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The New Mom Podcast is a Christian motherhood podcast for women navigating pregnancy, postpartum, and early motherhood.
Whether you're a first-time mom, expecting, or in the middle of sleepless nights, this show offers real, honest conversations about motherhood, marriage, identity, and faith. We talk about birth stories, postpartum recovery, relationships, mental health, and trusting God through every stage of motherhood. If you're looking for encouragement, practical advice, and a reminder that you're not alone—this podcast is for you.
Our prayer is that New Mom leaves you feeling seen, strengthened, and a little more equipped for the beautiful calling of motherhood!
New episodes weekly.
Welcome back to New Mom. I'm excited about today's episode with Doctor. Kayla Borchers. She is a holistic orthopedic and pelvic floor physical therapist, mama of four, and founder of the Holistically Well Method. Her online programs for preconception, pregnancy, and postpartum help women proactively prepare their bodies for every season of life.
Carrie:And with an office in Sydney, Ohio, doctor Kayla supports women both locally and globally through her root cause one on one physical therapy and virtual programming. Kayla is a total gift. I ask her lots of questions about pregnancy and postpartum. And is it too late for me as someone who's already gone through pregnancy to prepare my body better and my pelvic floor better before I head into my next pregnancy? She answers all those questions and gives us some practical tips of how to improve our pelvic floor and our overall health.
Carrie:I think you guys will really enjoy this episode. And also Doctor. Kayla does offer some programs both in person and online, and you can check out in the show notes. I have a discount code for those. Enjoy the episode.
Carrie:But, okay. So Doctor. Kayla, welcome to New Mom. You so much for being here.
Kayla:Yeah. I'm so glad to
Kayla:be here. Thank you for having me.
Carrie:Absolutely. Absolutely. I'm I literally am so excited for this conversation because this is like and we'll get to your intro in a second, but you you are one of those people. Like what you specialize in is something that me as a mom personally, I'm always like, okay. I know I need to know more about this.
Carrie:I know I need to take care of myself in these areas, especially in postpartum. And yet, I dodge. So I'm like so excited to talk to you. And I've told a few friends that I'm having you on. They're all
Kayla:like, I can't wait for that episode. I need it.
Carrie:Like we we need it. So thank you for being willing to just come on and like share your expertise and also just like share your motherhood experience as as a mom. So I'm really happy to have you on. Welcome. Would you mind just giving us a little introduction about your profession and all of that?
Carrie:And then also maybe just about marriage kids, just give us a little intro.
Kayla:Sure. So I am a doctor of physical therapy. I did my undergraduate in exercise science and nutrition. And so I did all of this at The Ohio State University and then started my career there in sports medicine. And it all really led to where I am today.
Kayla:So having that undergrad experience in exercise science and nutrition led me to start to dive into my own health issues kind of at the time. I was having one cycle a year ever since I had gotten my menstrual cycle. I was a foresport athlete in high school, and essentially, I was just very active and a lower body fat percentage at the time, really strong, like I wasn't skin and bones, but it was just more of I was a strong athlete. And it got me really curious. So I was able to heal my own hormone cycle during college by focusing on nutrition, more nervous system regulating activities, reducing toxin load, like a whole gamut of things.
Kayla:And then went on to become a physical therapist, worked in sports medicine, but I started getting frustrated with the traditional medical system and how reactive everything is. I've always come from a lens of like, let's be proactive when we can. And so I was working in that field at first when I wasn't yet married and didn't have kids of my own. And I was seeing so many women who were getting back into running, like running marathons, I was seeing more elite level or higher activity individuals. And they would come in with a labral tear or a significant hip pain or back pain.
Kayla:And I was doing running gait analysis on them and it was like, this could have all been avoided if we had focused on supporting the body preconception and during pregnancy, or at least been partially mitigated because these ladies would get the clearance at six weeks postpartum. It would just jump straight back into the training routine they had been doing before birth. And even if we're super active during pregnancy, postpartum we need rehabilitation, like we need to rehab our bodies. We can't just go straight back to doing what we were doing activity level wise in pregnancy. And we'll get into on this conversation, like why that is.
Kayla:So anyways, started diving into not only orthopedic and sports medicine, physical therapy, but also this whole gamut of pelvic floor physical therapy and pelvic health rehabilitation, which was this area of PT that's newer, that we really weren't trained on in school. And so I got my pre and postnatal corrective exercise specialist certification, got my pelvic floor certifications and ended up opening my own private practice in Columbus, Ohio. At the time, our second child was nine months old when I opened my own practice. And then we had our third baby and moved back to be closer to family. So now we're in like West Central Ohio in a very rural area and ended up opening my practice in the county that I live in.
Kayla:So I'm in the largest city of county that I live in now, office is, but it's still a smaller town, Ohio. So my office is in Sidney, Ohio. We live about twenty minutes from here. We're currently building our dream home. We now four children.
Carrie:Oh my gosh, amazing.
Kayla:Yes, ages six, four, two, and almost six months. So life is full, busy, and I'm just so grateful to be here and to be advocating for a more proactive approach to women's health across the lifespan.
Carrie:That is so amazing. Well, like I said, I'm so excited about all of this. Also for kids, that is amazing. Did you start like, I'm curious, were you interested in this before you had any kids or did you start going toward the pelvic floor stuff like because of pregnancy and because of what you experienced?
Kayla:Yeah, good question. I always thought it would be like sports medicine, orthopedics and physical therapy like pelvic floor rehab when we had like one introductory lesson in PT school about it. Was like, no, no, no, that is not for me. But when I started seeing how women were affected by pregnancy, and I was seeing them in the sports medicine setting, and I felt I didn't have the tools to help them fully. I could help them with their back pain or their hip pain, but the pelvic floor is this linkage between the two like it's the base of our pelvis and it's just something that's like no man's land.
Kayla:Don't touch in a typical orthopedic or pelvic orthopedic or sports medicine setting. And so I myself was like, I want to help avoid these issues whenever I have children. And when I asked my gynecologist at the time, like, what can I do preconception to help optimize like my chance of conception and like to feel good throughout pregnancy, she pretty much said, Well, nothing, just go have fun for six months? And then if you're not pregnant yet, you know, come back and then we can talk about like medications or things like that. I'm like, No, like that's not what I'm getting at here.
Kayla:So it was a bit of a combination. Like I started diving into it before I had kids because of a proactive lens and because of the injuries, birth related injuries and returning to activity too soon injuries that seen in other women in the sports because
Carrie:I feel like personally so I was like I I would say athlete loosely because I ended up being homeschooled all of high school. But middle school, was up across country, track, tennis, like loved loved to be athletic and I still work out all the time. And so as someone who loves the gym, loves to lift, loves to run some, I did not give my pelvic floor a thought until I got pregnant. Like, literally didn't even and and I'd hear women be like, you know, when you're pregnant or when you're recovering, like, your pelvic floor becomes a thing. And it's like, I don't know for another day.
Carrie:Like, I don't know. I just like wanna go run or whatever. And so I yeah, that's so interesting to me that you like I think a lot of women just don't there's no proactivity and there's no awareness of it until there has to be, which is fine. Like it's not too late. Like you said, there's things we can still do.
Carrie:But I do think, it's just cool like the earlier that we can pay attention to that. Because yeah, I've definitely like noticed that women that are on it sooner reap the benefits of that, just in physical health. So before we dive too far into all of that, I wanna ask the question I ask every mom on this show, which is what is the Lord teaching you in this season of motherhood? What's something that you're learning right now?
Kayla:Oh my goodness. Being where my feet are, like being present in the moment, we have a lot going on.
Carrie:Even Four kids, can't even imagine. And
Kayla:then just as an example, like this morning I woke up at six with my almost six month old, nursed in sideline, like he sleeps in a little pack and planter room, we're in a tiny, tiny rental house right now. So I just scoop him up into bed with me and he nurses in sideline and then kind of like dozes back to sleep. So I wake up to him and then I go out of our room and my toddler is getting up, my four year old's getting up, my six year old's getting up, I'm getting them breakfast and then I'm getting myself ready at the same time. And then we have a meeting at our new build house that as soon as our we thankfully have an in home babysitter come to the house for my work day. So as soon as she gets there, I'm able to take off at the new house.
Kayla:I had a meeting with contractors and then I'm here to my office to get on for a Zoom call with you. And then I have patients all afternoon so it's just wearing a lot of hats and so being able to kind of compartmentalize that it's huge because I think as moms it's so easy to feel guilt If I'm here, I should be with my kids. When I'm with my kids, should I be working or should I be? Yes. So being able to compartmentalize it and be where my feet are and know that the Lord has placed these different opportunities in my path for a reason.
Kayla:The Lord has given me the skill sets as a physical therapist and as a women's health specialist for a reason to be able to help other people and that I am serving my community in those moments that I'm away from my children. And so just knowing that that is all part of his plan for me to not feel guilty when I'm in one place versus the other and to just be where my feet are.
Carrie:That is so good, Kayla. That's so good. I was just journaling about this the other day because I was kind of like writing down I I'm very like reflective and I feel like sometimes I do best to process how I'm feeling by journaling. So anyway, I'm a journaler. So I was journaling and I was just kind of like writing out what it feels like with the identity shift of motherhood and all this stuff and like what has helped me.
Carrie:And that was one of the things that the Lord brought to mind that I feel like I'm learning right now too. So like, just I feel you, which is one kid, which is wearing the different hats like you said and just being where your feet are because there's so much power in in being present because you're right. It's so easy when like I'm with him to be like, oh my gosh, that to do list. Oh my gosh. There's so many things
Kayla:I need to do. What do need to do for work? What do need
Carrie:do for this? And then when you're working, feel like, oh, I just have to try to be with my kid. And then you're never present literally ever. And you're constantly in a state of guilt and you feel like spaghetti. Like your brain is just noodles.
Carrie:So anyway, I just that's so timely that you said that and kind of confirming that the Lord's like, yes, you know, study that, focus on that. Just, you know, try to pursue that because, it's just it's so wonderful to like, just be be present. And I think as women, like you said, there can just be guilt of wearing any hat besides mom sometimes. But you are given a gift of what you do and it blesses so many people. And so if that's something that the Lord has given you the opportunity to do, like do it with excellence.
Carrie:And obviously same could be said for motherhood. The Lord has assigned us these children. He knows what's on our plate and He also knows that they're on our plate to raise them and we're the perfect parent for them. So anyway, love that so much. That's like really good.
Carrie:Okay. So so much to cover on these topics. And I also like, I just don't know a lot about this so you can tell me things. But like I understand like there's the whole diastasis recti. I don't know how to say that fully.
Carrie:Is that right?
Kayla:You can say diastasis recti or diastasis recti. It kinda depends where you are in the country. Like Okay. What dialect it'll be said with.
Carrie:I've heard diastasis, but diastasis. Okay, good to know. Okay. So there's that. And then there's also just general pelvic floor health, correct?
Carrie:Or is it all related to that with pregnancy?
Kayla:So it's not all related to diastasis recti. So diastasis recti is a separation of the abdominal muscles like your six pack muscles that travel from your rib cage straight down to your pelvis. During pregnancy, baby has to go somewhere, right? Our body needs to expand. So there's this thin tissue called linea alba between your rectus abdominis muscles that starts to thin and allow space for those rectus abdominis muscles to separate and that's what a diastasis recti is.
Kayla:So it's a separation of those two muscle bellies and this thin fascia layer in between. Now it doesn't tear, it doesn't rip, not normally, that would be a hurry up, right? It and it spreads. And so in the third trimester of pregnancy as we near the end, most research shows anywhere from like ninety to one hundred percent of women have a diastasis recti late in the third trimester because we need to expand. And so the way you would see that oftentimes, when ladies are like sitting on a couch, and then you go to get up off the couch, you see this like coning down the center of your abdomen.
Kayla:It's like, what is that? Insides coming out?
Carrie:Yeah, it's so wacky.
Kayla:Yeah, it's because this thin layer of fascia is right down the midline now and your muscles are way out to the side. And fascia is not a contractile tissue. It's just supporting you from tension, but not from contracting. And so that's why you see this coning out of your internal organs essentially, through that area. Now it doesn't mean they're breaking through, it just means they're simply like pressing against that fascia and that's what creates that honing.
Kayla:Postpartum, sometimes that just doesn't come back together on its own, right? We've delivered baby, we've delivered placenta, well, the uterus takes some time to go back down to our fist size. So we still have some internal pressure, but also that fascia has just been spread really thin and now it kind of all comes back together. So the tissue elasticity just isn't there. If you think of like really stretching out a rubber band and then you're not stretching out anymore you just let it recoil and return to its original shape.
Kayla:Well, it's no longer going to be as tight as it once was, right? Because it's been stretched. And so that is where pelvic floor physical therapy can come into play. If we can do things like dry needling to stimulate blood flow to the fascia and to those abdominal muscles, We look at your rib cage angle. This is another thing that widens during pregnancy to keep creating space for growing baby.
Kayla:And a lot of times that will stay widened after we deliver baby. But we can do some manual therapy techniques, some sideline rib cage mobilizations to bring that top attachment side of those muscles in by bringing the rib cage angle down and in. The other benefit of that is if you were noticing like tension around your bra strap that or dresses just weren't fitting like they used to around your rib cage, it's because it widened during pregnancy and we can bring that in. And then with the diastasis, how this correlates with the pelvic floor is that in order to get a full core contraction, we need the pelvic floor to fire first. So the pelvic floor is kind of the bottom or the foundation that the whole core canister sits on.
Kayla:And so if we think of that area like a balloon, we think of a balloon sitting in our whole abdominal cavity. We just ignored the pelvic floor and we just tightened the core, we just squeezed the center of the balloon, that balloon's going to bulge downward, down into the pelvic floor. And so that's when we can see issues like prolapse occur. That's when those internal organs like the bladder or uterus start to prolapse through the pelvic floor muscles. We can see urinary leakage, peeing your pants a little bit with coughing, jumping, sneezing, or even just urge incontinence.
Carrie:Yeah. Yeah. Yeah. I sometimes get that. I honestly, I got that before like I was a runner.
Carrie:Like I said, I got that before I had kids where if I, like, worked too hard, I could pee my pants and I ran just sometimes a little bit. And I was like, this can't be good when I have kids if I already have this issue. So yeah, that's I need to know these things. Yeah.
Kayla:Yeah. Absolutely. Absolutely. And that's a great point. Like, you don't have to have kids do a pelvic floor issues because same like, experienced that too with running.
Kayla:So that's where we get this interconnect then with that diastasis recti, we want to approach that healing with kind of a bottoms up approach of making sure we're not ignoring the pelvic floor because if we only focus on healing the diastasis, you can create issues in the pelvic floor. And then vice versa, if we only focus on the pelvic floor, we're not gonna get its full contraction if we don't focus on those deeper abdominal muscle layers as well.
Carrie:Okay. That's so good to know because I feel like, again, my lack of my whole approach with pregnancy and postpartum was kinda like, just to give you a brief rundown, maybe some girls listening will be like, that was kinda how I was. But basically, like, I knew I knew it was a thing, a little bit. And so I was like, okay, I'm gonna make sure like I knew I needed to stay strong in pregnancy. And then I knew that I needed to do like, you know, people are like, okay, you do these moves, it will just help.
Carrie:Like obviously there's not necessarily preventing it, but it's like, okay, if you do these moves, you might lessen the diastasis recti. Can't say that The Doctor. The Doctor. Yeah. There we go.
Carrie:You might you might be able to to like, you know, prevent prevent it from being as extreme or whatever. So I did like have enough awareness to be like, okay, wanna make sure I'm doing proper pregnancy core, not just like trying to do crunches or like whatever when I'm pregnant. Like, I I wanted to really focus on like deep core connection and like, I would watch some videos and like, I had some level of awareness. And then with postpartum, I was like, okay, I know that like I need to do deep core work when I'm healing. Once I get my clearance, I know that there's certain things.
Carrie:Like I had like a very basic awareness. But what I feel like I really had less of an awareness for and still do, to be honest, is just is like how is pelvic floor and Doctor? Like how do we do both of the things? Because I can I can tend to just be like, okay, like I'm just gonna keep planking? I'm gonna keep doing these things to make sure my core is strong.
Carrie:And like to be honest, my core, I'm a year postpartum. Just came up on a year. And like I still feel I've I've done like the little test to see if I have major. I don't think I have anything major going on, which we could get into that. But, I still feel a little bit like like jelly spaghetti in my tummy even though I'm strong and I can feel my abs like make an effort to do that.
Carrie:So anyway, I focus very much on core strength because that's what I'm used to as an athlete. It's like, do I feel strong? Do I feel flat again? Do I feel like I can squeeze my core? But I'm not focusing on the pelvic floor.
Carrie:And so anyway, I'm probably a good example of someone where it's cool kind of, but like there's more whole body health to be done with both of those. Like, what does it look like? Obviously seeing a pelvic floor specialist is probably the answer for these things, but even on our own or like pursuing that, what does it look like to also like to prioritize both in post partum?
Kayla:Yes, so you want to start with the pelvic floor because that is the foundation for it, right? The number one thing is to begin with the breath. So as we inhale, you want to breathe in through your nose and you want to feel that breath travel all the way down into your pelvic floor. What I mean by that is when you take a good diaphragmatic breath, our diaphragm should drop. So that creates that negative airflow so that our air can travel into our lungs, right?
Kayla:Well, when the diaphragm drops, it pushes all of those internal abdominal organs down, down into the pelvic floor. And if the pelvic floor is just like inert and it just stays still, then we're kind of slamming all of those internal abdominal organs on the pelvic floor and we can actually see some spurts of leakage that way. What we want to happen instead is as the diaphragm drops, so we inhale diaphragm drops, belly, side ribs, low back expands, pelvic floor descends, so it actually lengthens because all of those internal abdominal organs are getting pushed down into the pelvic bowl. And so it's this pressure exchange, so as diaphragm drops, pelvic floor lengthens, as diaphragm recoils to move that air up and out, our pelvic floor should recoil too. And so it's this oscillation of the two.
Kayla:And so practicing that at rest first to make sure you're getting lengthened to the pelvic floor because what I see very often is that the pelvic floor is tight. So you think of childbirth, the pelvic floor goes through this huge expansion, then we can sometimes see the muscles just really tighten up and almost be on guard versus I think a lot of people just imagine that the pelvic floor would be more loosey goosey postpartum.
Carrie:Yeah, I wouldn't have guessed it would be tight.
Kayla:Yeah, whereas oftentimes clinically we see that it's tight and it's kind of on guard. And you think of it like an injury, for instance, if you slipped and you strained your hamstring, the hamstring just went through a huge lengthening process and then it's gonna contract and it's gonna So get on the same kind of thing is happening with the pelvic floor in childbirth most often. So that is step number one, it's actually restore length into the pelvic floor and we can do so with that restful breath work and getting you in different positions to help with that lengthening. So like child's pose where you're kneeling and then you're kind of folded your chest over your thighs, arms overhead can lengthen into that pelvic floor. Sitting on the floor in like a ninety-ninety degree angle where one leg is forward at a 90 degree angle, the other leg's back.
Kayla:So we're getting hip internal and external rotation.
Carrie:Those
Kayla:kinds of things can all be really helpful and can be done very early postpartum. So I actually created a postpartum program because I was finding like moms I like to see in office like four to six weeks postpartum, just to give them that first month at home, totally bonding with baby and not having to go anywhere. But you can start reconnecting with your pelvic floor and your deep core like literally day one. So I created a postpartum program that you could just press play on from home and start moving through that. You don't need to actually go anywhere.
Carrie:That's amazing. That's so nice. Because I did know that and I think so many of us just don't know what to do. You know, it's like, okay, if I don't have the resources, if I don't have a pelvic floor specialist and like you said, especially early postpartum, you're probably not gonna go at least for four to six weeks or you're not gonna prioritize that as much as like being home and being in the bubble. That's so amazing.
Carrie:I'll definitely link your website or whatever so I can share that resource with women. Because I did know like, you know, it's important to do the breathing and stuff right away. Okay. My next question is one that just came to mind. I'm like, this sounds so ridiculous.
Carrie:But you know what? Like, I may not be the only mom that feels this way. So like, forgive me if I sound a little silly. But like, it's so boring to do that stuff. So like I, for me personally, like I know the importance of breathing and of stretching and I don't want to.
Carrie:So like how is there this sounds so silly. Like, obviously the answer is you need to do it. Are there any like do you have do you ever have patients or clients that say that? And like how do you encourage them? What does it look like to encourage them to be like, are there little specific tricks or nuggets of time or things you can do to make this more enjoyable?
Carrie:Yes. Like just to to prioritize it, I guess.
Kayla:Totally. Habit stack it. So one of those things that just needs to become part of life. So like you mentioned, now you're focusing on core strength and planks and all of that great stuff. Doing breath work just sounds boring or sounds too easy, right?
Kayla:And I get it again, like ran marathons, tons of half marathons. I've always been very active. And so I understand what it feels like to want to be like, I'm being as effective as possible with what I'm doing and like sitting here and breathing
Carrie:doesn't sound Yeah and I think especially as a mom, you know, you can be like, I have thirty minutes to work out. Like, can't spend five minutes breathing, but tell me why I should. Yeah. It'll help me because I know I need to.
Kayla:Yeah. So for me right now, I'm a mom of four. Right? My baby is about six months old. I need to be doing this stuff.
Kayla:And so the way I prioritize it in my life is every time I nurse him, I am doing like three to five nice deep breaths at the start of our feed. So not only is that helping to lengthen and relax your pelvic floor, but it's also helping to calm your nervous system. What do we need a good letdown and good milk supply is our nervous system to feel safe and calm. And so it's not only going to help you physically, but it's going to help you and your baby's connection. They can read when we're like wired and overstimulated, babies can read that and that can lead to extra fuzziness, that can lead to refusal, nipple refusal, right?
Kayla:So if you're focusing on your nervous system with calming diaphragmatic breaths, it's also going to have that positive association with baby. If you're not breastfeeding, if you're pumping, do it when you apply your pumps. If you are bottle feeding, do it as you sit down to bottle feed your baby, right? So habit stack it. The other thing I like to habit stack it with is if you're commuting somewhere, if you're driving somewhere, every time you're at a stoplight.
Kayla:So every time we get to a stoplight, we're like, Oh, just wanna get to where I'm going, right? And it can be another thing that heightens our nervous system to more that fight or flight mode. Instead, try taking three to five nice diaphragmatic breaths because the goal with diaphragmatic breathing and with pelvic floor health is small amounts, bite size amounts throughout your day. So we really don't recommend like you need to do five minutes before your workout and five minutes after because then that's just keeping it to a chunk of one point in your day. Instead, I really recommend sprinkling it throughout your day.
Kayla:So that becomes your new homeostasis, your new typical And then it's automatic when it comes to working out that we get the pelvic floor to respond the way we want it to. Then the one other thing I'll say with this is you implement it to your exercises. So just the restful breath work, that's where we start but then we pair it with activity. So for me now, for instance, I'm using my breath in every exercise I'm doing. So if I'm coming up into a side plank, for instance, I'm gonna inhale first to get nice length into the pelvic floor and then I'm going to exhale engage pelvic floor first wrap hip bones together pull rib cage down and in and then come off the ground into my side plank.
Kayla:Okay. And hold my side plank and focus on breathing and you think of eccentric lengthening of muscles. So as I inhale, I'm still expanding that balloon in my core canister, but it's not going to expand as much as it would at rest. It's kind of like if you think of a biceps curl, the lengthening portion of your biceps curl, right? You're lowering the weight that muscle is lengthening, but it's not just dropping.
Kayla:And so that's what we want to happen in the pelvic floor muscles and our core muscles as we inhale during a plank hold, we're getting expansion and muscle lengthening while we're also resisting and holding if that makes sense.
Carrie:That makes so much sense. That's okay. That's so helpful. Also for postpartum, when it does come to Doctor and doing the core side of things, I know that, like, that is a process. What are some, like, what are some healthy things when you're a few months postpartum to that first year?
Carrie:Like, you know, let's assume you're not in the first few weeks where it's very tender and it's all very, breathing and stuff. What are like like, are planks good? What are some things that you're like, this is a good place to start in terms of, like, engaging everything again? What are healthy exercises?
Kayla:Yeah, so we want to think of the core as like your frontal core and then your side core or your obliques. And so that frontal core, want to start working that lying on your back versus your front plank position. So laying on your back doing something called dead bugs or hook lying marches, that's where you want to start and you can use your fingertips to really monitor the core and what's going on there. So lying on your back with your knees bent, taking a nice big inhale to lengthen through the pelvic floor and the core first and then exhale, kind of pulling it all together towards midline, march one leg up, set it down, march the other leg up, set it down and you can monitor that midline. Am I getting a bunch of coning or reopening of that diastasis or am I keeping it pretty firm?
Kayla:Great, now let's make it harder. Both legs are going start from more of a ninety, ninety position while I'm laying on my back and then going to tap opposite foot down. Okay, that's I'm getting a little bit of coning there, but I'm able on my exhale to kind of bring it back together. Then that's a good spot for you to work in. We don't need to like press pause at the first sign of coning.
Kayla:It's okay to get a little bit of that coning if on the exhale you're able to pull it back together because we want to stress the muscles and the fascia a little bit, right? If everything is too easy where we're not getting any coning at all, then we're not really going to see the change that we want to see. So a little bit is okay, but if it's what I call uncontrolled coding where it just stays coned the whole time And then that's clear that that's too much for you.
Carrie:Okay. That's really helpful. I feel like, oh, I'm so sorry, go ahead.
Kayla:That's okay. So from on your back to hands and knees, then I would go to like extended plank position and then obliques that's like on your side with side plank, again variations of like knees bent to start. I throw some rotations into those, but you're working your way up to a full.
Carrie:Love it. That's really helpful. I was gonna say I I'm appreciate you saying that about slight coning because I've noticed for me that when I do some core work and I'm a year, so, you know, I've been slowly building up, but I'll notice like very slight coning sometimes and I'll assume I need to stop then. I'm like, oh, there's like a little bit of like when I'm doing maybe like full, maybe now it would be like both legs down and tapping and stuff. I'll notice a slight coning.
Carrie:Anyway, that's just good to know. That doesn't always indicate that you need to stop. It's just like, it's okay to work it a tad bit. So that's that's interesting to note because I'm always like,
Kayla:oh no, I'm coding.
Carrie:I haven't improved at all. Right. Right. But that's so great. Okay.
Carrie:Let's also get into for for women that are pregnant that are listening that maybe it's their first pregnancy, maybe it's their second, but either way they're in that pregnancy process. What do you recommend just for pelvic floor health and everything? Like, is it different when you're in pregnancy versus when you're in postpartum?
Kayla:Yeah, for sure. So when you're in pregnancy, you're kind of working against the growing load of baby how baby So changes our posture, as baby grows, our pelvis starts to kind of tilt forward, which shortens our hamstrings and shortens our low back muscles, but elongates our glutes and our core. So it elongates your frontal core and your glutes, but shortens low back and hip flexors. And so I'll see a lot of women with hip pain, sciatica, low back pain, right? So something we want to be mindful of as baby grows is being able to kind of pull that frontal pubic bone up towards your belly button so that you're keeping your rib cage more stacked over your pelvis.
Kayla:That gives a little bit more length to those hip flexors. Activates core so that we're better supporting growing baby, better offloading that expansion of a diastasis. Again, we're not wanting to avoid a diastasis recti, but we want to help with that pressure management so that we don't turn into something like a hernia. And then we also want to offload those low back muscles, right, because that's something we hear so commonly is that low back pain
Carrie:or psychosis. So
Kayla:posture is huge with that because that's where we're living our daily life in, right. From an exercise standpoint to facilitate that, we want to strengthen those side hip muscles so that we can again support that pelvis and avoid something like sacroiliac joint pain or SI joint pain. And then I love working the core on our hands and knees and hugging belly away from the ground. You literally think about like inhale length and exhale, hug baby towards spine. And then while bracing in that position, we think of those eccentric exercises I mentioned earlier, you're bracing there each inhale you're still getting length to the muscles but each exhale you're further contracting and we can work arms there on hands knees, you could be doing rows while we're still also the core, you can do like donkey kicks or hip extension, fire hydrants where we're working those hip and buttocks muscles, we can do alternating arm reaches, so we're working the shoulders.
Kayla:There's so much you can do in that position that is strengthening the core, promoting optimal posture because we wanna keep that spine in neutral, but then we can strengthen our arms, our hips, our glutes and all of that functionally there too.
Carrie:Okay, that's awesome. That's super helpful. Okay. Now what about for someone like me, like someone that's fairly far in their postpartum, it's not super fresh and say that they're listening for the first time and they're like, okay, I I'm I've had two kids. I've never taken care of my pelvic floor.
Carrie:I've never prioritized this. Is it true that like it's gonna we need to take care like, because I think I can fall into like, oh, I'm gonna keep having kids. So should I take care of this after or should I be proactive? Which I know is like
Kayla:Which I know is the right answer.
Carrie:But I think a lot of us think that way where I'm just like, how much does it matter if I heal these things? Because I'm about to have another kid. But I know it does. So like speak to us that are in the process of like, you're not fresh postpartum, but you do wanna be pregnant again soon or hopefully in the next year. Like what like do we do now to prepare for the next pregnancy?
Carrie:What does that look like?
Kayla:I love this question. So I, with our first three kids at eighteen months postpartum is when I was like, okay, I'm ready for another one. And so this like twelve months postpartum to eighteen months postpartum starts to become this like gray area, like you said, I'm still kind of postpartum, but I'm also starting to shift towards the mindset of preconception, right? Because I want kids. So the better we support body before pregnancy, the better your pregnancy outcomes in terms of like how you feel, right?
Kayla:We want to control what we control. And so if you go into pregnancy without having rehab, diastasis, recti, without having giving your pelvic floor any attention, you are setting yourself up for more pain and issues during pregnancy. It's like spreading your energy thin, right? Like we want to go into the second pregnancy or third or fourth pregnancy being our best self for that child, right? And that brings in nutrition and all of that too.
Kayla:And so a three to six month runway ahead of conception is what I recommend.
Carrie:Okay.
Kayla:Focusing on your nourishment, so getting a quality prenatal. I really like full well prenatal, getting in micronutrients from something like beef liver, know, cooking that where it's grounded with your ground beef so that you're just getting it in your diet naturally. Obviously fruits, vegetables, all that stuff too, not only for you, but your spouse as well. And then from a movement standpoint, healing that diastasis, your goal would be that the closure. So we look at width and depth of a diastasis.
Kayla:We wanna be at like one to one and a half finger width in terms of width. If it's anything more, so let's say we're at like a two finger width separation, that's something we want to on continuing to bring back together. And then from the pelvic floor standpoint, we want to resolve any kind of leakage issues, right? Want you to understand how to exhale from this bottoms up approach that when we sneeze, we're not leaking pee. Because if we're leaking pee now with something like sneezing or running after our one year old, right?
Kayla:Our toddler, Think of what's going to happen when we start applying extra load within the abdominal cavity. We're leaking without that and so now we apply a load of baby and you apply an extra 20 and then 30 and then 40 pounds. We're going to be starting to leak all the time, right? So set yourself up for success on the front end so that you go into it without having those leakage symptoms.
Carrie:Yes.
Kayla:Maybe you'll start to experience it towards the end of third trimester again with that extra load and pressure on that bladder. Okay, but we didn't move through the whole pregnancy with that and it's just a little bit at the end versus like a continuous and all the time.
Carrie:Yeah, that's really good. That's actually really helpful because it's just easy to think all or nothing and maybe that's just my personality but it's so easy to be like, okay, well if I can't prevent it, if yeah, this might happen anyway, like, then I just I just won't worry about it too much. So that's like so encouraging to me and helpful to prioritize it now. I also want you to quickly, if you would walk us through how do we you're talking about that that width and the the length. How do we how do we check to see if we have Doctor ourselves as women?
Carrie:Can we do that? Like obviously, is that something we can do from home? Yeah. Just to see if we should contact someone to help us?
Kayla:Totally. So lay on your back with your knees bent and just kind of relax everything. You're going to take your fingertips to monitor your abdomen. So you're going to lift your head off the floor. So you're on your back, knees are bent, you're lifting your head off the floor and use your fingertips to feel right under your sternum first.
Kayla:Then you're just going to work your way down towards your belly button and you're going to measure how wide is it. So you're going to feel the muscle bellies on either side of your fingertips, right? If you don't feel either muscle belly, put another finger in, put another finger in the widest. Like a lot of times women will be like two to three whenever we have like a true diastasis going on, sometimes even a four where have to get that pinky in there to feel it. But if you at like one till you can barely get your second finger in there, then that would be considered normal.
Kayla:And we measure above, at and below the belly button. So you're just making working your way all the way down. You're also assessing depth. So if you're sinking in past that fingernail to like that first knuckle, second knuckle, that is when we need to focus more on what's called our transverse abdominis muscle. It's a deeper tissue abdominal muscle to help the depth portion of the abdominal separation.
Kayla:And so for that, we would just want to be sinking to not past our first knuckle terms of feeling confident that like, okay, that's healed and where I want it to be.
Carrie:Okay, good. That is very helpful. I'm gonna do that later. Catch me on the floor in an hour being like, how many fingers do I have in there? But yeah, thank you.
Carrie:That's honestly so helpful because I think so many of my friends when we talk about this, we're like, oh yeah, I need to take care of that. Oh yeah, do I have that? Like I've I've gone on walks with my friends and been like, I still have rib pain or I have this core thing or whatever. And we're all kinda like, do you think that's pelvic floor related? Do you think that's Doctor related?
Carrie:And then you just kind of just like, I don't know. So this is like so helpful and practical. The other thing I guess I would ask is like, when do you know, I mean, do you maybe it's for everyone. Like maybe every every woman would benefit from it, but like help us know like when we would need to see someone like you, like when we need to contact for for help. And also like what does that look like?
Carrie:Do people do virtual sessions? Do we need to come in person? Do people come to you? Yeah. Just like share a little bit more about that so we have some resources.
Kayla:Yeah, totally. So in Europe, it is standard of care that every single woman who gives birth is referred to pelvic floor physical therapy afterwards. Yes. Know. Every woman.
Kayla:You give birth, you have a postpartum pelvic floor physical therapy visit. It is standard. Just like you go in in The United States for a postpartum six week visit with your OB or your midwife, there is a postpartum physical therapy visit usually before that, anywhere from like that two to four weeks postpartum or two to six weeks, it kind of can depend. But if we think of that six week check-in with your midwife, a lot of times they're not checking anything physically, they're just asking you how you're doing, you're answering the questionnaire to screen for postpartum depression, and they're kind of sent on your way. I've had so many patients come in and just be like, that was a joke, like I don't even know why I went.
Kayla:Specifically if they've had tearing and if they had stitches and they're like, they didn't even check how things are healing down there. Even if you didn't tear, again, your body just went through this huge expansion and then this huge retraction, like we need to support its healing. And so my suggestion blanket statement is every woman should be getting a postpartum pelvic floor physical therapy evaluation. If you don't have one local to you, we do do virtual consults. Now our virtual consults, if you're in the state of Ohio, it can be like physical therapy.
Kayla:If you're not in the state of Ohio, we do holistic health consults. And so we do that postpartum check and just help guide you, like help you understand if what you're feeling to your questions earlier, if that's normal, if and what you can do about if you're having rib pain, the first thing that comes into mind for me is like we need to be doing sideline rib cage mobilizations. We need to see if that rib cage angle is wider than it should be because then you're getting where everything's just pressing into your spine with more compression, then it's happy position and where it should be at like 90 degrees or less. And so we can help mitigate these areas from becoming issues down the road, right? From becoming chronic rib pain, from becoming chronic SI joint pain, or having pain with returning to running, right?
Kayla:If we can address these things head on in those first couple of weeks, give you tools for your toolbox to start healing and supporting yourself from the comfort of home. And then you're good to go. And so again, that's why I created that postpartum program too.
Carrie:Yeah, so good.
Kayla:I feel like in The United States, women are just so under supported. And I will say too, there's so much noise out there like on social media that I was just becoming frustrated with the amount of influencers who are like, heal your pelvic floor. But it was just their own experience of like that they had had a child and they were a fit individual and then they felt that they could like educate others on it. And in order to learn how to rehab your pelvic floor, you need to be learning from a pelvic floor physical therapist.
Carrie:Like,
Kayla:there are so many great fitness individuals out there and all of that. That's great when you're further out and you've already focused on the rehabilitation side of the pelvic floor. But I've seen
Kayla:a lot of
Kayla:people come into my office who are like, yeah, I've done this program by this person. And it's like it made their pelvic floor worse because they on just the core strengthening and maybe they look great like washboard abs. But to the point earlier, if we just focus on tightening the abs, we start to balloon in the pelvic floor.
Carrie:That's so good to know. So good to know. Yeah. The girl that I I do did a lot of her pregnancy stuff. Love her.
Carrie:I appreciated her because she literally on her like postpartum core, she just had a she had her friend that was a pelvic floor, like therapist just with her. And she was like, she's gonna walk me through this workout for you guys. It was so cool. Yeah. Shout out to Nourish Move Love.
Carrie:I love her. But but she was like, this I need to be walked through this. Like, I don't know. And so that was cool because I felt a little bit more, you know, I was like, okay, well I feel safe doing this because this is with a pelvic floor specialist who's like literally feeling her Doctor and being like, this is what you do at this stage. Anyway, I appreciated that.
Carrie:Like she wasn't pretending to be the expert in that. She's like, I may be a fitness trainer. I need my friend to I need like guidance in this. Anyway, that was cool. Okay.
Carrie:So one more thing I wanna touch on before we wrap. You just mentioned tearing. I did tear. So I'm actually curious, does that change like would that I've never really thought about that before but like I had like a third degree tear in labor and stitches and stuff. Does that potentially make you at higher risk for like having maybe like a tougher time healing?
Carrie:What what does that shift anything in your in your body?
Kayla:Yeah, so then we have scar tissue involved. And so it's kind of things that I would recommend for a C section scar, right? Like there is scar tissue and scar tissue is not as pliable as our regular skin tissue. And anytime you've had surgery, let's say knee surgery and there's scar tissue, you're refer to physical therapy and they are working on that scar tissue. It's one of the first things that we do because it will affect range of motion and the muscles ability to fire.
Kayla:When there are scar tissue adhesions beneath the surface, which with any scar tissue that there is, the muscle gets reduced signaling and it's not able to fire as properly. And so we need to implement some manual therapy in that area. And this again would be true for scar tissue with a C section, but also with any kind of tearing during childbirth. And so with C sections, do, I like doing dry needling to help with the eight layers beneath the surface that are cut through, but we can also do manual therapy, which if I'm seeing somebody virtually, I'm talking them through that where we can mobilize around the scar tissue and then right on it. And then same thing with that pelvic floor, that is a hammock of muscles in a muscle tissue.
Kayla:And so we can mobilize those layers on each other because if we don't address that, your question's about being proactive for any next pregnancy, then that scar tissue is a weak link to just tear with that next delivery. And so it absolutely should be addressed preconception before any kind of additional pregnancies and throughout your pregnancy, right? So like if somebody's listening,
Kayla:they're like, Oh my gosh, I'm already pregnant again and I
Kayla:didn't address it. It's okay. Okay, we have so many patients who come in like that. And they're like, I just heard
Kayla:online and listened to this podcast.
Kayla:I learned I should be doing pelvic floor physical therapy to help reduce my risk of tearing with this next birth. I'm like, yes, let's dive in. And so pelvic floor physical therapists are trained to be able to do manual therapy internally, which is what completely sets us apart from any other provider. But I can also teach you how to do it from like an external standpoint as well. So there's a lot of different options in terms of how we address it, but it definitely should be addressed.
Carrie:Okay. Oh, that's so good. Thank you. I'm so excited. I'm so inspired now to like, because I am in that like the twelve to eighteen month period of like, okay, I don't feel fresh postpartum.
Carrie:I do feel like my definitely my heart is like preparing for the idea of another baby, you know? And so I'm like, okay, like how do I not just was I actually just talking to my husband about this because I was like, okay, the temptation and I think like maybe social media can make it a little bit social media can make it a little bit worse. But it's like, there's a temptation to be like, oh, like I just wanna Like I think sometimes when you look on socials and you see someone who's a year postpartum, people, we make the mistake of being like, oh, look, they look like they got their body back. They look like they're not pregnant anymore. And that can be our goal is sort of like, I wanna feel normal again before I have the next baby.
Carrie:I wanna feel like pre baby Carrie and then have the And so anyway, I've been working out a lot lately or a decent amount. And I've been like, okay, I don't think my goals should be aesthetic or even just like fit or strong, like sure some of that, but I feel like my goal needs to be preparation for another pregnancy. And what does that look like? And because of course it includes getting strong, but it it includes these things too. So I'm I'm so excited.
Carrie:I really think a lot of women listen to this are gonna be stoked because I have so many friends that are like, have had their first baby and are ready for the second or pregnant friends listening. So this is this is so good, Kayla. I really appreciate it. Before we wrap up, I wanna ask you a question I like to wrap with is just what would be a piece of advice you have for a new mom? Does not have to be medical.
Carrie:Like you're a mom of four, you've got all the wisdom, but like what would you tell someone who it's their first year with their first baby?
Kayla:To not wish any season away. Like every season with a new baby is just, it's the best. Like I feel like the gift of perspective with my fourth was such a gift. And I want to gift that perspective to a new mom to slow down to be okay with sitting on the couch all day and only having nursed your baby and enjoyed a cup of coffee and your cup of tea and to accept nourishment from others, know, to accept those meals that people want to bring over and not say no we're good when really you're not. Like accept help like my role this postpartum with my fourth was to never say no when somebody offered to be so good for the help like I even had a friend be like can I send you a box from Thrive Market and I wanted to be like no, I can just order it myself from my phone like, but I
Kayla:was like, yeah, that'd be great? And it was just like such a surprise gift. A week
Kayla:later, this box showed up on our step with all kinds of like nourishing
Carrie:recipes that
Kayla:I could just grab from easily that I probably wouldn't have bought myself just because I wouldn't have you know what I mean? So even though I could have right so accept help and it is okay to slow down. Like we brought up in this conversation a few times, we are both very active, like go, go, go kind of women. And I'm sure many of you listening are as well. And with my first, it was so hard for me to just sit and nurse, like I would get so frustrated, I would be nursing her.
Kayla:And I'd be like, it has been twenty minutes. How are you still nursing? Like we've done 10 outside. We should be done. I need to go like wash the dishes.
Kayla:I want to
Kayla:go on a walk
Kayla:like, and with my fourth I'm like, you want to nurse for forty five minutes? I don't care.
Carrie:That's so good. I I'm so encouraged to hear that. Like I feel like that's the advice I've had from so many moms that are like you that have had multiple kids. I was with a friend last night, a new friend, at this small group we just started going to and she's she has her second. I think there's like a three year age gap.
Carrie:And you know, we're thinking about a second. We're like getting to that place. And honestly like having one, I just think zero to one is a huge transition. It is. Right?
Carrie:Like it's just such. And so though we really want a second, there is a level of daunting of like, we're gonna do that again. Like, woo. And I just saw her there with with her little baby girl on her chest. I think she's four or six weeks postpartum.
Carrie:And like the peace that was exuding from her. And so I just walked up to her and I was like, how are you doing? Like, how is your second postpartum? And, and she was like, it's the best. She was like, it's so much better.
Carrie:Like and she just kind of said the same thing you just said. Like, I just I'm not as scared. I'm not as rushed. I know it's a season. Like I'm you know, she's got this four year old boy running around or three year boy.
Carrie:And it was so encouraging. And she and her husband were telling me and Connor, they're like, zero to one with your first is the hardest. Like that is just so hard. When you when you know you can get through that and then you learn the perspective of it like you're talking about, they were just saying that. So it's so cool to see you have the same thing.
Carrie:I'm seeing these moms that are cause you know, you have did you say your youngest is six months?
Kayla:Yeah. Just about.
Carrie:So it's like, so you know, you're in the baby phase, but there's just such a peace that comes from other and that's what's so beautiful. Like I named this show New Mom because I feel like we're always like new moms of every season. You know, it's like now you're a new new mom to four and like that, you know, but like the way that you're the way that you're walking through motherhood with four and like being a new mom to this fourth baby is is so different than the first. And that's just the beauty of growing as people, you know? So I'm so encouraged to hear that.
Carrie:I think other moms are gonna be encouraged to hear that advice too. It's so good. Totally. Yeah, thank you so much, Kayla, for being on and for taking the time. Super blessed to have this conversation.
Carrie:And I I gotta go, like, stretch and do my Doctor testing now and probably call you for a consultation. Yeah. Perfect. Awesome. Perfect.
Carrie:Thank you so much.
Kayla:You're so welcome. Thank you for having me. And if anybody wants to learn more, you can find me at Doctor. Kayla Borchers on all the places. So Instagram, my website, Pinterest, YouTube.
Kayla:I have a podcast as well. It's Holistically Well, which Carrie is going to be on. And those resources I mentioned can be found on my website. So drcaleborchers.com, you'll find the online programs there. And that is created literally for you to dive into from the comfort With of baby by your side, like all of the videos for the postpartum one, my kiddo is in it with me.
Kayla:And so you'll see how I respond to, Oh baby needs help now, I'm going do this movement with baby on me. And so just showing you how you can implement it into your motherhood and that supporting ourselves and helping our bodies heal doesn't have to be separate from your kids, They can be involved in it. So there's a preconception program if you're in that life season, a pregnancy program, and then the postpartum one that we talked about as well.
Carrie:Okay, that's amazing. I'm going to link all those in the show notes too. That's so good. Yeah.
Kayla:Oh, this is so great. Okay, thank
Carrie:you so much, Kayla.
Kayla:Thanks for having me.
Carrie:Thank you again for listening to the show. As always, I love to remind you to subscribe and leave a review if you feel like it. I hope you really enjoyed this conversation with Doctor. Kayla and it inspired you to take care of your body, whatever phase you're at. If you're preconception, if you're in pregnancy, or if you're preparing for your next one, it's never too late.
Carrie:So, with that being said, a reminder that I do have a link in the show notes to a discount code for her services in person and online. Thanks again for listening.