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

Episode Date: February 19, 2025

In this episode, Registered Physiotherapist and pelvic floor specialist Erin Degagne breaks down everything you need to know about pelvic health. Erin covers common signs and symptoms for both men and women, the difference between frequent peeing from drinking more water versus a pelvic floor issue, and how to recognize mental and physical cues that signal you need to go. She also shares how a bladder diary can help you track patterns, the surprising connection between childhood bedwetting and adult incontinence, and how pelvic health impacts weight loss and mental well-being. Plus, Erin sets the record straight on kegels (including reverse kegels) and gives practical tips for improving pelvic floor tension. If you've ever wondered whether your pelvic symptoms are normal or something worth discussing with your doctor, this episode is a must-listen!Where to find Erin:Instagram: @squats.and.coffeewww.lakecountryphysio.comYou can find the full video hosted at: https://www.facebook.com/groups/livymethodwinter2025To learn more about The Livy Method, or to sign up for the Spring 2025 Program, visit www.ginalivy.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.

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Learn more at wealthsimple.com slash match. 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. This program is more about more than just weight loss. It's also about awareness, especially with what's happening in your body.

And as you start to pay attention, eat healthy, nutritious, rich foods, drink more water. Sometimes you drink more water and you think it's just all the water and that's why you run into the bathroom every five minutes. Perhaps maybe it's something more than that. Today we're talking incontinence, we're talking constipation, we're talking bladder issues, pelvic health is the topic we are talking about today with Erin de Gagne pelvic health specialist. Hello. Hi. Hi, Tina. How are you? Good. Good. This is such a big conversation. I was thinking back to the first time we had this conversation and I wasn't as aware as I am now and I was blown away

with how many people were obsessed with this conversation. It was one of our most listened to, downloaded, watched conversation. Why do you think that is? I think there's just a lot of misinformation out there, right, a lot of people, they don't know a lot about their body, but we've been kind of fed this narrative that, if you have kids or as you get older,

once you go through menopause, or just in general that as you get older, you're gonna your pants when you sneeze, you're gonna cough and sneeze. So we just kind of assume that it's normal. Yeah, I hear like, I don't know what you would call them adults, protective gear, adult diapers, or like such a large, massive growing market. I love that you mentioned women. So I just thought that it was just so normal to pee my pants when I laugh or when I sneeze

or when I cough, God forbid I ever find myself on a trampoline after having four kids. But this conversation is not just for, you know, women who've had children, it's also for women who have not had children, it's for men, It's literally for everybody. Yes, we all have a pelvic floor. Before you have kids, you have a pelvic floor. There's so many things that can affect its function then. And then if you've never had kids, I see people all the

time and we treat men all the time as well with after they have a prostate issue, like their pelvic floor can get tight for the same reasons that women's pelvic floor can get tight. It just often doesn't get recognized the way that it should be because there's not, like I said, there's not that much information out there for people. So here we are. Okay. So pelvic health, a couple of the common issues for both men and women, urinary urgency. So having to go to the bathroom, like I gotta go now. Urinary frequency, having to go often. Waking at night to pee. Now we all know when you're going through the program a son of detox is waking up around that three or four o'clock

in the morning. We'll differentiate between that and this. Bowel issues, constipation, bladder irritants, bladder issues, bladder prolapse, incontinence, things that can weaken your pelvic floor signs and symptoms of bladder issues. Let's get into that. What are some signs and symptoms? So like you said, some signs would be if you are waking up more than once at night.

So once at night is considered normal. So if you're waking up at that three, four o'clock time going pee, fine, we're fine with that. If you're getting up more than once, that's a problem. It's gonna start affecting your sleep. It's affecting how you can function the next day, what you feel like eating, all of those things. So if you're waking up more than once at night,

that's a sign that there could be a pelvic issue, right? Urgency, where you feel like you're rushing to get to the bathroom, or if you know where every bathroom is, you're peeing when you leave your house, you pee when you get to Walmart, you pee when you go here. That's a sign that you shouldn't be thinking about where the next bathroom is. If you are, it's a sign that you're probably going way too often.

And your central nervous system has kind of gone overboard trying to find where every bathroom is. Okay. So a lot of people are going, well, wait a sec, because I'm up all night long, going to the bathroom. I'm, you know, running around looking for bathrooms everywhere I go with this program, we are drinking more water than what people are used to. So there is sort of a normalcy in increased trips to the bathroom as your body adjusts to that water. How would someone know the difference between a pelvic health issue and just I've started drinking more water? So typically would take about two weeks, you know, when you first start the program you're gonna be peeing more often your body isn't used to processing that much fluid, but then it Realizes like oh we need all of this water actually and so once you're well hydrated I would say but if your number of times you're peeing increases in the first two weeks, fine, don't worry about it.

You don't need to run to see your doctor. But if it's continuing past that point and if it's more than six to eight times per day, that's considered like too many times. So at that point, it would be good to look into things. You always want to talk to your doctor about any of these issues. It's something that's kind of people feel embarrassed about. They don't want to bring it up to their doctor or they feel like there's not really a solution. Either way, it's good to talk to them because you do want to rule out other things,

right? Okay. So here's Cindy, I'm waking up four or five times a night. I've never consumed this much water, 350 mL, so 3.5L. That's a lot of water. I mean, it is, but it's not, right? Like we now know science, I didn't make this number up myself. Science is telling us you need at least 2.7 to three and a half liters just for basic body function and just basic hydration. That's not even accounting for drinking alcohol,

sweating, dry environments, taking medications that dehydrate you. So let's just normalize that that is actually not a lot of water. Now it may be more than what someone is used to drinking. So that's where there is that adjustment period. But what you're saying is if the two to three weeks have gone by someone has, you know, been consuming the amounts of water they need to be properly hydrated and they still find themselves running to the bathroom. Is that all physical or could that also be mental? So urinary urgency or frequency,

it's kind of like a two-fold problem, right? Number one is typically, so we kind of assume, oh, if you're leaking, these muscles are super weak and we need to be doing Kegels. Oftentimes, for like a number of reasons, these muscles are really, really tight and can't function the way and we need to be doing Kegels. Oftentimes for like a number of reasons, these muscles are really, really tight and can't function the way that they need to. So let's just picture there's these tight muscles and they can't do what they

need to do. So that's problem number one. But then because of all of these things that are happening, I'll explain urgency in a second, but because you're going to the bathroom all the time or it's a close call when you get there, your central nervous system. So your body's protective mechanism kind of goes into overdrive trying to protect you. So then it's sending you the signal that you have to pee sooner than it typically would,

so that you don't, you know, pee your pants when you're at your friend's house. So, you know, there's things going on behind the scenes to try and stop negative consequences. That's what our whole body is meant to do for us, to protect us, right? From embarrassing situations situations from painful situations but unfortunately when it's been there for a long time it really does go overboard and it's sending

you a real signal so it feels real it's not like in your head you're not crazy it feels like your bladder's full when it's not okay so because i it's interesting i was with my daughter, we were skiing this past weekend. And this was her first kind of time out at a mountain. And you're in your own amount and you're up really high and there's not a lot of access to bathrooms. And it's really cold. So don't be dropping your pants in the middle of the of the hill. And she was just like stressing out and she had to go to the bathroom every five minutes. She was like, Oh my goodness, I'm going to pee. And then so I had a conversation.

I was like, listen, I think this is, this is in your head. You've kind of trained your body because you're doing so lot of water to go to the bathroom often and now you don't have the convenience of having a bathroom. Like you just like if you were in the car and you had to go and you couldn't pull over that urgency will go away Yeah So is that how you know it's in your mind is if you try not to go and this that moment passes Like how do we know we really have to go versus it's just in my mind So a bladder diary is a helpful thing to do just to write down like how many times you're going in a day How long you're peeing for so if you're going to the bathroom and you're peeing and you count how long you're peeing for so

Let's say like one one thousand two one thousand three one thousand if it's less than six seconds Although I think with Gina I've changed this number because people are normally so dehydrated That that I see that you know there they go pee and it's like two seconds. That means like you didn't actually have to pee your body sending you the signal prematurely. But on Gina people are well hydrated. So even if you're like eight seconds, but it feels like you're going more than six to eight times a day, your body can hold a lot more urine than that. So you should not be going that often. So if you if you're going

and it's like four or five seconds every time you pee, you know that yeah, your body is sending you the signal too often. And your bladder isn't really full when you're getting that signal. Okay. So at least you're saying like six to eight seconds. Mm hmm. Okay, at least like most it should be like 1012, you know, 13. Like it should be longer. Also on the other end, you don't wanna be holding your pee for as long as possible.

Like that's not good for your bladder, but you don't want to be like peeing A when you don't have an urge to go. And you don't wanna be going if you just, like if you just went pee 10 minutes ago and you get an urge, you wanna work on getting that urge to calm down. So we call that urge delay, because the likelihood of you actually

needing to pee 10 minutes after you just peed is it's not not real. Really? Mm hmm. So let's say you just want to pee 10 minutes ago, and you're about to leave your house. So again, the stress will play into it, your body's like, well, you're not going to have access to the bathroom. That's why your daughter has this issue on the ski hill. She's like, I know, I don't have access to a bathroom. Like that's stressful, right? And so your body's like, well, you're not going to have access to the bathroom. That's why your daughter has this issue on the ski hill. She's like, I know, I don't have access to a bathroom. Like that's stressful, right? And so your body's like, okay, well, let's protect her. Like, let's send her the signal all the time that she has to pee. So she just goes and then

we won't have this problem. But that's really annoying on the ski hill. And it's really annoying at night when you're trying to sleep. So the more you can work on getting that urge to calm down, your body just needs proof that like, no, you're not going to pee your pants, especially your daughter, like she's young, she's healthy, she probably has a strong pelvic floor, she probably doesn't have leakage.

So the chances of her having leakage if she waits is very low, right? And so you just have to try and get that to calm down. So let's say you get a strong urge to pee all of a sudden, which again, is not really normal. It should kind of be gradual, like, hey, maybe you should go pee, you know, 10 minutes later, like, oh, you still didn't go pee.

Like maybe you should go. If it's all of a sudden you need to like run to the bathroom, that's a sign that you probably have pelvic tension. You should probably see a pelvic floor physiotherapist. But also that there's other things that you can be doing so that this doesn't become a bigger and bigger problem. Because that's what happens.

It kind of escalates until you're peeing five times a night which is really disruptive. And so are we kind of retraining our body in a sense? Retraining your bladder, training your pelvic floor muscles to relax so that they can function optimally. So yeah, let's say you get this strong urge,

all of a sudden, what you want to do is run to the bathroom. Hold yourself, cross your legs, run to the bathroom. Unfortunately, let's assume your muscles are already really tight, they're trying to stop your body from just peeing, right? What's happening in that moment is your bladder is actually contracting your public your urethra comes down, your pelvic floor is here. So it's like, no, like we're not on the toilet, right? So you're rushing, rushing, rushing to get to the bathroom. But if these

muscles are already tight, and then you're contracting them as hard as you can and running, at a certain point, they're going to fail. And so sometimes that's when you end up with what we call urgent continents on your way to the bathroom, you have some leakage on your way there. Those muscles are like, we can't do this anymore. And they fail. And then your body sees that as a stressful situation. Oh, let's send this signal sooner next time, or let's send it stronger next time so she didn't wait so long right or he didn't wait so long and so that's how it becomes an issue but if you can stop when you get that signal take a deep breath get your pelvic

floor to relax a little I'll show everyone how to do a reverse kegel in a second if you want to do that relax those muscles and then really distract your mind our mind is a really powerful thing. So if you distract yourself, count backwards from 100 by twos, pretend you're you know, on a beach in Mexico, you know, do heel raises like do squats, something else your body's gonna be like, well, this obviously isn't an emergency like she's doing math. So that should get your central nervous system to

kind of calm down. Then you can make a decision. You don't want to hold, again, we're not trying to hold our pee, but do I have to pee? Has it been 10 minutes? If so, then don't go. If it's been an hour and a half, I had a coffee, I probably do need to go, I've been drinking water all day.

Okay, get the urge to calm down, slowly walk to the bathroom, pee, and then count. Oh, five seconds, like, okay, so now I know I can probably go two hours, two and a half hours if I've had a coffee and this much water. So you're kind of using data instead of the feeling because the feeling isn't always a good representation of what's going on in your bladder. Yeah, people are like, I'm telling you, listen to Erin, it will change your life. I was always going before I left a place with a bathroom just in case right like make sure you pee before we go. I mean, I even did this traveling. Okay, I gotta well I

would be like if I didn't go to the bathroom, then I would be like, I'm fine. I don't need to go and then I'd be getting the car and I'm like, okay, it's like an hour and a half drive. Like, I don't know. Now all of a sudden I'm thinking, okay, I gotta go and then I'm like, okay, I just gonna go just in case. And so we shouldn just gonna go just in case. And so we shouldn't necessarily go just in case we should try to hold it. So if it's only been 10 minutes or so if it's been a lengthy period of time, like an hour, or more, then it's okay to go to the bathroom. Okay. I was really amazed the first time I had this conversation with you because I thought it was weak bladder, weak bladder, small bladder, weak bell, bladder, when in reality it can

actually because you're holding a lot of tension in your pelvis. What causes the tension in our pelvis? So I kind of see it as this continuum throughout your life. And so man or woman, like, there's so many things that contribute and your body has a threshold. So let's say like you're you start out zero to 10 tension, right? There's there's a threshold that hits let's say it's at eight out of 10, where it's like, yeah, we can't function anymore like this, I can't use other muscles to compensate. And so you know, now you're gonna have leakage, you're gonna have

pain, you're gonna have prolapse, you're gonna have have prolapse, you're going to have all of these issues. But you can compensate for a really long time. So it seems as though there's like this event that happens, but really it's probably been building for quite a while. So things like obviously pregnancy and delivery are a problem, trauma, sexual trauma, but also emotional trauma, like a death in your family or something happening with your kids. All of these things will increase tension in your pelvic floor in the same way that it would increase tension in your neck, right? Like stress, you're just holding on

to that. Injuries, so like a knee injury, a hip injury that's changing the way that you're walking, IBS or bowel issues that are causing pain in your abdomen, endometriosis, right? That anything that's causing pain can cause tension in those muscles. And the problem with these pelvic floor muscles is that they're kind of bone bound. So they're trapped in your pelvis. So there's no way to stretch them like you would stretch your neck. So this tension just slowly builds degree by degree until it ends up causing a problem. And sometimes that's quickly and sometimes it's kind of slow over time. And then often with women, menopause is really something that kind of pushes it over the edge sometimes it's kind of slow over time. And then often with women, menopause

is really something that kind of pushes it over the edge. It's kind of been building, building, building, and then you go through menopause and there's a few different changes that happen there that really affect your pelvic floor, your lower urinary tract. And so it often gets blamed like, oh, it's just menopause. You know, this is what's going to happen, which is not true. It's definitely a piece of the puzzle, but there's all these other things that are going on that we're kind of ignoring. And so it doesn't get treated because you think,

well, I just went through menopause, so now I have this problem. Right. Well, first of all, our menopause add-on is starting up again on Monday. So please come and join us in that group and have this conversation specific to women and menopause. But I love what you just said.

It's not just all of a sudden you're in menopause, perimenopause or menopause, postmenopause. This has been an issue that's been building for a while. Let's take a minute to hear from our podcast sponsor today because this new year, why not let Audible expand your life by listening? Kind of like what you're doing right now. So you can explore audiobooks, podcasts, even exclusive audible originals that are no doubt going to inspire you, but more so motivate you. All you have to do is open up the app, tap into your well-being, and you can hear advice and get insight from leading influencers, experts, and professionals. Whatever your focus really or interest, there's a listen for you. You can find titles on better health like personal fitness or

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Acast helps creators launch, grow and monetize their podcasts everywhere. Acast.com. How is it, I just want to before we go to further, how is it different for men than women? So it's not really honestly, men obviously aren't having children. So that's a piece that gets taken out.

But there's tons of women that I see who don't have children. Their pelvis is smaller. And so often they often have more tension. Like I don't often see men with any weakness unless it's post-operatively for like a prostate removal, right? And so for men, most of the time, if they're having urgency, frequency, like if your husband's up all night peeing

and he's driving you crazy, he probably has a lot of pelvic tension. So give him your exercises. Because this tension again can build with back pain, hip pain, they're not going to the doctor to get any of this treated, or it could be a chronic prostate issue. So you want to make sure that if you do have this frequency, you see your doctor, once they've ruled out that it's not like a benign prostatitis or some other infection in their prostate that's causing this,

then it's likely tension, but the prostatitis can also cause tension. So you have one incidence of prostatitis, which is just an infection in your prostate. You get antibiotics. Oftentimes the pain from the prostatitis causes tension, which mimics the prostatitis. So they have the same symptoms. You're peeing all the time, you have this urgency,

you have this pain. So they just think, oh, this was the wrong antibiotic, you continue on with antibiotic after antibiotic. And the same goes for urinary tract infections for women, right? The symptoms are so similar between a urinary tract infection and pelvic tension, that they just think it's a urinary tract infection, you constantly are getting antibiotics when really the issue is that the pain from that UTI has caused tension in your pelvic floor. And that really the issue is that the pain from that UTI has caused tension in your pelvic floor and that's the issue now. Wow.

Okay. So for most people, does this start, like what about kids who, I had a question here from Pam. If as a child you had accidents through the night, are you likely to have an issue when you're older? So it is correlated for sure. Most of the issues with kids that we see is constipation. So if you have bedwetting past the age of, you know, four or five years old, oftentimes

it's a constipation issue. So even if you think you're going to the bathroom all the time or you think your kids are going to the bathroom, that's kind of the age where you stop checking. You know, you're not in there like, did you go to the bathroom? And so oftentimes they become really constipated, especially based on their diet, that kind of thing. And then when your bowels are really full, you can't really fully empty your bladder or your pelvic floor muscles can't function the way they need to, or if your kids are sitting on the toilet for a long time, really bearing down, it's a lot of tension in their pelvic floor. And then it also becomes a bit of a psychological, there is a psychological component

because they're stressed about it. They don't want to wet the bed if they're at a friend's house, or they don't want to have this problem anymore. But oftentimes it's, it's the same thing. And then it kind of carries on from there, right? You have pelvic tension as a kid, so you're already starting at like a four out of 10. So, so the constipation can be an issue for incontinence with adults as well. Yeah, yeah. Wow. Don't normally think of the two going hand in hand. Yeah, so closely correlated, right?

So constipation is often again, a tension in your pelvic floor. There's obviously other issues that could be happening with your diet and your GI tract, whatever's happening there. But because of the pain from that, if you have pelvic tension, when your bowels fill up, there's enough stool there to push past the amount of tension you have, but you end up not fully emptying your bowels. So then the stool's sitting in there

for longer than it should, and the water is kind of leaving it, right? So then it becomes harder. And then it's like this cycle of not fully emptying your bowels, and then it becoming hard stool, and then it becoming harder harder to pass and then you're sitting on the toilet. So it's a bit of a circle that you can kind of go around in with constipation. You know, it's interesting because I love this conversation with you because when people

start drinking more water, they start noticing, right? I'm running to the bathroom every five minutes, I'm peeing my pants, I have to go. So it's an important conversation. But from your experience, how would it impact someone's weight loss journey? Now, obviously if they're up 100 times a night, they're not getting the sleep.

How would it impact someone's weight journey? There's a lot of factors, right? If you're having leakage when you're exercising, right? Every time I go for a walk, I'm peeing, I have to wear a pad and like, I don't want to do that. Or I don't I'm embarrassed to go to the gym, because if I'm jumping, I'm going to have leakage. So it can affect you that way with exercise. But like, it really affects your mental health. I think there's not enough emphasis placed on that. A lot of the women and men that I see who have incontinence or prolapse, where they're feeling heaviness all the time, right? That would make you not want to be going out and doing more activity, and then you feel

the heaviness more. And it really does take a toll on your mental health. And so I think that ends up, you know, you're looking for a way to cope with that. Maybe you're turning to food, maybe you're, you know, having other unhealthy habits. But it is really something that can be a lot more emotionally draining than people think. Like, you know, we have a Kleenex in the room because people are crying all the time. Like, it's a really hard thing to be dealing with. A lot of people feel alone.

They don't know that there's something that can be done and they don't know that other people are experiencing it too. It's such a common issue, but our culture is very private, so we're not really talking about it a lot, right? That's why this is a great forum, I think, to kind of talk about it. Okay, again, these conversations with our guest experts are about bringing awareness.

We're not trying to fear monger or, you know, get people stressed out or feel overwhelmed or all those things. But, you know, it is a real issue that a lot of people experience. If someone feels like they do have these symptoms, or there's something underlying beyond just drinking more water, what do we do about it?

So if you have access, so if you have physiotherapy coverage, and you can see a pelvic floor physiotherapist, it's not covered by the government, like by OHIP, if you're in Ontario, but it is something that if you have medical coverage for physiotherapy, it's covered under that. So I would see a public for physiotherapist if you're having this issue. If that's not an option, there's other things that you can be doing. So we're going to attach some stretches. So the more you can stretch through muscles, muscles through your pelvis, through your abdomen,

the less your pelvic floor has to compensate for those muscles. You can do a bladder diary. We're going to post that as well to kind of get an idea of how many times you're peeing, you can work on the urge to lay at home to try and get those urges to calm down. Deep breathing, diaphragmatic breathing, breath work, those types of things to really calm your central nervous system can be super effective as well. So if you can do like even 10 deep diaphragmatic breaths by

the end of the day, like one hand on your belly, one hand on your chest, take a deep breath in through your nose. You can't see your belly should rise and then your as you breathe out through your mouth, your belly should fall this top hand should not be moving. Okay, so that's a good deep diaphragmatic breath that will force your diaphragm down force your pelvic floor down to relax so it's not tight all the time. Yes, you shouldn't be going up and down like that. No, should be your belly going out as if you're filling a balloon

and then out through your mouth. Which is great for your stress as well. Which is great for your self stress. And then the two are really closely tied. So those are all good things. Sleep hygiene so that you're getting a good sleep. If you wake up in the night and you just wake up for another reason,

you're in pain, you have something else going on, roll over and try and go back to sleep. If you've already in the night and you just wake up for another reason you're in pain You have something else going on roll over and try and go back to sleep If you've already gotten up to pee like the first time you go have to wake up go pee fine The second time roll over try and go back to sleep part of it becomes a habit and again, you're stressed You're like, I don't want to wake up again. If I don't pee like I'm already up I might as well just go like it don't be doing that. Just okay roll over triangle back to sleep If you're there for more than five minutes Just get up and go that's okay. But over time that should should get better

But you might need to see someone like if you have a lot of pelvic tension There's only so much that you can do Mentally, right to kind of get over this if you it's a real physical issue So and it's really not a complicated thing to fix. I know it's an internal exam. So a lot of people are hesitant, right to want to try it. I promise it is not as bad as it sounds. It's an and it's a very fixable issue. So if you can release the tension, the muscles are where they need to be. It's a quick process of not

seeing people for years and years most of the time, unless there's a chronic issue. It's quick. So it's worth the money to just invest in your health and it can make such a huge difference in your life. Erin, how would you know if your urgency is due to weak pelvic floor or tight pelvic floor? Is this where someone would have to go see a pelvic health specialist or can we self-diagnose that? I mean I'm going to say like 99% of the time if you have urgency it's tension. Okay, oh wow. Yeah, if it's incontinence like if you have urgency, it's tension. Okay. Oh, wow. Yeah.

If it's incontinence, like if it's leakage, it could be either. It could be that there's weakness or it could be that there's tension. I would look at other symptoms that you're having. If you're having vaginal pain, if you're, you know, up all night to pee. Uh, if you're having other pain, like hip pain or back pain, the likelihood that you have tension is high. If you don't have any issues, but you just pee when you sneeze, it could be a timing issue that those muscles aren't contracting right before you cough or sneeze.

So you could try to do more of like a timing program where right before you know you're going to cough or sneeze, you can contract those muscles and then see if that helps just on the timing front. But it's rare to just have weakness, honestly. OK. You're going to share some stretches with us. Yeah. You are also going to share an example of a bladder

diary with us. You were also talking about Kegels and reverse Kegels. So can we just take a minute for that? Yeah. Sure. So unless you've had an internal exam, honestly, you should not be doing Kegels because a we have no idea if you need to do them. Probably not honestly, to you're probably not

doing them right anyways. So it's not a great idea. But I'm going to show you how to do one so that you can mostly for a reverse Kegel. So man or woman, we can all do kegels, you're going to think about a ping pong ball at your vaginal opening or for men, a marble at your rectal opening. And you're going to think of pulling that up inside yourself. No one around you should be able to tell that you're doing this, your butt shouldn't be moving, your core shouldn't be moving, you're going to hold for five

seconds. And then I want you to release those muscles in the same way that you would like when you're Going pee when you have a bowel movement. That's what's happening. Those muscles need to relax So if you're stressed and you can tell that you're holding a lot of tension It's not a bad idea to locate those muscles do a contraction and then relax But we don't need to be doing is like a thousand Kegels No, like not it. No even like it those it. No, even like it, those muscles, they don't need to be that strong, right? They need to be able to like stop your P hold up your organs, which they're already doing all day. They don't need to be over trained.

Okay, really interesting. So no, so okay, so the difference between urgency is more tighter muscles leakage is weaker. So if you're having urgency, it's not that you necessarily have a weak bladder need to be doing kegel or pelvis that you need to do kegel exercises. All right. But before we go today, what am I missing in this conversation? Well, I know that menopause is a huge topic right now. And I think that there's a lot of misconceptions, a lot of like bad information out there, but it's a super common issue that can affect your pelvic floor. So as you age and your estrogen decreases, it will affect, so the thickness of your vaginal

wall that thins as our estrogen decreases, which makes it more likely for you to have a prolapse, which is either your uterus, your bladder, your rectum falling into your vaginal wall, and that leads to heaviness in your pelvis. But also it decreases the thickness of your lower urinary tract. So again, another notch of like if you're already at a six out of ten and then now your lower urinary tract is thinner, you're more likely to have incontinence or leakage then. So that's where a vaginal estrogen cream can be super helpful in thickening up that tissue again, it can also help with incontinence. There's good research for that as well. But then also as we age and as our estrogen decreases, but in men too, as you age, it's called sarcopenia, your muscle mass decreases. And so these are muscles as well.

And so as that decreases, it can also be something that adds into this increase in urinary incontinence. So if you can deal with all of this along the way, then when you get to menopause, or if you're already there, if you can release the tension, your body can cope with it. But it just, it can't cope if it's already at like a eight out of 10 when you get there. Okay, this is where you need help. Like if you had something going on with your knee or something, I don't know, bleeding out your eyeballs, you would see somebody. Not nothing to be embarrassed about. I mean, every time we have

this conversation, people seek out treatment and it absolutely is a game changer, not just for their weight journey, but their, their physical health, their mental health. What how do you feel before we go on? Like those machines, the those machines that you're now like a year or so? Yeah. Okay, so I think that there's good and bad with everything. Same with physiotherapists, like I think there's good and bad. So I think you need, if you're going to go that route, so I know some people feel nervous about an internal exam, so they think that this might

be better. But honestly, if you're not, so some of these places, you would see a pelvic floor physiotherapist first, they would do an internal exam, or if you're seeing a nurse practitioner, and they can do an internal exam to see, do you have tension or do you not, right? Do you have weakness that we actually need to treat? If you if they do an internal exam and you have weakness, I think it's fine. Like I think it can be helpful. If they don't do an internal exam, honestly, I think it's a it's a bad idea. For a couple reasons, if you have tension, it's going to make it worse. And it's very expensive. So I think it's about $2,000. And then there's more cost on top of that, where like to see a pelvic physiotherapist ranges depending on where you live, but

it your money would be better spent, honestly, if they're not going to do an internal exam to really find out what the root causes you can even see someone a couple treatments and then they can be giving you things to do at home. If the cost is a barrier. Okay. Lots of people talking about constipation. I just want to remind everyone that we do have a post on bowel movements. You might have missed it early on in the program so you can search it in the group or use your app to search out. We do have some tips for you whether it's the loose

bowel movements or you're dealing with more constipation. There are things that you can do there. I love what you're saying. There's lots of resources available to people. How do they find a physiotherapist near them? Is this something that they go to their doctor and they get a referral or is there a place, a website that they can go and look for a physiotherapist? Yep, so you don't need a referral from your family physician

unless you need it prepped for your insurance company. Sometimes they'll require a referral, but often not. And so, but if you go to pelvichealthsolutions.ca, the website is up there, then you can find someone in your area who's been through a great training program that they have. And so that would be a good place to find someone. Yeah. So that's pelvichealthsolutions.ca. And I know people are going to ask where to find you. They want to go see you. Erin, where where to find you. They wanna go see you.

Erin, where do they find you? Where do they follow you? Where do they reach out to you? Okay, so I work in Orillia at Lake Country Physiotherapy. If you do not live near me, you do not need to come and see me. If you live here, I'm happy to see you, but don't drive like three hours to come and see me.

Find a great therapist in your area. There's so many like amazing therapists if you need a personal recommendation, reach out to me. And I'll try and answer so there were so many good questions. So I will try to answer as many as I can on my Instagram at some point this week. For people who ask because there's like this, the information is endless on this. So I'll answer as many as I can. Okay I love it. You can also follow Erin like she mentioned on Instagram she's always sharing tips

not just about public health but your whiz in the kitchen, all sorts of health and wellness tips and she knows the program inside and out as well. Squats and coffee, squats.end.coffee, if you wanna follow her over there. Thanks everyone for joining me today. Like I said, there's always some good tidbits and takeaways from this conversation. It's a really important conversation that not a lot of people are having.

And if you think that you should be having it, make sure you reach out and you seek help for yourself. Erin Degagne, thank you so much. Always a pleasure. Thank you for joining me today. Thanks, Gina. yourself. Erin DiGagno, thank you so much. Always a pleasure. Thank you for joining me today. Thanks, Gina. Let's take a minute to hear from our podcast sponsor today because this new year, why not

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