Latest / She's Next Level / 51: Why A Strong Pelvic Floor Is Important For Sexual & Reproductive Health w/ Jocelyn Wallace
Transcript
- Jocelyn: Some of us haven't felt our stomach be relaxed in our whole lifetime because we've been told to stand up straight and suck it in and like sometimes people have never really felt that. I could only pick one thing, it would be for them to look at their vulva. should know what it looks like, we should be familiar with our own body. Darshna Patel: I love that. I smell my vagina a lot, but I don't look at it. So this is a good little Jocelyn: Yeah, do that too. Darshna Patel: Hello, everyone, and welcome back to the She's Next Level podcast. I'm your host, Darch. I'll help women live their most expansive life by looking hotter, feeling healthier, and being happier. And in today's episode, I have a special guest, Jocelyn Wallace. She is a pelvic floor specialist and a therapist, and she helps women post pregnancy in helping them build a strong pelvic floor. And I wanted to do this episode with her today because I want to give you guys a strong foundation around why it's so important to have a strong pelvic floor, regardless if you have kids or not. I personally want to know this information because I'm all about being proactive. And regardless if you want kids or not, I think this is so important because the topic that we're gonna talk about today dives deeper into our sexual health and our reproductive system, which is two of the biggest things that not many people actually talk about. And I feel like a lot of people struggle with. So before we get started on the heart of this episode, Jocelyn, I want to know for the women that don't know the importance of having a strong, healthy pelvic floor and what the hell it even is, including me. Can we just kind of Jocelyn: Mm-hmm. Darshna Patel: talk about what it is and why it's so important to have that strong pelvic floor situation going on? Jocelyn: Yeah, absolutely. So I always have my pelvis with me, but I will just for people who aren't watching the recording, I'll describe it as well. so Darshna Patel: I love it. Jocelyn: your pelvic floor is a group of your grvic floor is a group of muscles and soft tissue that is really the foundation of your body. It can help to orient to find your sit bones when you're sitting down and it goes from one sit bone to the other and then it from front to back, it goes from your tailbone to your pubic bone. So it really encapsulates everything we call our genitalia, the anus, and the rectum, but it is also a muscular support for our body and for athletic activities and everything that we do, really, every breath we take, our pelvic floor is involved. The bulk of it is muscular tissue. So on the model, I'm holding up all the red stuff is muscle, and then the white stuff is a representation of fascia or the other kind of ligaments, the other soft tissues that we have in our body. So there's also a lot of fascia and stuff inside the pelvic floor. But the most changeable part of it, the part that we can train, is the muscular part of it. And it's a pretty sizable muscle group that takes up the whole bottom of our body. It's often, its functions are often called the three S's: sex, sphincters, and support. And some people add what we call a sump pump. So sex that contributes to sexual function, which that we can get into in more detail. Support, it helps to support the organs that live here on top of our pelvic bowl, which is like the uterus, the bladder, the rectum. Everything that's in here. sphincters, it closes the holes to keep urine and gas and stuff inside of us and stool. and then sump pump, it actually has a sort of pumping mechanism and contributes to lymphatic flow and fluid flow and our our blood flow and vasculature through our body because all the nerves, blood vessels, lymph vessels, lymph nodes, there's a lot of stuff living inside of our pelvis. So a pelvic floor that functions well also helps to keep all of that fluid moving through the body. In a good way. Darshna Patel: So if someone has like struggles with like poor circulation in their body, or like a lot of women tend to like build up a lot of lymphatic like fluid in their bodies. Is that like what it means to have like if you have a strong pelvic floor, then all of those things are gonna be working? Like all of your systems essentially will be working better, right? Like is that like if we were to like take away everything, all the systems in the body and we had like a needle moving thing that really regulates majority of women's health, Jocelyn: Mm-hmm. Darshna Patel: would that be it, the pelvic floor? Jocelyn: Yes, this is definitely a major regulator. I think we could certainly call it that. A lot of women are living with what in layman's terms is often called pelvic congestion, which is just what it sounds Darshna Patel: Mm-hmm. Jocelyn: like congestion in the pelvis. So we have a lot of tension. So many of us are trained from young ages to suck in our stomachs all the time, to close our bodies, and that can contribute to like literally a congestion here. And then there's also like actual anatomical variances amongst people where blood vessels can be compressed. Those are called vascular compression syndromes, and they can contribute to pelvic congestion symptoms too. But a lot of people Darshna Patel: Interesting. Okay. Jocelyn: have a form of pelvic congestion that's more habitual and not anatomical. But the Darshna Patel: Interesting. Jocelyn: the pelvic floor strength is a huge component of it, but it should also be responsive. So our pelvic floor is supposed to move with our breath and then move even more with movement when we move our bodies. So it's it's having a strong pelvic floor has tons of benefits, but we really want a mobile pelvic floor and a pelvic floor that can move with us. But so many of us have been trained from so many different reasons in society to be very braced, very closed off and very shut down down here. Darshna Patel: That's interesting. I don't think I've ever like felt if maybe if I try to concentrate, maybe I could feel it, but I've never really like this is why I wanted to talk about this because I was like, I don't think I've ever like thought about it and haven't really heard a lot of people talk about it as much and like specialize in it. So I'm curious then. I personally like deal with tight hips and I know a lot of women do with like not having as much flexibility there. So is that connected anyhow to having a weak pelvic floor or how what's the correlation there between the two? Jocelyn: Mm-hmm. It's not inherently connected to your pelvic floor being weak. So having tight hips doesn't mean that your pelvic floor is weak necessarily. Your pelvic floor could be tight. It's way more common for us to encounter people with pelvic floor hypertonicity than it is for them to have really true substantial weakness. It is possible to have both. Like sometimes a the tight muscle is a weak muscle, and a weak muscle can have what's called muscle guarding and feel tightness. But absolutely, if someone says something like, my hips are always tight, like kind of identifies themselves as someone with tight hips, the pelvic floor should certainly be a consideration. Our hip muscles, like something I show to people a lot, if you're watching the recording, I'm holding up the pelvic model. Most of the pelvic floor muscles in the back. So this is called your perineum, the space between the vagina and the anus. And see how the bulk of the pelvic floor muscle is back here. And then it comes back and attaches to the tailbone. And then there's muscles that attach our femur, our thigh bone to the pelvic floor itself. And then our glutes, like the glute max, the big glute muscle we think of, lays on top of here. So if someone has tight hips, absolutely their pelvic floor should be a consideration. And we will often like cue them to focus on what their pelvic floor is doing while they're trying to stretch their hips, and it can make all your go-to hip stretches be more effective. And I'm happy to talk more about those cues if you want me. Darshna Patel: W yes. Hell yes. Please do. Jocelyn: Ha Darshna Patel: let's go into that actually. Like, what are some things like if women do if there is a little bit of a correlation, right? If that's like kind of a sign that hey, maybe you need to look into your pelvic floor to help support the hips. What are like some things that we can do to help kind of create that connection and keep it very fluid and loose? Cause I know fascia has Jocelyn: Yeah. Darshna Patel: something to do with it too. I've been getting into fascia work a lot lately. But to keep it simple, like what are some things Jocelyn: Yeah, absolutely. Darshna Patel: that we can do? Jocelyn: Yeah. The staples that we do with every single client in my practice are breath work. And we start everyone. I my business is a fully virtual business. So we do pelvic floor rehabilitation for for people online and primarily work with women who've had pelvic floor related surgeries, like prolapse repair surgeries, hysterectomies, stuff like that. So these are often people that have the worst symptoms, who've seen a bunch of pelvic floor PTs already, that have been through a whole lot down there. The first thing that we start with is breath work. And the first thing we usually have people tune into is when they're seated on something firm and you inhale, you should be able to feel a sensation of your sit bone spreading apart. That's usually how I'll start describing it. Then if someone has trouble feeling that, I'll have them focus on the anus and tell them to breathe into their butthole if we get to that level of comfort quickly and have them focus on can you feel any Darshna Patel: I'm trying to do it right now as you talk. Jocelyn: motion there? And sometimes that can be hard for people to feel, especially if they're Darshna Patel: I mean I fart a lot, so Jocelyn: tension prone. Darshna Patel: must be practicing something down there. Jocelyn: Yeah. Now, if if you want to get into farting, Darshna Patel: Thank you. Jocelyn: it should be easy to pass gas. If it feels like you have to kind of like force it and work gas to come out, that can often like be in a check in the tightness box more than the weakness box. Darshna Patel: Wow. Jocelyn: If it feels like hard to get gas to come out. and sometimes if sometimes people can't feel those things I just described. So then I'll often go to have some having someone cup their hand around the vulva so they can feel the tissue. And when we inhale and exhale, we should especially if we're breathing deeply. If we're breathing deeply and not like stuck up here in our chest, like so many of us are. But if we're really breathing deeply, we should be able to feel and see vulgar movement. It's very subtle, but it should move some. You can even see it with a hand mirror. So for people who are more on the tension prone side and are struggling with learning some of this stuff. Sometimes I'll have them lay down, look in a mirror with a hand mirror, just like spread eagle in front of a full-length mirror and work on breathing and like actually seeing some motion. Darshna Patel: That is so interesting. I'm like I'm like excited to like go give it a go and try it myself to see if Jocelyn: Hehehehehe Darshna Patel: this is moving or not. Wait, so Jocelyn: Yeah. Darshna Patel: I know there's like certain exercises I've heard of before, like the the little ball things that you put in there into the vagina. The Jocelyn: Mm-hmm. Darshna Patel: kegel balls? Yeah, the kegel balls. Is that like Jocelyn: Mm-hmm. Darshna Patel: that's something to help with the pu like why does it work? Like why does it help? Like what's I've always felt kind of weirded out by like putting something inside and like doing things with it. But what are your thoughts on that? Because I know it's pretty common. Jocelyn: Yeah. Yeah. I mean, yeah, it is common for people to feel weirded out and feel how you're describing. a lot of that is I think a lot of our conditioning. Like, can you imagine a world where men didn't know the ins and outs of like every part of their genitalia? And sometimes it's you know, we're in our thirties, forties, I've worked with women who they're in their sixties and they've never actually looked at their vulva and like have you know, have hang ups around putting things inside of their vag vaginal canal and stuff. But the the get to your question of what those balls and stuff can be used for. Sometimes they're used for strengthening. Intention-prone people, sometimes they can be a great tool for proprioabception, which essentially just means body awareness. So if someone's really struggling to feel those muscles, we might have them use something internally. I have something called a dilator in front of me. So this is a pelvicloid therapy tool called a dilator. Yeah. And they come in all kinds of different Darshna Patel: It looks like a mini vibrator. Jocelyn: sizes. This is a pretty standard size. This is a small one and they come pretty big. But this is an example Darshna Patel: yeah. Jocelyn: of a tool that you insert into the vagina and then it can just help you feel. Like it's it's like as if I, you know, put my hand on your shoulder when teaching you a shoulder exercise. You put this at the vagina Darshna Patel: Mm. Jocelyn: and it's like you have some tactile touch feedback there. And then people with tension, sometimes we're starting with something as simple as just having them breathe in and try to let it go, not so much squeezing it up. Darshna Patel: Mm. Jocelyn: But sometimes for people that do need to get stronger, it using Kegel weights or those balls can be a a method of, you know, you're sucking it in and training it. And it can go so many different ways. Like I've had people use those while squatting to help to retrain their pelvic floor in a squat. But they're basically an awareness tool. They also make Kegel weights, which I can show you if you want. Have them here. Darshna Patel: Wow. Jocelyn: So these are progressively weighted giga weights that get heavier. Darshna Patel: That is crazy. Jocelyn: And then they have the little string to pull them out. Darshna Patel: You're like lift you're like lift weight lifting your time. Jocelyn: Yeah, literally. Darshna Patel: So I have like so many questions because I'm like, wait, like I'm having different questions pop in my head about like so many things to do with this, but I would love to kind of go into like if you have, you're talking about like some people can feel that tightness in the vagina. So it's like about getting the sensation down there. When it comes to sex, I'll be honest, like I personally have felt like I would have a hard time getting the dick in, like just getting something Jocelyn: Mm-hmm. Darshna Patel: in there and I feel like I'm so Jocelyn: Mm-hmm. Darshna Patel: tight down there. What is does that mean Jocelyn: no. Darshna Patel: I have like a sh weak pelvic floor? What does that mean for women that may feel that versus some women that have more like looser, you know, vaginas, let's Jocelyn: Yeah. Darshna Patel: just say. Jocelyn: Yeah. So the medical term for that is called vaginismus. It's a diagnosed Darshna Patel: Okay. Jocelyn: medical condition that like we have a medical code for it. And it's more associated with pelvic floor tightness than it is weakness. And depending on the degree of severity, like sometimes people can't tolerate penetration of any kind. Like they can't even get a q tip into their vagina. They're so tight. But depending on the severity, trying to strengthen the pelvic floor is often the last thing. That should be done. Often the right method is using tools like dilaters. There's also like external perennial massagers. The most popular one in my experience is called the Kiwi, is the name brand for it. It's a little like handheld device that looks kind of like a vibrator, kind of like a kiwi. It's green like a kiwi. And you use it to help Darshna Patel: that's so cute. Jocelyn: to help to loosen up and massage the muscles that surround the vagina. And then lots and lots of hip stretching, lots of hip stretching, like every day focusing on actually feeling those muscles open up is usually the starting point for vaginismus. But some and sometimes people have such significant symptoms that they're starting with something as small as a little dilator or a cube tip or even just their finger and just putting pressure around the muscles on the outside. And then there's some people that have symptoms that are on the less severe side of the spectrum, and it's just like it takes. work to get penetration to feel smooth and it takes a while to get the muscles to loosen up. They often thrive with things like the perennial massagers. This is called a pelvic wand. So this is an internal Darshna Patel: Wow. Jocelyn: massager for your pelvic floor. This pointy end, so that if someone's listening, there's a skinny end, like a long skinny end and then a slightly thicker end. The long skinny end is used for rectal stuff, but most people who are using it vaginally are just using this as a handle. And then this part of it goes in the vagina and this can be used to self-massage different pelvic floor muscles to help with what you're describing, but this can also help with so many other pelvic floor issues. There's so many tools at your disposal. Darshna Patel: I I'm I was literally thinking about that. I was like, for someone that like if someone has a lot of toys and they like play with themselves a lot, they must be really great with their pelvic floor. Cause Jocelyn: Yeah. Darshna Patel: they're getting all the toys in and all the practice in. Jocelyn: Yeah, sometimes. Sometimes. It definitely helps to be comfortable with your body, but there are certainly people that have like you can have vaginismus and still masturbate externally frequently and stuff. Some people have tension in like very particular muscles. Darshna Patel: Yeah. I I ain't gonna lie, I did that last night. Felt really good. Like prepping for this podcast. Jocelyn: Yeah. and then to speak to sex, a lot of people don't realize that. so I'm holding up the model and this little yellow dot, but the clitoris Darshna Patel: Yeah. Jocelyn: is at the front. This little yellow dot is a representation of it. And then this blue line down the side is a representation of the sides of the clitoris. And our clitoris is way bigger than what we see on the outside. A lot of it lives inside of our pelvic floor muscles. So when these muscles have tension, especially Darshna Patel: Interesting. Jocelyn: if someone's more on the severe side of the spectrum and the muscles are always tight, they're not getting that pumping mechanism when they try to have sex, but also just in general when they go about their life. So they get worse blood flow here and they can often experience a hard time having an orgasm, sometimes have never had an orgasm or can only orgasm from direct clitoral content contact and not can't have vaginal orgasms. So that's sometimes how this can show up sexually. It's just a hard time having an orgasm, not able to have one, decreases in sensation or feeling like you don't really feel much or it doesn't feel as good as people have told you it's quote unquote supposed to. That's often what Darshna Patel: Yeah. Jocelyn: people will say about sex when they're struggling with tension. Darshna Patel: I can relate to that because I feel like for me I need that external to get the feeling versus like actually getting the whole thing. I've never Jocelyn: Mm-hmm. Darshna Patel: actually personally felt that. So that means that I need to like stimulate the sides, like the I think it's called the labia, right? The sides of the vagina. I need to stimulate that. Is that what you're Jocelyn: Mm-hmm. So Darshna Patel: saying? Jocelyn: Yeah. So the labia is what we call like the lips on the outside, but the muscles are like right underneath your labia, the muscles are there. And then if the finger is right inside the vagina and you're pushing to the walls of the vagina, you're also getting at those pelvic floor muscles that surround the vaginal entrance. and unfortunately we don't have tons of we don't have tons of research about what like the female's sexual experience would be like if there wasn't so much mucked up in it like from societal's expectations and what we're taught growing up and stuff. So we do know that a lot of women don't orgasm from penetration, but would that be different if we had more knowledge about our bodies? So I always hesitate to say, you know, like, yes, if you worked on this stuff, your experience would definitely be like someone else's. But what I can confidently say is yes, working on this stuff can make your experience better. But we don't really have a A true understanding of Darshna Patel: Yeah. Jocelyn: what's quote unquote nor Darshna Patel: I find it interesting too because sometimes I don't know if this is related, but sometimes I will have like a good feeling down there without any penetration. And I would just feel like I'm being penetrated or something, but I'm not doing anything. And I'm like, what's going on? Jocelyn: Yeah. So some people call that a corgasm. Like some people have orgasms when they're exercising from the muscles pumping. And that's often called a corgasm. Darshna Patel: Okay. Jocelyn: there's also a disorder called persistent general arousal disorder. And some people their muscles are so tight and just like so spasm y that they will have orgasms or just feel aroused for no reason. And that only the individual can decide if that's a disorder and if it's something that's bothersome to their quality Darshna Patel: Right. I don't mind it. Jocelyn: of life. But for some people it is. But that can come along with the muscles being tight. Darshna Patel: Like, I'll I don't mind it. I'll take it anytime. I'll take it anytime. So I know that you work with a lot of women like postpartum to help them recover their pelvic floor. So I'd love to know like what does it look like having like the pelvic floor before like pregnancy? And like what does that look like as far as like having a healthy pelvic floor? versus a pelvic floor after postpartum. Like why why does that happen postpartum of like the Jocelyn: Yeah. Darshna Patel: weakening of the pelvic floor versus before? Jocelyn: Yeah. Yeah. I mean part of the weakening of the pelvic floor from pregnancy comes from the pregnancy itself. It's not just from a lot of people think it's from the trauma of delivery. But a lot of it is is from just carrying a baby and going through the bodily changes that happen when we're pregnant. There's so much stress on the tissue of the pelvic floor. It can weaken it over time. and there's a lot of old school advice that women should like rest and be super easy and not strengthen their bodies while they're pregnant. And every bit of research has shown that to be not true and more of a myth and that women delivery outcomes are better, babies outcomes are better, postpartum pelvic floor outcomes are better if women are encouraged to stay active and keep their core and their pelvic floor strong during pregnancy. But a lot of it is pregnancy itself, just like the literal weight of the Of the baby and the pregnancy bearing down on the pelvic floor. And then we have the hormonal changes that go on that make our soft tissue all over our body more la lax. So all of our ligaments and stuff like get looser when we're pregnant, and that's for purpose to allow our skin to stretch and our bodies to change, but it does make the pelvic floor looser. And then a lot of people are under the misconception that. It's the pelvic floor that pushes the baby out and that like having a stronger pelvic floor will help get the baby out. And there's very little training about actually there's different positions that we can use at the pelvis and different breathing techniques and different ways of learning what we call pelvic floor down training, which basically means like allowing it to relax and lengthen. That can be a big part of prepping women for vaginal delivery if that's something that is that's what they want to pursue in their pregnancy. And then we've also got perennial massage, which is kind of like what I was describing earlier, like just massaging the muscles, stretching the muscles down there, which has been shown to reduce the rate of third and fourth degree tears and delivery. So that's the stuff that like goes into getting closer, getting up to delivery, like going through pregnancy, being prepared for delivery, that can all help with pelvic floor outcomes. And then vaginal delivery itself can be a major trauma to the pelvic floor. in a Darshna Patel: Yeah. Jocelyn: a whole bunch of ways and there's very little proactive rehabilitation for that, very little screening. Women are usually told like, okay, you're, you know, six weeks, you're healed, you're good, goodbye. When really we should be getting immediate support after vaginal delivery or C-section, however things go to help to restore those muscles and screen for lasting problems, but we're really left so alone in the way that the system is set up. Darshna Patel: Even for a C section? 'Cause they're not like they're taking it out from the stomach though. Like, why would it Jocelyn: So C sa yeah, C sections have lower rates of the major pelvic floor problems like that we think of, like pelvic organ prolapse, tears, like people you don't get a vaginal tear from a scheduled C section. Darshna Patel: Yeah. Jocelyn: but even women who've had a C section can have pelvic floor problems from just being pregnant. Just being pregnant itself can cause pelvic floor problems. Mm-hmm. Yeah. Darshna Patel: Because of the weight that's pushing constantly to the pelvic floor. Okay. Jocelyn: And the major bodily changes, like pregnancy causes major posture changes, our rib cage gets wider a lot of the time. And when we come out of pregnancy, even if we had a C-section, our posture and the weight we carry ourselves is often very different. And because so many women are discouraged from exercise, they're often also dealing with now you have this baby to take care of and you're going back to work and you're doing all these physical, often strenuous things, but you just went through nine or ten months of getting weaker. For no reason, because someone told you to be careful with your body when you did it, really need to. Darshna Patel: Yeah. So what are the things that you notice that you work on with women in helping them recover? Like if someone had a baby and they're hearing this for the first time and they have no idea what to do, like why is it so important? And like what are the kind of the the signs that they can see if they have a weak pelvic floor to help them be like, hey, maybe I do need help. Cause I think sometimes a lot of people are very unaware of these things until like, you know, they're aware of certain Jocelyn: Mm-hmm. Darshna Patel: signs or symptoms that can help them kind of determine what's going on. Jocelyn: Yeah. The most common one is urine leakage of any kind. That's been very much normalized amongst women. It's just like, you had a baby and now you pee your pants. That's absolutely the most common. More than fifty percent of women will experience it. Women experience it even if they've never been pregnant. And that's the most common by far a sign that you need help with your pelvic floor. prolapse is all also really common. Darshna Patel: Okay. Is it often though or is it sometimes? Is it often or sometimes? Cause sometimes I feel that's a piece. But wow. Jocelyn: Even if it only happens sometimes. Yeah. Even if it only happens sometimes. Now there's there's varying degrees of severity and it's up to every individual of in my opinion to decide, you know, how to extend their resources and when and what kind of help they can go get. Like for example, if someone has a a bad knee injury and they are leaking urine a little bit and you need a table getting help for your leakage for a while while you address your knee injury, that is a very valid decision. But even mild urine leakage, the sooner you get it assessed, the better. Darshna Patel: Okay. And why is that? Like what are kind of the repercussions if we don't Jocelyn: Yeah. Yeah. Well it depends the to answer the question of the repercussions, it depends on what kind of incontinence you're having. So you can have leakage from weakness, that's called stress incontinence. And that's the kind of leakage that happens when you cough, sneeze, laugh, jump. And then within that bucket, it can be different degrees of severity. So some people have stress incontinence that's so severe that every time they stand up they pee. Every time they cough, they pee. They're daily thing. First Some people it's very mild and they might have to be really tired. Like you just walk 20,000 steps and you've been at a concert laughing with your friends and your body gets more and more tired and then it happens. And it takes a lot of fatigue for it to happen. Those are two very different presentations of the same symptom of stress incontinence. There's also something called urge incontinence. That's really common in people with tension and a lot of the symptoms that you're personally describing. But urge incontinence is you're just chilling and all of a sudden you get this sudden urge to urinate, you have to pee out of nowhere and sometimes the bladder can just spasm and pee a little bit. That doesn't come from weakness. Darshna Patel: okay. Wait, but why though? Like how how does it like how how does it tie Jocelyn: Why does that happen? Darshna Patel: into with the P, yeah. Jocelyn: Yeah. often it's happening because the actual bladder is spasming. So your bladder's in here and it's holding urine and it's squeezing, it's spasming and it's squeezing urine out suddenly. That Darshna Patel: okay. And so the pelvic floor, if it's strong, you would be holding it. Is that Jocelyn: No, sometimes yeah, sometimes the bladder spasm is just so powerful that it's just making the urine come out even though the pelvic floor is strong. Like you could have a strong Darshna Patel: Okay. Jocelyn: pelvic floor and still have leakage. It's not always Darshna Patel: Wow. Jocelyn: the pelvic floor fault. Or sometimes the pelvic floor is really, really tight and your bladder sits right on top of here. So your pelvic floor is really, really tight, and then that can make the bladder overactive. So often people on that side of the leakage spectrum, they're urinating a lot. They do what we often call just in case peeing. So like they pee right before they go out and they pee before they, you know, get in the car, and like they're always peeing just in case. they often train their bladders to need to go more and more and more over time, and that can make it where the bladder is just so irritable that it overpowers the pelvic floor. But the fix for Darshna Patel: Wow. Jocelyn: that is not strengthening the pelvic floor a lot of the time. Darshna Patel: Interesting. I like how you kind of like like kind of share both sides to like what is a weak pelvic floor look like, but then what is a strong pelvic floor look like and the nuances between the two because it seems like at the end of the day, everything's about balance. The universe is all about balance, and it feels like in the body, Jocelyn: Yeah. Darshna Patel: it's kind of cool how you give different tools and different things that each person would need to balance out their pelvic floor. So what are the repercussions then? I want to know what are Jocelyn: Yeah. Darshna Patel: the repercussions if women, let's say, have over tight, Jocelyn: Yeah. Darshna Patel: like super tight pelvic floor, and then the women that have a weak pelvic floor, like what are the repercussions if they don't do anything to, you know, help balance it out? Jocelyn: Yeah. on the tight pelvic floor side of the spectrum, so if someone is having urgent continence and they're having urinary urgency and like that urge to go to the bathroom is really strong, it can just continue stacking and getting worse as years pass. So they're often the woman that their story sometimes goes something like, they're starting to wake up all night to go to the bathroom and now like they think it might be their hormones or something, but it's been like this slow burn over years, maybe decades, where They've just been peeing more and more and more as time goes on. Sometimes the person in that bucket will have flare-ups when they're more stressed because our one of our nerve beds, like we have the nerves that come out of our spine. We have tons of nerves in our pelvis. Same up here in our neck. Like our two main nerve hubs are in our neck and our chest, and then our pelvis. So these are often the first parts of our body that speak to us when our nervous system needs support. And Our bladder has tons of nerve supply. It's a very nerve-rich organ. So it's often the first part that will speak for people whose nervous systems need support. So you ignore those signals through a lifetime, and so many different things can happen. Ur going pee all night long and like feeling like it's just cascading out of control where you have to think about your bladder all the time. And that can become a diagnosis called overactive bladder. And there's medications and stuff for it. And If that if like we're continuing to follow that thread and what the repercussions of that, sometimes these people often develop the habit of having to strain to empty their bladder. Like it never feels like they can fully empty, and you're pushing a little bit to pee, and then you get up and you're like, I still need to pee a little bit, and you have to sit back down and pee a little bit more, and that chronic strain over time can start to weaken the pelvic floor. And then people start to develop what's called mixed incontinence, where you have both. where you have urgent continence, but you also start developing the stress incontinence with cough, coughing, sneezing, laughing and like peeing when your body's under pressure. So it can start to Darshna Patel: Wow. Jocelyn: turn into both at the same time. Darshna Patel: It seems like there's some nervous system. connection here with the pelvic floor and how Jocelyn: Okay. Darshna Patel: it how your body so I want to actually go to the nervous system before we get back into the reproductive system. But how does the nervous system kind of affect the health of the pelvic floor? And how can women start to just take the first step? I'm not saying let's give them everything because no one's going to do anything, but just the first step Jocelyn: Yeah. Darshna Patel: towards kind of having a more regulated I think the word I'm going for is a regulated pelvic floor. Jocelyn: Yeah. It absolutely starts in the pelvic floor in the nervous system. And that's often another reason why we give everybody breath work and why breath work is such a big part of pelvic floor therapy. Like sometimes we're thinking along the very anatomical thought process of okay, you're you're breathing in, you're lengthening your pelvic floor, but sometimes we're giving people breath work because they need their bodies need to calm down, and their you know, their shoulders are up to their ear, their jaw is clenched, they have jaw pain, They're feeling like their posture is getting worse and worse, even though nothing has changed in their life, like they're just kind of curling in on themselves. That's often a common theme for people where they need to start with their nervous system. Like their buff system is overwhelmed by whatever's going on in their life. Mm-hmm. Darshna Patel: Okay. Like a high stress state. Like a high like the stress is kind of the biggest contri Well, stress is a contributor to everything, honestly, at this point. It's really interesting Jocelyn: Yeah. Yeah. Darshna Patel: you bought this up because I've actually been playing around with fascia. I don't know if you've heard of human garage.net. They're pretty well known, but they they have Jocelyn: No. Yeah. Darshna Patel: like fascia maneuvers that they teach for releasing stress. And it's it's so Jocelyn: Yeah. Darshna Patel: wild, like just certain exercises I've been doing in my body for this 30-day program. And I've been working on releasing excess cortisol that, you know, I've had for a while. And it's cool to Jocelyn: Mm-hmm. Darshna Patel: see how I'm starting to feel like my body feeling lighter as I continue to do it. So I'm really b glad that we bought up the nervous system part because I think that it seems like the nervous system would be a big major player in having more of a healthy pelvic floor. is there any like, do you think that I wanna go over to the reproductive side of things now because we all get stress, we all get the nervous system and the importance of it. But when it comes to hormonal balance, how can we s like, how can we determine with if our hormones are kind of balanced or not and how does that tie into the the pelvic floor and having a healthy, balanced pelvic floor? Like what's the effect that it has on the hormones, if that makes sense? Jocelyn: Yeah, absolutely. I'm a big fan of blood work. I think that women are really kind of like gaslit out of blood work a lot of the time and often told that, you know, our cycles are constantly changing. Blood work doesn't mean anything. But if you know women are smart and the medical system really treats us like we're dumb a lot of the time and like we can track where we're at in our cycles and get blood work at the same time in our cycles and like look at our patterns over time, I'm a really big fan of that instead of just Willy-nilly throwing stuff, like taking this supplement and trying this thing and trying this diet to try to see what makes us feel better. so I really love blood work for helping to see what's actually happening with someone's hormones. And when I say blood work, I mean like estradiol, progesterone, testosterone, FSH, LH, DHEA, a hormone or a it's not really a hormone, it's like a building block of hormones called sex hormone binding globulin, SHBG. And then a full thyroid panel. Like if someone's struggling, those are all the those are the things I want them to get at least. And then there's also really great home hormone monitoring tools available to us now. So one of the most popular brands is called Mira, M-I-R-A. And it's a home urine test with like a little monitor and you have an app on your phone Darshna Patel: Okay. Jocelyn: and you can look at your cycles and your patterns over time. So I'm really a big fan of like data-driven things like that. So then we can Try to address one thing at a time, which could be like doing a fascia program, like what you're describing, and then see what happens on your data, see if it improves, and you also feel better at the same time. to speak to the how that relates to the pelvic floor, a lot of the conditions that are diagnosed for women who have hormone issues, like endometriosis, adenomyiosis, fibroids, or some of the big ones, PMOS, which is What PCOS was just renamed as PMOS, but PMDD is a big one that doesn't get talked about enough. But a lot of these hormonal issues can drive inflammation, stress, pressure at the pelvic floor. They can cause things like fibers cause constipation all the time. Like they can impact a lot of what's Darshna Patel: What is that? I'm like all these big words. Jocelyn: yeah. But the The symptoms, the the simple way of saying that is like the symptoms of hormone problems can impact Darshna Patel: Yeah. Jocelyn: the pelvic floor. Like bloating. So many women deal with severe bloating, GI Darshna Patel: Yes. Jocelyn: problems, all that stuff. And we're just kind of like pushed along. It's like, that's being a woman, that's being a woman, and we're pushed along that path for 20 years, 30 years, and that puts a toll on our pelvic floor over time when we could have, you know, been helped better earlier. So I don't know how helpful that is because this is also like there's so many different things all wrapped up together. But Darshna Patel: Yeah. Jocelyn: if someone comes to me and they're struggling with a bunch of hormonal symptoms and pelvic floor problems and they just have like a whole thing, I tell them to do a brain a brain dump and write every single thing down. Mood symptoms, hair symptoms, skin quality, sleep quality, digestion, urination. We have people do bladder journals all the time. write about like their experience with sexual function and some of the stuff we were talking about earlier, like literally just brained up everything. And then pick a few of those things as like these are the things that if they improved, they would really improve my quality of life. And then look into what hormonal things could we address to try to improve those first. Cause so many of us have just been like pushed along of like that's normal, that's normal, that's normal, that's normal. And by the time I am meeting with my typical client who's like 35 to 45, she has a a symptom list that's a whole you know printer paper full of stuff that she's going through. And we really have to dive into like what if you improve this, what would make the most important, the most meaningful impact on your quality of life. Darshna Patel: Yeah, that I love that. I love the approach how you go back to let's address the hormones first, and then it's then we can have a better foundation for a stronger pelvic floor and working on that. this is actually Jocelyn: Yeah. Darshna Patel: a great reminder for me because this has been coming into my awareness as I'm like working through hormones. And it's really interesting when you explained it that way too, because the energetic emotional root cause to hormonal imbalance is balance. It is having balance in life and in all areas of our life. So it definitely makes sense Jocelyn: Mm-hmm. Darshna Patel: from all the things that you were tracking. does Jocelyn: Mm. Darshna Patel: what about lower back? I want to talk about lower back pain because I know a lot of women struggle with lower back pain as well. Is that does that have any effect from the pelvic like having a overactive or underactive pelvic floor, like how is that connected and tied to Jocelyn: Yes. Darshna Patel: having lower back pain? Jocelyn: Yes. yeah. So anyone with lower back pain, any woman with lower back pain who doesn't get better, with your go-to stuff, like you have lower back pain, you start stretching, you do a little bit of stuff and it's not getting better, the pelvic floor should be considered. in a someone someone has a tight pelvic floor, it's really about lining up the other symptoms. So like if someone came to me with a primary complaint of lower back pain, I would ask them and look at their hip range emotion. And if they have lower back pain, And they report to me, like, my hips have always felt tight. And their hips look tight, like they are they've like we've confirmed they have hip tightness. I also ask all my clients about like their history with their cycles and their sexual experience and like if they're also reporting trouble with penetration and they've you know have some history of cycle problems and stuff, and we're like putting all of those characteristics together to be like, pelvic floor tension is probably driving this one versus Lower back pain that's more related to pelvic floor weakness, pelvic floor laxity. They'll often report symptoms where their back pain gets worse as the day goes on and as they get more tired. They might also report the symptoms of prolapse, which is the most common way people describe that is feeling like there's a bulge or a heaviness in the vagina, like they have a tampon in when they don't. So they'll often report symptoms along the weakness side, like feeling sensations of prolapse, but they might report stress incontinence like pain when they lapse knees jump and stuff like that. But both both buckets can have back pain. The back pain itself just often presents differently. Darshna Patel: Interesting. It's it's like so crazy how we've been able to talk about so many different aspects of like symptoms that women experience and how they're tied in unique ways to the pelvic floor. So I mean, shit, what what are the benefits of having a strong, balanced pelvic, healthy pelvic floor? Like I wanna kind of motivate women in this podcast that are listening Jocelyn: Yeah. Darshna Patel: and myself included, because now I'm thinking I'm taking mental notes here and I'm like, well damn, I may need to work on this, but Jocelyn: Yeah. Darshna Patel: I think everyone women actually probably needs to work on this, regardless if they had a kid or not, because of all the stress, because of all the contagions from society and all the things that we're holding in our bodies that cause us like cause these things to happen. So what are the benefits? Like why is it so important and what are the benefits that women can receive from investing their time and energy into creating a balanced pelvic floor? Jocelyn: Yeah, I mean feeling lighter in your body is a huge one. Like when you feel if someone does have a lot of that tension and you feel that tension lift, just like when we have tension like in our jaw or traps and you feel that that lifting, that removal of the tension, it feels amazing. But none of us have often been introduced to how that feels in the pelvis. So that's a huge one. better sex, better outcomes in our elder years. So a lot of the things that we associate of being older women, like urinary incontinence, like not being able to be up and around and not, you know, posture changes, all this stuff we associate with being older. It doesn't have to be that way. We don't have to lose our sexual function over time. We don't have to suffer, you know, when we're still relatively young, like in our sixties and seventies and stuff. We don't have to Yeah, we're not destined to suffer. Darshna Patel: We're always young always young Jocelyn: So working on our pelvic floors proactively can help to undo so much of that suffering that w generations of women before us went through, not because our bodies are destined to be that way, but because no one gave them th these tools. We didn't talk about these kinds of things so freely. Like our experience of those years can be completely different. And it can start with the pelvic floor, but like through that like unraveling that thread, women also get to know their nervous systems and learn the impact of stress on their bodies and set better boundaries with their, you know, working lives and stuff. And it can really unlock an incredible like step up into just a better life in general for a lot of people. Darshna Patel: I like that you tied in the emotional piece to it as well. Cause I think a lot of women, first of all, have been programmed to not even consider their emotions. And having developed emotional mastery myself as an intuitive, I can definitely. start to notice the sensations that I feel around my body and like when I'm feeling lighter. I don't think I have I will say that I fully feeled like open in that area. Like I I notice when my hips are Jocelyn: All right. Darshna Patel: loose versus tight, but I'm super curious to see what it would feel like to have that completely open because I imagine you'll be a lot more flexible and also a lot more open. in like in your heart being more open and just us being in that receivership energy as women. So I do want to wrap this up because I do value your time. I have one more question that I do want to ask you. And it is the the nitty-gritty question, which is, you know, if you were to give us something that we can walk away with, whether it's I would love to actually know like an emotional habits too, if you have any like anything on the emotional side, but anything from the emotional side to Any practical habit or thing that we can do to help us start, at least start the process of developing a strong, balanced, healthy pelvic floor, what would that be? Jocelyn: Yeah. Yeah. I am a huge fan of somatic techniques. Not something I'm like officially trained in or and not my direct expertise at all. But for a lot of women that I work with that might have resonated with a lot of the things we just talked about, I find that they've done a lot of like trying to calm themselves down. Like they've spent too much time often like just trying to tell themselves to be more calm and they've kind of become like their new most like their new critic in that way instead of actually learning how to feel and process their emotions. And I find that people that resonate with that often get better pelvic floor results too when they focus on doing something with their body that helps the pelvic floor relax in times of like when they're feeling big emotions that their bodies need to process. So examples of that can be getting up and shaking, like jumping around and shaking your limbs, vocalizing if possible. squatting up and down or sitting down in the bottom of a squat between work calls or between other things that bring up emotions for you and sitting down in the bottom of a squat and maybe humming can be a really powerful one. We have some people do something called mooing, which is literally just what it sounds like, which is just going moo and like feeling the vibrations through the pelvic floor. But stopping in an emotional moment, do getting down into a squat and doing something like that and feeling the way that it reverberates and help it helps to loosen and relax the pelvic floor. And not just doing that as like a checklist of exercises that your physical therapist told you you're supposed to do for your pelvic floor, but doing it because you've been listening to your body and doing it in that moment to help your body process. Like the squat example is an example for someone that is able to get into a squat and stuff like that. But for some folks it's as simple as just getting up and shaking their bodies and like literally getting that Darshna Patel: Mm-hmm. Jocelyn: like tapping those kinds of techniques that help to get that emotional energy processed instead of just always stuffing it down. Like we've so many of us have been taught to just keep trying to stuff it down and it shows Darshna Patel: Yeah. Jocelyn: up in our bodies. And I I think it often shows up in our pelvic floors and our jaws and like our necks and stuff up here. Those areas where we have rich nerve communication and where our nervous system really lives. Darshna Patel: That's really cool because this is the first time that I've learned and I've heard that the the most nerves that we have are like all around here and are like kind of like our shoulders are. I mean, my traps are like the one thing that I've been working on, like just getting them down, but also our hip area. Because personally for Jocelyn: Yeah. Darshna Patel: me, I noticed that like that is where I feel the most tightness in general. So I think it's really cool to kind of Jocelyn: Yeah. Yeah. Yeah. Darshna Patel: tie that together when it comes to just like I love that you go to the nervous system approach. Jocelyn: Yeah. Look up a picture of the nervous system. It's fascinating. Like when you just look Darshna Patel: Ya Jocelyn: at it as one it's not an object, but when you just look at it as like one being and you see where like the the bulk of the nerves live, it's like, that's why we hold our attention in those places and we spend our life just shoving it down and our bodies will show it to us if we don't feel it. Darshna Patel: Love this. Honestly, it's inspiring me. I do a lot of energy work for the body. And so this is like this whole conversation is inspiring me to create some type of energy work for like relaxing the nerves in these areas to help support, you know, women, and first of all, myself, because I'm gonna be doing this myself. So I really love that this Jocelyn: Yeah. Darshna Patel: conversation inspired me to like do something specifically for that. I do I have something that popped up, and it's all about core, the core. So I would love to Jocelyn: Mm-hmm. Darshna Patel: know from your like perspective how important is the core, like having a strong core. How important is that when it comes to also having pelvic health? Because I think I've been exploring ways to strengthen my core lately. I go to a chiropractor as well to, you know, work on my posture, and I've been doing that kind of like a maintenance thing, but I core core the word core gets like brought up so many times of like strengthen your core, Jocelyn: Yeah. Darshna Patel: work on your core, you can do all these crazy things with your body if you just have a strong core. So I know pelvic Jocelyn: Yeah. Darshna Patel: floor is important, but how does it tie into having a strong core? Like is there any correlation or just kind of want to get that in there? Jocelyn: Yeah. Our abs and our pelvic floor work together. I mean, they're supposed to work reflexively. So when you go to cough, for example, your abs and your pelvic floor brace automatically, or that's what's supposed to happen. But because of a lot of the things we talked about today, that reflex can go away, whether that's because of pregnancy or trauma or just clenching those muscles all the time. And if they're already clenched and then you go to cough or sneeze, they're already clenched, so they have nowhere to go. They can't brace for you. so they're supposed to work as an automatic system that we don't really have to think about. But because so many of us they're not working as an automatic system anymore, training the system, like training the core, can help to improve a lot of the stuff that we talked about today. And having a strong core is important for posture and so many, you know, so many other reasons like why having strong muscles is beneficial for our entire body. but Often people are especially us women, we're often too hyper focused on just core exercise, core exercise, core exercise and doing these workouts that are like a hundred Russian twists and all these crunches and all these things to like look more toned, but we can't actually expand and allow that like receiving kind of opening, relaxing energy. And all so many other women that we work with, what we first have to work on is getting them out to relax. Darshna Patel: Yes, sir. Jocelyn: their core muscles and not just the abs, but like all the muscles around the whole torso, they should all be they should all be able to relax just the same as they can contract. And if you're trying to if you have a core that is struggles to relax and you're trying to only strengthen through that without training the relaxation too, then it can like get people stuck in the cycle of back pain and stuff like that. So it's not that people Darshna Patel: How do we know? Jocelyn: should stop strengthening their core, but you should train Darshna Patel: Yeah. Jocelyn: both. Darshna Patel: How do we know when it's relaxed? Like what does that feel like or look like? Like, I know it's kinda obvious question, but Jocelyn: Yeah. Some of my favorite drills it's it's not. Some of us haven't felt our stomach be relaxed in our whole lifetime because we've been told to stand up straight and suck it in and like sometimes people have never really felt that. some of my favorite ways to have people learn it or to hold themselves. So if for people who are listening, I have my hands on my the bottom of my rib cage and like cupping around my rib cage and then inhaling and feeling your rib cage expand all the way around. And then sometimes depending on people's like surgical histories and stuff, I might have them put hand on lower back, hand on lower tummy and breathe in and out, and they should both go together as you're breathing in they should go out and as you exhale they should soften back to where they started. And then one of my favorite ways to make sure that someone's able to do that in exercise is to be on all fours in what's often called in the physical therapy world it's called quadruped. One of the exercises that's really popular is called a bare plank. So you're in all fours like you're gonna do a bare plank and breathing and when you inhale on all fours your whole abdominal wall should expand as a unit. So now I'm turning to the side and putting my hands on my stomach. So like when you breathe in and when you're on all fours, your whole abdominal wall should move together and it should go out and in. But so many people are so clenched. And especially when we're face down in a position like a plank, like we don't want people to see our stomach fat. We don't want like we don't want our stomach to be bigger. So we're holding it in, holding it in. So sometimes I have to like say like relax, relax, and get people to like actually let go. So vision that visual Darshna Patel: Yeah. I've noticed that. Jocelyn: or tactile can help a lot. Darshna Patel: So cool. I'm so glad that I asked you this and I'm so glad that you shared this because I think these are simple exercises that we can do to really help our core relax. And if we help our core relax, it'll be easier to help our pelvic relax too and just get everything going. Amazing. Jocelyn: Yeah. Yeah, exactly. And then like really tight pants, like jeans that are really tight around the middle, tight high waisted leggings and like tummy control stuff, waist trainers, stuff like that. They won't harm the public floor. Like they're not gonna rip or hurt a muscle. But for people that are dealing with tension, it can often be a trigger for more tension. So sometimes they have to stop wearing that kind of stuff for a while and focus on like looser clothes, comfy stuff, dresses. Darshna Patel: Yeah. Jocelyn: Things where they can actually feel safe letting their bodies relax, especially if they have a if like self-esteem is a thing and like they're they have a hard time letting Darshna Patel: my God. Jocelyn: their stomachs relax when they're amongst people. Darshna Patel: Especially waist trainers. Like I used to wear them back in the day and I would feel so uncomfortable wearing them. And I was just doing it obviously to like train the waist, which in a weird way it does work. Like it does kind of get you snatched up. But I was like, man, I I was the moment I'd put it on, I'd be like, I can't wait to take it off. Jocelyn: Yeah. I'm not anti-waist trainer at all. I just wish they came with like a waist trainer should come with like a lacrosse ball, which we use for pelvic floor massage a lot. Like it should come with both. It should come with like a facial release guide. So you have something you take the waist trainer off Darshna Patel: Maybe that's something you could invent. Jocelyn: and then you release Darshna Patel: Maybe you could that's something you can invent for women of like you can s have the the slim waist, but you can also have that too. It's actually pretty genius. I love that idea. Jocelyn: Yeah. Yeah. Darshna Patel: Well, we're coming up on time, and so I just want to wrap this up. Is there anything that you want to share with women that if you were to leave ev like if you were to like kind of sum up everything that we talked about today? And if there's something that you want women to remember if they took anything away from our episode. What would it be the Jocelyn: Yeah. I could only pick one thing, it would be for them to look at their vulva. Darshna Patel: Okay. Noted. Jocelyn: We should look at it, we should know what it looks like, we should be familiar with our own body. Darshna Patel: I love that. I smell my vagina a lot, but I don't look at it. So this is a good little Jocelyn: Yeah, do that too. Darshna Patel: I love that. I Jocelyn: Ha ha. Darshna Patel: love that. Amazing. I appreciate you so much for coming on and I feel like I learned a lot today. And I do feel like this is an episode, guys, that we need to re-listen to like multiple times because we really took it like far. We I mean I was just planning on talking about the reproductive sexual health, which we did go there, but then we also went to all the other parts of the body to really help gain a full understanding of what the pelvic floor. looks like, what it feels like, how what meet what it means to have a strong pelvic floor and the nuances between the two. I mean, I think that this is probably one of the best episodes out there if someone wanted to learn about pelvic floor health. Like we really went to all the little nuances, all the places where you can start to develop a healthier pelvic floor. So I appreciate you so much for sharing your wisdom, sharing your experience and your knowledge. If anybody feels inspired to work with you and be like, hey, I do actually want help with this, where can they find you and connect with you? Jocelyn: Yeah, I'm most active on Instagram and YouTube and my handle on both of them is Dr. DR Jocelyn Wallace. So Dr. Jocelyn Darshna Patel: Okay. Jocelyn: Wallace. Darshna Patel: Perfect. Perfect. So I will link all the information and how to connect with Jocelyn in the description box below. But thank you so much for tuning in. If you guys enjoyed this episode, please share it with a friend. I mean, honestly, every single woman on earth needs this episode because these are things that most people are not talking about, but it is so important, especially like in the long-term side of things. I want you guys to think long term. So share it with a friend. And if you guys enjoy this episode, please leave us a review. It helps us reach more women out there that need this work. But thank you so much for tuning in, and I will catch you guys in the next episode. Bye, Jocelyn. Jocelyn: Bye, thank you for having me.