livi, L-I-V-Y at checkout for 20% off your first purchase.

Again, that's bombus.ca slash livi. And don't forget to use the livi discount. Okay. How does this overall then, I want to get into what we can do about it. So there's a couple of things I want to ask you about. How it affects weight loss? Like if someone was trying to lose weight, how would that affect them? So having extra weight around your abdomen,

in your pelvis, right? All of that does put a lot more pressure on your pelvic floor. So not only are those muscles holding up your organs, but they're also holding up visceral fat. All of the fascia around all of that tissue is pulling, right? Like, so there are, there is a part of weight loss that should benefit your pelvic floor.

But I try not to put too much emphasis on like, this problem is just your weight, so come back when you've lost your weight, because A, that's not true. But that does kind of get sold to them by their family physicians. I hear a lot just like this is because you're overweight, fix the weight thing and this will go away. But the truth is I see people of all sizes.

I see people who are very, very thin, people who are very overweight. Both we can fix their pelvic floor issues, but it will help. Like it's a great thing. It's a part of a motivator, right? If you're on this journey to lose weight and get healthier, of course, that's going to help so many different parts of your body, including your pelvic floor tension or weakness or just the stress that it's putting on your pelvic floor all of the time and the physical stress on your bladder. Those things matter, right? That's part of why during pregnancy this gets worse. It's the same thing. There's extra weight on your bladder. There's extra weight on your back. You know, things aren't really where they should be. But don't let it be a barrier

to seeking treatment. Okay. It also tends to get worse as we age and especially through menopause. Are they connected, is it just because we're aging and menopause is connected to aging or are they separate? What's happening in aging also is separate from what's happening in menopause. So as you age, the tissue gets weaker, the muscles get weaker in general, just like everywhere else in your body, right? So these pelvic floor muscles, they will get a little weaker as you get older, but never to the point

where you should have leakage, honestly. So it's not like, oh, these muscles are just weak, forget it, like you need a sling put in or something because those muscles are too weak. That's not gonna happen. Outside of like, you know, if you have a neurological condition that's affecting the strength of those muscles,

but otherwise it would be the same as if your arm got weak and we just said, oh, well, you're old. So I guess you just have to live with that. Right? I mean, when you say it like that, yeah, we're like, oh, yeah, that's like, that's like when your pelvis gets weak and you just like go wear a diaper. That's like if your arm was weak and they said, oh, just wear it. Yeah. For the rest of your life. Oh, my gosh. When you say it like that, okay. Yeah.

All right. There is a hormonal component too, right? So as your estrogen decreases, it really does thin the tissue of your vaginal wall. So it makes it more likely to have a prolapse, which is when a bladder or uterus rectum is kind of falling into your vaginal wall that feels like heaviness.

It's really uncomfortable. It affects the quality of the tissue. So it's easier to have like bleeding or irritation, pain with intercourse, that kind of thing, which again, kind of gets pushed off as like, well, you're going through menopause, like this is what's going to happen. But it's not true. There's a lot of things that you can do, hormone replacement therapy, local estrogen treatment to that tissue is often really, really effective in helping. But it also affects your lower urinary tract. So right where your urethra exits your body, that tissue also becomes thinner.

So if you already have incontinence or you already have leakage or urgency going into menopause, often menopause is the thing that kind of pushes it over the edge where it becomes unmanageable or I feel like now you're having all this leakage, it's really affecting your life. And then, you know, it becomes the snowball issue where you finally come and see me. I just want to reiterate someone just joining us right now. When we cough or throw up, I don't know about throw up.

Yeah, I guess it's not normal to pee. No, it's actually not normal to pee. And we've been taught just deal with it. Just part of aging, it's part of menopause, it's part of having a baby, it's part of whatever. It's actually not normal. And there are things that you can do about it, which I wanna get into now.

We talked about bladder retraining, keeping a diary. We talked about breathing. I wanna get into pelvic floor strengthening. Are there exercises we can do? What about those Kegels? Should we do them? Shouldn't we do them? And then also those things that you sit on and that that strengthens that as well. I want to know all your thoughts on all of that. What can we do?

Okay. So the thing is, is that we can't see these muscles. It's not like your shoulder where you can kind of see what's going on. You can test things out, you know, in the comfort of your home or in a physiotherapy office, your pelvic muscles are, you can only be access them through your vaginal opening or through your rectum. And so unless you have an internal exam, which I understand. So what, what pelvic physio is, we should probably explain this. It's an internal typically exam of these muscles to find out are they weak, we'll check your strength, show you how to do a proper contraction to see if you

can physically do it and how to relax those muscles. And are these muscles really tight? So you know, like, oh, yeah, that feels like a tight muscle, like anywhere else in my body or like, no, that feels fine kind of thing. And I mean, as the assessor, I know, yeah, this is tons of tension here, right? So we're assessing those muscles vaginally for women and rectally for men, sometimes rectally for women as well, depending on what your issue is. If you have tailbone issues, often we can treat tailbone things rectally as well. Yeah.

And I, before you get into this, even more people are like, no fucking way I'm doing that. I can't tell you how many people in the comments are like, I have gone to see Aaron or because of this conversation, I went to go seek my own physiotherapist. And it was a game changer. I mean, if you're peeing your pants all day, you can't sleep all night, a little bit of uncomfortableness will go a long way to really affecting how you live your life. So I totally get it. The thought of this for me is just like, I don't know. But man, if it's really affecting my life, and there's something that

you can do about it makes sense. And again, a lot of these are our lifestyle, the way we've come to live our lives. It's not just like a flaw in the human body. No, no, we just push things off. We're rush, rush, rushing all the time, like pushing ourselves to our absolute max, ignoring problems, right? But yeah, I understand it's a super uncomfortable idea to go and have an internal exam, I promise. It is so much better than what you're expecting. Almost every patient I see when they leave say like, Oh, hey, like that was way better

than I thought. Like most people are nervous going in. That's very normal. But it's it's worth it. Like if this didn't work, I said this to people all the time, if this didn't work, I would not do it. Like, it's not something that I'm like interested in doing if it's not going to help somebody. And it's really effective treatment. So what we do is we'll see what's happening in those muscles. If there is tension, it's not like the

muscles are damaged, there's nothing horrible happening. They're just so tight. And there's no other way to release them except for internally. So we're doing like manual release of those muscles, stretching those muscles basically internally, instead of like, because you can't stretch them externally. And often, I know this sounds crazy. It sounds like, okay, this is never gonna actually work. And that's how I felt when I first took the course.

I was like, there's no way this is gonna do anything. It's so effective. The muscles are then at their normal length, they can function the way they need to, contract quickly when you cough or sneeze, or send that proper signal to your bladder. Like it gets them to where they need to be so they can do what they need to do.

Yeah, so, so, and people are talking about how it is much easier than they than they thought it would be. Yeah, much easier than they thought it would be. Again, it's just a thought of that, right? And a lot of times it's our thought of it or that's affecting us. It's when in reality, this is a real thing. Do people notice instant relief? Yeah, so I, I'm always like, not anymore. I've been doing this for 15 years. I'm less shocked. But I remember when I first started doing this thinking like, okay, this isn't gonna make a huge difference. Like, maybe it'll help a little bit. I have people every single day coming back. Oh, my gosh, like, I'm Yeah, I used to wake up four times a night. I didn't even wake up last night. Or I used to have like I'm wearing depends every single day I was doing four diapers. Now nothing. Like it's not a partial fix. Like this should be a fixable, completely fixable, like no leakage, no urgency, no frequency. It's not something that you should just deal with a little bit. Like it's fixable. So it's worth it. Okay. What about exercises? What about what can we do? What can we do on our end of things?

Yeah. So like I get that's kind of like physio. If you got your shoulder, your neck, you're going to someone who's releasing those muscles makes a huge difference. But there's obviously things that I can do on my own to strengthen or release or stretch, in this case, those muscles. What can we do on our end of things that I'm sure will make a difference as well? Yeah, so any deep diaphragmatic breathing or breath work is a great place to start to really get your pelvic floor

to relax, contract when it needs to, that kind of thing. So stretching for your back, your hips, muscles around your pelvis can be super helpful. I think we have a video that we did before about different stretches that might be helpful. But yeah, the more you can kind of stretch muscles in and around your pelvis, then your pelvic floor isn't compensating for those muscles and those muscles aren't compensating for your pelvic floor. Keeping a bladder diary is really insightful because most people have no idea how many times they're peeing a day. They just know it's a lot. And then counting

how long you're peeing for. So like we said, if it's less than six seconds, that's too way too often that you're going. And if you're paying more than six to eight times a day, again, too many times work on either urge delay, which we haven't talked about. We could talk about that, which is just getting that urge to calm down because it's a central nervous system issue. It's not a bladder problem. It's that your, your body's trying to protect you. It doesn't want you to have leakage in the street. So it's sending that signal more and more often, but you can get that to retrain. Yeah, that's, that's really key because that's sort of like you're driving the car.

I have to pee. I have to pee. Oh my God, I'm going to pee my pants. And then you just like, okay, let me distract myself. I'm fine. I'm fine. I'm fine. I'm fine.

And all of a sudden you can go like another half hour and you're just like, what? I was just going to piss my pants. What's going on there? And so at home, this is where we think, Oh, I got to go. And then so we do go just go. We're just like, we're just keep creating that. So whenever we think that, then we got to go and then it just makes it makes it worse. So we have to kind of try to resist that urge sometimes. Yeah. So only if you if you've done a bladder diarrhea and you know that you're getting there and it's like three seconds, four seconds, that's when you can start working on this urge delay.

You don't want to be holding your pee as long as possible. That's not helpful either. You're way more likely to have leakage when your bladder's super full. Let's say, yeah, you pull into your driveway. This is often a really specific trigger for people. You pull into your driveway, all of a sudden, boom, you have to pee. It's because your brain knows there's a bathroom in there. If you pee your pants at your own knows there's a bathroom in there. If you pee

your pants at your own house, like the stakes are pretty low. So it's like go now kind of thing, right? So it's tried to my mom's I swear to God, I mean, she does live an hour and 40 minutes away, but I go to the bathroom before I leave my house. I am running in her door every single time. Like I'm just gonna piss everywhere. And I don't I think it's triggered to my mom's place. It's just like, it's nowhere else. I could drive two, three hours somewhere else. I'm fine. Go to my mom's. I'm running in the bathroom.

Yeah. Familiar places, right? Tend to be a trigger. So if you know you have this specific trigger, work on it before you get there. So like as you're pulling up to your mom's house, start thinking, okay, like my bladder is great. It can hold a lot of fluid. My pelvic floor strong, like I'm not peeing my pants all the time.

Like this, my pelvic floor can handle this, right? So what you can do is a pelvic floor contraction. So you can do a Kegel in this situation. So think about a ping pong ball at your vaginal opening or a marble at your rectum if you're a man and then think about pulling that up inside yourself and then relax those muscles. So that's a sign to your body like no this is not a signal. This is what these muscles should be doing in this instance but they're not. They're like freaking out. So once you do that, take a couple deep breaths, distract your mind. So go on your phone, answer an email, you know count backwards from a

hundred by threes, pretend you're in like Mexico somewhere, just distract your mind so that your body again, it's getting it to calm down. Oh, you know, this can't be an emergency. Like she's doing math. So once that calms down, then you can decide, okay, you like for you, you drove an hour and 40 minutes probably had a coffee on the way, you probably actually have to pee, it just should not be urgent. So it's not the peeing that's the problem. It's the fact that you have to sprint in there

that really triggers to your body like, oh, this is still a problem. Next time, send the signal sooner. Next time, send the signal stronger, right? But if you can just get it to calm down, calmly walk in, be like, oh, I'm gonna say hi to my mom, bring in the groceries, whatever, then go pee, get there

and then count. How long was it? Oh, like 10 seconds. No, I did have to pee, but it just shouldn't, it should never get to that point unless you've waited like, you know, four hours or something. Yeah. I love that you suggested to use Kegels in that way. Everyone thinks that's the answer for everything, but that might not be the case.

When do Kegels come in and when they don't? I want to talk about Kegels and I want to talk about like the Euro spot, those other things in the time that we have left here. So there are cases where strength is a problem, right? In the same way that there's cases where you don't have enough strength in your shoulder and you want to strengthen that. But you wouldn't do that first, right? So if you came in with a shoulder injury, we would release all

the tension, get the joint moving first, then if you had weakness, we would strengthen it. If it starts hurting, we don't tell you to go out and like pitch, you know, nine innings in baseball to make it better, right? You don't want to strengthen something that's already not doing well. That's so interesting. Because when I did have some shoulder issues, I when I go to see Kyra on Vizio, I'm like, okay, when do I start lifting weights?

They're like, no, no, no, no, we got to release the tension first. And then we have to deal with that first. And then you can start building. That makes so much sense. That makes so much sense. So the key goes, we're all like, all right, let's just strengthen the area when it's, okay, got that. Wow. All right. So you might not need a strength. Like it could just be a tight muscle. Like

if you went in with, you know, a tight hamstring, you're not going to run a marathon to fix that you're going to release the tension. And then you really probably haven't lost that much strength unless you've been in bed for, you know, two months or something. So then your muscles fine, you might have to do a little bit of strengthening. So but unless you've had an internal exam and you know that you don't have tension, I would never do it to kegel. Like there's just no need to do it like I mean one here and there like like we said with the urge delay or like do a contraction to relax those muscles or if you're doing it in conjunction with exercise like that's all fine. It's the 100 kegels at the stoplight

or the like the chair, the Euro spot chair. It's just not that functional, right? Like, A, you don't know if you have tension or not, because a lot of places aren't doing internal exams. So if they're not going to do an internal exam, I don't think it's a good idea. Because you don't know, you might have tension and now you've made this worse. You've done basically a pelvic floor marathon on a tight muscle, like not helpful. So if they do an internal and they say, No, you don't have any tension, you just have some weakness, then that is an option that that would likely work, right? Okay, not the worst thing ever.

It's just that a it's very expensive. And so but if you feel super uncomfortable with like having internal treatment, it's it's an option or if you have the money and you want to do it, that's fine. But you could literally see a pelvic physio for a couple hundred bucks, a couple sessions, and get the same thing out of it. So don't feel like you need to do something like that to fix your problem. Unfortunately, it does kind of get sold as that. This is the answer to your problem.

I mean, it could help, but I see so many people that unfortunately, it does make their problem worse because they've never done an internal to find out what the real problem is. Okay. So still like if I have a tear on my shoulder and I'm just going to exercise it out, I'm just going to muscle it out. And meanwhile, at the same time, I'm actually making it worse rather than making it better. That makes a lot of sense.

And so they can be effective if that's the issue that you are dealing with at the end of the day. All right, Erin, always, always insightful, honestly. Where? So people want to know where to find you. So first of all, you work out of Lake Country Physio. So people can go to that website, lakecountryphysio.com.

Obviously you are sort of in the Orillia area still. Yeah. Just kind of north of Toronto. I mean, worth a drive if you want to go see Erin, absolutely. If people want to find a qualified physiotherapist, how do they go about that? Do they go through their doctors? Do they need to do that? What do they do?

So you can go through your doctor. It depends on your coverage. Most of the time you don't need a referral from your family doctor. You can just look for a public physiotherapist in your area. You can ask your doctor for a recommendation if they have someone specific that they recommend. PelvicHealthSolutions.ca, that's where I did my training through. They have a list of qualified pelvic physiotherapists in and around, I believe, Canada. So you can find someone in your area.

There's no need to come to see me if you live like super far, see someone in your own area. Everyone is trained super well. If anyone has questions, they're always welcome to just message me on Instagram or anything. I'm happy to answer any question. It's just so nice for people to have this information because I know it's not out there.

You can reach out and follow and she also gives lots of great tips, lots of lifestyle tips and she's like, and some good recipes too. You can follow Erin at squats.end.coffee. And my team tells me that they are gonna post the stretching video that Erin had given and done for us before and the bladder diary.

So if anyone is interested in those things. Thanks everyone for all of your comments and suggestions. I know it can be unnerving, and I love that you're sharing in the comments your individual experience, which is for the most part, all seem to be really positive. Thank you for joining us live. Thank you for all of your comments and questions.

And of course, thanks, Aaron. It's always a pleasure. I mean, I just, every time we have this conversation, I think we need to have it more and more and more and more until we normalize what's going on here so that we can leave our house without peeing our pants or get on a trampoline. Exactly.

Thanks for having me, Gina. It's so good to share this information. Thanks, Erin. Thanks, everyone. Bye.