Latest / Two Girls and a Cup of Wellness / Pelvic Floor Explained: What No One Teaches You with Erin Dinsmore | Ep 16
Transcript
- Crissy Florio: Hello everyone, welcome back for another Two Girls and a Couple Wellness conversation. This is Chrissy. And this is Marie. And today we have Erin Dinsmore. Hello, Erin. Hello. We're honored. We're very, I know for me, I'm super excited about this talk. excited too. Yes, because I think that we hear all over social media, just constantly am seeing pelvic floor health, pelvic floor health. Erin Dinsmore: Hi, thank you guys for having me. Crissy Florio: And I think that a lot of people need to number one, understand what that is, what they can do to help themselves. When do they need to go see a specialist and just kind of talk all things pelvic floor. So yay. Erin Dinsmore: Yes, I know. Crissy Florio: ⁓ Well, let's start with like what got you into that field. Erin Dinsmore: So that's probably like my number one question from like all my patients are like sitting on the table. They're like, why do you do this? How did you get into this? It actually started my first year out of PT school. I was working in an orthopedic clinic and my friend had just had a baby who I was working with. So she was a PT too and started going pelvic floor therapy. ⁓ and because she was having a lot of pain and issues. So she then started taking some like pregnancy and postpartum classes and wanting to do that herself. I was pregnant at the time. So it kind of piqued my interest. And then after I had my son, I really, I didn't have major like pelvic floor issues, but I was really just like disappointed and had a hard time after having him. And there was like no support. You know, you're like, okay. see in six weeks and you're good, like nothing else you need. And I had a really hard time with nursing and just kind of adjusting to everything. So that kind of set a fire in me to do something within my scope. wanted to ⁓ initially start with like pregnancy and postpartum rehab. And then it kind of led me into, okay, well, I need to know the pelvic floor in order to help with any of this. And then it kind of further led me into, well, everyone has a pelvic floor and you know, it doesn't need to be like initially. when you're pregnant or initially postpartum. After you have a kid, you know, can still have issues 10 years down the line. And some people have issues without ever having kids. So I kind of just opened the doors for that. And that's what led me here. Crissy Florio: Wow, that's good. So I know that for me, I've had three babies, all vaginally, and I feel like in the last five years, so my oldest is 15, my youngest is 11, every time, I'm just gonna say it, I'm just gonna say it. Listen. I'm afraid to sneeze. And I need to sneeze. I can't stop it. I'm afraid if I don't, like my eyeballs are fried out of my head. to jump too much. If I jump a little bit, it's like. Erin Dinsmore: Yeah. Yeah. Crissy Florio: When they jump in jacks at the gym at burn I'm like, oh no, here we go. I don't want my panty liner. I don't even care because this is serious. I know a lot of other women are dealing with this or if you get a bad cough, sometimes it's nerve wracking. You're like, oh my gosh, got a cough in public and I got cross my legs. So how can you help us? Erin Dinsmore: Yes. Yes, that is super common. I think it's a lot, you know, we joke about it because it's like, you know, kind of, right, I know. But it also like, becomes a little more like normalized when it's not. There's definitely an avenue you can take to help correct it. ⁓ So that's what we call stress incontinence. ⁓ So that's when there's exertion or stress, you know, coming down on the bladder pelvic floor. And there's a lot of different Crissy Florio: What else are we going to do? I can't cry about it. Mm-hmm. Erin Dinsmore: reasons why that could be happening. ⁓ The treatments individualized per person, but like it could be that those pelvic floor muscles, because they support everything, ⁓ they're not working at the right time. There's a lack of coordination there. There's deficits in like how we're managing pressure in the abdomen. So when we cough, laugh, sneeze, it's a lot of pressure. And if we're not managing pressure well and the pelvic floor is not working at the right time. then that leads to leaking or sometimes even like prolapse and symptoms like that. really, in pelvic floor therapy, it's not like an easy fix. It's not like just, okay, go home and do 100 key goals because that's not necessarily going to work. do like a head to toe approach. could be with... Crissy Florio: Which is a fear of mine, right? Erin Dinsmore: deficits in like how we're breathing or getting upper back mobility. It could be something in your foot that needs to be addressed, you know, along with your pelvic floor and strength and your hips and core. So, it is, it's all connected. Yes. Crissy Florio: Mmm. Yeah, because the whole body is connected, right? So, and the fascia and something down in your calf could be affecting your shoulder and vice versa. So the fact that we are bringing this in now into the pelvic floor and seeing that it's not just the Kegels, let's just do, I because that's how we grew up. That's how we were raised. After a baby, it was like, ⁓ okay, well, strengthen your pelvic floor now, just go ahead. It wasn't even pelvic floor. It was like, your vagina again, right? Erin Dinsmore: Right. Yeah. Crissy Florio: And that's what it was. Just do the Kegels and that was it. I mean, this is fascinating to me. What actually, like the actual pelvic floor, what does that entail physically in the body? Erin Dinsmore: Yeah. So they are the muscles right at the bottom of the pelvis. ⁓ I can grab my model really quick if you guys. Okay, so we have my little pelvis here. ⁓ Yeah. Crissy Florio: Yes, sure. I would love that. Show and tell, I like this. We haven't had this yet. And sorry for those of you who are listening to this on one of our other platforms, go over to YouTube and watch it on YouTube. Maybe we can get some pictures to put them up later. All right. Erin Dinsmore: So everything in red here, those are the pelvic floor muscles. So we have this superficial layer. have the muscles, wrap around the opening. So you have like your anal opening, vaginal opening and urethral opening. So they help open and close. You have like the anal sphincter and the other sphincter muscles around like the vagina and the urethra. And then if you look down into the pelvis, you see the deeper layer here. So you can kind of see it. like a hammock or, you know, has kind of like a trampoline type function ⁓ because it supports everything that sits inside here. So you have your bladder, your uterus, and your rectum. ⁓ It also has a function in like stabilizing the pelvis, sexual function, lymphatic function, and then like we talked about the sphincteric function, that, you know, helping with, with continence and that in those regards. So those are your actual pelvic floor muscles. Crissy Florio: Hmm. Very helpful. Erin Dinsmore: So, you know, if we have issues with it, you could see not just urinary leaking, but you could have issues with bowel movements, fecal incontinence, sexual dysfunction. So back pain, hip pain, there can be a whole host of ⁓ symptoms that come along with that. Crissy Florio: Mm-hmm. And you mentioned a word before which I know and I don't know if you know and maybe our listeners don't prolapse. So I think you should explain what that is. Erin Dinsmore: Yes. Yeah, definitely. ⁓ A pelvic organ prolapse is when one of the organs within the pelvis is descending. ⁓ Now, typically, it's like into the vagina. So we have ⁓ like a bladder prolapse, would be the bladder dropping down into the vaginal wall. You can have uterine prolapse that's coming out of the vagina. then ⁓ erectus seal is when the Crissy Florio: Mm-hmm. Erin Dinsmore: rectum comes down into that vaginal wall. A rectal prolapse is actually when the rectum's coming out of the anal opening. So it's just the descent of organs. Right. So it can be really common though, and a lot of people can live with it and not know they have it. So ⁓ I know a lot of people are really scared when they come in and they're like, something's coming out of me. And ⁓ I think that is Crissy Florio: None of that sounds good. We don't want that. none of that sounds good. prevent that. I know. Erin Dinsmore: you know, an issue with some of our just education in general that, you know, ⁓ so they're a little more scared, but it is like super common. But again, there's always, you know, there is treatment for it to help manage it and ⁓ get people back to living their life without feeling those symptoms. Crissy Florio: Now can you strengthen, say you have a very minimal prolapse of a bladder, can you strengthen that pelvic floor and just pop that bladder back up? Pop that bad boy back up. Erin Dinsmore: You can reduce, know, to some degree. I always tell people it's not going to go back to exactly how it was, you know, because a lot of the structures too that are, ⁓ you know, have more laxity like the ligamentous structures and things. So we're not actually going to like correct that. That's not really like tissue that we can strengthen. ⁓ But, you know, managing pressure throughout our... Crissy Florio: Mm-hmm. Erin Dinsmore: abdominal, pelvis area, strengthening the pelvic floor and all the supporting structures around it, like your glutes and all of that, they help with that support for those organs. So ⁓ you can get it back to where you feel like you don't have any issues or symptoms as far as the prolapse there. If it's more severe, are, I'm sorry. If it's more severe too, there's other conservative methods that Crissy Florio: Hmm So prolapse. No, no, go ahead. Go ahead. Sorry. Erin Dinsmore: can be used like pessaries and things like that. Crissy Florio: Mm-hmm. Right. Yeah. So prolapse would be kind of like the highest level of intensity, right? And then there's probably like weakness or tightness that would be kind of a level below it, of things that people can start to recognize as symptoms so that they don't get to the prolapse level, right? So what would some of those kind of symptoms of a either weak or Erin Dinsmore: you Mm-hmm. Crissy Florio: overly active pelvic floor B. Erin Dinsmore: Right. So some of these symptoms overlap too. ⁓ And with weakness in the pelvic floor, different signs of that could be leaking, whether that's urine or stool, there could be prolapse. And there's different degrees of prolapse too. So like a minor bladder prolapse, like a grade one or two, I wouldn't say that's anything super severe that you need to get very ⁓ like super concerned about because it is very manageable. ⁓ But and then, you know, there could be because of weakness, we could have pain to another areas like our back or our hips because we're just not able to support and other muscles are kind of, you know, ⁓ taking the slack for for weakness. ⁓ As far as like overactive pelvic floor, what we can see is pain. So you could have pain with Crissy Florio: show. ⁓ Erin Dinsmore: intercourse as far as like for female pelvic floor, like anything insert, gynecological exams, inserting a tampon, all of that requires those muscles to stretch. And if those muscles are really tight, it's going to feel uncomfortable to stretch. There could be constipation if those muscles, you know, don't want to, again, like the anal opening doesn't stretch very well. There could be pain with bowel movements. There could be constipation. You could have difficulty urinating, weaker streams, you feel like you don't fully empty. ⁓ Sometimes symptoms of a UTI too, where we have negative cultures, but we're like, we feel burning, we feel urgency, we feel frequency. That can all be like overactive pelvic floor as well. Crissy Florio: Hmm. Wow, that's interesting. I know. I'm sitting here thinking about certain people that I know have come to me just have, you know, were telling me certain things, friends, family, whatever. And I'm just like, ⁓ yeah, can, ⁓ maybe, okay, I might be sending them your way. Because it's definitely... ⁓ Erin Dinsmore: I'm You Yeah, I think a lot of people don't always correlate all of the symptoms with like, ⁓ I need pelvic floor therapy. And sometimes people don't even talk about it. They just say, I'll live with this until maybe it hits a certain point where something happens and they're like, ⁓ this might be the problem now when. Crissy Florio: Yeah. Mm-hmm. Isn't that funny how people do that? And sometimes I'm that way too, or like, I just kind of wait to go to go see something until it gets bad. Exactly. Because we just don't want to make a thing of it. there are, like you said, there's so many ways and things that you can do and exercises that you can do to catch it before it gets really, really bad. And I think that's a message across the board that we need to... encourage more and more people to understand when things are not going, don't feel right in their bodies. There are things that they can do beforehand to level it out, to create more ease, to make themselves feel better rather than waiting till it's too late and then it's like, that's a real big problem. Erin Dinsmore: Right. Yeah. It's, I've had a handful of patients too. They're like, you know, going through history, they're like, yeah, when I was in high school, I was really athletic. But when I'd run, I'd always leak a little and now they're having like more urgency and pelvic pain syndrome. And it's like, well, that was kind of the first indicator of those muscles were probably really tight when you were in high school, because that's not normal for a young, you know, ⁓ know, teenager to be leaking when they run. Right. ⁓ Crissy Florio: Mm-hmm. ⁓ Young athlete. Sure. Erin Dinsmore: So sometimes like that tightness was there, but they just kind of like, I told people about it, but then they were like, didn't know where to send me. Crissy Florio: Yeah. So what are some of the risk factors, obviously pregnancy, but what are some other risk factors of pelvic floor weakness? Erin Dinsmore: Pelvic floor weakness, Pregnancy, ⁓ the menopause too, just the changes in hormones are kind of more susceptible to some of those issues, maybe even more, stand out more, get a little worse around that time. Straining, constipation, that's like a stress to the pelvic floor, so we could have more weakness because of a history of that. Crissy Florio: Mm-hmm. Mm-hmm. Yeah. Mm hmm. How about obesity? Erin Dinsmore: that can put more of a strain on stress on those muscles. Crissy Florio: Mm hmm. Or maybe lack of exercise. How about if someone doesn't exercise? I don't know. I was just thinking. Erin Dinsmore: Yeah. I mean, movement's always important for everyone and exercise. Crissy Florio: Yeah. Yeah. Okay. I'm a huge advocate for movement for sure. How are going to fix this? Well, I actually, have, before we talk about the fixing of it, you know, everything that you're saying in my mind is, you know, I keep hearing, okay, the tightness, if we're talking about an overactive one, I guess I'm assuming, right? So the tightness. What is the root cause of somebody's pelvic floor being so tight? What are they? Erin Dinsmore: Right. Thank Crissy Florio: emotionally or energetically holding on to in their fascia that is just constricting, right? Have you ever kind of unraveled that with any of your clients or coworkers? Erin Dinsmore: Mm-hmm. ⁓ Thanks So there could be a, mean, and it's hard. There's a lot of factors and it really depends like on the individual too, what they're like, what stressors, because, you know, the stressors play a big impact in how, you know, we hold on to that tension, right? And I do see a lot of tension held in the pelvic floor. There could be trauma. I mean, the trauma could be abuse or, you know, to like childbirth. Crissy Florio: A lot of different things, but. Erin Dinsmore: traumatic too, especially to that area. you know, sometimes after pregnancy, a lot of people think like weakness, I'm weak, but really those muscles need to like let go and relax because it went through such a traumatic time that we're holding, you know, holding tension. ⁓ They're, you know, ⁓ I also commonly see like people that are really like flexible, hypermobile, sometimes their pelvic floor is a little more tense because it's trying to stabilize for the lack of stability elsewhere. ⁓ So, I mean, that's just a hand, a couple, but I do think, yeah, and certain personality types too, like if we're more, you know, high stress individual, we internalize that and hold onto that too. There could also be just like pain syndromes that cause some of that tightness too, ⁓ like endometriosis and... ⁓ Crissy Florio: Yeah, yeah, no, think that's great. type A. Erin Dinsmore: you know, diseases that cause a little more like pain and then our body tenses up more. So we see a lot of pelvic floor dysfunction with disease processes like that. Crissy Florio: Yeah, and inflammation. Yeah. recently, how recent has some of this been coming out? Because I think for years and years and years, so many people are like, ⁓ she just had a baby. It's like, it's no big deal. But just understanding the trauma that, let's just call it for mothers who have given birth, you know, are getting older and the menopause timeframe, they just, you know, people want to just like brush it off. But Erin Dinsmore: So, yeah. Crissy Florio: recognizing that we are really holding on to so much tension and correlating it with that. mean, how far back has that research kind of been updated or like recent? Erin Dinsmore: So, I mean, as far as like pelvic floor therapy, I think it really started in, I'd say the 90s. So it's still relatively, which I think is still relatively young or new. But it's really taken off since then. There's a lot more providers. There's a lot more research going into it, a lot more like education you can get. ⁓ The two providers that I think of, Crissy Florio: Mm-hmm, yeah. I agree. Yeah. Erin Dinsmore: with pelvic floor therapy that really started it all were Holly Herman and Kathy Wallace, and they have an institute where you can take courses, it's called Herman and Wallace. But since then, there are a lot of more mentors, and it's still not, I think, to where it needs to be, but it's definitely growing in, and they're getting, I would say, more research in all different areas too, not just pregnancy postpartum, because now, You know, we treat men and women and so it's definitely growing and there's a lot of great resources now. Crissy Florio: Great. Knowledge is Awareness. There's a lot of awareness, which is important, rather than just shushing it under the rug. That's right. And making it feel like it's nothing or you can't talk about it. That's why we want to do these things, because we want to get it out there like you were talking about when you pee or I jump and I'm like, oh, God. I mean, but these are the things that we need to talk about and make it less uncommon, more common. Erin Dinsmore: Mm-hmm. Right. Right. Yeah, definitely. Crissy Florio: So what are some of the ⁓ types of exercises or tools or tips that you give your clients? Like what are some things that we could possibly give some of our listeners to help them every day? Erin Dinsmore: So a lot of what I start with, with most of my patients is breathing because our diaphragm and pelvic floor, they work together. And if we're not getting that nice rib mobility and upper back mobility for our diaphragm to get its full excursion, ⁓ it also helps with, ⁓ Crissy Florio: as I'm sitting here breathing. Like, let me take a big deep breath. Let me breathe laterally. Let me breathe up. Felt good. Erin Dinsmore: It affects how our pelvic floor moves. ⁓ Our core is really our diaphragm, our pelvic floor, the transverse abdominis, which is like our deepest abdominal muscle, and then these small muscles in the back called the multifidai. So ⁓ getting all of those muscles to work and coordinate together is really important. So most of the time I'm starting my patients off with some breathing, some rib mobility, because ⁓ they're lacking a lot of that movement there. Crissy Florio: That's fascinating. interesting. The power of breath. You needed to sing too. Did you know that when you joined my singing club? She's crazy. I don't sing. But I remember learning my first voice lesson, I think I was in the fourth grade, and she laid me down and she put her hands on my stomach and she said, have to breathe. And it seems like so many things in healthcare too are just surrounded around breath work. Erin Dinsmore: you Yeah, it also helps, you know, like calm the nervous system down. So if you are, you know, a little more tense or upregulated, it helps. You know, I always I tell my patients, I'm like, it's a twofold, you know, we're trying to get this movement, but we're also going to help, you know, calm. Yeah, exactly. Crissy Florio: immune system. regulate the nervous system. Yeah. And then when you have a regulated nervous system, your immune system is working better. Your lymphatic system is working better. Your fascia is gliding and flowing and hydrated and juiced up and all of the things. And you start to create that sense of harmony in your body. When it's like working the way that it's designed to and it's not holding on and so constricted and tight, when you can just relax, then things are going to flow. Erin Dinsmore: Bye. Yes. Yeah. you Crissy Florio: better and you're going to move better and you're going to feel better, no doubt. ⁓ A lot of times I've heard that if you have a tight pelvic floor, you have a tight jaw or vice versa. Can you talk about the connection? Erin Dinsmore: Right. Mm hmm. Yeah, there's a big correlation between jaw clenching and hip and pelvic floor tension. I have a lot of my patients start with like doing body scans too. So I guess that's another one I could bat it. But like just checking in because so much we clench our jaw or have our shoulders up to our ears and we don't even realize it because it's just the state we live in. ⁓ yes, that is a lot of times I'm like, do you clench your jaw? And they're like, I do. Like, OK, well. Crissy Florio: Yeah. Yeah. Erin Dinsmore: there is this correlation between the two. ⁓ And you know, it could be that ⁓ we're just kind of upregulated and we're tensing a lot of muscles at once when we clench our jaw, you know, ⁓ but ⁓ that, you know, that is a correlation. So yeah, I have people kind of check in every 30 minutes, every hour, kind of what, you know, what's your jaw doing? Are your shoulders up to your ears? Is your butt clenched? And then if they can't tell because it's just the state that they live in, I'm like, okay. So we're gonna lift our shoulders up and let them down. And now we know what tense and relaxed feels like. And you can kind of do that throughout all the muscles in your body to help learn like what that let go feels like. ⁓ With the jaw, I teach them the resting jaw position. So in our resting jaw position, our tongue should be on the roof of our mouth behind our front teeth and your teeth shouldn't be touching, but your mouth can be closed. So just kind of to reset because a lot of times we do have our teeth touching in that. Crissy Florio: Hmm. Erin Dinsmore: does cause more of that tension. Crissy Florio: So the tongue up to the roof of the mouth, because sometimes, I used to teach that, then sometimes, because I teach yoga, and sometimes I have them just drop their tongue to the bottom of their mouth and keep their mouth closed and teeth not touching. What's the difference? Erin Dinsmore: Okay. Mm-hmm. Yeah. Necessarily, no, I mean, think the probably the most important part is the teeth not touching because that's really what's going to clench. Yeah. Crissy Florio: just the, okay, right. So not practicing it right now. know, I know. And then I'm like, I don't know which one I like better. mean, it's interesting. Okay, so maybe it's just tomato, tomato and what feels good to you. Well, I, you know, I do teach it a lot when I'm teaching yoga class. I know they mentioned that. But one other thing that I do right before we go into Shavasana, not every class, but every now and then when I think about it, as they're getting ready to fully lie down, Erin Dinsmore: Yeah. Thank Thank So, I'm ahead and end the video. ⁓ Crissy Florio: I have them take a big inhale and I have them clench every part of their being, their jaw, their face, their hands, their thighs, their glutes, just bring a sense of tightness into their whole body and then maybe hold it there for a few moments and then exhale and fully release it. And then that way they can really, really understand tightness and tension and then fully relaxing. But it also gives them an opportunity to release if there is still any Erin Dinsmore: Mm-hmm. Right. Crissy Florio: constriction in their body and just fully releasing it. So it's very helpful. found people, lot of people like that a lot. That's just the awareness around it, Understanding. Erin Dinsmore: Right. Right, yeah. It is, it's all, it's a lot of awareness because we kind of get into these patterns and we don't even realize it. Crissy Florio: That's it. A lot of people are just going around their lives and their days fully unconscious in just go mode and they're like robotic and don't take the time to tune into their bodies. And the beautiful work that you do, the beautiful work that we do encourages people more and more to drop in, to live more consciously, to understand how their body is communicating and how it's signaling. When something just feels off or if something feels really tight, understanding where we hold our attention in our bodies and hold stress and how we can release it through all of the different modalities. It's, ⁓ yeah, it's, the body is a powerful, powerful thing and we just need to live more consciously. It's no doubt for sure. All right. So what are the tips do you have? Erin Dinsmore: Right. It's true, yeah. Okay, what other tips? ⁓ Crissy Florio: You Do the Kegels work or is it just a myth? Erin Dinsmore: So, the... Crissy Florio: Cause I've read they can actually do more damage than good. So I don't know what to do anymore. Do I clench? Erin Dinsmore: Right, so you need to, yeah, you need to be evaluated by a therapist to see what the best treatment course is because like we talked about, you could be leaking because your muscles are tight. So sitting here and doing Kegels isn't gonna help. I also think that even if you're weak, sitting here and doing Kegels isn't going to be the answer either because... Crissy Florio: Right. Mm-hmm. Erin Dinsmore: you know, when you're leaking, you're probably doing something like a squat or a jump and just sitting doing Kegels, there's not a big functional carry over there. ⁓ So we want to know like, why is it when you're squatting that you, you leak or when you jump, it, you know, are you holding your breath? Is that how your foot lands? Is it weakness in your, you know, your glutes or, you know, that's making the pelvic floor not react the way that it needs to. So. Crissy Florio: Mm-hmm. Erin Dinsmore: ⁓ Yeah, I don't know, you know, as far as just sitting doing Kegel. Yeah. ⁓ Crissy Florio: No, so guess everybody's different. I understand that, especially with my patients. So once you're on a path, say you figure out Marie, right? You figure me out and I'm on a path. And again, this is probably a question that's very variable, but how much treatment do you need? this something that whatever exercise I learn as your patient, is it something forever? Like is it like just the muscle you use that you lose it kind of a concept I always have to be doing? It's not the quick fix, you know? Erin Dinsmore: Mm-hmm. ⁓ Right. Yeah, I would say there's really no such thing as the quick fix. ⁓ know, ⁓ typically I'm on average seeing patients once a week or maybe every other week, just kind of depending where they are in their course of treatment. ⁓ But as far as like keeping up with everything, they might not need to do it as frequently after they stop seeing me, but it should be something that they're actively doing. And we really try to incorporate, you know, Crissy Florio: Right. Mm-hmm. Erin Dinsmore: things that they like to do and exercises that they're already doing and we're just trying to make better for them, right? So it's not as hard to incorporate in their day to day. Crissy Florio: Yeah. Make it better, okay. keep coming back to that theme too. We seem to be, yeah, in all of our podcasts. a lot of our conversations, when we're talking about people who are offering services, right? And it's all about trying to find the thing that that person enjoys. So it makes them want to do it more and less of a struggle and less of the quote unquote, have to do this and, you know, making it more doable. Erin Dinsmore: ⁓ really? Right, Mm-hmm. Exactly. Yeah. You get right, and you're gonna see more benefits that way too. I mean, you do have certain patients that are like, I don't care what you give me, I'm gonna do it all. But then, that's not everybody. ⁓ You know? Crissy Florio: now. Yeah, no, no, definitely not. So then you give them homework and I mean, because then I think the homework is good because it's it. ⁓ Your homework is now you're taking a proactive approach, right? You're taking that action and then the action then starts to become more of a routine. And then they start to recognize when when things are not feeling good. ⁓ got to go ahead and do my routine. Right. Got to get back to it. Yeah. Erin Dinsmore: Mm-hmm. Exactly. Right. And they'll have their different phases of home exercises. if after, you know, they've seen me, it's been a few months or a year and they're like, oh, something, you know, doesn't feel right. They have the resources and tools to help themselves. And if it's something that they can't help, you know, they can always come back. But the goal is, know, Crissy Florio: Right. Now goal is, I'm sorry, go ahead. Erin Dinsmore: Sorry, the goal is that they can, you know, be okay on their own, hopefully. Crissy Florio: Yeah. And you don't... The surgical options aren't nice because I know when I did my OB rotation, that's those... Euroguine, first of all, if anyone wants to go into a niche field, that Euroguine surgery, there's like not many of them, those surgeons. And I was in the Boston area when I did my rotation. But it's also not always the most successful surgery. And I don't think that's one you'd want to do twice. What would you think, So I think prevention is key. Erin Dinsmore: No, there are not. Right, yeah. Yeah, exactly. Prevention is key and conservative methods. know, again, there's always, you know, sometimes surgery is what people need, but yeah, the... Crissy Florio: We do. Erin Dinsmore: the recurrent rate on some of those surgeries are not great, as far as how long it's going to last. ⁓ I always tell my patients that may be in that situation. Hopefully ⁓ we can correct this. ⁓ But even if you do end up needing or wanting a surgery, Crissy Florio: Mm-hmm. Erin Dinsmore: it's better to have this foundation before because it's only going to help you in the long run. And then coming after surgery too, like it's not always ⁓ even like standard of care to even have, you know, it's like the surgery and then you're done. There's, it's like, well, if we can't manage pressure and our pelvic floor is not strong before surgery, we have surgery, like what's the longevity look like there too? So. Crissy Florio: Mm-hmm. Right, you still have to. Yeah. So what are some of the props or tools that you guys use? I see some foam rollers, see some of the like squishy balls. Yeah. Yeah. Yeah. Erin Dinsmore: Yeah, balls, bands, yoga blocks. Yeah, those kind of just like through treatment, you know, different exercises. ⁓ There are different like tools that I, you know, if people are having like more pelvic pain ⁓ that I can I recommend for them to get at home like the pelvic wand or dilators that can be used for more like pain with intercourse or just like ⁓ certain areas of the pelvic floor, like the wand I can show you. ⁓ Crissy Florio: I never even heard of a wand or a dilator. actually have a question too now thinking about these wands. ⁓ Erin Dinsmore: So this is a pelvic wand and it can be, this is just the model. So I don't use this in treatment. I'll recommend people go buy one and use it at home. But when they're doing just like we'll do internal work in therapy. So it's something that they can use at home. So they just gonna be, they can use either end and insert it and just kind of put gentle pressure along with them at the muscles where they're. Crissy Florio: and like relax them. ⁓ Interesting. Erin Dinsmore: tight or tender to help calm that down. Dilators are a little different. They start like at a small size and get bigger and you're inserting them typically vaginally. There are rectal ones too. ⁓ Just to, you know, I would say more used for like pain with intercourse commonly. So the goal is to kind of just get to, you know, whatever size or bowl is, you know, for you. Crissy Florio: Mm Mm-hmm. Erin Dinsmore: but to be able to tolerate insertion and even deeper ⁓ insertion too. Crissy Florio: Okay. Yeah, this is important because a lot of people don't talk about this. yeah, no, they'll be embarrassed or you know, or they'll still suffer through their pain with their spouse, which can create strain later in the relationship, you know, The work that you do is so valuable. So valuable. I'm really glad that we were able to highlight it and to talk about all of these uncommon things. Erin Dinsmore: Right. Yeah, thank you guys for highlighting it. It's always good to spread the word and let people know. I'll be sorry. Crissy Florio: Yeah, I have one more question. I'm so sorry. We're going over our time. there are those electrical stimulation wands that are used in some OB-GYN offices. I know one's called the Mona Lisa. Do you think those are successful for urinary incontinence, like a stress? I've had mixed reviews, and I don't know if the research is strong, but I just wanted to see what your opinion was. Erin Dinsmore: So, right. ⁓ So I think the Mona Lisa, I'm not mistaken, it's more of like a laser, like for collagen boosting. And then there's some OBGYN offices that like advertise. Crissy Florio: Yeah. Do you know what this is? Okay. Erin Dinsmore: pelvic floor therapy and use like a probe with like electric stimulation to help like the muscles contract too. So those are like two different things, but the probe, I mean, it's a tool you can use as far as like the electric stimulation, like the probe that you insert vaginally. And what it's going to do is the electric stimulation stimulates the nerves and then the muscles contract involuntarily. And they're trying to get, you know, Crissy Florio: Right. Mm-hmm. contract. Erin Dinsmore: you to contract with the muscles and then relax and then contract. So essentially it's a little passive in like doing Kegels. So I do think that some people may have success with that. I don't know like long term of how long their success is going to be, but I think there has, it's like for a very specific patient population. And it's not, you know, not everyone's going to benefit. It's not like a one size fits all. Crissy Florio: Okay. Okay. Or quick fix is what I'm hearing. Back to that. No quick fixes. Thank you. Sorry about that. No, I love all the questions. I love all the questions and this was super, super helpful. Thank you so much, Erin. We really appreciate it. And I know our community. Yeah. And she's in Palm City. So yeah, schedule your appointment for your evaluation. Yeah. And I mean, and for those of you who don't live in our area, Erin Dinsmore: bright. ⁓ Yeah! Crissy Florio: please Google, is there a wording that people should Google around their areas if they're not close to us here? Erin Dinsmore: ⁓ yeah. So there's actually some websites, ⁓ you can go to, think it's called like pelvic PT finder. ⁓ it's through the Herman and Wallace website where like they take courses and you can find, you can like type in your area code and find, ⁓ pelvic floor therapists in your area. So there's a couple, I don't know if there's like a link or anything like that. I could, I can send you guys like the links. Yeah. ⁓ Crissy Florio: Great. Yeah, send it over. We'll put it in the show notes. Yeah. Yes, that'd be great. Erin Dinsmore: There's a couple of different websites where you can look in your area and see. Crissy Florio: And send a picture of your pelvic floor model. We'll post that. Right? I like it. I know. It's so cool. I mean, we love learning about this stuff and just obviously learning more and more about the human body in general, but the female body too. And again, coming back to, and I've said it so many times, coming back to talking about the uncommon and making it common. Yeah. It's just really... Very important. Very, very important. Erin Dinsmore: Okay. ⁓ Mm hmm. Right. Yeah, definitely. Oh, yes, it was great. Thank you guys so much for having me. It was great talking with you. Crissy Florio: Thank you, Erin. Thank you for your time. was lovely meeting you. Yeah. Amazing. Thank you so much. All right, guys, until next time. Bye. Erin Dinsmore: you