Speaker 1: Wanting to have kids is a huge life decision. But
Speaker 1: once you're ready to embark on that journey, what do
Speaker 1: you actually need to know? This podcast is the community
Speaker 1: you never knew you needed from mums and mums to be.
Speaker 1: We're about to embark on this learning journey together and
Speaker 1: it's going.
Speaker 2: To be real.
Speaker 1: It's going to be raw and a completely non judgmental space.
Speaker 1: You're listening to Where's your bump hat? And this is
Speaker 1: Anamacavoy Staples. I'm going to be interviewing experts in the
Speaker 1: field so that all of our burning questions can be answered,
Speaker 1: from understanding our cycle to knowing what is the best
Speaker 1: time to conceive, and so much more. We'll get into
Speaker 1: the difference between natural verse c section births, strange pregnancy
Speaker 1: symptoms and everything in between. Okay, Hello, we have my
Speaker 1: osteopath Meg in the Judeo today to talk all things
Speaker 1: of helvic floor and so much more.
Speaker 2: I'm so excited to have you on the show. Hello, Hello,
Speaker 2: thank you for having me, Thank you for coming in.
Speaker 2: It's so funny.
Speaker 1: I was just saying to Meg that she actually I
Speaker 1: had an appointment with her the other week and she
Speaker 1: was like feeling my tummy and she's like, yeah, I
Speaker 1: think the baby's breach. And I was like, okay, you
Speaker 1: found out, like told me way before anyone else, Like
Speaker 1: they had to do a proper scam before anyone else
Speaker 1: told me that. And they're like, the baby's breach and
Speaker 1: I was like, yeah, I know. And they're like, how
Speaker 1: do you know? And I was like, well, my Osteo told.
Speaker 2: Me is a wizard. She is. She's a magician.
Speaker 1: So I think that we should start from the beginning
Speaker 1: as to why and how we even know each other.
Speaker 1: And I guess to do that, I have to start
Speaker 1: back in Oh, I'm going to say like two thousand
Speaker 1: and six.
Speaker 2: Maybe I was.
Speaker 1: We didn't meet each other in two thousand and six,
Speaker 1: but he was drunk. I was black out drunk in
Speaker 1: two thousand and six and I fell off a bed
Speaker 1: onto a concrete floor.
Speaker 2: And at the.
Speaker 1: Time it wasn't that painful, but I woke up in
Speaker 1: the morning and I was in the most excruciating.
Speaker 2: Pain of my life. It was like my eyes opened and.
Speaker 1: All of the I don't even know what to call them,
Speaker 1: just like every part of my body just shot to
Speaker 1: my coxic bone.
Speaker 2: All of the pain. It so painful. Oh so painful.
Speaker 1: I was in Singapore at the time, had to pace
Speaker 1: the aeroplane from Singapore to Melbourne on a night flight,
Speaker 1: and I was like walking so slow and people thought
Speaker 1: I was nuts and I felt nuts. And for the
Speaker 1: next five to six years, I think I suffered with
Speaker 1: really excruciating coxic pain.
Speaker 2: I saw a physio. They couldn't really do much about it.
Speaker 1: They gave me some exercises and and by the end
Speaker 1: of it, they kind of just told me that I
Speaker 1: would have to live with it and it would eventually
Speaker 1: go away, which it did.
Speaker 2: But then that's right, yeah, eventually. But then I got pregnant.
Speaker 1: And when you get pregnant, I think everything kind of
Speaker 1: well you've said to me, then everything, Yeah, things that
Speaker 1: maybe were kind of an issue at one point in
Speaker 1: your life, if they've not been fully fixed, I feel like,
Speaker 1: come back when you can become pregnant. And I was
Speaker 1: speaking to my sister in law and she was talking
Speaker 1: about seeing an osteo and I've never seen an osteo.
Speaker 2: In my whole life until becoming pregnant.
Speaker 1: And anyway, I did a call out on social media
Speaker 1: and was like, does anyone know good osteo? Who specializes
Speaker 1: in coxic pain, and I swear to you now literally
Speaker 1: there was like six seven people being like, Meg is
Speaker 1: a magician, he needs to see her.
Speaker 2: She's going to.
Speaker 1: Solve all your problems. I was like, I'm sold the dream,
Speaker 1: and they're right.
Speaker 2: You did.
Speaker 1: At three months pregnant, I was in excruciating coxic bone pain,
Speaker 1: and since having sessions with you, I no longer have it,
Speaker 1: which is.
Speaker 2: Shocking for me to even say. So, I guess let's
Speaker 2: maybe talk through.
Speaker 1: Our appointments maybe and like what they entail because little PSA,
Speaker 1: it's not what you're gonna think.
Speaker 2: Yeah, so I'm gonna pass. You can explain that. What
Speaker 2: something that's really interesting that you touched on was so
Speaker 2: many people forget old injuries that they've had, Like I'll
Speaker 2: be taking a medical history, and I was like, not,
Speaker 2: no surgeries, no injuries. And then I started assessing them.
Speaker 2: I'm like, what has happened to you? And they're like, oh,
Speaker 2: I had open heart surgery or I just broke. You
Speaker 2: just forgot that. But not everyone that is pregnant or
Speaker 2: even postpartum like has pain. So the people that do
Speaker 2: have pain or just not recovering, how we would expect
Speaker 2: I'm always thinking why, like, what else has happened in
Speaker 2: your history that hasn't allowed you to fully recover? So
Speaker 2: straight away with you taking your history, I was like,
Speaker 2: have you fallen in your coxics? You're like, yeah, but
Speaker 2: that was ages ago. And what can happen is in
Speaker 2: that acute injury phase you can have a lot of tightness,
Speaker 2: you can have a lot of inflammation, and that can
Speaker 2: start to settle down. However, the thing that probably hasn't
Speaker 2: happened is the joint. We haven't got that cocksix. It
Speaker 2: is a joint, we haven't got that moving properly. So
Speaker 2: then you're pregnant and the body is trying to expand
Speaker 2: and soften and really prepare, and if that joint isn't moving,
Speaker 2: it just gets more and more jammed. So from an
Speaker 2: assessment treatment point of view, we really need to look
Speaker 2: at the whole body, but also the peer with floor. Yeah,
Speaker 2: and the power floor. It's a group of muscles and
Speaker 2: it's like a hammock and it just sits at the
Speaker 2: bottom of the pelvis, but it does it attaches onto
Speaker 2: the cocxix. So if your cosix is stiff for not moving,
Speaker 2: that can create public full tension, and then when you've
Speaker 2: got that tension that's going to yank on the coxsix.
Speaker 2: That can create more coxic stiffness, which is probably why
Speaker 2: like you've had some treatment, you've done some stretches. It
Speaker 2: can give short term relief, it can help get into
Speaker 2: the muscles in the area, but nothing's actually dressing the
Speaker 2: joint and getting that moving. So what I do as
Speaker 2: a pelvic health osteopath is we need to assess that area.
Speaker 2: And really the only the gold standard of assessing the
Speaker 2: public floor is an internal vaginal assessment. For the COC six,
Speaker 2: it's a little bit different. The only way to fully
Speaker 2: check the mobility of the coxigs is internal rectal which
Speaker 2: is what we did.
Speaker 1: Which is what we've done, and I would highly recommend
Speaker 1: it because it's worked. And I think when you're in
Speaker 1: that much pain, like I'm talking, you're standing up and
Speaker 1: you're just in pain, or you sit down for ten
Speaker 1: minutes and you have to stand up because it's so sore.
Speaker 1: If someone's like I'm just gonna do actual assessment or
Speaker 1: a vaginal assessment and it's potentially gonna help, you're like, absolutely,
Speaker 1: go for gold please.
Speaker 2: And the people that are coming to us that have
Speaker 2: been in this pain for so long. They'll do anything.
Speaker 2: We just get people traveling from like so far and wide,
Speaker 2: being like I've heard that you can do this thing.
Speaker 2: Sometimes people don't believe us, Like I remember saying to you,
Speaker 2: like you actually can get out of this pain. It's
Speaker 2: not going to be like this fit of us. It's
Speaker 2: not going to be like this about you whole pregnancy
Speaker 2: and you're like yeah, okay, and then you're like, oh no,
Speaker 2: it actually works, actually worked. I know.
Speaker 1: Well, I think when you've because I've obviously seen physios
Speaker 1: in the past and they were kind of just like.
Speaker 2: You're just gonna have to learn to live with it.
Speaker 1: So I've been you know, I've had other techniques, or
Speaker 1: I would be putting like heat packs, or I'd be
Speaker 1: sitting on donuts and doing all of this other stuff.
Speaker 1: But then the work that you've done has just completely
Speaker 1: it's gone, it's alleviated, it's disappeared. I'm like literal magician,
Speaker 1: And thank you to everyone who messaged me Meg, because
Speaker 1: it worked.
Speaker 2: You guys were right.
Speaker 1: So I was like, we have to have you on
Speaker 1: the podcast because you have helped me so much throughout
Speaker 1: my pregnancy, and I think we go into pregnancy, well,
Speaker 1: I've went into my pregnancy and I've known nothing. And
Speaker 1: then you meet people throughout your journey and they kind
Speaker 1: of inform you or help you, and you just want.
Speaker 2: To share the love. Yeah.
Speaker 1: Really, And I think a huge part of talking about
Speaker 1: our pregnancy journeys that people get worried about.
Speaker 2: Is the pelvic floor.
Speaker 1: So I thought we start and talk about just the
Speaker 1: basics of what what your pelvic floor is.
Speaker 2: Yeah, so the pelvic floor, it has a lot of
Speaker 2: roles and a lot of people know of it is
Speaker 2: this muscle that we need to do keegels and strengthen,
Speaker 2: but it is so much more than that. So it
Speaker 2: is supportive. So it supports our pelvic organs. We need
Speaker 2: it for continence, we need it for sexual fununction, and
Speaker 2: we need it for structural support. So we need to
Speaker 2: look at it very holistically. And look, some people come
Speaker 2: in they're like, oh, you know, having told I've got
Speaker 2: a type public floor, and I'm like, that's like telling
Speaker 2: me that you've got a headache. It's just a symptom.
Speaker 2: What I want to know is like, why in you
Speaker 2: do you have that symptom? Because it's going to be
Speaker 2: completely one symtom is going to be completely different for
Speaker 2: everyone else. And so when we're looking at pregnancy, there's
Speaker 2: a couple of ways that I will look at someone
Speaker 2: that's pregnant and the palvic floor, and part of that is,
Speaker 2: you know, is your body aligned. We want to make
Speaker 2: sure that as bulb grows, that your body is adapting
Speaker 2: effectively to the baby. And even say with you, it's
Speaker 2: like when you first came in, I was like, your
Speaker 2: bumpy is really low and forward, and then we really
Speaker 2: worked on not just the palvic floor, but your whole
Speaker 2: body and your rib cage and making sure we had
Speaker 2: enough space in your like your abdomen. We got you
Speaker 2: doing some really cool fun exercises upside down. And then
Speaker 2: you actually came back in two weeks later and I
Speaker 2: was like, your bump is so different city in a
Speaker 2: different position. So there's alignment and the biomechanics like what's
Speaker 2: your body doing, how is baby growing, and how are
Speaker 2: you adapting effectively to that? And then when we look
Speaker 2: at birth, so it's like, right, how do we prepare
Speaker 2: you for Some people will have a plant s's air
Speaker 2: in birth. Some people have a vaginal birth. There's a
Speaker 2: lot that's out of our control. There's a lot that
Speaker 2: is in our control. And so when we're looking at
Speaker 2: the palvic floor and the coxigs for the baby to
Speaker 2: descend into the palverse and come out the other side,
Speaker 2: we need that cox SIGs to get out of the way.
Speaker 2: So anyone that has had a cocxix injury, whether in
Speaker 2: pain or not, highly highly recommend getting your cocxix assessed
Speaker 2: ideally rectily to assess that mobility and make sure it
Speaker 2: gets out of the way. Then when we're looking just
Speaker 2: at the pelvic floor during pregnancy for a vaginal birth
Speaker 2: is the power floor has two roles. One role is
Speaker 2: we need good tones, so good strength in that public floor,
Speaker 2: and that encourages the baby's head to flex forward so
Speaker 2: that the smallest part of the baby's head is presenting first.
Speaker 2: And so for anyone that's had a vaginal birth, we
Speaker 2: always want the smallest part, not the biggest part of
Speaker 2: the baby's head to come through. And then the other
Speaker 2: part is a passive role, So we need that palvly
Speaker 2: floor to relax, get out of the way, and lengthen
Speaker 2: so again so that the baby can come through, so
Speaker 2: that in a nutshell, is what I'd be looking for
Speaker 2: or assessing for the palblic floor to do during pregnancy,
Speaker 2: vaginal birth and then well recovery as well. So we
Speaker 2: want to make sure we've got good strength and ideally
Speaker 2: we're bouncing back and getting back to postpartum goals.
Speaker 1: Yeah, so what happens if you do have a weak
Speaker 1: pelvic floor then.
Speaker 2: So there's different things that we look for to actually
Speaker 2: assess if the palvic floor is week we get people
Speaker 2: coming in thinking they've got a week public floor and
Speaker 2: it's actually got way too much tension. So look, kegels
Speaker 2: can be great, and so pelvic floor which is a
Speaker 2: pelvic floor strengthening exercise, But again we need to look
Speaker 2: at right, when can you do a kegel effectively? Can
Speaker 2: you use your breath? So are you doing it properly?
Speaker 2: And then what are your goals? We've got to make
Speaker 2: sure them functional. So people can lie down on their
Speaker 2: back and do kegels or sit down and do kegels,
Speaker 2: But how does that then look when you want to
Speaker 2: go for a run. It's a completely different kind of
Speaker 2: exercise or activities. So definitely I would recommend getting an
Speaker 2: assessment and then making sure you're getting the appropriate exercises
Speaker 2: to strengthen it. Yeah, yeah, I know that.
Speaker 1: We said you can have a week public floor. Can
Speaker 1: you have it pelvic floor that's too tight?
Speaker 2: Absolutely okay. And again if we look at your situation,
Speaker 2: you actually came in and said to me, when I
Speaker 2: do a kegel, it hurts my coxis more. And for
Speaker 2: me that was straight away, I was like, yes, because
Speaker 2: you've got tightness.
Speaker 1: Yeah.
Speaker 2: So it's almost like going from muscles going from being
Speaker 2: tight to tighter, and then it's going to create that pain.
Speaker 2: And every time we're in pain, the palvist and the
Speaker 2: pelvic floor, it's such a sensitive like sacred area, and
Speaker 2: so it's a it's going to be very protective. So
Speaker 2: if we're in pain in that area, whether that's pain
Speaker 2: with sitting on your cocksix, pain with sex, the brain
Speaker 2: goes that doesn't feel good, I'm going to tense up
Speaker 2: more and then we get into this cycle of pain, tension,
Speaker 2: more pain, more tension, and it's really hard to break
Speaker 2: that cycle if you don't have someone address the palvip
Speaker 2: floor properly.
Speaker 1: And I think it's so interesting because everything's so related.
Speaker 1: Like when we've done our treatments, like all of it
Speaker 1: just is so interconnective. And I think that's the interesting
Speaker 1: thing about what you do, because you just know like
Speaker 1: everything that's connected, and you know, it's almost like when
Speaker 1: you push on a certain point that's really sore and
Speaker 1: you get the referred pain.
Speaker 2: It's just very interesting. Another thing too on that is
Speaker 2: when people are coming in for public palic floor tension
Speaker 2: and that might look like, you know, symptom wise, it
Speaker 2: might be pain with sex. Some people just feel it
Speaker 2: like I feel like my public floor, I'm always clenching,
Speaker 2: it's always tight. They might be constipated, and that's you know,
Speaker 2: they can't relax their public floor to be able to
Speaker 2: do a poop. Yeah. And one of the things that
Speaker 2: I do do is I can assess the palvic floor,
Speaker 2: but I can also treat the pelvic floor. And that's
Speaker 2: quite a point of difference to other practitioners out there,
Speaker 2: is we can feel for tension in the muscles and
Speaker 2: the connective tissue and actually release it off, get you
Speaker 2: to connect with your breath, and also have an understanding
Speaker 2: of how to relax your palvic floor or breathe and
Speaker 2: help to lengthen that pelvic floor. But I could spend
Speaker 2: for some people it releases beautifully, and then other people.
Speaker 2: I could spend hours and if it's not releasing off,
Speaker 2: I'm like, well, there has to be another reason. And
Speaker 2: that's where I would look at the ankle joint. I'd
Speaker 2: get the ankle moving, go reassess the pelvic floor because
Speaker 2: it's all connected. Yeah, look at the cocksix. Even for
Speaker 2: some people it's looking at the jaw. I had this
Speaker 2: one lady she'd had a massive fall to her cocksix
Speaker 2: and she just couldn't even have sex with her partner.
Speaker 2: It was so excruciating. I couldn't even do an internal
Speaker 2: vaginal assessment on it because it was she was just
Speaker 2: she was so tight and it was too painful. She
Speaker 2: was really worried that it was going to be painful,
Speaker 2: and I was like, look, we're not going to do
Speaker 2: an assessment. Let's just see if we can treat your body,
Speaker 2: get your whole wady to relax off. We treated a jaw,
Speaker 2: I treated her cocksix bone, and then we're able to
Speaker 2: go back and actually then at the end of the session,
Speaker 2: I was able to do an internal vaginal assessment release
Speaker 2: some of that tension so that she could then have
Speaker 2: sex with the husband inside, so it's just so connected,
Speaker 2: and just looking at the pelvic floor it just isn't enough. Yeah,
Speaker 2: it's like a piece of the puzzle. For some people
Speaker 2: it will be a little bit bigger, but for some
Speaker 2: people it's just a small piece, and we've got a
Speaker 2: look whole body.
Speaker 1: I think when we did our treatment, you spoke a
Speaker 1: lot about the interconnectedness of the pelvic floor and asking
Speaker 1: if I squeeze my bum when I stand, and I do,
Speaker 1: and I also clench my jaw and normally I have
Speaker 1: botox in my jaw to release it because I do
Speaker 1: hold so much attension there. But obviously you can't get
Speaker 1: botox when you're pregnant, so I've had started clenching again unknowingly.
Speaker 1: But it's just good to even talk to someone to
Speaker 1: just put that to front of mine, to be like, oh, yeah,
Speaker 1: I need to release or if sometimes I'm starting to
Speaker 1: get a migraine and I don't even realize I'm clenching
Speaker 1: my jaw so bad. Okay, speaking about kegels, because you
Speaker 1: mentioned it before. Every time someone says the word kegel,
Speaker 1: I can instantly feel myself doing one.
Speaker 2: I feel like.
Speaker 1: Everyone who's listening is probably doing one too.
Speaker 2: Everyone relaxed.
Speaker 1: What is some misconceptions people have about keegels, Well, firstly,
Speaker 1: what is a kegel for people who.
Speaker 2: Don't like atibation, So if you feel like it's like
Speaker 2: a lift up, a squeeze up, it's like sucking urine
Speaker 2: back up. Yeah, would be the main cues that would
Speaker 2: give people. So that's what a chegel is. It's a
Speaker 2: palic floor activation. More is more like I always joke
Speaker 2: that we've got kegel culture. I'm like, okay, stop, just stop.
Speaker 2: It's too much. Do too much. Keygels similar to this
Speaker 2: concept right of like clenching the jaw with like our
Speaker 2: traps are on, our shoulders are up to our ears,
Speaker 2: we hold our breath, our bums are on, palvic floors
Speaker 2: are on. So it's a nervous system tension, especially if
Speaker 2: you're a busy person. Go go go, Like some people
Speaker 2: are just going to be a little bit more active
Speaker 2: through those areas. So there is great research. Kegels can
Speaker 2: be great, great for strengthening our palvic floor and just
Speaker 2: overall function, but not everyone needs to be doing them
Speaker 2: all day every day, and they're not very functional. Like
Speaker 2: people do their kegels and they're holding their breath, and
Speaker 2: we know that the palvit floor it needs to be
Speaker 2: in sync with our breath. The palpate floor has to
Speaker 2: be able to lengthen to be able to contract. So
Speaker 2: holding a muscle in a constant contracted state it can
Speaker 2: create a dysfunction. So that would be the first thing.
Speaker 2: More isn't more if someone has concerns, like if they've
Speaker 2: got symptoms or they're just not sure where they're at,
Speaker 2: Like you need to get assessed to know whether you
Speaker 2: need to be doing those exercises and if you do,
Speaker 2: like how many how long do you hold for? Are
Speaker 2: you lying down? Are you standing? Are you on one leg?
Speaker 2: Are you lunging? Are you squatting? Like it has to
Speaker 2: be functional. Yeah, that would be the That would be
Speaker 2: the main one. And then also just this idea of
Speaker 2: again I always go back to looking at the whole body,
Speaker 2: like you can't just look at the pelvic floor. Where
Speaker 2: we can do better than that. How long should kegels
Speaker 2: go for for everyone who's interested? Depends on the per
Speaker 2: like it really depends.
Speaker 1: Yeah, I know that they say that if you're pregnant.
Speaker 1: I just feel like it's in some ways common knowledge
Speaker 1: that you should be doing your kegels to tighten the
Speaker 1: pelvic floor.
Speaker 2: How accurate is that? Look, there's great, there's definitely great
Speaker 2: research behind it because it again it aids in strength
Speaker 2: of the public. But the power floor has to also
Speaker 2: be able to relax. So some people can be again,
Speaker 2: they can be really really strong, but if you can't
Speaker 2: lengthen and connect and relax to your palblic floor, it's
Speaker 2: gonna be tricky to have a vaginal birth. And when
Speaker 2: you've got tension in the pallic floor and in that
Speaker 2: paranal body, you can have you know, increased risk of
Speaker 2: tearing and things like that. And then we look at
Speaker 2: postpart and so again you need good tone in the
Speaker 2: pelvic floor. We want those muscles to kind of bounce back.
Speaker 2: So yes, you do need strength, but we also need
Speaker 2: this ability to lengthen and let go. Yeah. Yeah, So
Speaker 2: everyone's just so different. It's interesting. It's kind of like saying,
Speaker 2: what glute exercise should I do? There are a million
Speaker 2: exercises out there, and what one person does could be
Speaker 2: really effective for their running, but then I might do
Speaker 2: it and it might hurt me, or may I might
Speaker 2: not be able to connect and get that glute firing.
Speaker 1: Yeah, and I think as it's a public exlaw, not
Speaker 1: that it's taboo, but maybe it's just like this is
Speaker 1: the one thing that you can do now.
Speaker 2: Yeah, go do them.
Speaker 1: Yeah.
Speaker 2: Yeah, almost, it's like we don't want to talk about it. Yeah.
Speaker 2: And look, it's very like for a lot of women,
Speaker 2: like it's very fearful. We hear so many bad stories
Speaker 2: pregnancy and birth, Like there's just so much fear. And
Speaker 2: so this is where I love love birth preparation because
Speaker 2: you know, I listen to what women want, what makes
Speaker 2: them feel safe, what makes them feel positive, and then
Speaker 2: you can really support them and educate them to be
Speaker 2: empowered to make these decisions. And so for some women
Speaker 2: that is a vaginal birth in hospital, for some women
Speaker 2: that is a home birth, for some people that is
Speaker 2: a cesarean, depends on what medical issues pop up. So yeah,
Speaker 2: it's just not a one size fits all.
Speaker 1: Yeah, let's talk more about birth preparation.
Speaker 2: Yeah, and where's your bump hat?
Speaker 1: Yeah, there's a lot of pregnant ladies listening or pretend
Speaker 1: chili mums who are going to have their second, third,
Speaker 1: fourth baby, whatever it might be. What is the best
Speaker 1: things that we can do as mums to be to
Speaker 1: prepare because it is scary.
Speaker 2: Yea other than to ya, I think one of the
Speaker 2: first things I'll talk to So if someone comes in
Speaker 2: for birth prep, they're coming in in twenty weeks, one
Speaker 2: of the first things I start to talk about is
Speaker 2: pain science and like mindfulness visualization stuff and addressing you know,
Speaker 2: any fears that pop up or any concerns that they
Speaker 2: might have, So that would be one of the first things.
Speaker 2: And there's heaps of positive, fine, positive stories, positive birth experiences,
Speaker 2: and when you're reading stuff or listening to podcasts, go
Speaker 2: with what are lines for you? There is so much
Speaker 2: information out there. Some can be quite science y, some
Speaker 2: can be quite spiritual. But pick what suits you, pick
Speaker 2: what suits your partner, so that you can start to
Speaker 2: think about and kind of create a bit of a
Speaker 2: birth map, so to be the first thing. Definitely, Like
Speaker 2: we know that strength, exercise, mobility stuff's really good. Again,
Speaker 2: it's kind of tailoring that to what you need. And
Speaker 2: then palvic floor is so important. Again I explained before,
Speaker 2: there's two roles. We need good tones, so there is
Speaker 2: an element where we want good strength and tone in
Speaker 2: the pelvic floor, but we need to make sure that
Speaker 2: public floor can get out of the way when that
Speaker 2: baby's head is descending through the palverse to come out.
Speaker 2: One of the other things I'll assess women for is,
Speaker 2: you know, do they have an effective push? Ideally we
Speaker 2: want the body to have the fetal ejection reflex so
Speaker 2: that you can push the baby out itself. Not all
Speaker 2: women get that reflex. And knowing how to if a
Speaker 2: woman is coached to push, knowing how to do that
Speaker 2: effectively where it can be less strain on your pelvic
Speaker 2: floor and making sure that push is really effective is
Speaker 2: super important as well. Is there ways that or things
Speaker 2: that women can do during birth to help them not
Speaker 2: to tear? The position is really important. So there's a
Speaker 2: couple of positions, so we know, like a deep squash,
Speaker 2: you know there's more of a likelihood to tear in
Speaker 2: that position. Being as active as possible is great. So
Speaker 2: that's something I'll definitely go through with people because we
Speaker 2: know that the more active you are, it really encourages
Speaker 2: that they need to kind of move and get to
Speaker 2: an optimal position. I always encourage women to stay off
Speaker 2: their back as long as they can, just because we
Speaker 2: need so our tailwines, our sacrum and our cocsis it
Speaker 2: needs to get out of the way. It allows for
Speaker 2: more space to open up through the pelverse. So if
Speaker 2: we're flat on our back, that coxix and sacrum it
Speaker 2: cannot move. So I'll give people strategies like I'll people
Speaker 2: to put cushions under their bottom so that allows a
Speaker 2: little bit of movement through, like through their bottom, through
Speaker 2: that sacred sidelining, getting on all fours, kneeling and this
Speaker 2: is all stuff that people might start practicing throughout their
Speaker 2: pregnancy so it becomes familiar to the brain so that
Speaker 2: when you're going into the hospital they're not you know,
Speaker 2: you don't want it to be foreign and be thinking
Speaker 2: what was that thing that that was meant to do?
Speaker 2: I can't remember. And then peranial must massage is a
Speaker 2: great tool for women from thirty five weeks onwards. It's
Speaker 2: something they can It's tricky to do on yourself when
Speaker 2: you're pregnant, so this is where I encourage partners. People
Speaker 2: can come into the clinic. I can do it for
Speaker 2: them to It's almost like you're trying to massage and
Speaker 2: just soften that peraneum which is between the vagina and
Speaker 2: the rectum. Get that to soften as much as possible
Speaker 2: so that when that baby's head is crowning and coming through,
Speaker 2: we want the power floor muscles to really slowly adapt, adapt, adapt,
Speaker 2: rather than if it's super tight, we're more likely to tear.
Speaker 2: Is that like outside of the vagina area internal well,
Speaker 2: the paranal body is like where is that? It's a
Speaker 2: bit of muscle and skin between the vagina and the rectum, right,
Speaker 2: But to actually stretch it, it would be putting a
Speaker 2: finger into the vagina and pulling back towards the rectum
Speaker 2: or towards the cox eggs. And that's how it would
Speaker 2: be like massage or stretched. Yeah, so from thirty five weeks,
Speaker 2: that's thirty five weeks. A couple of times a week
Speaker 2: about five minutes can make it into like a sexual thing.
Speaker 2: Most part, I think it's like kinky time thinking I
Speaker 2: feel like, no, this is serious. It's generation.
Speaker 1: How important is the public floor if you're opting for
Speaker 1: a sea section or if you end up having an
Speaker 1: emergency sea section.
Speaker 2: It's still super important. So this idea of the core
Speaker 2: is it's our breath, so through our diaphragm, under our
Speaker 2: rib cage, muscles, through our tummy and then our public
Speaker 2: floor and they all work together, and so fur recovery,
Speaker 2: like caesarean births, they're cutting through multiple layers of muscle
Speaker 2: and connective tissue. It's a it's major abdominal surgery, and
Speaker 2: I think we forget that and I always remind women
Speaker 2: like people who tear the ACL and haven't knee reco
Speaker 2: they g had a twelve month program on how to
Speaker 2: like bounce back, and women who have caesareans you get
Speaker 2: like a sheet of paper and it's like on your
Speaker 2: merry way, good luck. It's nuts. Yeah. So there's a
Speaker 2: lot of research that's come out that talks about a
Speaker 2: three week abdominal wall assessment now and then we always
Speaker 2: recommend internal public floor assessment around six to eight weeks.
Speaker 2: Those two areas so core kind of our lower abdomen
Speaker 2: round scar tissue and then the pelvic floor. They need
Speaker 2: to work together. And so some women can still have
Speaker 2: weakness in the pelvic floor from a cesarean birth and
Speaker 2: you're still recovering, like the pregnancy is massive. You know
Speaker 2: your body is changing and constantly adapting. That can still
Speaker 2: put a lot of pressure on the pelvic floor. There's
Speaker 2: a lot of hormonal changes that affect the pelvic floor.
Speaker 2: So it's still an area that definitely needs to be
Speaker 2: addressed postpartum. Recently, you told me or informed me.
Speaker 1: I think I've heard of it before, but I've never
Speaker 1: really spoken about it, and that was AB separation. I
Speaker 1: think we need to talk about this because I think
Speaker 1: this is a concern for a lot of pregnant women. Firstly,
Speaker 1: what is AB separation.
Speaker 2: So we have if we think of our six pack
Speaker 2: muscles through the middle, We've got this sheath and it
Speaker 2: expands and adapts, and it has to because you've got
Speaker 2: this growing belly. But what we want to make sure
Speaker 2: is that it's still strong and contracting effectively and efficiently.
Speaker 2: So it really comes back again to the breath and
Speaker 2: that core contraction. What we don't don't want to see, though,
Speaker 2: is excessive strain of that area, and that's when some
Speaker 2: women might get what we call coning. So when you're
Speaker 2: rolling over in bed or getting in and out of
Speaker 2: like a chair or the car, if anyone sees that
Speaker 2: coning or the doming, it can be assigned that there's
Speaker 2: too much pressure going to that area. So things throughout
Speaker 2: pregnancy like compression garments and might be shorts, it might
Speaker 2: be some tubu grip can be really beneficial, and then
Speaker 2: again postpartum making, I definitely recommend people get that assessed.
Speaker 2: It used to be about you know, how many fingerwits
Speaker 2: and the depth of it. But what we now know
Speaker 2: some people can still have quite a wide separation, but
Speaker 2: they might contract really really well and their functions really good.
Speaker 2: Whereas someone might have a really small gap, but we
Speaker 2: get this kind of bulging through that area that again
Speaker 2: we've got way too much pressure, way too much strain,
Speaker 2: and then that can create just yeah, that issues down
Speaker 2: the track.
Speaker 1: When you're talking about the cony, is that at the
Speaker 1: top of the stomach. Yeah, usually, and so it kind
Speaker 1: of like looks like old tepe almost teh little tepee.
Speaker 1: And there's obviously different levels of ab separation that you
Speaker 1: can get.
Speaker 2: I have a little bit. I think you said just
Speaker 2: a tad really slightly, and it was more with you
Speaker 2: we were talking about just like it's you're fine. It's
Speaker 2: just making sure when you're doing those things like getting
Speaker 2: up out of the bed, don't try and do like
Speaker 2: a like an ub crunk, which I do to be
Speaker 2: really safe. Roll to your side, you know, use your
Speaker 2: arms to push up.
Speaker 1: Yeah, it's so funny because I didn't even realize I
Speaker 1: was really doing it until Meg was like, oh, you're
Speaker 1: doing that thing, and I've been doing it like getting
Speaker 1: in and out of the car and like who yeah,
Speaker 1: like an old man, honestly. And it's so funny because
Speaker 1: it's just obviously innately in me with all of the extra.
Speaker 2: Weight and pressure.
Speaker 1: But also I hadn't really been in tensing my abdominal
Speaker 1: muscle at all because I don't know why, but someone
Speaker 1: told me that you shouldn't tense it during pregnancy, which
Speaker 1: I think is misinformation or I've maybe have heard it
Speaker 1: somewhere or on a TikTok.
Speaker 2: I don't know where someone's trying to do me dirty.
Speaker 1: But you are as opposed to tense your muscles during
Speaker 1: pregnancy at times.
Speaker 2: Right, So we still want similar hopeful, we still want
Speaker 2: a good core. Yeah, it's the constant contraction. So it's
Speaker 2: like the breath holding, all this sucking in and again,
Speaker 2: like women, even they may not be pregnant, so many
Speaker 2: women breath hold and we suck our tummies in and
Speaker 2: you can kind of see like some people will come
Speaker 2: in and they might be presenting with just low back pain,
Speaker 2: and straight away I'm like, I can tell I'll be
Speaker 2: really narrow at the top underneath their ribs, and that
Speaker 2: we call a pressure belly, So they're really tight under
Speaker 2: their ribs, and then they almost have like a slight
Speaker 2: kind of pooch ure a curve in their lower belly
Speaker 2: lower down, and then that's a bit sign that they're
Speaker 2: breath holding or they're only contracting the upper portion of
Speaker 2: their abdominals. So it's still important, like it's like being fit,
Speaker 2: still want to be fit, be toned, but it's making
Speaker 2: sure we're not overdoing it. And so you might be
Speaker 2: a little bit more conscious with say getting out of
Speaker 2: a chair rolling over in bed that you activate your
Speaker 2: abdominals and your core muscles. But it's not something that
Speaker 2: we want to be doing all day every day. It's
Speaker 2: like clenching the jaw. The jaw, if you do that
Speaker 2: all day, that is going to get so sore, it's
Speaker 2: going to give you a headache. It's going to lead
Speaker 2: to dysfunction. Absolutely. Yeah.
Speaker 1: Okay, well this has been extremely interesting. I think we're
Speaker 1: going to talk all about sexual dysfunction and sex next.
Speaker 1: Let's talk about sexual function and the role that the
Speaker 1: pelvic floor plays with sexual function.
Speaker 2: Yeah, this is always a really fun one and in
Speaker 2: a nutshell, the palid flow it has to be able
Speaker 2: to contract. This for women contract and relax. We need
Speaker 2: good blood flow, we need good lubrication. But the biggest
Speaker 2: part is does the palvic floor have the ability to
Speaker 2: lengthen and relax for penetration to occur. So part of
Speaker 2: that again, it comes back to this concept. We need
Speaker 2: good tone, we need it to be strong, but we
Speaker 2: also need to have this ability to lengthen and relax.
Speaker 2: So for a lot of women where you know it
Speaker 2: might be painful experience having sex, it can be indicative
Speaker 2: of tension or you know. That's where I'd go back
Speaker 2: and be like, all right, what else is in your
Speaker 2: history that might indicate palvic floor tension? Have you fallen
Speaker 2: onto COXYX? What's a nervous system like? You know? Have
Speaker 2: they had trauma? Do they clunch their jaw? It's all
Speaker 2: about the why for sexual function because everyone is just
Speaker 2: so different. And it's not until these women come in
Speaker 2: and I'm asking them lots of questions. You don't know
Speaker 2: sometimes what you don't know? Yeah, and I'll talk about
Speaker 2: you know, do you have this discomfort and they'll be like, no, no, no,
Speaker 2: I'll come back in the next session and they're like,
Speaker 2: I actually do like I've got Yeah, I do have
Speaker 2: a lot of pain and that was became my normal.
Speaker 2: And then we'll break that down, you know, I'll ask
Speaker 2: whomen is it at the entrance of the vagina? Does
Speaker 2: it feel deeper? Does it feel like something's hitting your cervix?
Speaker 2: You know, could this person have endemetrio sis. There's so
Speaker 2: many different reasons, but yeah, that is the role of
Speaker 2: the pelvic floor. Sexual function in a nutshell.
Speaker 1: We obviously there's dysfunction when it comes to sex for women.
Speaker 1: How would we describe that like sexual dysfunction?
Speaker 2: The biggest symptom of dysfunction would be pain. Pain. Yeah,
Speaker 2: some women struggle with orgasm. They might have pain with
Speaker 2: an orgasm. It can also be about their arousal, like
Speaker 2: can they get around? It might be pain with lilitteral stimulation.
Speaker 1: After I had sepsis, every time I would orgasm it
Speaker 1: would hurt.
Speaker 2: Interesting because it.
Speaker 1: Started from like a kidney infection. I don't know how
Speaker 1: on Earth it's related. Well, it was UTIs into kidney infection,
Speaker 1: intercepsis and I can probably explain that, can you, because
Speaker 1: it was like maybe like maybe five months and is
Speaker 1: this new normal?
Speaker 2: Okay? This is I love talking about this. So the
Speaker 2: entrance of the vagina it's called the vestibule, and the
Speaker 2: mucosa to the tissue through that area and then the embryologically,
Speaker 2: so when we're developing utero, that tissue and the urethra
Speaker 2: are the same. So when that tissue is sensitive, so
Speaker 2: you've had a UTI, you've had an infection. There's this
Speaker 2: cross talk between the two areas, so it can feel
Speaker 2: painful in that tissue. So for example, if someone comes
Speaker 2: in and they're like, I feel like I get these
Speaker 2: chronic UTI's is something I hear of a lot, and
Speaker 2: I'll say like, did you have do you always have
Speaker 2: a positive culture when you get checked for a UTR
Speaker 2: And they're like, no, it's not always positive, And that's
Speaker 2: usually a hint for me that the urethra has had
Speaker 2: infection in it. That cross talks with that tissue and
Speaker 2: then the entrance of the vagina becomes hyper sensitive. So
Speaker 2: we would put that in this category of volver dinner.
Speaker 2: So you've got essentially it's a symptom. It just means
Speaker 2: you've got pain in the vulver. There are subsets of
Speaker 2: the vulvar, so we've got the clitorists, which would be
Speaker 2: clittery dinner clural pain, and then the vestibule vestibulo dinner.
Speaker 2: So you've probably in having this infection. It's hyper stimulated
Speaker 2: those nerve endings and that mucosa and that tissue, so
Speaker 2: that then when you have sex it's uncomfortable. The pelvic
Speaker 2: floor muscles react because it's there so detective. You get
Speaker 2: this tension. It's like even the apprehension, it's like you're
Speaker 2: like clencher pelvic floor just thinking about it. Yeah, and
Speaker 2: then it reiterates this pain tension cycle again. Hmmm, Yeah,
Speaker 2: that's definitely what I was serious. Yeah, it's really common,
Speaker 2: and so you kind of then left with this pattern
Speaker 2: of you know, you've just got this chronic tension and
Speaker 2: then add onto that you've falling on your cosix to
Speaker 2: solve the problem. Seeing but I mean.
Speaker 1: We all have these issues and sometimes for example me,
Speaker 1: obviously we had never met, so I wasn't like, oh,
Speaker 1: I'm gonna go see Meg about this, or I'm gonna
Speaker 1: go see and O'SO about this. You can help me
Speaker 1: with this pelvic flaw issue or pain during orgasm. Sometimes
Speaker 1: you just kind of eat it and you're just like, Okay,
Speaker 1: this is how it is for now.
Speaker 2: Hopefully it goes away the amount if I had a
Speaker 2: dollar every time I was told by a patient that
Speaker 2: their doctor their health professional told them to just relax,
Speaker 2: I'm like, it's like telling you to chill out. Sometimes
Speaker 2: chill out it just does not help. Or haven't drink
Speaker 2: like health professions telling someone to have it wine before
Speaker 2: they have sex. I'm like, is the worst advice, Like
Speaker 2: as if you haven't thought of that or try that,
Speaker 2: and if it's a chronic issue, yeah, like we need
Speaker 2: to we can do more, we can we can do better,
Speaker 2: we can think better.
Speaker 1: Yeah yeah, okay, So what are some osteopathic techniques that
Speaker 1: help improve pelvic f law sunction?
Speaker 2: One of the things, and this is a bit of
Speaker 2: a bit of a point of difference, actually treat the
Speaker 2: public floor. So if there is tension in the public floor,
Speaker 2: I can actually feel it. So I've got my finger
Speaker 2: in the vagina and it feels like I'm in a
Speaker 2: bowl and I'm just feeling like where does that tension lie?
Speaker 2: Is it in the muscle? The fashion, the connective tissue,
Speaker 2: we can hold it, get you to connect with your
Speaker 2: breath and actually release that off. And then there's just
Speaker 2: so many other things. Sometimes it's not too you see
Speaker 2: in OSTEO you actually fully understand how it is a
Speaker 2: little bit different. But we do a lot of like
Speaker 2: jointation and mobilization. I do a lot of work visceral work,
Speaker 2: which is actually getting on the organs like the bladder
Speaker 2: and the uterus and seeing if there's tension in those areas,
Speaker 2: working on the gut, working on the diaphragms. It's a
Speaker 2: real combination of you know, working on some soft tissue,
Speaker 2: the joints, everything. Yeah, yeah, all of it. But I
Speaker 2: would say in general, I personally am more hands on
Speaker 2: and Ostropats I would say across the board are more
Speaker 2: hands on. Some a bit more rehab focus, but that
Speaker 2: is what I would be doing for like, yeah, the pelt,
Speaker 2: floor and body, and say with your jaw, so I've
Speaker 2: got a type out with floor, there's work. I can't
Speaker 2: know if I've done that on you your jaw. Put
Speaker 2: a glove on and come on to the inside of
Speaker 2: your jaw and like release these muscles through here. And
Speaker 2: sometimes that can be a game changer for some women,
Speaker 2: like release the jaw and they're like, I just fell
Speaker 2: my public full let go or unclenched for the first
Speaker 2: time ever. Really Yeah, see that's so interesting connection. Yeah,
Speaker 2: we know that people who have tension in their power
Speaker 2: for there's like a high percentages that will clunch their jaw.
Speaker 2: It just doesn't work the other way rounds. So just
Speaker 2: because you're a jaw cluncher doesn't mean it doesn't.
Speaker 1: Stand I'm coming for Let's just say, for everyone who's pregnant,
Speaker 1: what are we recommending sex wise, because obviously some people
Speaker 1: feel comfortable having sex, some people don't.
Speaker 2: People think is it going to harm the baby? All
Speaker 2: of these things, So some people will have medical issues
Speaker 2: going on and they will be told not to have sex.
Speaker 2: But it really depends sex is this event it's like
Speaker 2: so physical, but then it's so like hormonal, mental, emotional.
Speaker 2: You gotta want it to sort of fear a roused
Speaker 2: and have that good lubrication. And some women will be
Speaker 2: so aroused throughout pregnancy, and I don't have sex all
Speaker 2: the time. Others don't want to be touched, so I
Speaker 2: think that's a big factor. Yeah, But then also it
Speaker 2: depends on how you're feeling physically, like you're able to
Speaker 2: even get into certain positions where you're comfortable and can
Speaker 2: relax and feel it's hard something we've a girl of pain,
Speaker 2: so that they might even need to experiment with different
Speaker 2: positions and try some new things. But you know, and
Speaker 2: then we partners, some partners are just so fearful that
Speaker 2: any form of penetration is going to hurt the baby,
Speaker 2: which I just don't think.
Speaker 1: It's my partner for the first twelve weeks, he's like
Speaker 1: the first twelve weeks, it's like it's a challenging time,
Speaker 1: like we need to be super careful, so like no sex.
Speaker 1: And then by the twelve weeks, I was like, okay,
Speaker 1: I'm over sex. Now had your.
Speaker 2: Window, two sailing boats in the night, we see each other.
Speaker 2: I've had a few pass though, where so spam has
Speaker 2: there's something you know, I think it's like a prostera
Speaker 2: gland and that can help bring on labor. Really sure
Speaker 2: how true that is that is. But a girlfriend of mine,
Speaker 2: she was like forty one weeks and she's like, get
Speaker 2: this baby out of me. I was like, just had sex,
Speaker 2: see what happens, And no joke like that night she
Speaker 2: went to labor. It's true. It's true. Didn't call any
Speaker 2: cart actually, and I'm sure she said that. On one of.
Speaker 1: She was like, I'm just gonna go have sex so
Speaker 1: that the labor starts, and apparently it did.
Speaker 2: I don't know, then it must be true. There you go.
Speaker 1: In pregnancy, there is a risk of having prolapse, So
Speaker 1: vaginal or rectal prolapse.
Speaker 2: Can you talk us through all of that? Itself is
Speaker 2: not a risk factor having prolapse. Ah. A prolapse is
Speaker 2: where a pelvic organ descends into the vagina, so it's
Speaker 2: going into a space where it really shouldn't be. So
Speaker 2: the front wall is the bladder, which is really common.
Speaker 2: The back wall is the rectum. We can get a
Speaker 2: uterus or cervix prolaps. That's the uterus coming down. There's
Speaker 2: also an troca, which is actually the small intestline coming down,
Speaker 2: but that's less common. So the pregnancy alone not a
Speaker 2: risk factor. But yeah, a vaginal birth and then things
Speaker 2: like an instrumental birth, so vacuum forceps definitely more of
Speaker 2: a risk there too. So post birth is looking again,
Speaker 2: I'd definitely encourage everyone to at least have an assessment
Speaker 2: because some people cannot be symptomatic and they may be
Speaker 2: getting back into exercise and not doing things correctly. They
Speaker 2: may not have a strong core or a strong public flow,
Speaker 2: and then they can start to get symptomatic for making
Speaker 2: sure that they're doing the right things from the get go.
Speaker 2: Most women will have a sensation of either a dragging
Speaker 2: or a bulging feeling that can indicate that there may
Speaker 2: be a prolapse present. And so something that I would
Speaker 2: assess for is okay, like where is it? What is it?
Speaker 2: But also how do we grade that and then coming
Speaker 2: up with management strategies so they can improve, they can
Speaker 2: get better. It's such a fear for a lot of women,
Speaker 2: but a lot of the women that I see coming
Speaker 2: into clinic they improve. Yeah, but yeah, the symptoms of
Speaker 2: a prolapse vary. They do vary a lot. So for
Speaker 2: some women, you know, constipation can be really common and
Speaker 2: we can put a lot of that down to diet.
Speaker 2: A lot of people get constipated and non laxatives post
Speaker 2: whether it's vaginal births are and bath. But sometimes if
Speaker 2: we've got a rectal prolapse and so we've got a
Speaker 2: slight bulge of so we might have a small amount
Speaker 2: of pho's still sitting in a little pocket in the
Speaker 2: rectum and we're not fully evacuating, and it can feel
Speaker 2: like constipation where it could be an indicator that there
Speaker 2: is a rectal prolapse present. And then things like in continents,
Speaker 2: so you know you're able to hold your e are
Speaker 2: able to get to the toilet. Do you have any
Speaker 2: kind of random leakage do you like with coffer or sneeze.
Speaker 2: A good test that I'll always get everyone to do
Speaker 2: postpartum is and you stop your Wii mid flow, you
Speaker 2: should be able to stop it immediately hold for three seconds.
Speaker 2: That's testing. It's a little bit of the public floor,
Speaker 2: but it's more than urethral the sphincter.
Speaker 1: Okay, yeah, someone told me that that was part of
Speaker 1: like the kegel exercise almost like.
Speaker 2: If you're wing, you like stop and try to tend similar.
Speaker 2: Oh it's the same essentially, Yes, you are. It's like
Speaker 2: a kegel, so you're activating your public floor. Yeah, but
Speaker 2: it's a bit more targeted and it's a test for
Speaker 2: the urethroal sphincter. Yeah.
Speaker 1: Yeah, speaking of like utiys and things like that. Whilst
Speaker 1: we're on it, as well, because I had no idea
Speaker 1: about this, but apparently, and you can correct me if
Speaker 1: I'm wrong, but you WI, and then you could you
Speaker 1: should be able to wait a little bit and then
Speaker 1: there should be more WE that comes out and that
Speaker 1: can really stop utiys.
Speaker 2: So when if you're doing a pulpful activation mid WII,
Speaker 2: it's almost your wiis like a belt curve. So it
Speaker 2: starts off slow, gets sort of to its full volume,
Speaker 2: and then it kind of tapes off. So when you're
Speaker 2: doing your activation, you want to do that in midstream. Yeah,
Speaker 2: because the brain will recognize that there's a good decent
Speaker 2: volume left and it needs to get rid of that.
Speaker 2: If you only have a little bit of WE left,
Speaker 2: the brain may not recognize that. So you may actually
Speaker 2: retain a bit of that week and therefore you can
Speaker 2: get back toial infection from that. So and you shouldn't
Speaker 2: really hold it for much longer like three seconds no, okay, No,
Speaker 2: So it's just like a one off thing. It would
Speaker 2: just be a test, and if you're struggling with that test,
Speaker 2: then that can become your homework. Yeah, so something I'll
Speaker 2: give people against postpartum or you know what, if that's
Speaker 2: coming with blooded complaints, I may still give them that
Speaker 2: there's a bit of homework to try it. And if
Speaker 2: someone can't do it, so say in the morning, they're like,
Speaker 2: I was fine in the morning. And often that's when
Speaker 2: the polic floor has a bit of contraction. Throughout the
Speaker 2: day they're on their feet, the paler flour muscles might
Speaker 2: get really tight and fatigued, and then they go to
Speaker 2: do a wehe at the end of the day and
Speaker 2: they're like, I could not hold on. That becomes their homework,
Speaker 2: and always you would be all right, it's a three
Speaker 2: second hold. You should do it straight away. If you're
Speaker 2: struggling with that, part of your homework might be all right,
Speaker 2: let's actually get you doing that. But we might get
Speaker 2: you doing some kegels or probably floor activations. But again
Speaker 2: they need to be functional, so you know, that might
Speaker 2: be lying down to start off with. It's just like
Speaker 2: an absolute baseline level, and then we might go all right,
Speaker 2: let's get your standing and see if you can activate
Speaker 2: your probably floor in a standing position. Yeah. Yeah.
Speaker 1: Moving into the third trimester of pregnancy, I'm struggling so
Speaker 1: much more to hold my wheeze and now I'm kind
Speaker 1: of I think I'm at two or three times a
Speaker 1: night where I'm waking up in the middle of the
Speaker 1: night to we what's normal.
Speaker 2: Like how often should we be waking up? Look, it's
Speaker 2: everyone's going to be really different. And if you've got
Speaker 2: it when you're pregnant and you've got bladder issues, it
Speaker 2: might be frequency urgency. It's really hard to get on
Speaker 2: top of because you've got more fluid in your body.
Speaker 2: You're going you just it's one of those symptoms. You're
Speaker 2: gonna go more at nighttime the baby kicks the bladder. Yeah,
Speaker 2: you've got so much pressure going down. And we know too,
Speaker 2: like the bladder responds to stretch receptors, So as your
Speaker 2: bladder is filling up, sends that signal to the brain
Speaker 2: bladder is full, you need to go to the toilet.
Speaker 2: But now you've got a baby pushing on that. And
Speaker 2: so when you've got those external factors and that pressure,
Speaker 2: it can send that signal you need to do away. Yeah,
Speaker 2: so you can be limited with what you can do
Speaker 2: for that. You still need to make sure you're hydrated.
Speaker 2: Sometimes what I find is women are drinking so much water,
Speaker 2: but you're missing your electrolyte, so you're not absorbing it.
Speaker 2: So sometimes I look at that. But if someone's got
Speaker 2: bladder concerns, usually what I do is give them a
Speaker 2: blaoder diary, because I want to know, over three days,
Speaker 2: what are your patterns, what's the volume, what's your liquid input,
Speaker 2: what's your output when you're pregnant. I'm never doing a
Speaker 2: bladder diary because it's well, it's just too many, like
Speaker 2: hormonal factors, catch from the baby. It's just not going
Speaker 2: to be accurate. It would be more looking at postpart
Speaker 2: and making sure you're recovering. If you're finding during your
Speaker 2: pregnancy that you're coughing, laughing and you're doing a bit
Speaker 2: of we that that stuff that we definitely want to manage,
Speaker 2: and that can be you know, for some people, it
Speaker 2: can be doing kegels. Sometimes people have so much tension.
Speaker 2: And I always use my fist as example. It's like
Speaker 2: if I squeeze my fist and then you say to me,
Speaker 2: squeeze more, I'm like, I can't. It feels really weak.
Speaker 2: So if my power fools already really really tight and
Speaker 2: then I go to cough or sneeze and I need
Speaker 2: more of a contract, I can't do it. And that's
Speaker 2: where tension. Too much tension can create blood of leakage.
Speaker 2: So it's looking at that too. Does that person actually
Speaker 2: need to do some strengthening exercises or do we need
Speaker 2: to focus on lengthening first. So those sorts of bladder habits, yes,
Speaker 2: we definitely want to tackle, but the paying at not.
Speaker 2: It's a tricky on. It's a trick huan. Yeah.
Speaker 1: I think for the longest time, I've just thought that
Speaker 1: all pregnant women when they get to the end, are
Speaker 1: a little bit incontinent.
Speaker 2: It's really common, Okay, not normal, but really common.
Speaker 1: Okay, So if we have this symptom, then we probably
Speaker 1: should be working on it with an osteo or with
Speaker 1: a specialist.
Speaker 2: Yeah. Because the thing too is, you know, if you
Speaker 2: are getting some leaking, it's a pressure management issue. So
Speaker 2: we've got so much pressure coming down. The public flow
Speaker 2: can be contracting really well, but it just doesn't beat
Speaker 2: the pressure from above. Yeah, and so we want to
Speaker 2: manage that as much as possible so that postparton we
Speaker 2: don't have issues. Yeah. You know, I had a lady
Speaker 2: in last week actually, she came in for in her
Speaker 2: last trimester, and I was like, you've got a blood
Speaker 2: of prolapse, and she'd had this chronic cough and she
Speaker 2: was severely constipated, so she's like coughing and straining. And
Speaker 2: anyone that's been pregnant knows how awful I can feel
Speaker 2: when all you're trying to do is like hold on
Speaker 2: for your life, trying to keep yourself dry. It just
Speaker 2: can be this constant, daily strained, strained strain, and that
Speaker 2: can create a lot of weakness and dysfunction in the
Speaker 2: public floor. Yeah, so you want to get that checked out, definitely.
Speaker 2: You know where you're at, what should you be doing,
Speaker 2: How should you be managing it appropriately. I don't know
Speaker 2: if this is a good time to tell you, but
Speaker 2: I coughed this morning. In a little bit, we came out.
Speaker 2: We'll check that like the tiniest, tiniest look me.
Speaker 1: Thank you so much for coming on the podcast. It's
Speaker 1: been a pleasure and I've learned so much. I'm sure
Speaker 1: everyone else has learned so much, So thank you for
Speaker 1: your time than having me.
Speaker 2: It's been really fun.