Fire Within Nutrition and Fitness

Fire Within Nutrition and Fitness Trailer Bonus Episode 48 Season 1

Kegel/Kahgel - Tomato/Tomahto

Kegel/Kahgel - Tomato/Tomahto Kegel/Kahgel - Tomato/Tomahto

00:00

What the heck is your pelvic floor and why should you care? It may affect more of your health than you think. We talk with Dr. Alexis Elias-Spohn, DPT from Empower Pelvic Floor Physical Therapy.

Show Notes

In This Episode: 
  • If you're having pelvic floor issues that can look like, bladder dysfunction, bowel dysfunction, peeing when you jump, vaginismus, or general hip issues.
  • When Alexis got into her practice she thought most of her cases would be due to pelvic floor weakness after childbirth, but at least half of her cases were with women who experience pain with sex, a lot of young women specifically are having these issues.
  • We unpack what is the pelvic floor?
  • Pelvic Floor PT is a specialty area of physical therapy that focuses on the pelvic floor, which is composed of a group of muscles that support your abdominal contents and make up the base of your core. 
  • Sometimes they become weak, and sometimes they carry too much tension. Anyone with pelvic pain, weakness (that may present as incontinence or pelvic pressure), or tension (pain with sex, urinary frequency, vaginismus, and even constipation) could benefit from a Pelvic Floor PT evaluation. 
  • We discuss the importance of breath when it comes to correcting issues that affect the pelvic floor.
  • Alexis walks us through the right way to practice correct breathing to help with your pelvic floor with a step-by-step guide.
  • We talk through the benefits of Kegel exercises.
  • We spent time talking about fascia, which is a thin casing of connective tissue that surrounds and holds every organ, blood vessel, bone, nerve fiber and muscle in place. 
    • Top things to do when you're looking to get balance in your pelvic floor
    • Learn to breathe
    • Strengthen your core
    • Increase your knowledge and flexibility
    • Improve stress and sleep quality

Quotes from This Episode: 
  • "If you're going to do one thing for your pelvic floor: learn how to breathe the right way." - Alexis
  • "Not everyone needs to kegel." - Alexis

Links To Things I Talk About: 
Episode Sponsor: 
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Brandon: Welcome fire within community.

This is the fire within podcast, where we
talk about all things, health, fitness,

and nutrition related our community.

Now we're a community now, right?

That's right.

And that's an outer of the
Facebook community group.

We're going to be launching very soon
where you can find out all kinds of fun

information, talk to other people who
think like we do and get good information.

You can ask questions and
I'll be doing some live.

Lives and today we have
a very special guest.

Her name is Alexis, the last spawned.

And she is a pelvic
floor, physical therapist.

So we're going to talk about your junk.

Alexis: perfectly.

Brandon: So Alexis, tell us a
little bit about what you do and

then we're going to spiral off into
all kinds of fun conversations.

Alexis: Perfect.

I love tangents.

So I am a physical therapist
and I specialize in pelvic

floor physical therapy.

And so basically Any type of
therapy, if you're having any

type of bladder dysfunction, bowel
dysfunction or sexual dysfunction.

So this kind of runs across the
board to many different issues.

One of the most common things I'll
see is like urinary incontinence.

Sometimes you pee your
pants when you jump.

A lot of women have this after
they have a baby to, painful

intercourse constipation and then
just all the general like hip stuff.

Like my hips are really tight.

My glutes are really weak.

Getting all of that in order.

Yeah,

Brandon: absolutely.

Let's let's just go ahead and
start off with something nuts.

So I actually have had several clients
and I'm probably going to sell this

say this wrong with painful sex.

And it was some kind of vaginismus.

Does that sound right?

Yeah.

So I think a lot of people more than
you'd have conversations with struggling.

Yeah, it doesn't

Joe: just come up like how's your day.

Brandon: Okay.

So there's more listeners with that issue
then than we are willing to admit it.

Can you talk to us a little bit
about the issue what's going on and

Alexis: yeah.

Yeah.

Coincidentally, like when I first
got into pimp hell like health,

like I thought I was going to
mainly see this whole pregnancy

postpartum, pelvic floor weakness.

And I quickly found out that the
most of my population was more like

this, not specifically vaginismus,
but like painful and our course.

So I would say either vaginismus
or too much recruitment of the

pelvic floor muscles just too
much tension in that region.

So I'd say at least a
minimum of half my cases.

Was that type of thing.

And it really is just a more like
tension within those muscles.

So there, there's obviously
physical components, but there's

the psychological components too.

I'll see a lot of young women
actually with this and they, some

of it I would, can go back to, okay,
how are we Trained or untrained as

women growing up and let me tell you
about your bodies and how they work.

And they don't really
get any good information.

And a lot of women here, okay.

The first time you have a
sex, it's going to hurt.

And so then when the second time it
hurts and the third time it hurts.

And the fourth time you start to
think, oh, that's just normal than me.

This is just painful.

And then the more, it hurts, the more
you're barred at body over guards.

And so vaginismus is basically
the vagina's like closing.

I don't want anything in here.

Like this hurts.

I don't want to do anything.

Brandon: Let's back up for a
second and give our listeners

a little bit more background.

What the heck is your pelvic floor?

Alexis: All right.

Perfect.

Your pelvic floor is this little
bowl of mussels at the base of.

Hovis and it's going to be, what's
responsible for all of those

functions within that region.

So we think the reproductive
track, the urinary tract, the

GI tract is all housed in there.

And it's all jammed in that region.

It supports all of those contents.

And it's gonna relax and contract.

Those things function normally.

Letting the urine out, letting the
feces out, allowing for penetration,

allowing for orgasm, all those, all
the pelvic floor muscles are going

to be responsible and they have to
be able to contract efficiently.

Also relax efficiently and effectively.

Brandon: Now what types of things
go wrong to make this too tight?

What are the physical things people
are doing day to day that lead to this

imbalance or whatever you would call
it for specifically for vaginismus?

Alexis: I feel like the big
thing is, starts with breath.

So a lot of us aren't really breathing
through our diaphragm and taking that

big, deep, inhale every time you.

The way you're supposed to do, which
is puffing kind of the belly out

your pelvic floor lowers and relaxes.

And then as you expel all
that air, it rises back up.

Most of us breathing through
our chest, so we're not really

engaging through a diaphragm.

And then, holding.

Sucking your belly and all the
time, we're self-conscious.

Yeah.

We don't want to let it hang out.

So we're sucking it in and
we're not really contracting

those muscles the way we're

Brandon: meant to.

Yeah.

And I do want to back up just a
second, you were talking about

diaphragmatic breathing and there's a
huge time with the exercise portion.

This is the stuff I do understand.

I don't know the pelvic floor side as
much but so I always have my clients

when they're lift doing lifting
portion, I want them to exhale.

So that diaphragm gets out of the.

So the transverse abdominis can tighten
more, so they have better stability.

So just since we were talking
about the diaphragm, a lot

of people go do I breathe in?

Do I breathe out?

Why?

And when I personally teach to
exhale during the difficult part

for that course stability as a
pelvic floor specialist, is that.

Alexis: Yes that I tell
people exhale on exertion too.

Cool.

So you're stabilizing that

Brandon: region because it
was super heavy lifting.

Another technique is with our salvage
maneuver, which I've done and I can lift

more and I do have more stability, but I
ended up with a hemorrhoid and you don't.

And so I don't teach that way.

It was great.

I'm like I added 80 pounds to my
deadlift, but now my butt hurts.

It wasn't worth it.

Yeah.

Okay.

And the other thing I was going to
mention with the diaphragm part in

how it also connects with stress and
depression is if you're never breathing

into your diaphragm and you're constantly
have the short, shallow breath nor

epinephrin and adrenaline raises, and
that can increase anxiety and depression.

So

Joe: telling your body to get
into the fight or flight mode,

Brandon: It's sensing, there's
some kind of stressor and it's

not enough oxygen to the blood.

So I never thought about that
leading to like painful intercourse

and all these other problems.

So anyway, go ahead.

That was a big tangent.

Alexis: That's perfect.

I would tell people like, if you're going
to do one thing for your pelvic floor,

learn how to breathe the right way.

So it's as simple as in it,
especially for people who.

Avid exercisers is like really you're
going to tell me to breathe as part of

the program, but I'm like, yes, you need
to learn how to breathe the right way.

So at least I'll say five minutes before
you go to bed, five minutes, put your

legs up, breathe through your belly,
feel the belly, expand and come back in.

And then you could
coordinate that with the.

Tomato

Brandon: on a t-shirt that's
the show episode tomato title.

I how do you explain.

First, eventually T
tell us what a Kegal is.

And then before that,
let's go back to breathing.

How do you tell your client?

And in full disclosure,
she's working with my wife.

She's done an awesome job.

She is lovely, but how do you
teach breathing personally?

Alexis: So what, so I will first
just get the breath pattern, right?

Ah, Chest and belly deep breath
in fill the belly expand.

You want expansion through your
belly and then also laterally

through your rib cage as well.

So sometimes I'll even have people
put like a little TheraBand around

the rib cage and really feel
themselves breathe into that.

So that's first step.

And then once we start to teach.

Kegal archival.

I usually say Cagle then I try to
coordinate that with, so what you

would do is big, deep breath in, and
you're relaxing your pelvic floor

and then expel all that breath.

And your belly sucks in at the end of the
exhale, do a little squeeze or a Kegal.

So Kegal is just a contraction
of the pelvic floor.

So to locate that, those muscles,
that would be like you would either

stop your urine stream or stop a fart.

I tried to describe both ways too, because
if you're just thinking of stopping

your urine stream, that's more on the
front of the pelvic floor where, whereas

like that bowl of muscles, like really
the anus is right in the middle of it.

So you want to visualize both of
those to get the whole pelvic floor.

It's almost like a

Brandon: sink basin with
the drain binger butthole.

Yeah.

Alexis: But what are the benefits

Joe: of giggle?

Alexis: It depends on It depends on
they're very beneficial, first of all.

But so I will say not
everyone needs to be giggling.

So a lot of people have too much
tension in their pelvic floor, so

they actually have the vaginismus one.

So they have to actually learn
how to relax their pelvic floor.

So I think of the Kegal as more of this,
like being able to fully contract, but

then also being able to fully relax.

And so if you're strong and functional
within there, you're going to have normal.

Normal like urinary patterns and
like normal pooping and I'm able

to function sexually as well.

Brandon: Now my clients has
struggled with constipation.

Could that be related to tight pelvic

Alexis: floor muscle?

Absolutely.

And a.

Kind of not really knowing
when to contract and relax.

A lot of people with
constipation at this thing.

It's like this synergy.

So the muscles don't know when to
relax and contract in the pelvic

floor and the bladder and rectum
have these opposite relationships.

So the pelvic floor needs to
be able to relax, to let the

poop out, let the pee out.

So if the pelvic floor is over tense all
the time, the bladder and the rectum can

get a little bit confused as when's it.

My turn.

You're always contract.

I don't know why I'm supposed
to let this stuff out.

Brandon: And that's a really big
problem for women, especially I

think estrogen could build up and
create hormonal imbalances if you're

constipated and sometimes it's diet
related, but I had a client where we did

everything we could nutritionally and.

Yeah, we got a Squatty potty too.

Yeah.

I think the missing piece was maybe
this really tight pelvic floor,

which at the time I had no knowledge.

I didn't even know you guys existed.

And other than hearing a yoga
teacher say pelvic floor and I

kind of giggle inside this child.

I never understood the integration
with what I work with clients and the

connection with things like constipation.

Alexis: So yeah, with the lake constant.

So you like Squatty
potty is a great thing.

So postural like unkinking the colon.

I love the Scottish potty commercials too.

I'm like, they're so accurate
with a unicorn poop and yeah.

I can never see self
serve the same way now.

So that's like a great component
then also breath on the potty.

If your need to relax your pelvic
floor out, encourage people.

Okay.

Do some of that diaphragmatic
breathing and then also pretending

like you're blowing bubbles.

And I know if you can hear that
in the mic or blowing raspberries,

it relaxes all of that region.

So that could help with
them pooping as well.

Brandon: That's very interesting.

I had no idea and I may tell
more of my clients about that.

Alexis: Yeah.

Just use your Squatty potty
and do some deep breaths.

Brandon: Yep.

And if any of you guys listening
are struggling with a lot of

these issues I know a great
pelvic floor, physical therapist.

Oh, you'll

Alexis: have to give me her number.

Yeah.

Brandon: Oh, Alexo or something like that.

Alexis: I have to be confused with
Alexa then all the electronics go on.

You just

Brandon: ruined everybody's day.

Goodness.

So we talked a little bit
about incontinence type stuff.

If women sneeze or jump and urinate
a little bit, what kinds of things

can you help them with to fix

Alexis: that?

Yeah the first would be I, what I
would teach them would be like that.

Brace.

So this is just learning
how to manage the pressure.

So when you increase inter-abdominal
pressure like a cough or sneeze, or even

rising sit to stand leaning over to bend
and pick something up, you get into this

habit of contracting the pelvic floor.

So doing that Kegal and then also
sucking the belly in squeeze, squeezing

the butts, squeezing the size, almost
like you're zipping up a tight pair

of pants and you squeeze everything
really tight before you increase that

pressure to provide that support cause
otherwise If we could visualize this,

you have your bowl of mussels there.

If it's really like loose and you
increase pressure, it's like you're

punching down on the pelvic floor.

So you might be leaking then
in that pot, in that instance.

But if you hold it really
taught, it absorbs that pressure.

So that would be first step.

And then if there's a weakness issue,
which you would do a pelvic floor

assessment to determine, okay, can.

Contract or Kegal.

And can you relax and that if it's
weak, teach them some strengthening.

Additionally, like working for
strengthening, working through the TA

and making sure that's nice and strong
and the hips particularly the glutes.

Cause most people have weak
glutes because they sit all day.

You probably see a lot of that,

Brandon: especially glute medius.

Yes.

Alexis: Piriformis.

And then a lot of people have with
going back to tension, they have this

hypertonicity or over recruitment in
the pelvic floor because the glutes that

specifically meet in men are really weak.

So it's like those stabilize your pelvis.

If those are super weak than your pelvic
floor, it's this helper, muscle it over

contracts to stabilize from the inside.

And then that's another reason
you could have this too much

tension within the pelvic floor.

Brandon: You don't have
Bible study or Sunday school.

The answer to everything was Jesus.

I feel like in my industry, the answer,
when you strengthen your glutes,

Alexis: I

Brandon: is.

Yeah.

So now could even help with some of the
sexual dysfunctions and things like that.

I said, that's something else I just
learned, this very second is that weakness

in the glute medius could be potentially
causing and in the sexual dysfunction.

Yeah.

Alexis: I've read an article
once that said the glutes and

the pelvic floor are besties.

They've got to be strong together.

They help each other.

And who knows?

I want a nice booty.

That work it absolutely

Joe: Is there a specific, different
way to strengthen your pelvic

floor if you're a man or if
you're a woman or is it the same?

Alexis: Yeah, it's across
the board at the same.

It's yeah, women are a
little bit more aware.

I think of the pelvic floor,
just because periods and we have

babies and all that good stuff.

So we had a slight more awareness,
but that said maybe not.

But no, you strike them the same way.

I will say.

I feel like what I've seen through
treating is most people have underlying

tension and I will say men, particularly
if I'm going to see a male who has

pelvic pain or pelvic dysfunction, it's
normally because of too much tension.

So there's been like a craze
lately, especially about a young

amongst younger men, do your key
goals, key goal all the time.

It's going to make the second grade.

And it's maybe not necessarily.

It's good to know where those muscles are,
but a lot of men have too much tone there.

It's you gotta be able to have both.

Brandon: So on the male side,
what can it cause to be too tight?

Alexis: The your pelvic floor
can be too tight and so like

symptoms that can manifest.

Same as constipation could be
one, but urinary frequency.

So if you're pinging all the time, Yeah.

I'll oftentimes that is indicative of
too much tension in the pelvic floor.

So we're talking about that
whole inverse relationship

between bladder and pelvic floor.

So if you're all, if you're so
tense there, sometimes that could

mimic feeling like you have to
pee and there's not really urine.

And then it has to, and then once you
get that signal off between the bladder

and the brain, it gets confused on
what, when is the bladder actually full?

Because you're emptying it sooner
than it needs to be emptied.

So then like the.

Line goes down and it's normally
it could hold this much.

Now the bladder things, I can
only hold, eight ounces now, even.

I should be able to hold more

of

Brandon: that.

It confuses signal timing.

We talked about with women's sucking
in and being self-conscious of their

valleys and that being some of the
contributions, is it same for men?

Could it be where they wear their belts?

What are some of the youngest?

Yeah, I

Alexis: think that men can have
some of those body things as well.

Certainly.

And I think the breath really comes in.

Yeah.

'cause I was a

Brandon: fat kid, so I always grew
up sucking my belly and I looked

at Dick Dulles, but I thought,

Alexis: no, I think that's
and stress and anxiety too.

Especially, I see a strong
correlation between like TMJ.

So if someone circles on their
intake form TMJ, I'm like, oh,

too much toner your pelvic floor.

Because if you're clenching here, you're
probably clenching down there too.

Brandon: No.

How about being seated?

I mean of the hip flexors.

Alexis: Yeah.

Yeah.

Certainly when you're sitting all
the time, the hip flexors tighten

and then the glutes are super weak.

So you just create this imbalance.

And like I said before, the pelvic floor
is just, it's really a helper muscle.

So it's going to help
whenever it needs to be.

So if your hips are really tight and it
goes, they're really weak, it's going

to try to make up for some of that.

Joe: You mentioned that the ways
that you can help in improve the

strength of your pelvic floor through
breathing and as well as key goals.

What about stretching?

What other kinds of things go
into a healthy pelvic floor?

Alexis: Yeah.

So what I am assessing I.

Primarily an orthopedics for 10
years before I specialize in pelvic.

So I always include, and I think
it should be included more of

an orthopedic assessment too.

So I think, anything from the lower
ribs to like mid thigh, let's see

what's going on in that entire region.

Tension in the diaphragm relation
to the diaphragm, I do a lot of

skin rolling through the abdomen
to reduce some of that fascia.

That piece of fascia goes all the
way down into the pelvic floor.

So if you're working through the
abdomen, it breaks up some of that.

Yeah.

And then low back, a lot of
times the back is really stiff.

So some mobilization to the lumbar spine,
to the sacred and the sacred, like the

hip joint there, if that's really tense
and then muscle testing, all of the like

hip flexors, hip extenders, rotators,
especially some of the rotators sit really

deep into the pelvic floor, so you can
palpate them externally and internally.

So releasing tight muscles and
strengthening weak muscles all within that

region is going to create more balance.

And then the breath.

And TA,

Brandon: and I have a question when
we're doing all these corrective

types of exercises, we're consciously
trying to make it perform properly.

How long does it take and does it ever
get to the point where subconsciously.

It does what it's supposed to.

Yeah,

Alexis: I think it does.

It could take some time.

Cause most people coming to me of,
breathe the wrong way, their whole

lives and have had that weakness.

So muscle changes is basic.

From training, it's really takes about
six to eight weeks to really see muscular

changes as far as strength specifically.

But yeah, those habits, if you could
get into that habit every single

day, it can correct itself timeline.

I'm going to be like a normal medical
provider and say, it depends on

the patient, which I know I hate
that answer, but it really is.

And a lot of the treatments that I give,
you're not going to have to do forever.

Even that the Kegal if you were to just
straight week, that's, let's say, and

I'd say, you're going to do 60 day.

They cubicles a day, every single day.

You're not going to
have to do that forever.

Once you have built up your strength, then
I say, okay, do you want to maintain this?

But maybe just.

Three days a week, three
sets of 10 kind of thing

Brandon: now.

Now what can somebody expect
when they do an exam with you?

Cause I know you also do like a manual
for women, like even an internal exam.

Can you explain this process?

What you're looking for,
what you're feeling for and

what would they experience.

Alexis: So first I always start with
like more of an orthopedic exam.

So I want to look at the mobility
and the spine, all the muscles

within the pelvis externally.

Big one is that abdominal fascia to see
how well it moves and if there's been

any type of abdominal surgery in the
past, a lot of times that scar tissue

can impair movement and then make
a lot of things, a little wonky and

then even a gait assessment, posture,
assessment, and breath assessment.

So internally, so if you want to
feel the muscles within the pelvic

floor, you do an internal assessment.

So for women who have had like
a gynecological exam, they have

an idea except it's no speculum.

So it's all a digital assessment and it's
to test muscular strength and function.

Basically you visualize do your pelvic
floor is that bowl, but like a clock.

So your pubic bone is 12 o'clock
and the anus is six o'clock

and you stop on each point.

To make sure that everything
feels the way it's supposed to

feel, especially with tension.

Cause sometimes you'll push on a spot and
it feels really tense and the patient will

be like, that feels tense or slight pain.

And then you get like this
idea of, okay, where are your

trigger points within the panic?

And then as far as your muscular
strain, you're going to see

how well they can Kegal.

So how strong they can hold that and just
as important, how well they can relax.

So people with tension, they they'll
Kegal a little bit, and then you say relax

and they hang on there and would use the
classic, like biceps example of okay, if

my bicep is contracted already, and I say
to contract, I it's going to seem like

I'm weak because I don't have that range.

I'm working.

So we want to see how well you can
contract the muscle and then how

well you can then relax the muscle.

So it's like strength and
flexibility, and then the coordination

of how you can do those two.

And we'll say even with the breath, like
if I try to cue people to do the breath

with the Kegal, you could see okay,
are they doing this the correct way?

Am I feeling a little
rise of the pelvic floor?

And then a little lowering
of the pelvic floor?

Most people are just
stuck in one position.

And then after a couple
minutes, They've corrected.

And I say, okay, do
those deep breaths now.

And you can feel everything
moving the way it's supposed to.

Yeah.

It's crazy how it, it does happen
like pretty quickly, but like you,

you have to do it all the time.

Brandon: How about for a male?

What would an exam for a male look

Alexis: like?

There's only one way in, so it can
be a little jarring for the men.

So I always say, this is how I
would assess the pelvic floor would

be a rectal assessment, similar
kind of visual as far as pubic

bone 12 o'clock anus, six o'clock.

And you work around that bowl
the same way, and you'll say,

okay, do a Cagle, relax acute.

And see where the tone lies, where
if there's any pain where the pain

lies and same see how coordinated
they are and how flexible they

are and how strongly she could

Brandon: be really important for
men like after maybe like a prostate

Alexis: man after prostate surgery.

For sure.

And yeah, just learning how to manage the
pressure after that and how to normally

contract the pelvic floor and relax.

And sometimes there's pain involved too.

Like post prostate removal

.
Joe: You said a minute ago
or a while back that the.

It's more about balance than
it is about building muscle.

And you made a joke that guys are like,
he goes, we're going to make sex is great.

Cause that's the way we're yeah.

There's muscles down there.

I got,

Alexis: look at my pelvic floor,

Joe: but but I've done.

So I think the question that I had is
how do you know that you're in balance?

Like how do you know that you're in the.

Thing.

And what are the triggers that somebody
who's listening could be listening for

to be like, oh, maybe I need to go see
a professional, like you, or start doing

kegels regularly or I'm in the right

Alexis: spot.

Yeah.

I think that pain is a thing
that kind of drives people to me.

And it's this pain of I
don't know why this hurts.

It doesn't make any sense.

So like for men they might have
And what direction or like any,

actually any type of erectile
dysfunction to testicular pain?

I seen, I saw one patient really early
on who came in for testicular pain and he

went to the hospital because he thought he
had like torsion or something like that.

And then they, yeah, he didn't have that.

They ran like a billion tests.

Cause I thought it was an STD or an STI.

None of that.

And they had no answer for him.

Somehow or another, she must've
just done his own research.

He found me and it was like,
oh, he may have had a friend.

Maybe they discussed.

I can't remember.

And so he came into me and so
I explained to him like what

I do and what it would entail.

And he was not super comfortable
with the pelvic floor assessment.

I said there's other things we can do.

We don't have to do.

Brandon: Yeah, different

Joe: kind of patient you
want to avoid completely

Alexis: There are other
things we could do.

Of course it's beneficial to
know what's happening there.

But I guess my point to this is
that we just did abdominal skin

rolling because that fascia goes
down into the pelvic floor and cause.

All that tension can create
tugging and pulling in that region.

And we did a ton of low back stuff
and abdominal rolling and SSI

movement and stretching all the
different muscles in that region.

It took away the pain.

We didn't even have to
get into the pelvic floor.

So Yeah, that doesn't have to be

Joe: similar to a chiropractic practice
and that people come regularly and

over time they start to see benefits
or is it sometimes it's one and done?

Alexis: I don't, it depends
on what they're coming for.

I will say pain if they're coming for
pain, that typically takes a bit of time.

Some patient I'll see, six to eight
months typically I'll see patients a week.

And there's a lot home stuff, so there's
things that you're doing every day.

And then like homework assignments.

But some of them, especially postpartum,
some of those can be like a one and

done because it's just a matter of, oh,
you're pretty weak in the pelvic floor.

You've had this trauma let's teach
you how to manage the pressure.

Let's teach you a strengthening program.

And then it's just this timeline of in
the first two weeks postpartum, you do

this and the next two weeks do that.

And it's more.

It doesn't necessarily mean you
need all of this one-on-one care.

Some more time.

It just takes some time and
you have to do it at home.

Brandon: Yeah.

Now skin rolling.

Is that kind of like pinching the
skin and rolling your fingers.

Alexis: Yeah.

Yeah.

And so it's pulling us.

So if you think I'm most like
a deep tissue massage, it's

pushing down on everything.

So skin rolling kind of pulls up similar,
like with cupping and stuff like that.

It's going to pull up on everything and
reduce some of those fascial restrictions.

I always think of fascia I think one
of your guests called it like saran

wrap, and I liked that analogy too.

So I, I will tell people it's like a
pantyhose, so I don't know if either

of you have ever worn panty host

Brandon: funny story.

So I was in drum Corps and it, there's
a lot of your uniform has to look solid.

Everybody has to look the same.

So they came and we had white pants
that have been almost see-through.

So they didn't want underwear through.

Showing through.

So like for five days, they
convinced the Corps to try try on

that's when you know, you're taking

Joe: drum Corps too serious.

Brandon: So I ended up getting,
you have to wear panty.

I ended up getting like horrible
jackets from stupid pantyhose.

So they had the pool.

Over so I can get medical help and
these damn pantyhose again, and I threw

a fit and never put them on again.

But anyway, so fortunately, yes.

No, I'll never live that

down.

Joe: I haven't had, and then on my legs,
but I do remember once as a kid pulling

them over my head, like a bank robber.

Alexis: Yeah.

I feel like we've all done that.

Brandon: Derail that train fascia
called like sausage casing.

Alexis: Yeah, that's a

Brandon: great example too.

It covers the muscle and the
textbook anatomy trains is

absolutely incredible resource.

For most people you probably won't
understand past chapter one, I'm pretty

educated and I really struggled past
chapter one, it gets really medical,

but that first chapter gives you just an
extraordinary understanding of fashion.

Please movement biomechanics

Alexis: and all kinds of, it's such
a role, I mean it head to toe, right?

So you could have a restriction
in one spot and then it just

creates these imbalances and
movement if you're stuck in a spot.

So I see a lot of slack, I will say sticky
fascia in the in the abdominal area.

So I like to do a lot of scar work too.

So especially like a woman who had a
scenario in section, like working on

that scar can really help with any
type of pain really, but like pelvic

floor dysfunction and like hip pain
sometimes that's where it's coming from

is just that, those adhesions in there.

Yeah.

Brandon: How would you describe
an adhesion and fascia?

What would they know to look for?

Alexis: I feel like things don't move
the right way or you just feel tense.

Oh, I can move this way better than that.

So mobility restriction, mobility
restrictions more and then if there's a

scar around, if you push like above and
below the scar, move it side to side.

A lot of times you could tell moves
more to this direction than that.

So you say, okay, like it's
restricted in that way.

Okay.

Brandon: So the fascia covers
what the abdominals next?

Alexis: Yeah, I mean fascia.

Brandon: So in terms of the stomach, cause
you, you mentioned several times rolling.

Yeah.

So

Alexis: Stands in the abdomen, like all
the way down into your pelvic floor.

Okay.

Because it's all connected.

So it's all connected.

Brandon: And then under the abdominals,
you have the transverse abdominis under

that is the diaphragm and then more of
the pelvic floor and blah, blah, blah,

Alexis: good anatomy.

Brandon: And the green grass grows
all around in real tree, in the whole.

Alexis: That was I had to so
that was what took me to pelvic

VT and made me learn all about it.

Cause I didn't I knew it existed, but
I was doing orthopedic therapy and

I was like after my second, Sarah,
so I had first this area and then I

tried to be back for the second year.

It didn't really happen.

In hindsight, I wish I had gotten
a lot of scar work done after

my first one, because, you don't
really know until you go in there.

And so then they went in
there for the second one.

And it made sense based on how my
labor pains that everything was

just like tightened and pulled up.

So it's re-up, my rectus
was adhere to my uterus.

My uterus was adhere to my bladder.

And so everything's just stuck.

And so supposedly they unstuck everything.

After my second scenario in which my
daughter like seven and a half ish

or so now I had my own pelvic floor
dysfunction and I was like, wow, I feel

like someone could help me with this.

Like I'm a physical therapist.

I've heard of pelvic
floor therapists and a.

Yeah, I went and to her and did a
few things and improved and didn't

really think about it again until
like I moved down to North Carolina

and I thought I want to do something
a little bit different than just

orthopedics and so got into pelvic floor
physical therapy and just loved it.

It just felt like this missing
link to a lot of dysfunction.

That happens.

And a lot of those issues that are not
talked about and people can get help for,

and instead it's a very rewarding field
to be in because a lot of people come into

me that are feeling a little bit hopeless
and I don't, nothing's going to help this.

Especially when there's pain involved.

And to be able to help
them with that is amazing.

Yeah.

Brandon: And not just the pain part,
but the relationship part I know for a

lot of couples that painful intercourse,
that could, that's devastating on a

relationship, so I'm super fixed that.

That's awesome.

Yeah.

Alexis: Yeah.

There's I think some of the base of
all of that just comes from knowledge.

And and I love one of the things I love
most about my job is just teaching people

about their bodies and how they function.

And I think that's a big thing with
the women who have painful intercourse,

like here's how your body works
and here's, the things you can do.

And this is a common problem and there
are things that you can do to fix it.

And.

Talking it out and
learning and just lovely.

Joe: It's funny how quickly we will
just be like this is the new normal, and

it looks like some terrible thing can
be like that's just the way it is now.

Brandon: So it looks like some of
the primary things pelvic physical

therapy can help with incontinence,
sexual dysfunction, pain maybe

even some mobility restrictions.

Some of the best ways to help
are going to be deep breathing.

Having a therapist, manually work stuff
like skin rolling, and some of the

internal stuff you can do digitally.

And then strengthening the glute medius.

Now the answer is

Joe: always sit ups.

That's what it is.

Alexis: Necessary.

Brandon: Frog bridges.

What are the top three things you would
tell somebody looking to improve their

Alexis: right.

The first thing would be to
learn, to breathe correctly.

So to really engage through their
belly and to do that deep breathing The

second would be to strengthen your core.

So strengthen that correctly.

So actually not set ups.

Yes, we went to strengthen the deep core.

So the TA and a transverse abdominis.

Yeah.

Transfer subdominant and the glutes.

So we would think of when we think
of core, you think, and not just

your belly muscles, but like your
hip muscles, your pelvic floor,

those are all part of your core.

And then, gosh, what
are we going to X one?

Let's say it's a toss up between
like education and awareness of

your body and how it functions and
probably like flexibility within the

hip to those, then we could go, I'll
often, stress and sleep and just all

that, the health components as well.

Yeah.

Brandon: Now what would you
add on the stress and sleep?

Alexis: Don't be stressed and get sleep.

It's very, it's a very technical,

Brandon: Cause we talk about
that a lot on this show.

What do you think are some habit
changes that need to happen to

improve stress and sleep quality?

Yeah,

Alexis: I think that if you do your
diaphragmatic breathing nightly,

I think that's a great start.

At least that's that would
be my first step when I am

encouraged people to do that also.

Before you go to bed because
that will help relax your body

kind of prep you for sleep.

You're ready in bed.

It feels relaxing.

That seems like the most
appropriate time to do it.

Brandon: Yeah.

No, that sounds good.

Yeah.

Nice and relaxing.

I should whisper for the rest of the.

Alexis: Kind of sleep now, relax your

Brandon: pelvic floor

Thank you so much for sharing
all your wisdom with us.

If somebody wanted to get in
contact with you how would they do

Alexis: My practice is called and
power pelvic floor physical therapy.

It is in Kerry and my
office is in Kariana.

Great of health.

Do you want my email, my phone number
to Alexis at empower pelvic Florida com.

And my phone is (330) 771-0770
because it's very lucky.

And I chose that number when I was like,

Brandon: Awesome.