Latest / Wellness, Actually with Emily Oster & Perry Wilson, MD / Pelvic Health with Emily Oster and the Vagina Whisperer

Transcript

Pelvic Health with Emily Oster and the Vagina Whisperer · Wellness, Actually with Emily Oster & Perry Wilson, MD

• 0:00
  Speaker 1: So I am so thrilled to be here with doctor
• 0:03
  Speaker 1: Sarah Reardon. She's a doctor of physical therapy, women's health,
• 0:06
  Speaker 1: pelvic floora therapist. She has two children. I know you
• 0:10
  Speaker 1: besked from Instagram where you are the Vagina Whisper, which
• 0:13
  Speaker 1: is just the absolute greatest Instagram handle. And I'm really
• 0:17
  Speaker 1: thrilled to get to talk. But before we get started,
• 0:19
  Speaker 1: can you just introduce yourself a little bit beyond what
• 0:22
  Speaker 1: I just said?
• 0:23
  Speaker 2: Absolutely, I feel you just like you wrapped it up
• 0:25
  Speaker 2: really well though. But I am Sarah Reardon. I am
• 0:28
  Speaker 2: a pelvic floor physical therapist. So I went to Washington
• 0:32
  Speaker 2: University in Saint Louis for undergrad and then physical therapy
• 0:35
  Speaker 2: school and specialized in pelvic floor therapy immediately after, which
• 0:39
  Speaker 2: really means, you know Pete's work with muscles in the body.
• 0:42
  Speaker 2: I work with the muscles in the pelvic region, which
• 0:45
  Speaker 2: are responsible for peeing, pooping, sexual health, menstruation, and have
• 0:50
  Speaker 2: a very important role during pregnancy and childbirth. I have
• 0:53
  Speaker 2: a private practice in New Orleans, which is my hometown,
• 0:56
  Speaker 2: called Nola Pelvic Health, and then an online platform for
• 0:59
  Speaker 2: education and exercise called also the Vagina Whisper.
• 1:03
  Speaker 1: Amazing all right, So we're going to touch on all
• 1:06
  Speaker 1: of that stuff, but I actually want to start a
• 1:08
  Speaker 1: little bit more with the basics, which is what is
• 1:12
  Speaker 1: the pelvic floor and where can I find it?
• 1:15
  Speaker 2: Well, everyone has one, all bodies, and the pelvic floor
• 1:21
  Speaker 2: is really a basket of muscles at the base of
• 1:23
  Speaker 2: your pelvis. So we think of the bony pelvis kind
• 1:25
  Speaker 2: of with your hip bones on the side and your
• 1:27
  Speaker 2: sit bones on the bottom, pubic bone in the front,
• 1:30
  Speaker 2: and then your sacred mind tailbone in the back, and
• 1:32
  Speaker 2: that helps support your spine and it plays a very
• 1:36
  Speaker 2: important role in movement. But the pelvic floor muscles are
• 1:39
  Speaker 2: at the base of that bony structure and they sit
• 1:42
  Speaker 2: like a hammock. So imagine a hammock kind of at
• 1:44
  Speaker 2: the very base of your pelvis, and that hammock supports
• 1:47
  Speaker 2: your pelvic organs, including your reproductive organs, so your bladder,
• 1:51
  Speaker 2: your rectum, your uterus, your ovaries, and it has a
• 1:56
  Speaker 2: supportive role. It also has what we call a sphincteric roles,
• 2:00
  Speaker 2: So there's openings in those muscles. In a female body,
• 2:05
  Speaker 2: there are three openings, one for the eu rethrow where
• 2:07
  Speaker 2: you're in exits, one for their anus where poop exits
• 2:10
  Speaker 2: and then the vaginal opening. In male bodies there are
• 2:13
  Speaker 2: two openings, one for urine and semen and then one
• 2:16
  Speaker 2: for the anal opening where poop exits. And then this
• 2:19
  Speaker 2: role also has a sexual function. And then again in
• 2:23
  Speaker 2: a female body there is a role with menstruation and
• 2:26
  Speaker 2: then pregnancy and birth, and so if you have a
• 2:30
  Speaker 2: vaginal birth, the baby exits through the vaginal canal.
• 2:33
  Speaker 1: Okay, So I feel like my introduction to the pelvic
• 2:38
  Speaker 1: floor was in the sort of pregnancy postpartum period. I
• 2:41
  Speaker 1: think prior to that, I had presumably not heard of this,
• 2:46
  Speaker 1: although I was benefiting from it. But I wonder if
• 2:50
  Speaker 1: sort of you could give us a sense of like
• 2:51
  Speaker 1: why is that where we're hearing it, Like what are
• 2:53
  Speaker 1: some of the issues that arise, or at least what
• 2:57
  Speaker 1: is the role that the pelvic floor plays in the
• 3:00
  Speaker 1: pregnancy postpartum period, and why do we hear about it
• 3:04
  Speaker 1: right period?
• 3:05
  Speaker 2: It's a great question, and you know it's really I say,
• 3:07
  Speaker 2: we see women all across the women and men, but
• 3:10
  Speaker 2: all across their lifespan from as early as difficulty inserting tampons,
• 3:13
  Speaker 2: their first attempt at sexual intercourse, and it may be
• 3:16
  Speaker 2: painful bladder or ball issues, and then even later in
• 3:19
  Speaker 2: life menopause. Postmenopause, we often hear about urinary leakage as
• 3:23
  Speaker 2: we age, so all across the lifespan. I think one
• 3:26
  Speaker 2: of the reasons we hear about it more often during
• 3:28
  Speaker 2: pregnancy and childbirth and postpartum is because our bodies go
• 3:32
  Speaker 2: through such a huge transformation. So these muscles that again
• 3:37
  Speaker 2: sit like a hammock, support your growing feetus during pregnancy.
• 3:41
  Speaker 2: So when we get those emails that are like, your
• 3:43
  Speaker 2: baby's the size of a blueberry, then it's the size
• 3:46
  Speaker 2: of an avocado, and then it's the size of a pumpkin,
• 3:49
  Speaker 2: we'll think of a hammock supporting a blueberry or an avocado.
• 3:52
  Speaker 2: It's not going to change that much the way that
• 3:54
  Speaker 2: hammock is supporting. But if you think about putting a
• 3:57
  Speaker 2: watermelon or a pumpkin and a ham we can think
• 4:00
  Speaker 2: of that hammock sinking lower, getting more stretched out, And
• 4:04
  Speaker 2: that's literally what happens to our pelvic floor and our
• 4:06
  Speaker 2: ligaments during pregnancy. So pregnancy itself changes the way that
• 4:11
  Speaker 2: our muscles are supporting our organs and the way we're
• 4:14
  Speaker 2: able to keep those sphincters closed, so we have a
• 4:17
  Speaker 2: more difficult time holding in urine, a more difficult time
• 4:20
  Speaker 2: holding in gas or stool because everything's just lengthened. And
• 4:24
  Speaker 2: then we take it to the next level, which is
• 4:27
  Speaker 2: a major event, which is childbirth, and often, unfortunately in
• 4:31
  Speaker 2: the United States, the majority of folks who give birth
• 4:33
  Speaker 2: fagulie are lying on their back, which is not the
• 4:36
  Speaker 2: most optimal position to necessarily open the pelvis and have
• 4:40
  Speaker 2: baby come down the birth canal. But they're also pushing
• 4:43
  Speaker 2: and holding their breath for a really long time.
• 4:45
  Speaker 3: So if you are.
• 4:46
  Speaker 2: Pushing and straining again, that's putting a lot of pressure
• 4:49
  Speaker 2: on these muscles which are already vulnerable and lengthened. And
• 4:53
  Speaker 2: then the majority of folks giving birth vagulie also have
• 4:56
  Speaker 2: a paraneal tear, which is kind of compromising the muscle
• 5:00
  Speaker 2: function in the structure. And then they go on to heal,
• 5:03
  Speaker 2: but it maybe doesn't heal as well as it was
• 5:06
  Speaker 2: prior to that injury. And then thirty percent of folks
• 5:09
  Speaker 2: are giving birth via cesarean section which we may think
• 5:13
  Speaker 2: is kind of spares the pelvic floor, but that's a
• 5:15
  Speaker 2: major abdominal surgery, and your abdominals are closely connected to
• 5:18
  Speaker 2: your pelvic floor. In addition, you also went through pregnancy
• 5:23
  Speaker 2: and so that itself changes your body. And then the
• 5:26
  Speaker 2: last thing is postpartum, and we know that we just
• 5:29
  Speaker 2: have very little follow up care and rehabilitation for moms
• 5:32
  Speaker 2: after giving birth. There's maybe one visit in our you know,
• 5:36
  Speaker 2: postpartum care with medical providers, and forty percent of folks
• 5:40
  Speaker 2: don't even attend that visit and then that's it. So
• 5:42
  Speaker 2: after this huge transformation, potentially major surgery, potentially a tear
• 5:46
  Speaker 2: at the vaginal opening or scar tissue, there's no rehabilitation.
• 5:51
  Speaker 2: And we don't do that with any other major medical event.
• 5:54
  Speaker 2: If you have surgery, if you have a knee replacement,
• 5:56
  Speaker 2: if you have a shoulder surgery, if you have an
• 5:58
  Speaker 2: ankle sprain, you get physical therapy, and yet there is
• 6:02
  Speaker 2: no follow up after this huge physical change.
• 6:06
  Speaker 1: I find that, you know, when I think about these issues,
• 6:10
  Speaker 1: just one of the pieces that is most frustrating about
• 6:14
  Speaker 1: the way we talk about postpartum and I don't know
• 6:18
  Speaker 1: how much of it is just that people want to
• 6:20
  Speaker 1: hide this, that it feels a shameful in the way
• 6:24
  Speaker 1: that if you said, my ankle hurts you. That's not private,
• 6:28
  Speaker 1: that's just something that could happen to anyone. But I
• 6:32
  Speaker 1: actually feel like part of the issue is that a
• 6:34
  Speaker 1: lot of the symptoms that arise as a result of
• 6:38
  Speaker 1: some of these issues are things that we have come
• 6:40
  Speaker 1: to think are just well, that's just what happens, right.
• 6:44
  Speaker 1: People are like, well, you know, after you have a baby,
• 6:46
  Speaker 1: you're just going to pee on yourself a lot of
• 6:48
  Speaker 1: the time.
• 6:48
  Speaker 3: And I guess that's just something you have to live with.
• 6:51
  Speaker 1: And I think they also have a hard time sort
• 6:55
  Speaker 1: of where is the line, like, where is the point
• 6:57
  Speaker 1: at which this is not just the way it is?
• 7:02
  Speaker 1: And like to be sort of very concrete for most people,
• 7:05
  Speaker 1: the first time you have sex after you have a baby,
• 7:07
  Speaker 1: it is a little different and can be uncomfortable, and that,
• 7:14
  Speaker 1: you know, But then the question is if that's still happening,
• 7:18
  Speaker 1: you know, six months later, that's a different thing. And
• 7:21
  Speaker 1: so how kind of how do people know when they
• 7:24
  Speaker 1: should ask for help? Maybe the answer is you should
• 7:26
  Speaker 1: always ask for help, But I'm curious if you if
• 7:28
  Speaker 1: you have a sense of how people could to understand
• 7:34
  Speaker 1: what's normal and what's something they should they should ask,
• 7:37
  Speaker 1: they should ask for.
• 7:38
  Speaker 2: Help with right, So I think this, I actually think
• 7:40
  Speaker 2: about this in two parts, is that one absolutely, as
• 7:42
  Speaker 2: a society, as a female, as a mom, one, I
• 7:47
  Speaker 2: am not the best at asking for help. I am
• 7:49
  Speaker 2: like I can do this.
• 7:51
  Speaker 3: I'm amazing.
• 7:52
  Speaker 2: I'm gonna push through, put my head down and just
• 7:55
  Speaker 2: keep going. And I think that that's a narrative that
• 7:57
  Speaker 2: we have kind of accept did because it's the way
• 8:01
  Speaker 2: that society is kind of set up for us. Right.
• 8:03
  Speaker 2: We don't have a ton of support physically, emotionally, psychologically
• 8:08
  Speaker 2: anything after giving birth, and so we really didn't feel
• 8:12
  Speaker 2: like we had another choice. The other thing is we're
• 8:15
  Speaker 2: talking about probably the most intimate part of our bodies.
• 8:18
  Speaker 2: It's not often that we that peeing problems, pooping issues
• 8:23
  Speaker 2: painful intercourse. That's not dinner table conversation for most people.
• 8:27
  Speaker 2: It's dinner table conversation for me.
• 8:29
  Speaker 1: But one of the things I might just one of
• 8:31
  Speaker 1: the things I admire so much about all of the
• 8:34
  Speaker 1: stuff that you do is just how much you're out
• 8:36
  Speaker 1: there like this is how you should sit to pee
• 8:39
  Speaker 1: like me. It's just amazing.
• 8:41
  Speaker 2: Okay, Well, I'm also and at work, I have this
• 8:43
  Speaker 2: amazing opportunity to work with people all day where this
• 8:46
  Speaker 2: is what we talk about, and so you see actually
• 8:48
  Speaker 2: how common it is, because you know, we have you know,
• 8:52
  Speaker 2: waitless of folks coming in to see us, and so
• 8:54
  Speaker 2: we realize, like, this is really common and people should
• 8:56
  Speaker 2: have access to this information. I always thought it wasn't
• 8:59
  Speaker 2: fair that I just happened to pick this right profession
• 9:02
  Speaker 2: where I got all of this education, and I'm like,
• 9:04
  Speaker 2: why doesn't everybody get this education?
• 9:06
  Speaker 3: This should be the standard of care.
• 9:08
  Speaker 2: But again going back to the question, I think that
• 9:11
  Speaker 2: these are really intimate things to talk about, and it's
• 9:13
  Speaker 2: once we do feel like, okay, maybe I should say something,
• 9:16
  Speaker 2: we don't even know where to go, like.
• 9:18
  Speaker 3: Who do you go back to?
• 9:19
  Speaker 2: Do you go back to your obgin, do you go
• 9:21
  Speaker 2: to your primary care doctor? Do you just talk to
• 9:23
  Speaker 2: a girlfriend? And then once you go to those people,
• 9:26
  Speaker 2: it often feels dismissed. And so I think that that
• 9:29
  Speaker 2: comes back to the medical side of things, where why
• 9:32
  Speaker 2: aren't our medical providers offering more care. I can't even
• 9:36
  Speaker 2: tell you how many times that I've been to an
• 9:38
  Speaker 2: office visit and I've never been asked about my bladder health,
• 9:41
  Speaker 2: my sexual health. It's kind of like you run through
• 9:43
  Speaker 2: this battery of tests and they're like, Okay, we'll send
• 9:45
  Speaker 2: your lab results if anything pops up. And there's no
• 9:48
  Speaker 2: question about any of these issues where I've given birth,
• 9:52
  Speaker 2: I'm going to be reaching menopause soon, I'm my body's changing.
• 9:56
  Speaker 2: Why aren't these questions being brought up so we can
• 9:58
  Speaker 2: proactively screen for them and give people the resources that
• 10:01
  Speaker 2: they need, which is where I think a lot of
• 10:03
  Speaker 2: the education needs to come in from the medical provider side.
• 10:06
  Speaker 2: And the data is clear that if we don't ask
• 10:09
  Speaker 2: patients specifically about these issues, they're not going to tell us.
• 10:13
  Speaker 1: And I think part of that is also that because
• 10:16
  Speaker 1: there's not education, people have no idea what that there
• 10:20
  Speaker 1: are resources, that there are approaches that could help them.
• 10:23
  Speaker 1: And so when I sometimes talk about this with people,
• 10:28
  Speaker 1: the impression I get is that they think if they
• 10:30
  Speaker 1: bring this up, they'll just be told do more kegels,
• 10:32
  Speaker 1: right I heard about Yeah, yeah, yeah, I know.
• 10:35
  Speaker 3: I'm supposed to do kegels when I watch TV. I'm
• 10:37
  Speaker 3: supposed to do kegels.
• 10:38
  Speaker 1: But I presume that there are things that one can
• 10:41
  Speaker 1: do beyond just additional kegels.
• 10:43
  Speaker 2: Right, That's exactly right. And so you know, the things
• 10:46
  Speaker 2: I tell people is that, like, if you are having
• 10:49
  Speaker 2: any sort of pain, pain is not normal. Pain is
• 10:51
  Speaker 2: a signal that something is not functioning optimally in your body,
• 10:54
  Speaker 2: and that should be addressed. And again that comes down
• 10:57
  Speaker 2: to like, well, how often do I just like kind
• 10:59
  Speaker 2: of grit my teeth and bear it like you don't?
• 11:02
  Speaker 2: I if sex is not pleasurable, comfortable, it shouldn't even
• 11:05
  Speaker 2: just be tolerable, then you should be seeking help. And yes,
• 11:09
  Speaker 2: the majority of people do. Nine out of ten people
• 11:11
  Speaker 2: do experience painful intercourse their first time after having you know,
• 11:16
  Speaker 2: giving birth. But again we should tell them that, like
• 11:18
  Speaker 2: we should say, hey, it may be a little bit
• 11:20
  Speaker 2: uncomfortable when you go back to it, U use lubricant,
• 11:23
  Speaker 2: take it slow. If it is uncomfortable persistent after that,
• 11:27
  Speaker 2: you need to go check in with a pelvic for therapist.
• 11:29
  Speaker 2: Like let's give them the resources to say, hey, when
• 11:32
  Speaker 2: you go back to exercise, when you go back to sex,
• 11:34
  Speaker 2: if there's an issue, this is who you see so
• 11:38
  Speaker 2: painful intercourse, pelvic pain of any sort, urinary leakage, no
• 11:42
  Speaker 2: amount of leakage is normal, So you may experience it
• 11:45
  Speaker 2: with a cough or a sneeze, but again that's in continence.
• 11:48
  Speaker 2: That is saying your sphincters are not responding well with pressure,
• 11:52
  Speaker 2: and that's that's a muscule skeletal issue that needs to
• 11:56
  Speaker 2: be addressed. Same thing with pooping issues, hemorrhoids, fissures, straight
• 12:00
  Speaker 2: with bowel movements, constipation not normal. You need to see
• 12:03
  Speaker 2: a petem so. And then again people say, well, like,
• 12:08
  Speaker 2: maybe it doesn't bother me that much. I'm like, well,
• 12:10
  Speaker 2: once it starts bothering to you the point where it's
• 12:12
  Speaker 2: affecting your life. You don't want to go out with
• 12:13
  Speaker 2: your girlfriends because your word, you're going to pee your pants.
• 12:16
  Speaker 2: You don't want to go running with your kids at
• 12:18
  Speaker 2: the park because you're afraid you're going to leave. You
• 12:20
  Speaker 2: quit working out, which is so important for your mental
• 12:22
  Speaker 2: health because you soak through your gym shorts or leggings
• 12:27
  Speaker 2: into me issues. I mean, as if we need enough
• 12:30
  Speaker 2: barriers to returning to sex after kids, pain does not
• 12:34
  Speaker 2: need to be one of them, right, I find the time,
• 12:40
  Speaker 2: right if I'm like, if I can just stay awake
• 12:41
  Speaker 2: long enough, you know, and so you know, we have
• 12:44
  Speaker 2: enough things that we have going on, and I think
• 12:47
  Speaker 2: that prioritizing ourself careen saying hey, this is bothering me.
• 12:51
  Speaker 2: I need to go see a therapist. And so it
• 12:53
  Speaker 2: is unfortunate that we often have to wait until there's issues.
• 12:57
  Speaker 1: But so I mean, I also think that so many
• 13:00
  Speaker 1: of those things you said, things like going out with
• 13:02
  Speaker 1: your friends or working out, I think we have trained
• 13:05
  Speaker 1: people to think of those kinds of self care as
• 13:08
  Speaker 1: sort of luxuries, like well, like I don't, you know,
• 13:12
  Speaker 1: sure would I like to be able to go running
• 13:14
  Speaker 1: without you know, urinary leakage. That would be great, but
• 13:18
  Speaker 1: you know, I I should just suck it up, like
• 13:21
  Speaker 1: you know, this is just something, Yeah, this would be
• 13:22
  Speaker 1: enjoyable for me, but I don't really have the time
• 13:25
  Speaker 1: to invest in in myself. And I think that that's
• 13:29
  Speaker 1: that is a dis you know, that is a disservice.
• 13:31
  Speaker 1: That is part of the kind of societal way that
• 13:33
  Speaker 1: this gets swept under the rug and that and that
• 13:36
  Speaker 1: we learn to try to just you know, push through
• 13:38
  Speaker 1: and Okay, I guess I'll do a kind of exercise
• 13:40
  Speaker 1: I don't like as much. But of course that is
• 13:43
  Speaker 1: that is also very damaging.
• 13:46
  Speaker 2: It is and I think that that's it's a lot
• 13:48
  Speaker 2: of it because we put more onus on the mother
• 13:50
  Speaker 2: right where I feel like, I mean, again, the research
• 13:52
  Speaker 2: also shows if you're experiencing gurinearying continence during pregnancy, you
• 13:56
  Speaker 2: have a higher risk of experiencing incontinence postpartum. So during pregnancy,
• 14:00
  Speaker 2: why aren't we sending those moms to a pet to
• 14:04
  Speaker 2: help train their pelvic floors. Why aren't we proactively educating
• 14:07
  Speaker 2: people on how to push optimally during you know, during birth,
• 14:11
  Speaker 2: or training medical providers about how to help patients do that,
• 14:14
  Speaker 2: versus kind of going through the same things we've always
• 14:16
  Speaker 2: done and then we're getting the same results that fifty
• 14:19
  Speaker 2: percent people are incontinent after the age of sixty five, right,
• 14:22
  Speaker 2: So I think it's always kind of looking at it
• 14:24
  Speaker 2: from both sides. But again, I mean, the hard part
• 14:28
  Speaker 2: about these pelvic floor issues is I don't think we
• 14:30
  Speaker 2: realize how far these ripples go. Like if you are
• 14:33
  Speaker 2: not able to do things that maybe feel like a luxury.
• 14:36
  Speaker 2: But we know that exercise helps with depression and anxiety
• 14:40
  Speaker 2: and sleep.
• 14:41
  Speaker 3: We know that.
• 14:42
  Speaker 2: You know, if you're not interacting with your kids in
• 14:45
  Speaker 2: the same way, that can affect your relationship, if you're
• 14:47
  Speaker 2: not interacting with your partner in the same way. People
• 14:50
  Speaker 2: are missing work because of pelvic floor issues, if you
• 14:53
  Speaker 2: are have a job where you have bladder issues and
• 14:56
  Speaker 2: you can't use the restroom off and I mean, I
• 14:58
  Speaker 2: think the ripples of these things we think, oh gosh,
• 15:01
  Speaker 2: but like how severe is that? I mean, I've had
• 15:03
  Speaker 2: people teachers who can't work, nurses who can't work because
• 15:07
  Speaker 2: of pelvil core issues. So these ripples start to really
• 15:10
  Speaker 2: kind of seep into different aspects of our life, and
• 15:13
  Speaker 2: that's unfortunate. Again, if we need we don't need more
• 15:16
  Speaker 2: barriers keeping women out of the workplace, right, so we
• 15:19
  Speaker 2: don't need more things affecting our mental health. So I
• 15:21
  Speaker 2: think it's you know, I think I always come back
• 15:24
  Speaker 2: to these statistics are very clear to me, and I
• 15:27
  Speaker 2: think that the medical system really has to change the
• 15:30
  Speaker 2: way it's functioning to provide more proactive care and make
• 15:34
  Speaker 2: this an integral part of pregnancy and postpartum recovery.
• 15:38
  Speaker 3: I agree with that.
• 15:39
  Speaker 1: I also think there's a potentially a role for more advertising.
• 15:45
  Speaker 3: I guess is the way I would I would put it.
• 15:47
  Speaker 1: I mean, I remember you presumably remember when viagra first
• 15:51
  Speaker 1: came out.
• 15:52
  Speaker 3: You know, there are a lot of commercials. It's probably
• 15:54
  Speaker 3: so true.
• 15:54
  Speaker 1: I don't watch commercials anymore because of streaming, but I remember,
• 15:58
  Speaker 1: you know, there's a lot of commercials for viagra. But
• 16:00
  Speaker 1: in some ways it has the same you know, like
• 16:03
  Speaker 1: a recktyle dysfunction has some of the.
• 16:05
  Speaker 3: Same shame aspects around it that you know.
• 16:08
  Speaker 1: But somehow, because it was for men, uh it or
• 16:13
  Speaker 1: maybe for another reason, uh, it became a something that
• 16:17
  Speaker 1: we were sort of telling everyone about. And I think
• 16:19
  Speaker 1: that was actually quite important for people to understand. Okay,
• 16:21
  Speaker 1: if I'm experiencing this, you know, it may not be
• 16:24
  Speaker 1: something I want to talk about with everybody. But now
• 16:26
  Speaker 1: I know that there's this sort of solution. So I
• 16:28
  Speaker 1: almost wonder if there's a role for I don't know,
• 16:32
  Speaker 1: like maybe you could have some advertisements, right, so television,
• 16:37
  Speaker 1: so it's Super Bowl.
• 16:40
  Speaker 2: That's that's the hard part is that those things take money,
• 16:43
  Speaker 2: and this yearn't backed by pharmaceutical companies or I mean
• 16:45
  Speaker 2: there's not a lot of like physical therapy isn't sexy, right,
• 16:49
  Speaker 2: it's not like that, and there's not a lot of
• 16:51
  Speaker 2: money in it. It's it's so there's nobody backing this,
• 16:55
  Speaker 2: and there's nobody backing the research either. I mean, who
• 16:57
  Speaker 2: backs these drug company trials. I mean these drug trials,
• 17:00
  Speaker 2: it's pharmaceutical companies.
• 17:02
  Speaker 3: So that's that's the hard part.
• 17:04
  Speaker 2: I always feel like it's a little bit of like
• 17:06
  Speaker 2: David versus Goliath, that like, these physical therapists are like
• 17:09
  Speaker 2: the boots on the ground and we're trying so hard
• 17:11
  Speaker 2: and we're just trying to work against this medical system
• 17:13
  Speaker 2: and these pharmaceutical companies that are just they really have
• 17:17
  Speaker 2: such an up because we're not taking doctors out to
• 17:20
  Speaker 2: lunch or we're not putting commercials on. And I do
• 17:23
  Speaker 2: think that some there are a lot of female There
• 17:27
  Speaker 2: are a lot of companies that are servicing female bodies,
• 17:31
  Speaker 2: like incontinence liners and you know, period product things where
• 17:35
  Speaker 2: they are changing their narrative a little bit instead of
• 17:37
  Speaker 2: seeing I'm hearing less and less little leaks are just
• 17:41
  Speaker 2: part of being a lady, and I'm hearing that like, hey,
• 17:44
  Speaker 2: this can help you live your life, but there's also
• 17:46
  Speaker 2: other resources for you. And I've worked with those that
• 17:49
  Speaker 2: really have that same philosophy of I'm not trying to
• 17:52
  Speaker 2: normalize this. I'm trying to make this normal conversation. But
• 17:57
  Speaker 2: I'm also giving people other options that are long term
• 18:00
  Speaker 2: versus just like flip a line or on and then
• 18:02
  Speaker 2: kind of go about your day.
• 18:04
  Speaker 1: All right, So I want to end by talking about resources.
• 18:07
  Speaker 1: So obviously your Instagram is is a resource, but in
• 18:11
  Speaker 1: terms of other you know, other resources.
• 18:14
  Speaker 3: If people feel like, you know, a I need to
• 18:17
  Speaker 3: learn more about this or more than that.
• 18:19
  Speaker 1: You know, I'm experiencing this issue and maybe I feel
• 18:21
  Speaker 1: dismissed or I brought it up to my provider and
• 18:23
  Speaker 1: they said, you know, little weeks are normal, you know,
• 18:26
  Speaker 1: don't don't worry about it.
• 18:27
  Speaker 3: What is the what is the place to go.
• 18:29
  Speaker 1: To almost arm yourself with information or understand what is possible?
• 18:34
  Speaker 2: So I think there's two that I would think about.
• 18:37
  Speaker 3: Is that one? Google? So Google?
• 18:41
  Speaker 2: Right? No, I mean, so you know what we're doing.
• 18:44
  Speaker 2: It's it's actually surprising. Social media has really helped elevate
• 18:48
  Speaker 2: the presence of pelvic floor physical therapy. It is and TikTok,
• 18:51
  Speaker 2: I mean there, this is where people there are pelvic
• 18:54
  Speaker 2: there's a pet pelvic floor. Yeah, and so there's several
• 18:58
  Speaker 2: of them. And so I think it's really as how
• 19:00
  Speaker 2: we're able to share this information that's free and reach
• 19:03
  Speaker 2: masses of people who we feel deserve this information and
• 19:07
  Speaker 2: then you know, I always say, they're like, oh, congratulations
• 19:09
  Speaker 2: on your follows. I'm like, that to me is not
• 19:12
  Speaker 2: I mean, if you work hard for those things. But
• 19:13
  Speaker 2: it's a testament to how many people really want this information. So,
• 19:18
  Speaker 2: but there are two places I would say to look.
• 19:20
  Speaker 2: One is called the Academy of Pelvic Health, so that
• 19:24
  Speaker 2: is where all physical therapists are. Not all physical therapists,
• 19:28
  Speaker 2: some physical therapists are members. It's our kind of national
• 19:30
  Speaker 2: organization of pelvic floor pts. But there's also on there
• 19:34
  Speaker 2: a PT locator, So if you're looking for a pelvic
• 19:36
  Speaker 2: floor therapist in your area, I would go to that
• 19:40
  Speaker 2: website and go to the PT locator and look for
• 19:42
  Speaker 2: someone in your area. And then in every state in
• 19:45
  Speaker 2: the United States, you can get a evaluation by a
• 19:51
  Speaker 2: physical therapist without a referral from a physician, So you
• 19:54
  Speaker 2: can at least get an evaluation to say like, hey,
• 19:57
  Speaker 2: how is my pelvic floor functioning? Do I need anything else?
• 20:00
  Speaker 2: And then most often we have relationships with physicians who
• 20:03
  Speaker 2: would you know, see you if you need a continuous
• 20:06
  Speaker 2: medical care or in my state, you don't even need
• 20:09
  Speaker 2: to follow up with a PT I mean with a
• 20:10
  Speaker 2: physician we can just continue seeing you as long as
• 20:12
  Speaker 2: you progress. And there's another website called Pelvic rehab dot
• 20:16
  Speaker 2: com that also is another great resource to find a
• 20:18
  Speaker 2: physical therapist. And then even on my website, I mean,
• 20:21
  Speaker 2: we have tons of blog posts about like what helps
• 20:24
  Speaker 2: with pain after sex? If you have, you know, pubic
• 20:27
  Speaker 2: bone pain during pregnancy, what do you do? How do
• 20:29
  Speaker 2: you push optimally during birth? I mean there's and I'm
• 20:32
  Speaker 2: not I'm sure there's so many other physical therapists that
• 20:35
  Speaker 2: just have these this information that we're teaching people day
• 20:38
  Speaker 2: to day in our clinics, and we just want more
• 20:40
  Speaker 2: people to have access to that info.
• 20:43
  Speaker 1: Also on your Instagram, sometimes you dress up like a vagina,
• 20:46
  Speaker 1: so that I do.
• 20:47
  Speaker 2: I do own a volv a costume, which my kids
• 20:49
  Speaker 2: think is a hot dog bun.
• 20:51
  Speaker 3: It doesn't. They're like, why what are we doing with a.
• 20:56
  Speaker 2: Hot dog bun today?
• 20:57
  Speaker 1: Mom?
• 20:58
  Speaker 3: And I'm like, just a couple of videos, you know,
• 21:00
  Speaker 3: so I do.
• 21:01
  Speaker 2: And it's you know, part of it is that I
• 21:03
  Speaker 2: also want to bring some levity and lightness to this.
• 21:06
  Speaker 2: I mean it kind of these are to me, these
• 21:09
  Speaker 2: are such approachable conversations for me personally, and I'm like,
• 21:13
  Speaker 2: we can have fun. It doesn't have to be so serious,
• 21:15
  Speaker 2: but we also don't have to like we can normalize it,
• 21:17
  Speaker 2: but it can also still be kind of fun to
• 21:19
  Speaker 2: talk about and learn about.
• 21:20
  Speaker 3: So right, I love it, I love it all right.
• 21:24
  Speaker 3: Thank you so much. This was a treat, and.
• 21:26
  Speaker 1: We'll put for those of you guys who are listening
• 21:27
  Speaker 1: on audio, we will put all of the in the transcript.
• 21:30
  Speaker 1: I'll put all the links in so if you want
• 21:32
  Speaker 1: to visit any of these websites and follow Sarah on
• 21:35
  Speaker 1: Instagram and everywhere else.
• 21:37
  Speaker 2: Awesome. Thank you so much Emily for having me