Latest / The theunhingedhygienists’s Podcast / Its Not Just Kegals | Catrina Fabian PT | EP32

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Its Not Just Kegals | Catrina Fabian PT | EP32 · The theunhingedhygienists’s Podcast

• catrina podbean: Ken. Do you look for this? Or do you see for number I don't know what you're talking about. Take. Okay. Welcome back to the Unhinged Hygienist, where we goof around. However, we are here helping hygienists think differently so patients can live differently. Ooh, isn't that good? But can I confess something? If someone had asked me a year ago what a public floor actually did, I probably would have shrugged and said, I don't know, Kegels. I think that's legit. I I mean, I don't think you're alone on that. No, but now like sometimes I sneeze and I pee myself. And turns out these muscles not only influence that, but they influence how you breathe. Right? How you move, your bladder, your bowels, your posture, your back, your core, holy hell, your sex life obviously. And even how your nervous system responds to stress. yes. No one told us all that though. Wow. It's amazing how the things that nobody is talking about are often the things that are actually affecting millions of people every single day. Right. Right. Today's guest is someone I've actually known for years. Which makes this conversation even more special. Because I met Katrina in Las Vegas back when she was in school in physical therapy school, and she used to dox at my little OD. Odie was cute. And she was great, but then when she graduated, she was no longer dog sitting. No. But I understood. I understood that her life plan was not to dog sit until she was retired. So I mean I guess. I supported her life decisions. She retired from dog sitting. So on that note, I would say I love this story and its origins already. So hey Katrina Welcome to the Unhinged Hygiene. Welcome. Thank you. Thank you. Yes, yes. After retiring from dog sitting, I found my second career in physical therapy. So now I mean that's a big switch, sister. Yes. Probably we can relate the two as well, but Officially, formally, I'm Doctor Katrina Fabian, Doctor of Physical Therapy. I specialize in pelvic and women's health, so Yes, I am discussing all conditions of the pelvic floor muscles every single day and how they relate to bowel bladder and sexual function in the hips and the abdomen, everything that Tosia just listed. Isn't that crazy? It's amazing. It's how did you specialize in that part of our physical therapy body? So there are several specialties in physical therapy and the more I was exposed to the topics in this field and the more stories I heard from women. and then eventually men too about issues in this area, the more I was hooked. And it's just such a fascinating topic to learn about. So in physical therapy school during my clinical rotations, I started postgraduate education already in order to have a clinical in this specialty. And then the learning continued for up till now. Up till now, I'm five years out. And I'm still taking a lot of continuing education. Curiosity is our main thing. That's it. That's what we push. Yeah. That's awesome. So what do you think the biggest misconception people have when he they hear like pelvic floor therapy? They usually say, for pregnant women? like for women, right? Or just women in general, yeah. Because that's not a term I knew like maybe twenty years ago. I didn't even know men could do it. And I didn't know it was anything besides the key goal. Like learning about the floor of the mouth and the bla and the core and I mean just being a myofunctional therapist and when I think about diaphragmatic breathing and kind of teaching about this sort of middle body fascial aspect, it makes sense. Yeah. Cause obviously it kind of crawls up and all the way around us, right? So Yes. Our Tim Hortons fairy is here. Yeah, we have a Tim Hortons fairy. Tim Hortons fairy. But what is this? What is it? Is he flying in? cheers! It's not even have the little flag on it. I know the MVP. Thank you, fairy. Woohoo! Yeah, he's he's our IT specialist. Extraordinaire. And the most handsome coffee IT fairy you've ever met. That's right. He's like, I'll do this next time too, ladies. And you keep talking about me like that. Right. But I have a question because this might be dumb, but I don't think it's dumb because maybe a lot of people where is the pelvic floor? Is it a single location? I am just so glad you asked. my God, that's the best. That's better than our mouths, our type of daunts. We actually have now if I could juggle. then maybe I'd be able to juggle all three of the pelvises. If you learn how to juggle the pelvic skeleton, you're going on tour. Yep. You know? You're gonna have to work on it. My brain goes, I think I can make that happen. yeah. my gear. Yeah, exactly. But Yes, it's only in one location if we're talking about the pelvic floor muscles, and that is at the bottom of the pelvis. So if we have the spinal canal in the very back, we have our hard pubic bone in the very front, and then our sit bones at the very bottom of the pelvis. And the tailbone, the sit bones or ischial tuberosities, and the pubic bone are the borders for the pelvic floor muscles. And so Men and woman have the same muscles. They're just oriented differently. But you can see on a model that they truly form a bowl. There's the hip. Yes. Okay. Interesting. Yeah. Okay. Mm-hmm. And there are indeed hip muscles inside of here, in addition to the muscles that do a Kegel. And so you can start seeing how the pelvic floor muscles or region. is so connected to hip motion and mobility. Interesting. And back. Like I think about right now, even sitting and I have to be on a long plane ride tomorrow. And I feel like the left sciatica, for lack of a better word, is right up into that area where my sit bones are. And I have to adjust all the time. So I feel like that must be really the root of all evil is that sort of area of our body. So what would we do? What's saying? Wow. What what would we do tomorrow during your flight? Or just in general. For people who really cause I think for me, aside from peeing when I jump on a trampoline, is that pelvic floor? Is that pelvic floor or is that low progesterone? Or could it be both? you know it could absolutely be both. It could be a mix of vulgar atrophy, contributed to or can because of a depletion of hormones. it could be muscle atrophy. It could be incoordination. It could be poor breath mechanics. I it could be weight. Yeah. Sure. There's a lot. Hip weakness. Mm-hmm. And I feel like most people have hip hip weakness or like I don't even know what hip weakness means. I don't know either, but it sounds good. And I feel like most people would have it. It sounds like something just like I feel like most people have very tight hip areas. It's not an area that we're used to stretching or our mobility in our hips is not probably very good. We Well, I'm speaking for myself now. Gosh, I feel meaning where I'm at. Kristen, we need to have her in on this conversation too. Wow. Okay. Okay. So Sissy is like N equals one. The research shows. Yeah. That's where her brain goes. Where is the definitive answer? So okay. So the pelvic floor is basically a bowl of muscles. Yes, it's a bowl of muscles. It should be considered part of our core. And we the average person, I think, thinks of the six pack abs and maybe the obliques as the core, but those are truly like the superficial muscles of the abdomen, and the deep core exists within the pelvic floor muscles. This big muscle called the transverse abdominis that wraps all the way around the Abdomen, the diaphragm is the ceiling, and then our little spinal stabilizers, the multifidae, are at the back. So that to me is a core. And so the pelvic floor is yes, at the bottom of the pelvis, the floor at the core. Man, when you really break down the human body, like remember that body works, the traveling that cut the humans in half and stuff. That was fascinating for me because right now my brain is dissecting. Like, okay, I'm gonna peel my skin, I'm gonna peel my. my abdominal wall and then there's a stomach there. And then now there's the deeper muscles that you were speaking of. And like there's layers. Sort of. Yeah. So many layers. They're all layers. Yeah. The core muscles are very superficial. Like they are are still superficial to the organs, but like within the core there are the layers of the obliques and then behind that the rectus abdominus and then behind that the TA. And so you can see how, yeah, it it they do actually protect all of the organs in the abdomen. And affect the movement of the viscera. So when you take that deep diaphragmatic breath, it actually, you know, pushes down on the colon. Which yeah. And I try to explain that when I'm doing the breath coaching work, that constipation can be helped along with deep, good breathing because you're really massaging everything in and out and in and out. So if anyone's sitting on the toilet listening to this right now, and you're like, take a moment and this is how you shall breathe. That's right. That was beautiful. Don't you feel relaxed? Hello. I'm careful if we're not on the toilet. But do you feel like there's a lot of women who have pelvic floor issues and think that this is just like their normal part of life? Yeah. Do we have to? Like it's just our lot. Yes, absolutely. I don't know what the specific number is at this point, but the attitude is so much of, I I mean, I'm I I was pregnant or I was I delivered or no one told me that sex shouldn't hurt. Or I mean I can live this way anyway. I didn't realize there's help out there. So it yes, it's nor like issues are very normalized for this area when in fact like resolution should be normalized. Amen. For it's like a periodonal disease. I feel like the parts of our body that are inside of our body, like the mouth Or the pelvic floor, they get ignored because no one can see them. Yeah. Yeah. Yes. If any of these problems, that's like what we say about disease, what's the ratio with the hands? And they say like people who have periodical disease, if you put all those ulcerations, it's like the size of the palm of your hand. If you had it's a lot of disease. Like an open wound the size of the palm of your hand on any part of your body, would you be like, it's fine. This is my normal. Or if any other muscle on your body atrophied or hurt or we leaked or something anywhere else, why would it why do we normalize this? Because it's a is how did did we get embarrassed? Did we get gaslit somewhere? Or we just said yeah. Like we just got pushed off. Everything else is covered. Your bone is covered in every other area of your body except your mouth. Your teeth are directly into that bone. So that if there's bacteria in there, it is it is going into your bones. It is going into your body. So We are sharing knowledge today. I know I love this. Like a collaborative. But I f a collective collaborative connection. Say that five times fast. That's fine. But I feel like back in the day, no one said, I'm gonna go see a pelvic floor specialist. The only person in my life who even knows what a pelvic floor specialist is is one of my friends who recently had children. And then after her kids, so she had two vaginal births. And then sex was really painful for her. And her, thankfully, she had a progressive gynecologist who said, Hey, we have one of these in our community. This person can help you. And she was literally out of the gazillions of people that we know and talk to, she's the one person who's ever said that. Wow. It's crazy. It is crazy. Who refers to you? Like, yeah. Like, how do we refer to a pelvic floor specialist? So Just like you said, you're a gynecologist, gynecologists, some primary care. to be honest with you though, a lot of my patients come through learning about it because of a friend or family member. So truly, word of mouth is still so important so that people get the help they need here. And that's why I love that you wanted to talk about this. That is great. So thank you. We're gonna learn a lot, but we don't and that's why for everyone out there, it's like we are the unhinged hygienist, but we don't I tell people I don't love teeth. Yeah. I love what the teeth are connected to, which is the whole person. The human. Yeah. Uhhuh. There is every system works together. We're not separate. Yeah. They all communicate. So yeah, we talk about everything. Everything and anything. We are healthy. In a deep way. Yeah, in a deep way, like there is always deeper meaning to everything. And it's almost like your portal for someone's health and wellness and mental being. It like that's this is my portal for that. And this is just what I know a lot about, but it truly does connect to everything else. Yeah. We are on the either end of the same tube. Yes, we are. We are see you. I see you down there. So if someone say him was jumping on a trampoline with their stepdaughter, thankfully with a power washer, so no one knows which liquid was going where. And you're jumping and you're like, Lord, I might pee myself. Maybe I am. And then the eleven year old turns to you and says, Tosia, that's your pelvic floor. She's so smir smart. Incredible. Okay, guys, I'm talking about myself. So anyways, I've bought I've done so much yoga, like so much Pilates. So I feel like I should be like You should have been. Right. What has happened? Maybe it is my estrogen's like a hundred and eighty and my progesterone is one. So I'm doing that now. So hopefully that helps. 'Cause great Guys, now when I have to pee, it's like the w I'm midpatient and I say Hold on. Which is interesting when she talks about coordination and That's you know what I would wanna know? And I wanna tell you to see it that it's okay, don't worry. I I understand that I should be better at this. This shouldn't be happening. I do Pilates, but I I actually did research or looked at research studying people with their pelvic floor function and Pilates. Somewhat like most of the time, people still need supervised pelvic floor muscle training. Like a p Pilates doesn't teach that per se. So They they in you know, cue you to engage the court often, but it is actually very hard to know what your pelvic floor muscles are doing if not assessed by someone else or even by yourself. Yeah. And so I'd be curious about what was happening, like when you were jumping and boasting. And it was almost peeing. That's what was Yeah. I think there's a lot of other muscles that are on point though. So We just need to more focus for me. Exactly. Exactly. Well, it's like going to the gym and you're not gonna expect your quads to get better when you're doing bicep curls. So just because we're doing Pilates and working other muscles doesn't mean that they're automatically integrating into these areas. Cause we have to focus. You have to say biceps, curl, pop. You know, that's but I think even when you're doing it, if your your instructor is not there to tell you, even when you're doing breathing, you're like from the diaphragm, if the person breathing doesn't know what the hell you're talking about. They're not gonna be doing it correctly. So here you've never met a Katrina. Here are my quick fixes. Here's what I would try if that were happening to me and my stepdaughter told me that. So here's what I would do. One, I would put on a really good pair of compression underwear or shorts or athletic leggings. So really compressive. And there are even specific compression garments that are now marketing towards these conditions. like leakage. Okay, so that's one thing I would do. The next thing is make sure my entire body is pretty relaxed when jumping and that I'm exhaling as I'm jumping and keeping everything really loosey goosey. That way there's less impact on the pelvic floor muscles and they can more easily rebound from the impact. Interesting. Yeah. Those two things. I'm literally can turn the computer sideways and I could go jump on the trampoline right now. Should we do a live demonstration? That will be at a later time. We will come back to that one. We'll film this after our episode. This will be bloopers. Yeah. Right. After hours with the uninch hygienist. Yeah. Wow. Okay. So all right. That's interesting. What do you think is something everyone should? I mean, okay, do people not Have pelvic floor issues, or does pretty much everyone has something they can make better? So absolutely. A lot of people have pelvic floor muscles that are functioning quite well. And that would include things like they are able to hold their bladder for two to four hours. They can hold, they they have an urge that's controllable both for urinary and bla bowel function. insertion is comfortable. And there are so many other signs that say your pelvic floor muscles are just fine. so yes, absolutely there are people with normal pelvic floor muscles. However, I do believe that throughout a woman's lifespan and a man's lifespan is that changes in hormones, a physical condition will absolutely change. And they could benefit from preventive education or or an assessment at that time. So So even yeah, how does like painful intercourse how does that correlate with like pelvic floor? Like cause I feel like a lot of people just think, you know, PCOS or like some type of issues like that. It's just psychological, yeah. Yeah. So where does that come into play? So painful intercourse can be because of a few different things. If it's not vulvar or vaginal atrophy and it's not the cervix or it's not the hip. Those pelvic floor muscles can be so contracted at rest that not even arousal is enough to reduce that. And so muscles that are contracted all the time end up going through this ischemic state. So there is less blood flow, less oxygen, and any tissue exposed to that environment will be irritated and aggravated. And those muscles will have less excursion. So any pressure from them, from, say, a penis or finger or anything, will be quite uncomfortable. Yeah. Interesting. I imagine it'd be like in on the outside of your skin if you're if you had like this bald up muscle and somebody just went really hard, it'd probably hurt a lot. You'd be like, get off of me. That's interesting. That is interesting. Now I'm thinking, yeah. Because you're talking about conditions too. My dad has Parkinson's. And he's had a catheter for a while. And I'm wondering if he could benefit from pelvic floor or because obviously the bladder or the the neurological, you know, kind of connection to everything is very interesting. I wonder how that would be. Probably you know, like if someone still has the connections of the nerves, literally from like S2, S three, S four to those levator AI muscles, the kegel muscles, they they will be able to voluntarily contract those muscles and like they would benefit from pelvic floor muscle training and then a lot of self-care education or strategies to help them manage those symptoms better. It feels like you're a master at cueing or telling somebody like where to think about 'cause like even you know we're both like trying to squeeze everything right now. And I'm like, hold on, what muscle is that? I don't even know what am I feeling? It's like When I try to get someone to do myofunctional exercise, people have no idea how to move their face or their tongue. And I'm trying to think about how would you tell anyone how to move this bowl and you know, like how do you do that? What does a session look like? No, you know what? And I appreciate so much, like as someone who went through myofunctional therapy and it improved my sleep apnea scores. So that was super cool. But it was so difficult to learn how to move those muscles to move my tongue into those shapes. for the pelvic floor muscles, it's really the openings that are affected you know, with a contraction and then a relaxation. And so a few different areas to think about as a woman would be okay, in the front we have the urethra. So can you with good posture like rib cage stacked right over hips, nothing overly exaggerated, just nice upright, comfortable position, can you squeeze? Just these internal muscles to squeeze as if you're not think so. I if you're still only the front. As opposed like I think about it like I can move these muscles like independently, right? I don't have to do this. Uh-huh. I don't feel like the back or the center is moving. Okay. Yeah. And there are three parts with the there are three parts. Like there there is the the front part, the middle part, and the back part. So like with the front part, it's like Stop the flow of urine with the middle part. Maybe you imagine a blueberry inside your labia and you're picking it up. And then for the back part, you're squeezing as if holding back gas. So then all three of those combined will get you a good contraction. I've never picked up a blueberry. I'm good at holding gas. I was like, I've never picked up a blueberry. We're we're in dentistry. I've never tried, I'd be really good at controlling what happens because your head is down here. Yeah. Like you think about where people lay in a dental chair. We are extremely conscious of what happens in our bowel area. Or all of that area. Our stomach. Like if we get hungry or we're gassy or we're Your head is in our vagina. Essentially. I mean metaphorically and technically speaking. You know Absolutely. Yeah. Sorry, I said that and Hey, we're unhinged. We're allowed to say that stuff. But that's true. So I mean and thinking about kind of where and how we move, like Okay, cool. And then just awareness. And this is one of the things that I think we know all the time. We ask people, do you breathe through your mouth or your nose? They don't even know simple stuff like this. So trying to make somebody aware of their, you know, first, second, or third holes and what's happening. Like we're gonna be even weirder. We're gonna go back to work Monday with a a lot of things we've learned over the weekend and we're gonna be asking some even weirder questions now, you know? You're welcome, general public. Do you put yourself? right. Right. And you know, honestly, if you do, th you'll probably get a lot of reactions of like, I'm so glad you asked because you're the first provider that's ever asked me that. Yes. Yeah. We get that a lot in general. We ask weird questions because and we can put it as we love bodily fluids, so you know we love saliva. We love oral. We do love oral. So we do a lot of giggling in dental school. that's so great. My Use a lot of oral and gingivas. Yeah. It's bad. But I never do men realize they have a pelvic floor? Oftentimes no. I I mean, I think the landscape is changing now because information's so much more accessible. Yeah. But in general, no. You're not getting it friend from Kansas City to be like, I ain't got one of them pelvic floors, those are for late nights. Yeah. Yeah. Yeah. And in in a way, like I no longer think these issues are as taboo for women. I just don't. I mean, there because there's ladies like you, you know, like yeah but for men, it's still way more taboo. So it's almost behind. It's like the only area sure. Maybe you can correct me, but the only an area in healthcare where woman's health is more advanced. Well, at least we have that. That or gynecology. Right. Right. So what would you say is like the most common reason for pelvic floor issues for men or women? Women. For right now. We can and both. Ooh. Or like I say, not like the mo maybe like the worst case scenarios. You know why? The I would say so back pain and or uncontrolled stress and anxiety for the conditions that I see often, those two things and and it was shown in a study of women who experienced back pain, fifty percent of them had pelvic floor dysfunction. So 'cause that's core. Yeah. Yeah. Like I mean, I even think about their posture, right? 'Cause now you can imagine low back pain, they're always like, And I just think about like even shifting my hips kind of forward and backwards. And I mean I was a gymnast, so I'm kind of aware of that area of my body, maybe more. But also I sit in a saddle chair. We like we both have saddle chairs at work. So interesting. So are you are you doomed once you have a vaginal birth? No, absolutely not. Hey. See? So good. We don't have to. Because it seems like that's just what every one of our friends that has kids is like. Well I shot a human out of my Vijay J, so I'm gonna pee every once in a while. I'm like, I've never shot one out and I'm peeing. So and my mom, who's like eighty-one, within the past few months, she's like, you know, she's like she noticed a little bit and she's like traumatized. She's like, This is not okay. And I'm not gonna tell her I'm 46, mom, and I'm way worse than you. So I wouldn't talk, you know? Yeah. My mom is 68 and still blames me when she sneezes and pees. I'm like, mom. Some king's, but apparently, I'm gonna go say, go see Dr. Katrina and get some phone therapy. Yeah, get how would trauma show up, like trauma, stress, and stress. That's so interesting. So, you know how you you guys might have noticed how if someone has chronic stress or anxiety, a lot of that tension occurs up here of the accessory breathing muscles. And in the research. And in my clinical practice, it is obvious. It is obvious that the pelvic floor muscles behave the same way. The pelvic floor muscles increase in resting tone when someone is in a fight flight freeze state. And psychologically that makes sense. Yes. Yes. That's so interesting. Man, I bet does the body keep the score talk about that? Ooh, that is a great question. I read that maybe a decade ago or more. And I don't remember, but we probably need an update. Right? I mean, because you think there are so many places in our body where we realize, like of course, we talk about jaws and we talk about how trauma and stress sit here specifically. But I would think if because this is also a protection of the inside of us. And so if if from you know, start to finish essentially, yeah, the whole inside, think about when you get really cold. And you just like I it's gotta be the same feeling. And I think women hold on to it so much more in general because we're just so go go go and just hold everything in until you break out in hives and have to move to Michigan and my friend again. Yeah, my friend, she's pretty awesome. She's awesome. you know, and that's what they say. We hold on to everything because we're the ones who have to The caregivers, take care of you, take care of them. How are you feeling? Like we put ourselves last a lot of the times and then we're the ones who are suffering and then who's helping us, you know? Yeah. And what about even like the imbalance of holding a kid? Or huh. Like I think about while my core is gonna be lumpy this way, or a backpack, or a purse, or crossing your legs, or these things that kind of we do without even thinking about it. I'm sure that is huge. Absolutely. Yeah, I see that a lot too. And did you know, fun fact here, factoid. Sometimes if you assess the pelvic floor muscles, you'll see that there's asymmetry between two sides. So like one side could be overactive and tight and the other side is normal or the opposite or less tight. Yeah. That makes sense. Yeah, I think about that with like how chiropractors assess like the hips and the feet and like osteopaths and such and so Mm, does one actually have a leg that's longer than the other, or could it be pelvic floor tension? Ooh. I'm gonna ask him a great question. Well pelvic floor tension. yeah. Chris, did you know that you have a pelvic floor? Yeah, I think I'm pushing it right now. See, he is aware. He's aware he has to pee. Yeah, he's aware. That's I mean. That's good. Okay. Pelvic floor tension. Where were we? You know, pelvic floor tension could it could reduce hip range of motion. So in that way, it could potentially show up as a leg length discrepancy. I I wouldn't I wouldn't rule that out completely as a potential cause. Yeah, hip tightness, at least a contributor. Yeah. Yes. Yes, yes. Yeah. Mm-hmm. And then if you go into the fascial connections between those muscle groups, like a lot of the lumbopelvic muscles share f they do share fascia with the pelvic floor muscles. So there's tightness in one area, there's probably gonna be tightness in the Sure. I mean it's you think about the scar tissue, that deep line fascia, do you have that like poster up in your room where it connects all the way from the tongue to the toes? I don't have the poster, but I love that. No, I ha like My colleague and I have a book of fascia in the audience. Is it by those Italian scientists? because they're like in the eighties and nineties, it was like a dad and a daughter in Italy who they're the ones that discovered like the real fascial chains and really did the pathology of it. No, was it not Travel and Simmons, right? I think I'm thinking of something different. I think of myofascial trigger points. Anyway, I'll look it up. Okay. what's her man? What's our next question? I I just Where do we go? Okay. I have I have something that would be interesting for you guys. I have a list. And I'm just like, I'm trying to make it flow somehow because I have a lot of here's here's another way our worlds, your world and my world connect. So okay, so the tissue in the vagina and the rectum and the mouth, the it's all thin epithelial tissue, right? And it is all sensitive to certain things. Like For example, you eat something spicy and then you poop and you're like spicy butthole. Okay. So we know that there is a connection there. Well, I also think of like inflammatory diseases that show up in the GI tract, but then they could possibly change the urethral lining too. And then I'm I mean, I'm curious if you see that in the dental side of things, but it just makes me think how like all of this is connected and oftentimes Like what you were saying with autoimmune disease is like inflamm inflammation is usually the underlying factor. Of everything. And I tell my patients, you know, the root cause of all major illness disease is inflammation. And if it's in your mouth, it's not isolated. If it's here, it's not it's it's everywhere. Nothing is isolated. And that's why I wish more like medical providers would work together. Cause even when I had my hives, it was like Go to the rheumatologist, go to the dermatologist, go to the endocrine like all working together to figure something out. Like it's like each system is treated so differently, but no one's kind of like, okay, how are we putting this together? I know. Divine concern. And then is it as simple as like, do you what if you notice that, do you go into the holistic side of things and ask, like, what is stress management looking like for you? Like the because that's a whole that's a big bucket to go into and We all deserve that, but it's that is tricky. It does take a lot of time, right? To make natural changes. Because I feel like I tried as much as I could for the year that I was, you know. Like 'cause we did I did like therapy, like childhood trauma therapy. I did meditation, yoga, as much as I could when I wasn't covered in hives, but it was there was still no answers. It was and I'd see nutritionists. That did help my gut a little bit. But the natural path at that time wanted five thousand. I couldn't because I was also By alimony and everything else. So emergency room. My yeah, my ER bills, because I was in the ER. We do have me in the Southern Hills hospital. Shout out to you guys because they saw you a lot. I was there every three weeks. They had your prediction. They're like, welcome back. I'm like, You're all so nice, but I'd never want to see you in here again. Yeah. Yeah. But yeah, so it's just sad that no one knew what to do. Yeah. So they did nothing. This is So in our clinical dental chairs on a daily basis, w unfortunately we don't get to have these kind of conversations very often. Right. This has been something. So I'm also a wellness coach. And so I try to add in the wellness coaching and stress aspect of it into my myofunctional therapy. that's So I'll get a client in well, and I'll get a client in for Mayo. And I'm like, let's work in some lifestyle questions and changes. And what does this look like for you? And what does You know, really making somebody envision this or even not only do I want you to envision where your tongue is moving or where your pelvic floor is flexing or how your diaphragm is moving, what does peace look like to you is very hard. It's like asking somebody, what makes you happy? Like people just aren't given that opportunity to think about that. And I think that that's even stress management. How do you manage your stress? People are gonna say, I drink and smoke, I do whatever. yeah. We don't all have the luxury of a sauna or a personal train, you know, whatever. Dr. Stecko. That was his name. Stecko. Stecko Car Carla and Antonio Stecko, S-T-E-C-C-O. They're the ones that made that. Thank you. Yes. Have fun nerding out on that later. Yes, yes. Thank you. Okay. Yeah, or you know what people? Ooh, myths. Okay. Mm. So one big one that if someone leaks, they should probably do kegels. Of course. That's immediately what I thought. Isn't that Kegel the answer to I was like, I've done so many kegels, so that's not working. It's like, it's like, yes, but it's more complicated than that. It's like, yes, we want your pelvic floor muscles to be able to do a great kegel and a great relaxation. some people simply need. to learn how to do that. But for some people, that's like step 10 after all the other steps beforehand, which may include teaching those muscles or physically mm helping them relax those muscles. To huh if if you can s they might be up tight and contracted all the time, right? And so we need to allow them to come down to a normal resting baseline. For those muscles to be able to contract and relax. okay. Now I can think about can you here's probably the common question for this. Do you only work the pelvic floor muscles from the inside? And if so, how does a man do that? great question. my answer is the most direct way. Of relaxing those muscles would be internally. And so, yes, for a man that would be introctily. However, the most important part, I think, in trauma-informed care is to allow the client to choose from a menu of options. And so the right, the other options we have could include indirect techniques like stretches that look like hip openers, hip mobility. external hands on work in the perineal area. I even do dry needling of the pelvic floor muscles and I have had clients who would rather undergo that than have a finger up the anal canal. Anywhere. Up the anywhere. Yeah. Yeah. I have I have a fri my my friend who I learned about pelvic floor therapy from She has a red light therapy wand. That's what I was I was like, like someone told me. And then now, thank you for saying that. From fringe. I've seen that. I'm unsure who she got it from. Whatever. She's in Texas, so I don't know what's going on over there. That's a whole different country. but that's interesting. So obviously, red light therapy and this is non-keratinized tissue. So it seems like you would have access for the light and the wavelengths to penetrate deeper, whether you're doing red or blue. you know, six hundred, eight hundred nanometer, whatever you've got. But then she talks about the the pressure point. And I think about like a the evil foam roller or something and how we roll and you're like us yesterday getting our nails done. We're on the chair like you know. And I imagine what would this feel like as you've got this pressure happening in this and you find that spot where you're like you know Yeah. That would be Here's what I'd see a lightsaber. I see. That'd be hilarious. Watch this. It's a wow. You know? This is where I store my lightsaber. And then it's like and that you know, if it was like a one-time treatment, that'd be so awesome. And that's it. And then what is They're it's funny that you asked that because I that actually buy that different store now. They're they're wearable vaginal dilators is what they're called. So, but I know if I Go ahead. I've seen the video game that's like an egg and you hold it and you're actually you're like watching and walking around with like a Nintendo Switch, but you're not using your thumb. I've seen it. You're using your vagina. And you're like you can play you can play like ha Flappy Bird with your polyclor muscles. Like for real. Yes. this could be fun. Harry's couple. But we'll report back. Wait, you should just include like a screen recording of you guys like playing at this time. Yes. my god. And our hands here. Like, let's see who wins this round, Florence. It's gonna be like battle bots. That's that's a good birthday gift. My partner will thank you. Right? Like either a vibrator or a perifit. Both is called awesome. Perryfit. Perifit is one brand. Lvie is another. There are more. I'm thankful that people are inventing these because Yeah. This is something that I think we don't talk about, right? Like there has to be yeah. Yeah, so see video games. For everyone watching, here is one. there's a discount, guys. Discount. yeah, it was 179. It's 143. Hey. That's how they get you. Valentine's Day special. Whatever this is. This is gonna air. She might not air tonight. She goes. This is crazy, pants. So man, these are good. What other what else? What have you got? Okay, other myths. Other myths. Ugh jeez. Or any good information that you know. This one's a little different. People think that if they have a cesarean delivery, that they will be essentially immune to pelvic floor muscle dysfunction. I would think that too. Yeah. But for many months, that person is still carrying a growing baby. And so those muscles are still undergoing a lot of load and tension. And so that There is still an increase in prevalence or likelihood of pelvic floor dysfunction in a housearian. It has to be pregnancy. And that's the only reason why people think that women are the only ones with pelvic floor issues. Or if or if somehow it came to be that that was jargon for vagina. Because instead of us saying, you know, vaginal opening or cervix or whatever, we said yeah, pelvic floor like we're little church ladies. But that's actually a I guess an actual term. It's like Yeah. Tuberosity, you know? I know. And and the thing is like we like that what is it? body literacy literacy is so important because say someone does have chronic pelvic pain and they're trying to explain to their doctor what exactly is going on. Yeah. The more knowledge we have of like egg where exactly the pain is is going to help. And I'm gonna be saying every doctor. Going to the mechanic. We're like, Yeah. You know, it's the squeaky geek geek geek boom boom boom. Don't you know what I'm talking about? Like that feel very similar. Dear pelvic floor therapist. I feel pain where? I don't I don't know. Right. How would we even describe it? I don't even know. Beh under I know. Above this hole. Also, how do we know that it's not no normal? Right? Poisoning helps. Pointing helps. For people who have like, say, endometriosis, adenomyosis, like that type of stuff, you're gonna have pain during intercourse too. So but I feel like certain trauma maybe certain people have experienced at a younger age can affect that as well, too. Cause Yeah. And I'm sure trauma informed care is very important in this area. I mean, the fact that you even said that is is wonderful because there's a lot in dentistry, we have to be very trauma informed too. Because if somebody has been sexually harmed in a way, it's the same position. You're on your back, you're forced down, you've got scary people, you know, it's a saber-toothed tiger kind of thing. So it's a very see everything. Yeah. Yeah. It's vulnerable. And anytime you're in a vulnerable position, and I would think pelvic floor therapy is as sensitive as oral care therapy. Yes. Yes. One side of the spectrum to the other. Same I know. I'm looking at We see Katrina down there. my gosh. Right. hey guys. That's it's like the Jetsons. We were watching that yesterday. There you go. my gosh. Okay, next. So if there is something patients are embarrassed to tell you about, is there something that they wish they would have told you sooner or wish they would have said sooner in general? Hmm. Ooh, if there's if they're embarrassed by something. Yeah. 'Cause you know, some people like even like menopause, perimenopause, no one talked about it for years and all of a sudden we're all suffering and we're learning about it now. So is there something that maybe someone had and didn't know but was too embarrassed to say? Yeah. You know what? For so leaking, yes, that's that is often one because and and and we'll I mean, we'll talk about the things that really no one wants to talk about. Like, some of my patients are truly scared that they will smell like urine when going out. So they stay at home or they limit their fluid intake when they go home. some people are experiencing fecal incontinence, so they're leaking stool. And because of that, they don't want to date because they're scared that they'll leak during sex. some people have erectile issues and they they they don't know what's wrong. They don't know what's wrong. They don't know if it's the pelvic floor muscles, if it is their psychological state. that is their manlyhood. And that is very embarrassing to talk about. I would never think about I mean, I immediately went to like prostate issues for erectile dysfunction. But I would make sense that pelvic floor therapy could help because that's the origination of a lot of those muscles. we have to get you to your meeting. So we need to wrap it up in five minutes ish. One line question quick. What is the one symptoms people should never ignore when it comes to pelvic floor? The first thing that came into my mind was pain. I I I'm almost always sad and angered when someone comes to me and they've been dealing with pain. Yeah. Even while under medical care for months, years or decades, unfortunately. Like that is so unacceptable. Absolutely. So hundred percent pain. I think that's really common for all of us. And I think we just deal, right? Right. Because are we afraid of the doctor? Is it because we've been gaslit? Is it too expensive? Do you think there's just nothing? Or it's your normal. Yeah. Yeah. Right. Wow. All right. So we're definitely gonna have a part two of this episode. But please tell the world how to find it. Find you. my goodness. Okay. Find me on Instagram at Power in the Pelvis. Yes. If you want to follow my business Instagram. It is P as in Power, W as in Wellness, and R as in Rehabilitation. So PWR period. L V at l as in Las Vegas. Or you can look up my website, PWRL V dot com. Ooh. Go look out. So do you do virtual or can you? I if I do a virtual appointment and we are out of the boundaries of the state of Nevada, it would be considered wellness. Okay. However, it's the same information. Yeah. Mm-hmm. And I do do virtual appointments, which would be telehealth as well. In those Nevada. So PWR dot L V. We are going to put all of this in the show. We're on it. We're wonderful because I've learned a lot today. Yeah. It's amazing how all of it's connected and somehow to the mouth. I know. my gosh, you you can reach out to me. for more, e even if it's outside of the podcast. I can't wait for another episode, but also like talk to me girls. Yes. You know, now you're connected. We're gonna put we're gonna start a group chat and we're gonna have the best. my gosh, yeah. If somebody picked up our phone and read our group chat, they'd be like, and I tell people like we can even pop on here and not like record, but not like an episode, but just use it for connection. Yeah. You know. Because we're all here trying to help other people live better lives. And that's the reason that's why we're thankful you're here. Thank you for being willing to talk about your subject matter and connect it and even connect it back to dentistry and myofunctional therapy because I think we are here to remind people that the body is indeed connected to every part of itself. So absolutely. So I I appreciate you. Thank you so much. I appreciate you. We are thankful. All right. So everybody remember that you know We need to ask better questions and stay curious. Curious. Yes. And don't be afraid to ask the questions. Because I mean, especially to your medical providers, that's what we're here for. You know, we're all here to help each other live better, healthier lives. So And if they're not, come find us and we'll help you. Exactly. Exactly. Or at least recommend finding someone else. Exactly. Well, we can't diagnose but put you in the right direction. We can help you learn how to ask better questions. Yes. And create more curiosity. So Thank you so much. You are amazing. I love you and I miss you. And follow us too, guys. This is been part one with Dr. Katrina. Part one. Stay tuned for part two next Wednesday. Great. Bye. Thank you so much. Thank you.