Ep 142: Preparing the Pelvic Floor for Postpartum - interview with Pelvic Floor PT Dr. Brandie Freeman

(rebroadcast) Are there things we can do during pregnancy to help prepare for postpartum?  Sure thing!  Dr. Brandie Freeman of Connect Pelvic Health shares some of her wisdom and knowledge from working with postpartum moms.  Her own birth and postpartum experience shape how she runs her practice, and her passion is contagious!  

Topics discussed:

• Preparing for postpartum recovery of the pelvic floor
• Her recommendations for moms during immediate postpartum
• Postpartum cesarean recovery for the pelvic floor (including scar healing)
• How a pelvic floor PT visit is different from an OBGYN visit
• How her birth experience influences her work
• Common issues and problems she helps with
• Her favorite prenatal resources

Be sure to follow Dr. Brandie on social media because she shares so much knowledge in creative ways. 
Resources
Connect Pelvic Health Physical Therapy
@Connect Pelvic Health on Instagram
@Connect Pelvic Health on Facebook 

Transcript

Unknown 0:00

You are listening to the aligned birth Podcast. I'm Dr. Shannon, the host and today is an interview day and for this interview, we are talking to Dr. Brady Freeman who is a pelvic floor physical therapist so I'm so excited to have her on the show today because she has a wealth of knowledge so we're going to try to jam packed this episode with all of her knowledge into an hour. But we're gonna focus on and I have some reasons why I we had I reached out to her because she she posted something recently and I was like, Oh my gosh, we need to talk about this on the show. So I want to talk about preparing for postpartum recovery. Of the pelvic floor. So what can we do prenatally to help prepare? What does she recommend for moms in that immediate postpartum time? Postpartum C section recovery, so not only pelvic floor recovery, but scar tissue recovery? And then how pelvic PT visit is different from an OB GYN. Visit and then everything else that we'll talk about, so Dr. Brandy, found her passion for pelvic health while healing from her own chronic pelvic pain following the birth of your two children. She graduated with highest honors from Baylor University with a doctorate of physical therapy degree after leaving her career as a state and national award winning chemistry educator to serve our community as the pelvic physical therapist. She's a lifelong Georgia resident, so Holten advanced pelvic health certification following the completion of a year long intensive training program through evidence in motion and pelvic floor treatment for all genders. She's a postpartum, postpartum. corrective exercise specialist has completed additional coursework in this role mobilization for gi urinary system, pelvic floor dry needling, post surgical scar repair, trauma informed care and its sexual function from Herman and Wallace and other organizations. When she's not doing all of those amazing things. She's pretty active too. So she enjoys CrossFit hiking yoga and is a 500 hour registered yoga teacher as well as a prenatal yoga teacher. So she lives in the local metro Atlanta area with her two sons and her husband on a small hobby farm and I am so stinking excited to have Dr. Brandy Freeman on the show today. So welcome my friend.

Unknown 2:08

Yes, thank you so much for having me. I'm so excited to just like you said, this is my passion to just educate other people and make them aware of what even their pelvic floor is and how they can optimize function. So that we are not like our mothers and grandmothers who just kind of laugh off if we have problems with incontinence, are we you know, we're never really found our core going after our kids. So this is this is my calling and I appreciate you having me.

Unknown 2:32

Yes. And so I want to jump right in with with that because that education is key, you know, and really going into Okay, well we've heard some of those things like, oh, you know, can't jump on the trampoline anymore. Like, you know, you hear those things are like going for a run and I feel myself Well, it's kind of like, okay, what can we do about that? So, I want to dive into preparing for postpartum recovery of the pelvic floor, but prenatally so what are some things that you go over with your patients, if you're seeing them prenatally to help them in that postpartum recovery?

Unknown 3:07

Absolutely. So pelvic floor physical therapy is great a evidence based way to prevent birth injuries and the tearing of you know, the pelvic floor muscles in the perineum during birth. So if we can prevent those muscles up, so people just kind of laugh it off and say, Oh, had a great Tutera had a great week here. That would be like tearing your hamstring and then after words just saying, Hey, I'm gonna go for a run. So prevention of tearing and optimizing the birthing process no matter what that's gonna look fine for you is a great way to get started. I also want to bring awareness to the deep core. So when my pregnant people are basically transferring from you know, the chair to standing or sitting on the bed to laying down helping them find those deep core muscles while baby is still growing. Well, kind of transfer really well to postpartum and being able to use your core to help you move because it's going to be you know, it's you made a whole person and they came out of you. So if you can't find your lower and your, your transversus abdominus, that low, kind of force it muscle when you're pregnant, after baby arrives, especially if you have a C section, it's going to be really hard for you to do that in your daily life. And so what ends up happening is people do things like hold their breath or bear down and while we're healing and all of our pelvic organs are going back to where they came from, that's not the best strategy. So, you know, to bring awareness to what is the pelvic floor and how to do a contraction and how to find your deep core when you're pregnant before you have the the birth process happened, that that sets you up for success.

Unknown 4:52

And that makes a lot of sense. But you're saying and it's kind of that awareness and engaging and like what you were saying the whole Well, if we how can we engage these muscles if we don't even know where they are? So with books that you're working with, when you have a prenatal appointment, like walk us through a little bit of that because I want to know to like, do you see a lot of hypertonicity or hypo tonicity. And both can be, you know, can give you a different set of issues or problems. So walk us through an appointment

Unknown 5:23

Yeah. So I hope to see people starting sort of towards the end of their second trimester definitely can start earlier than that and people having things like pubic bone pain or SI joint symptoms, but what I like to do is assess the pelvic floor around 28 weeks or so. And I would say most especially my first time moms are hypertonic are so their, their pelvic floor muscles are overactive and so we immediately go into how to lengthen those and we actually practice that by me teaching the mom how to and this is gonna sound funny, but it works really well about how to have a bowel movement without pushing and straining and holding our breath because we actually want to breathe the baby out. We want to give our tissues and our body the time to lengthen and let the baby kind of come into the world. With the uterus pushing right the uterus contracts and patients are maybe we shouldn't hold their breath and turn blue like you see on movie so I'm go ahead and show them how to do that. Because every day when you move, it's an opportunity to practice how to have something leave your body without it being a big dramatic bluefaced kind of clinching situation. So as our treatment progresses depending on when people come in and I also show them how to do the perineal massage which is really a stretch of the perineal body. I give folks the one to do that because you can read when

Unknown 6:43

you're when you're by me you can reach that

Unknown 6:47

to take their thumb and reach so I have like a closet full of fun stuff and the pelvic floor ones is one of the things that I give people so I'll show them how to do the perineal stretching. That usually happens around 33 or 34 weeks and then I typically see people one more time and they bring their birthing partner in and we go over how to maximize kind of pelvic positioning and pelvic floor for the stages of labor. So when babies hide the pelvis versus when they're engaged versus when it's time to deliver so you go into your birth feeling very educated and aware of what you need to be doing when and then you also know that you can find your pelvic floor muscles even if you're having like for example had a woman on Friday who's having an epidural. Well now she has the muscle memory of how to lengthen and how to open up in version of APR, even though she may not be you know, aware of it because she's a little bit more numb. And same thing with people. I have a lot of people that do home births and so they'll feel a little bit more confident that they kind of know how to find those muscles can help them to just open because that's their job during birth is just, you know, allow the universe to do its job.

Unknown 7:55

That's so beautiful as far as because the uterus is this amazing muscle and so you do want it to do its job. You know well and to function optimally. And so I love the concept and aspect of working with the breath and bringing the baby app because I do we have to dispel a lot of things that we see in the movies.

Unknown 8:19

And I know that you probably preach this to your people but the uterus when we're in labor and actually contracts forward. It contracts like ahead of us. So when we're on our back, we're fighting gravity. And so just to be able to teach the person Hey, this is how your uterus actually functions and this is how you can position yourself to help it function better and this is how your partner can give me some support so that you know those waves of sensation or less are less kind of they're more tolerable off say it like that right

Unknown 8:52

or less intense but you're you're working with it instead of against it right so then and it's and that's why you'll, you know, I love childbirth, education classes and all those types of things. And then it's like, well, all of these other birthing positions. That's why they work and that's why they're so helpful or why, you know, they'll feel that urge, like Okay, I just don't want to be in my back anymore. I feel like I need to squat or I feel I need to be on all fours. It's almost that you know, is that innate in us telling us this is how we can help our uterus. Um, so what do you recommend for moms in that immediate postpartum time because I do feel like that's such a vulnerable time. It's such a big transition not only you know, it's a baby born but also like this new motherhood journey. So what, like, when do you work with moms and what are some of those big things that you recommend?

Unknown 9:47

Yeah. So the biggest thing that I can say for people postpartum no matter how you deliver your pelvic organs are going to be sitting down lower into your pelvis. And so if you can find time to when you're resting to elevate your hips up so that gravity helps all the you know, your bladder and your uterus to start to head back up towards your head back up into the abdominal cavity. That's very helpful. And then also to like you can start almost immediately doing gentle pelvic floor contractions with your breath and that deep core. Now that is going to be very difficult to do if you don't know where that is and you didn't, you know, access that while you were pregnant or some sometime before you had your baby. But you can immediately start to time your breath out and do that deep diaphragmatic inhale and then exhale with that gentle contraction. Um, it is important to rest to have women though that want to get back to running or yoga or have a you know, a semi professional crossfitter. And so depending on people's goals, you know, I had a professional ice skater. Those people tend to come in three, four weeks postpartum, and we start to give them exercises that help them to involve that deep core and their posterior chain and their hip and thigh muscles. in a safe way that's not going to cause prolapse or we're not going to cause any issue so a lot of people will wait to their six week appointment come see me especially if they tear a little bit before they have intercourse and I can help work on the pelvic floor but you know, it's fine to come in three, four weeks. This is what I do. I mean, you don't have to be clear to be active because the truth of it is you're up vacuuming, you're picking up your baby. Why can't we get the muscles turned back on before six weeks? I'm obviously not going to do internal work before then just because the uterus is healing where the placental wound is, but you know, it really varies by person. But if you want to get back to running or even just taking walks and pushing your stroller, you need to make sure that that deep core is is engaged in that. If you do have a little bit of a prolapse beyond normal or you do have, you know, a wound that you're feeling whether it be at a tear or C section, and there's a lot of options and opportunities to get some physical support where it's like we had a hip surgery or knee surgery, you would immediately go to physical therapy, but these people all these people that are birthing are just kind of going it alone. And there's options to help you get back to where you want to be quicker and safer. So, but yeah, let's say three or four weeks for people, especially if you're active and you're you want at six weeks, you want to go back to the gym and you want to do stuff because we can start that process a little earlier, but you don't have to be afraid of like that. First time to have intercourse after sex. You can come and see me and I can make sure that if you have any scar tissue that it's feeling well or the muscles are back to the appropriate length. So I love that you even talk about pelvic because you're doing way harder things that the exercises I'm going to be doing to get your body back coordinated the way it should be at home. So Let's optimize that because like I said, you are going to be those infrastructure. You're going to be picking up your baby you're going to be you know taken and picking up groceries. I cannot show you how to pick things up after you have your baby if you're gonna go to Target and get a bunch of stuff that you know, it just it's illogical.

Unknown 13:16

I know and I remember to I had a C section with my first and going home and it's like, oh, you're not supposed to do stairs and all these type of things. And I was like, Whoa, everything in my house is like what am I supposed to do? So instead of I think saying don't do these things or or that aspect? It's like, hey, like what you were saying? How can we engage the muscles and train? So when and it probably differs to that if you've got someone who is at a certain fitness level, even like pre consecutively throughout their pregnancy and then in their postpartum Do you notice differences and working with them? Getting back to that fitness level? Like can you speak on that at all but differences in patients?

Unknown 14:02

Yeah, so like I said, I have professional athletes and I've actually gone to courses for how to rehab professional athletes quicker than not normal, like it's all safe, but like for example, I have an athlete that regularly does handstands she didn't do on during the end of her pregnancy. But like the big one of the biggest themes postpartum recovery is to help the pelvic organs to move back up, you know, into the abdominal cavity. So like one of her things pretty quickly and this is a beautiful thing to do with people is like wall walks where you you come into a push up position, and then you just walk your feet up the wall until you come into like a pretty safe handstand. Like that's a great way to reposition your bladder for her because she can you know deadlift 300 pounds and she was doing strict handstand push ups before her pregnancy. That is a very safe thing for her without do that for every woman. No. Is that a great way for her to engage your core and not have to worry about prolapse? Yes. And so everybody's different. But some of my people like one of my girls that came in and she wanted to get back to teaching pretty quickly. We gave her things that look like yoga postures, but again, we were trying to turn on the deep core so she had a quote unquote yoga flow pretty early. Just to get her back to feeling normal again. And then whatever your goals are, if you are a runner, I'm going to have you be you know, doing single leg things because running as a whole and single leg stance and so like whatever it is that you want to do, I'm gonna get you back to and I mean that's the difference between me and a YouTube video you tell me what you want to do and what's difficult and we're going to figure out what that we have is going to look like for you. And so I can also assess your pelvic floor. I can assess your abs and your core to see if you have some Diocese's or if you don't and so I think it's really unfair to just put everybody in a box and then at six weeks that you're free and then you know people are running around and they don't have any glute meet strength, that's your side but muscle that stabilizes you. So why why can't we start a little earlier to give you some safe things to help optimize that return to whatever activity is

Unknown 16:11

and it's so individualized what you said because everybody has different needs. They're coming in with that different you know, fitness level, that different set coming into that pregnancy. And so I love that too. You're like okay, this is why it not everybody fits into this little box because everybody's so different. Ah I know. I'm glad to address that. Now. You had posted something recently. So and I will say that so I found you through. So Rachel is my co host on the show. And so she has a dual agency and Hannah and Rachel and Hannah have done an interview as well. And Hannah is her doula partner and Hannah had posted something and I was like oh my gosh, she was Dr. Brandy Freeman because she's you know up in my Erin you my office. So then we were able to connect which I absolutely love and you've helped so many of my patients which is wonderful, but you had posted something not too long ago, and it was C section recovery specific and it was specific for the scar and I remember feeling I was like, Well, no one told me that after my C section. I mean Grant was 12 years ago, but still I was like oh people need to know this. So that's why I was like oh my gosh, I have to have on the show. So I want you to go over because here's the misconception I think too, just because you maybe didn't have a vaginal birth, it doesn't mean that your pelvic floor has not been impacted. I don't necessarily need to say like traumatized because I don't like to think that all births are trauma traumatic doesn't have to be like that, but there is an impact to the pelvic floor and just the actual being pregnant and carrying the fetus. So I want you to touch on what is some of that the postpartum recovery but for a C section specific.

Unknown 17:56

Absolutely. And I feel like Georgia is a little bit behind here. One of my doctoral internships I spin out in Colorado and we would actually go in a physical therapist would go in the next day after birth while the women were still in the hospital and we would show them how to help their C section scar heal. And the biggest thing that we would we would communicate is that if you're sitting down or you're listening to this, your hip crease where your legs are meat your belly, that's where your lymphatic drainage is occurring from your lower body. So what that means is all the fluid you know when you're pregnant, you kind of have this extra blood volume and you've use have you know a lot of people have residual swelling especially. And so right there where those lymph nodes are, that's the main transport for that fluid to get up and get back into your bloodstream and get kind of cleared out when we sit especially when we have a C section. That fluid kind of pounds up and it can't really circulate well. So what ends up happening is your scar is going to model in that hip crease and so you're going to notice that it's going to for some people, it's going to make that shelf shape and if if even if not it's going to hinder your body's ability to kind of clear up fluid in your abdominal wall. So even if you need to use a pillow, if we can lie flat, especially if we can lie on our belly that pressure from the pillow or the floor or the bed underneath us is going to help bring circulation back to that area and it's going to help that scar model in a long gated way instead of all the skin being bunched up there. Because I know I'll work with women and they'll have like hovering of their scar or the skin underneath is kind of wavy. And you can almost see where they stand and that scar modeled after they're hurt. And it's just like if somebody has a if you go into a burn unit and somebody burns their shoulder, they actually let you heal with your arm kind of open so you don't have a contracture. It's the same kind of idea, but for whatever reason we're not telling new moms this and it's it's unfortunate. So if you can be long and let your torso be in a leaf and state even like I said if you especially if it's a little uncomfortable, you can use pillows, but to be able to lay flat especially on your belly is going to optimize that wound healing and get the blood flow that you need so that your scar isn't as thick and it's not as I want to say shelf life but you we don't it's going to take the shape of whatever you're doing as the new collagen is getting deposited there.

Unknown 20:29

That just I don't know why that just blows my mind because I feel like when I just remember right after that C section it was my first baby and I just remember feeling like oh my gosh, there's a whole list of things I can't do. And it was almost like you were supposed to be so gentle with yourself that like you don't do anything. I don't know if it's like that. If there's a little bit of fear of like, well you could hurt yourself if you do this too soon or do this too much. And so having a PT come into the hospital Hello Georgia, that would be amazing.

Unknown 21:01

You're not doing that. Currently, I'm in rehab program, but I don't believe they have it any longer. But we just we dropped the ball there. So when I have my moms come in prenatally, I kind of go over everything and when they have their baby, if I actually since I've opened my practice I have not had a mother that has had to have a C section. But if that day does come because I have them check in with me after that I'm gonna immediately get on the phone and be like, Hey, make sure you're doing this, this this and we talk about it but there's a lot of information coming at folks. So it's just it's an easy thing to do. And you know, I don't know about you when I had my my C section with my 16 year old. I slept in the recliner because it was hard for me to get them down because I couldn't I hadn't gone over how to engage my core and haven't gone over how to use my breath to help me and so then I'm sleeping and this hip crease and then you know, my scar did not remodel well. It didn't I don't you know and I don't have a time machine to go back and fix it. But you know, even if you missed the boat there like there are manual techniques that I can do to help your score feel better and to have a different appearance. So it's not like the end of the world. But I feel the same way that you do. It's like why didn't anybody tell me

Unknown 22:08

this? I know but that's why we do what we do. And I wanted to touch a little bit Tim, we'll get to that. Why? How your birth impacted? What you do, because and so and you answered I had written a question down because I write all kinds of notes while I'm doing these interviews and I was gonna say so can you you can work with scars and scar tissue. Well after the fact granted, there's limitations to matter. So there will be limits to that. But you know, I do want folks to hear this as far as like, oh my gosh, well, maybe we could get some work done on that C section scar. Yeah, I

Unknown 22:41

have people that can't feel below their belly button two or three years after, and unlike Okay, and then they're coming in and they they're not happy with how their ads are working and they're doing situps and they're doing core work and they're only filling their top apps. And I asked him I say, well, let's pretend you sit kind of crisscross on the floor for a while and you stand up in your footsteps. And you're you know, how is your leg muscles gonna function if you can't feel your leg? How does that and that's the same thing with your deep core. If you can't feel an area of your body, the muscle and force production is going to be decreased. And so usually after one visit, people can start to get that sensation back to their lower abdominal wall and I show people how to work on themselves. At home. I use cupping and different visceral mobilization techniques. And then also if people are open to it or do with acupuncture, acupuncture needles are driving the lowest bar and that's that's very painless, especially if you're numb and then that immediately almost brings the sensation back within session and it can definitely lighten the spark in and help it be a lot more pliable. So there's a lot to be done there. It's not like it's a lost cause. But if we can just educate people come in, straight out that would be amazing.

Unknown 23:53

Exactly. And I like to get you mentioned the live aspect of it too because there is a lot of fluid retention, especially after a C section and that that large amount of lymph drainage is occurring in that floor area. And so even giving people ways to mobilize that because you know, you know, movement obviously is a wonderful way to move limbs throughout the body. But if we are in that recovery mode and we're resting a little bit more, then having the that like self massage aspect could be super beneficial to help decrease that swelling.

Unknown 24:36

Right. It's not really that hard yet she sent me a patient and I worked with her a couple weeks after system and she was so swollen and I was able to show her how to do her own lymphatic drainage and it's it's not hard it's just hard to find that knowledge like if you just go Googling and you know you have to do it with the right amount of pressure but it's I'm trying to empower people so I show them what to do in the office after I work on them because you want to be able to continue it on and you know you have a new baby to come see me every day. So that's that's yeah, it's important.

Unknown 25:06

Now let's chat about how a pelvic PT visit is different from an OB GYN visit.

Unknown 25:16

Yeah, so I find that people when they book appointments with me, they have this idea that you know, it's not a there's a reason they think this way, but you know, you don't have to take all of your clothes off and sit on a piece of paper in here. I have like real sheets and everything is very. I spend time I spend a whole hour with my patients. And so when we when I see patients, especially when they're pregnant, I'll work on the abdominal wall and I'll check the hip muscles and I'll check the fun muscles and see what's going on with your movement patterns. It's not like you come in here and a hat. There's no speculum. There's no stirrups. Everything we do is really gentle and informative. And I use a very purposeful trauma informed kind of model to my care where I'm making sure you understanding everything I'm doing and I'm getting full consent. And I actually teach people during the session I kind of watch people's nervous systems. If I can tell they're nervous. I'm like this is a perfect opportunity for you to tell me no, because when you're at your your your birth, you need to be able to stand up for yourself and say what you're thinking and that's going to be the way that you're going to prevent birth trauma. So I let the patient kind of lead the pace there. But you know, I do check the pelvic floor but it's with one finger and I'm checking each layer of muscle and while I'm finding things that you know, need a little work I just go ahead and work on it. So it systems really nice, calm flow state and it's not where you sit in here with a hose on for 20 minutes and I'm doing whatever like I'm with you working with you and it's a different it's a whole different energy where you feel cared for versus kind of rushed.

Unknown 26:53

Well, it sounds I was gonna say it's a totally different energy and it sounds that you're it's not to speak ill of any sort of, you know, OB GYN care but it is it can feel very factory as far as like you're just a number kind of in and out we only have you know this much time and that is due to the you know sheer volume of patients they have but there can also be a certain bedside manner that can be taken and you can still listen to people. And I love that you said you have real sheets.

Unknown 27:28

It's a whole it's a

Unknown 27:30

that's like a big thing. But I think that's important for people to know too. As far as like okay, this is because I can feel people sit thinking that like Okay, I just come in and I have to get a dress and let me wear this paper gown and sit on paper and like what am I supposed to do and what does that look like? So I think it's important to know that it is a little bit different,

Unknown 27:52

right and the amount of time I get to spend with people just this summer I found a pregnant person with very high blood pressure she had to we were able to get some help for her. She did have to have her baby early but they had missed her have her midwife administer high blood pressure and so I really feel like I helped save her and her baby as far as from any morbidity and I found a cyst on somebody's tailbone that if they get infected, they have to have surgery and so we were able to stop at one of them had a skin condition that needed that needed to help investors within the last like month. So that expert kind of individualized attention I mean because I do have a little more time with folks. It could really be kind of a game changer for finding out some information not just about birth, but like your current state of health.

Unknown 28:40

And it is it's another level of like eyes looking at a patient but different lens and sometimes it's important to have those practitioners but that different lens that they're looking at the patient through you know, because even when I'm looking at like X rays I feel like I look at it a different lens than yeah like I you know, I'm looking for space occupying lesions and those type of things and like fracture and but when a radiologist sends the report it's a little bit different because I'm also looking at like alignment, you know, so it's kind of that other lens that someone's looking at the patient through

Unknown 0:02

Um, so I want to touch on how you got started into pelvic floor physical therapy, you know, coming from, you know, having that science background and having that knowledge there, I think is is important but also you know, you had a lens that you were looking at the world through with that, but then also what happened and what changed for you and did your birth experience kind of influence what you do now?

Unknown 0:33

Yes, so I guess we'll go back to about 2017 I was teaching yoga and learning yoga and doing starting my way towards teaching prenatal and so that definitely kind of got me very interested in pelvic floor things and actually started my first business while I was kind of doing my day job. You know, helping people prepare for birth and postpartum as far as why I got into the field if we run, rewind, unfurl a good bit, I actually had a dream like a real dream where I saw this beautiful woman. I remember her faces that Day. You know, I think one day actually meet her and she had her hand on my arm, my forearm and her legs were covered up with a sheet. And I could tell she was that pelvic floor therapy because I hadn't had to go after members. And she was telling me thank you and she was crying and it was I mean, I still get chills thinking about it. And I just really felt that that was the beginning of my calling. So I mean, I was formerly like the state science teacher of the year and I quit my job. I mean, and God just kind of worked everything out step by step. Everything fell in line and within nine months of having that dream, I was in PT school, which is a very hard thing to get into and I was able to get all my prerequisites in and it was just kind of miraculous. To be honest, I still can't believe I'm here and I'm getting used to this way but I love every minute of it. As far as me. I had a C section with my herbs in 16 years ago, people didn't know what they know now. I mean, and I can see now like, the way my scar healed and my pelvic floor pelvic floors, by the way, after you have a C section, they can get overactive and tight and painful because your core muscles if you don't rehab them, kind of take a little vacation and your pelvic floor wants to do all your stabilization and that was what was happening with me and I actually had a hip surgery for hip pain that was actually pelvic floor pain. And so those things just really helped me to empathize with patients. But that journey led me to even know what pelvic floor therapy was. Because if we go back a decade or two people didn't know people still don't know what I do and that exist. And so back then it was very much you know, you had to go to several different specialists and have a few operations you didn't need until you until someone would tell you about pelvic floor work. So that's how my journey landed. And you know, if I was going to do it again, I'm almost 40 So I think I'm all done but the childbearing years but I'm trying to do it all again or someone do it differently, but I feel like my own experiences just helped me to be more patient and perceptive with my clients. And I just have amounts of empathy and patience with folks. So

Unknown 3:14

and that's why that's one of my favorite questions to ask because, uh, so many birth workers that I work with, or even just No, just locally in this area, I'm not even talking about like, you know, across the US but so many birth workers have that story so that reason you know why they're doing what they're doing. And then that really plays a part in how they set up their office, how they interact with people, and that's exactly what you're saying. Like it's, you know, because you know, what it feels like, you know, that people are lacking some information. And so it's kind of how can you best deliver that keeping that empathy as well. So, ah, and I love I mean, it's the same thing to like, you know, you hate what you had to necessarily go through or the lack of knowledge that you have, but on the flip, now, you're able to impart that knowledge actually for others. So hopefully, hopefully, people are learning something. Now what is if you had to kind of in my head I'm like, I usually have like the top three things that I you know, see people for or whatnot, what would be the most common you know, issues, things people that are coming to you for as far as like you helping them over come?

Unknown 4:36

Sure. And this isn't just postpartum people. But I do see a lot of postpartum folks. I mean, I see women and men and children, but I did a lot of people with pain. With intercourse. That's something that I that's one of my favorite diagnoses. And I think that that intention kind of brings us people in my door. So I enjoy helping empower people to get back to not only what they enjoy, but being with our partner because, you know, that's that's a tough dynamic. To live with as a person suffering from pain with intercourse. Tailbone pain is my absolutely favorite thing to deal with and a lot of chiropractors will send folks to me because there's an internal piece all the pelvic floor muscles, every single pelvic floor muscle you have that controls urination and of course of bowel moves connects to your tailbone and so I can work on that in a way that sometimes if you can't do internal work can be difficult. And then the last thing is obviously, urinary issues, frequency leakage. And so you know, I can work on the whole body but those three things are really in my wheelhouse and then in my ability to work on because there's not a whole lot of practitioners that can do the pelvic floor work that's needed to really get the whole picture of how the muscles are functioning. Basically, everything from the pubic bone to the tailbone. This is sort of our wheelhouse as pelvic floor therapists.

Unknown 5:57

Now with with those three main things, are you seeing most of those people? I guess I would say like postpartum like, is it postpartum, painful intercourse or those type of things or is there is there not necessarily a connection to pregnancy?

Unknown 6:19

Well, I would say for pain with intercourse, it's about half and half. So right now I have 32 or 33 year old patient that's never had intercourse. She's had a lot of surgeries and stuff. There's a condition called vaginal, this where the muscles around the vagina spasm and you can't insert even acute and so she's well on her way to to intercourse. You can have a baby but sometimes I meet people at that part of their journey they're like I can't even have a penis to make up child's so like that's, that's definitely part of the story. When people have C sections they'll often have pain with intercourse because his muscles are overactive and they can't relax to have penetration so and then obviously with vaginal deliveries that any kind of tearing or birth trauma that could occur, definitely can lead with that but I have a lot of in today I have an 18 year old that is having pain with intercourse and she is she does not have any children. So it's about half and half with payment and of course, for sure. So it's an interesting thing because people sometimes this is the limiting factor to having children and I don't think people know that that's as common as it is.

Unknown 7:26

So even that consecutive aspect to it of that health and wellness and having that pelvic floor assessed. Yeah. I love it my friend. Um, what are some of your favorite pregnancy birth postpartum? Resources that you give to your patients?

Unknown 7:49

Absolutely. So like I said, I have a closet full of very fun things.

Unknown 7:55

I do. You mentioned last time I thought you were like my positive fun. I'm like, Ah, I love it.

Unknown 8:00

Especially my pregnant people. One of the things that I give them is actually give them cut pool noodles. So I'm going to make an Instagram video backpack today I think actually, but sometimes a when we're in the hospital, for somebody who may want to lay in our back pocket to give birth or maybe if there's something going on the baby and we're needing to speed things up a little we might have to lay on our back for the physician to help us a little bit better. So actually give people pool noodles to allow their sacrum and their tailbone to be able to open up the pelvis opens up. And it's fascinating. I wish I could show picture. So I'll get people pool noodles I do also use the intimate rose products, whether it's their moisturizer. Sometimes our hormones can kind of be funky when we're pregnant and especially for breastfeeding estrogen kind of goes in the tank so I give people a moisturizer to help them be more comfortable and also the one to help stretch the perineal kind of area and make sure that they see a prenatal chiropractor, they make an appointment with a lactation consultant, and then also give them sources for doula. So make sure they have a whole team because you're bringing a whole new human being into the world and this is this is the kind of mom or something you need to surround yourself with support with so but as far as a goodies and things I the pool noodles and that their pelvic floor ones are two of my favorite items to make sure each person has as and as well as making sure their partner comes in and understands the whole process to So involving them just in this layer of support and trying to meet their goals you know for you want to have an epidural great if you want to give birth in a bathtub of crystals awesome. Like how can we optimize that for you?

Unknown 9:49

I love that. That's the whole bit like what how do you want to feel with your birth and then what can we do to support that? Exactly the no judgement zone. And I feel like so many birth workers that do have like what you have that history of why you're doing what you're doing. And when you have that and then you come into this line of work. I feel like sometimes you are really focusing on that team and that knowledge and like hey, have you thought of this? Have you heard of this? And so sometimes I sent emails out and I'm like, prefacing this information overload you know, let me know if there's too much but blah, blah, blah, like and then I word vomit. I tend to so you sent by the same as far as like, hear all these people and maybe sometimes someone's hearing the word doula for the first time in your office. Yeah, they absolutely. It's huge. I know. And that says same thing, too. I'm like, Hey, have you heard of, you know, doula? So I think that's just a beautiful aspect. And like birth support team support is so important to because it does take it does take a village so you got to create that village. Sometimes it doesn't just happen upon you. Um, all right, my friend. Is there anything else that you wanted to chat about today? Anything that's come to mind since we've been talking we're like oh, you know what I really wanted to say this in case I didn't ask it.

Unknown 11:10

Well, I think that we're just kind of moving into a time where people that are pregnant or postpartum are starting to wake up to the fact that a huge change in your life has happened and you know, you'll see your midwife or OB, you know, 10 or 12 times while you're pregnant, but then afterwards, you have like one checkup at six weeks, and they're clearing you to make sure that your stitches are healed, and they're trying to make sure you don't have like your bladder come in and out of your vagina. And they're, they're checking some things, but there is a lot to do, especially the C section as a major surgery. You're going through seven layers of abdominal wall, get help get support as you return back to the things that you want to do. Whether that is continuing. You know, I can have your baby continue your chiropractic care continue with your pelvic floor therapy because now the focus moves from healthy baby and delivery to returning back to health especially if you're planning on having future children. But do want to make sure your body is functioning and your muscle mass and your your stability is back to where it needs to be before you make another person or before you just continue on with your life. Because you are important to your baby is important but you are important too. So I just want to throw that out. there that don't under don't underscore how much you've been through. If you've given birth or you are currently pregnant. So surround yourself with these layers of different support whatever they may be.

Unknown 12:46

Yes, so beautiful. I have to agree with that, you know 110% So I want you to mention where people can find you. So social media, your website all of those things

Unknown 13:01

are so I'm on Instagram and Tiktok I'm trying to connect pelvic health. Also have a Facebook page connect pelvic health and physical therapy. My website is connect pelvic health.com And I'm located in Acworth off of Cedar Crest Road, which is really convenient to like where your offices or people in cars called Dallas Hiram Marietta so I've tried to find a spot where I could serve as many people as as possible because there's not a whole lot of me in this northwest area. So no, that's why I was so

Unknown 13:33

excited to find you. I was like you weren't needed my friend, or knowledge all of that. Well, thank you so much. This has been wonderful. It's been so insightful. I hope I probably should have prefaced until people like grab your your pen and paper and make notes because I am a note taker. So I always tell people like take some notes during these episodes. I love what you do. I love working with you. And thank you so much for being on the show today.

Unknown 14:04

My pleasure. Thank you so much for just allowing me to bring some awareness to

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