January 24, 2025 • 36 mins
Have you ever wondered WHY you're experiencing pain during sex and have waived it as a lost cause or dealt with the pain? Join Dr. Allison on today's podcast of Edmonds Moms Room where she breaks down the reason why millions of Women could be experiencing pain during sex and even before/after & gives the BEST advice on how to fix this issue for good!
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Episode Transcript
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Speaker 1 (00:00):
Hello, and welcome to another episode of the Edmund's Mom's
(00:03):
Room podcast. I'm your host, doctor Alison Feldt, owner of
Body Motion Physical Therapy, mom of three, and founder of
af Wellness Coaching, where we help moms live fabulous, energetic
lives and relieve themselves of the chaos of mom life.
Speaker 2 (00:20):
So I am here to chat with you today.
Speaker 1 (00:24):
I'm putting on my hat as a pelvic expert physical therapist.
Speaker 2 (00:29):
And if you don't know Body Motion.
Speaker 1 (00:31):
Physical Therapy, we are a very specialized clinic helping people
through fertility, pregnancy, postpartum, through menopause, and we help people
restore their confidence, improve the function of their joints, improve
their core so they can lead absolutely epic lives right
and we want to do that by just like creating
(00:53):
true internal health, and we do that through public floor
physical therapy. So what this episode is about to it's
a little bit harder to talk about. I want to
answer the question of what to do if sex does
not feel good for you and or if you don't
enjoy sex. So we're gonna dive deep into it today.
And it's actually epically perfect that we're talking about this
(01:16):
today because I just finished at the gym, and after
I work out and get my lift in, I always
I always have oatmeal with my protein powder and with
creatine on it and the and then so I got
like a cup.
Speaker 2 (01:30):
Of hot water at the coffee shop and.
Speaker 1 (01:34):
I asked for it half filled so I can put
my oatmeal in here and cook it.
Speaker 2 (01:38):
And on the label it.
Speaker 1 (01:40):
Says cup of water hoe filled, And I was like,
that's so epic for a episode today about sex. So
I have a hoe filled cup of hot water and
it's really half filled and made my otmeal in it.
But anyways, I thought it was so fitting. So when
the lady handed it to me, I just couldn't help
but chuckle. Well and yeah, so here we are, let's
(02:03):
dive into it.
Speaker 2 (02:06):
I think it is really.
Speaker 1 (02:08):
Common for people to go through phases where sex doesn't
feel good for them. A it doesn't feel good or
B they just don't feel like having it. This is
really common throughout the postpartum journey. So after you have
a baby, your estrogen plummets, especially if you're breastfeeding. That
estrogen can stay depleted for a very long time and
that can have an impact on your sex drive. You
(02:30):
just will not have the libido that you probably did previously,
and now that libido can also be.
Speaker 2 (02:37):
Affected if you are on birth control.
Speaker 1 (02:39):
And that is a whole nother bag of worms that
we're not going to dive into as much today, but
I do want to talk to you about what to
do if you don't enjoy sex, how can you make
it better for you? On Christmas Eve, I got an
epic text from a client who is like, I just
had my first orgasm in my.
Speaker 2 (03:00):
Entire life, and that was the coolest thing to hear.
Speaker 1 (03:06):
Because when you restore the function of your pelvic floor,
you teach you can you can restore the function of
having an organism. A lot of people end up in
their forties, fifties, and sixties never having experienced the pleasure
of having an orgasm. And that's not great, right, Like,
if that was the case for men, we would have
(03:27):
a lot more solutions.
Speaker 2 (03:28):
Well, we absolutely did, right.
Speaker 1 (03:29):
We have a pill that can literally make it so
you can have sex if you lose the ability to
get an erection, right, But for females, we don't.
Speaker 2 (03:37):
Have that kind of option.
Speaker 1 (03:38):
We don't have that kind of ability to just go
pop uphill and.
Speaker 2 (03:43):
Make it so.
Speaker 1 (03:43):
We want to have sex and make it so sex
doesn't hurt. That's just not a thing for us. So
you might be wondering, okay, but why does sex hurt
for me? And there's a whole host of reasons. There
are different diagnoses. That's like dysporinea is one of them.
It's where you have pain with anything penetrative. You can
have volva dineo where your volva just kind of hurts
(04:04):
all the time, and then you can have vaginismus where
your pelvic floor muscles are literally in a spasm, making
it nearly impossible for something to enter.
Speaker 2 (04:13):
And if you spend any time in a heightened.
Speaker 1 (04:17):
Nervous state of your nervous system, then what can happen
is your pelvic floor can just be semi contracted. And
the reality is a lot of women are walking around
in their sympathetic nervous systems being activated, which causes a
reactive spasm and tightening of the pelvic floor, and that
pelvic floor just stays in that heightened, tight, alert state.
Speaker 2 (04:39):
And never lets go.
Speaker 1 (04:40):
Now you might think, okay, well that's great, my vagina's
going to be tight and it's going to make sex
feel really good for my partner. And it's going to
feel really good for me. But that's newsplash, not what
we're going for. A tight vagina does not feel good
for anybody. And I've addressed this on a few other episodes,
But when you have a tight pelvic floor, what happens
(05:05):
is you lose your blood flow to a lot of
those muscles, making them more fibrotic, making them less healthy
of a muscle so that they can't open and contract
as well, so then they become kind of dead. And
then that's when people often feel like their public floor
is super weak. And so when we get that kind
of public floor state, it can if you live in
(05:29):
that state for a long period of time, it can
just cause a lot of general tension and a lot
of fascial tightness, which can then create some scar tissue.
It can create some adhesions, It can create inflammation in
the tissue. And when we have all that, that can
make anything penetrative very uncomfortable.
Speaker 2 (05:48):
If we have that tension, that.
Speaker 1 (05:50):
Can create that pain with insertion, or even if it's
just uncomfortable feelings, it might feel a little burnie, you
might feel like you have to like especially warm up.
Speaker 2 (06:02):
That means that there's something going on in the pelvic floor.
Speaker 1 (06:04):
So if you are having pain with penetrative intercourse, whether
that's with the initial penetration or whether that's with deep thrusting,
that means that there's something wrong inside the peblic floor,
that the palic floor is just not optimized, it's not
working well for you.
Speaker 2 (06:19):
And you can.
Speaker 1 (06:20):
Work with a pelvic expert physical therapist to do some
hands on therapy to help improve the health of these
muscles and therefore you then can improve your ability to
enjoy the sexual experience. And there's nothing better, right, Like,
you want to be able to want to participate in
connect with your partner or whoever you're engaging with, and
(06:42):
if it is uncomfortable, it makes it a lot less desirable.
Speaker 2 (06:46):
Not to mention whoever you're.
Speaker 1 (06:47):
Engaging with, you know, might be like, well, I don't
want to hurt you, or I don't want you know,
I don't want to make this, you know, any worse
for you, and you don't seem like you're enjoying it,
And it has a major impact in relationships, and so
dealing with pelvic floor health and like healing the pelvic floor,
optimizing the pelvic floor can absolutely change the relationship you
(07:10):
have with your partner over the course of the years,
and I think it is one of the best things
that you can do for your partner. And so the
funny thing is is so so frequently and often when
when women like reach out and they're either like trying
to get pregnant or they are pregnant and they want
to prep for childbirth, husbands will be like, oh, why
(07:32):
are you doing this, Like this is just a waste
of money. Just fix yourself afterwards. But the reality is,
you get your pelvic floor healthy before you conceive or
during your pregnancy, you all of a sudden have this
like dynamic, healthy pelvic floor that's going to make intercourse
a lot more.
Speaker 2 (07:48):
Tolerable during the pregnancy.
Speaker 1 (07:51):
So if you want to be sexually active during the pregnancy,
some people do. Some people have incredible desire during the
pregnancy with all the rest of the hormones, and some
people have zero interest at all. Both are completely normal,
and so you want to be able to have a
healthy public floor because when it comes to the childbirth process,
then the pelic floor can open and expand baby can
(08:12):
leave the body with a lot more ease, and so
therefore the muscle can recover so much faster with that
childbirth experience, And so hopefully you see that, you know,
investing in your public floor wellness and your health is
so preventive in your fertility conception journey and then also
(08:32):
during the pregnancy itself. So these are just really important
essentials that I don't think men realize actually benefit them
because the less damage you have during the childbirth process,
it is going to be a heck of a lot
easier to get back to being intimate and having intercourse.
(08:52):
Because let me tell you, when you have tears in
scar tissue and you just experience significant trauma in the
public floor in the pelvis, not a lot of people
want to engage in sexual intimacy after that experience. And
when they do, they often go back to it and
are having to like grit their teeth and just kind
(09:14):
of like bear it. And a lot of times what
they'll do is, like during the intercourse experience, they'll tighten more.
Speaker 2 (09:21):
To try and like brace for it.
Speaker 1 (09:23):
But when we're tightening embracing for it, it actually makes
things worse. So one thing if you are experiencing discomfort
with intercourse that you can start to do now is
you can work on breathing through the intercourse experience. And
now I don't ever suggest it bearing through it, Like,
I just don't think that's a great pattern for the
(09:43):
brain to learn, because if your brain is gritting your
teeth and you're bracing during the intercourse experience, like yeah, sure,
you're doing it for connection with your partner or to
help please your partner. But if your brain is like
red flag, red flag, this is painful, that's gonna be
a pattern that is now lodged in the brain and
(10:06):
you're gonna have to rewire that once it feels good again.
So it's not something it's not like an exercise you
just want to push through and build the muscle up,
Like you just don't want to do that, because if
you do that, then you're telling your brain like this
is a painful experience and your body can't enjoy this experience.
Speaker 2 (10:23):
So then you're gonna have to get yourself back to enjoying.
Speaker 1 (10:26):
Like rewiring the brain to know that like, once it
feels good again, this is a safe experience.
Speaker 2 (10:33):
This is a pleasurable experience.
Speaker 1 (10:35):
But what happens is you have women and I see
this across generations that after childbirth, they never get really
interested in sex. Again, there's probably some trauma that happened
to the pelvic floor, whether that was some tearing, daring childbirth,
the use of fourceps, or they had a cesarean, and
cesarean absolutely causes a lot more restrictions through the pelvic
(10:57):
floor and tightness in the pelvic floor.
Speaker 2 (10:59):
And again, that type isn't good tightness.
Speaker 1 (11:01):
This isn't like, oh, we created a tight vagina and
this is super good for my partner. This is a
kind of tension that creates cement, that creates rigidity, that
creates fibrous beef turkey tissue that we want to soften
and heal because it's the softening and the healing and
the hydration of the tissue that makes the tissue feel
(11:24):
really good and feel like you have a really strong
vagina and strong pelvic floor. And so that is the goal.
And in order to help achieve that goal, we need
to be able to get rid of the scar tissue.
We have to heal the pelvic floor after we have babies. Now,
some people have painful intercourse and painful penetration even before
(11:47):
they have kids. Maybe they grew up in a world
where touching themselves was you know, off limits. There was
a lot of shame around the pelvic floor and the genitalia,
and so they just like they just closed it off
and like mentally disconnected. And when we do that, there's
a lot of tension through these areas, and that tension
(12:09):
can often lead to the diagnosis of badginismus, where you
just get that chronic spasming of all three layers of
the public floor, and we have to untrain that and
get the brain to be like, this is a safe area.
It is okay to touch my genitalia, It is okay
to engage with my partner, it is okay to have orgasm.
But if we don't have if we don't have that
(12:31):
mental mindset and this area is still off limits, it's
really hard to heal the poblic floor. So people come
here from all walks of life where they're in the
phase of they just want to be they just got
married and they just want to be intimate with their
partners to they are trying to conceive, but they literally
can't even insert anything.
Speaker 2 (12:53):
So they're finding it nearly.
Speaker 1 (12:55):
Impossible to be able to have sex during during their
ovulation cycles, and so then they work through that right,
And it's not just working through the muscle tension, it's
also working through the mindset of being able to accept
your body and accept the pelvic floor and like, learn
how these function, learn how the palic floor functions.
Speaker 2 (13:18):
I think a big.
Speaker 1 (13:19):
Reason that people never get, like we never get the
education in like fifth grade flash class when you learn
about sex of how your pelvic floor functions.
Speaker 2 (13:31):
We don't.
Speaker 1 (13:31):
No one ever teaches us like, Okay, your public floor
and your genitalia are actually muscles. And a lot of
times when we're in a heightened state of alertness, or
we're exercising, or we're stressing out over an exam, our
public floor has a lot of tension in it. And
in order to relieve the tension, we have to do
(13:51):
some deep breathing and allow the diaphragm to open, which
allows the pelvic floor to open.
Speaker 2 (13:57):
So you can do things.
Speaker 1 (13:58):
Called diaphragmatic breathing and that can help open up the
pelvic floor. Well, if we were only taught this in
fifth grade flash class or even earlier, then we would
realize like, oh, we have this control of our pelvic floor.
Speaker 2 (14:12):
Well, the pelvic floor is a deep.
Speaker 1 (14:14):
Core muscle, and is absolutely essential for the function of
our core as well.
Speaker 2 (14:18):
So if we live in this titan state of.
Speaker 1 (14:22):
Pelvic floor function, then we actually miss out on the
eccentric motion of the pelvic floor, which is a big
piece of where our shock absorption comes in from the core.
And so we have to have that shock absorption to
unload the joints and help keep our joints healthy, and
that helps keep us free of like si joint pain
(14:44):
or knee pain even and hit pain and neck pain.
The tigher our pelvic floor is, the less restricted it,
the more restricted it is, the less movement there is,
the less shock absorption happens, and the weaker the core
actually is, it becomes less functional and so so therefore
we have to train these muscles to have range of motion.
(15:04):
When you train the pelvic floor to have this epic
range of motion, then all of a sudden, sex becomes
really good.
Speaker 2 (15:10):
Orgasms become even better because if you have.
Speaker 1 (15:13):
To work really hard for your orgasm, a lot of
times it's because the pelvic floor is at such.
Speaker 2 (15:17):
A heightened state and already so contracted.
Speaker 1 (15:20):
But if you can have a relaxed pelvic floor and
you can get yourself to that opening where the muscle
can be fully open, elongated.
Speaker 2 (15:27):
And relaxed. Then there's a lot.
Speaker 1 (15:29):
More range of motion to build up for that orgasm,
and you don't have to work as hard at getting
that climax and getting that peak.
Speaker 2 (15:37):
State of arousal.
Speaker 1 (15:39):
And sometimes people have such tension that they're just in
a constant peak state of arousal and that when they
have like orgasm after orgasm after orgasm, and that is
actually very not comfortable because a lot of times they
can't even work out without having those orgasms. So they
really have to work on training and opening the pelvic
floor in order to get the range of motion, get
(16:00):
a blood flow, and take them out of that constant
climax state.
Speaker 2 (16:04):
And so you know, it works on both ends of
the spectrum.
Speaker 1 (16:08):
But the more range of emotion you have of your
pelic floor, the more control you can get of the
pelvic floor, the better the sexual experience is going to
be for you, and I hope I've made this clear,
but also for your partner.
Speaker 2 (16:20):
And of course, like the less pain you're.
Speaker 1 (16:23):
In, the more you want to engage with it, the
more that you enjoy it, that's.
Speaker 2 (16:27):
Also better for your partner.
Speaker 1 (16:29):
So I take it back to the men that you
know put a stop on their wives getting like good,
true holistic pelvic floor physical therapy, which is hands on
manual work of the pelvic floor and teaching the palvic
floor how to attain these new ranges of emotion and
these in these states of the pelvic floor and making
these muscles super healthy for prevention. That improves your sex life,
(16:54):
like the man's sex life.
Speaker 2 (16:56):
So why not have your woman come here into this
way right?
Speaker 1 (17:01):
And that baffles me every time, and I don't know
how to get the word out other than like, if
this is your husband, send him this podcast and hopefully
he will listen to it and be like, oh, my
sex life is going to improve.
Speaker 2 (17:15):
You're telling me that your.
Speaker 1 (17:16):
Vagina is actually gonna feel even better if you get
this range of motion, like hands down.
Speaker 2 (17:20):
I'm in right, Like who doesn't want that?
Speaker 1 (17:25):
But oftentimes, like just like females like men have been
sold keego culture and like just strengthening the pelvic floor
and work the pelvic floor and keego keegel. But let's
be real, like that doesn't help anyone if you have
tension in your pelic floor and you're already semi contracting.
Contracting even more is not helpful, and it's actually detrimental
(17:46):
and will make the sexual experience worse, will prevent you
from orgasming, and will also wear out your joints in
the long run. So do your fifty and sixty year
old self a favor and work through the pet floor restrictions. Now,
I do just want to like die, like talk a
little deeper into like the importance of this for relationships.
(18:09):
And I've said this multiple times on multiple platforms, and like,
I'm no relationship expert. I happen to be married for
the last ten years. But fuck it's hard, right, Like
there's no like sugarcoating. I have zero expertise in this.
I'm just like learning and failing forward, right and so
and we have three children, right, so it's like we
(18:29):
live the chaos and life of being married, and we
try to stay married, right and enjoy each other's company
and like remember why we got married in the first
place and all that all that stuff.
Speaker 2 (18:41):
I have zero expertise in this field.
Speaker 1 (18:43):
But what I will say is being an observer of
my patients and seeing them after they have their babies,
the transition from delivery we get to if we get
the pleasure of working with them during pregnancy. This is
this happens a lot less frequently. But what happens often
is when we see a new client post partum.
Speaker 2 (19:05):
And the reason, sorry, let me back up.
Speaker 1 (19:07):
The reason that happens a lot less frequently when they've
had pelvic work during pregnancy is because they heel so
much faster. They usually want to engage in sex more
frequently after delivery because there's just a lot less trauma
to the body, so they feel more ready to go.
They don't feel the pain that you might feel or
the pressure you might feel after having childbirth without any
(19:28):
pelvic floor prep. So that's really the value of doing
your pelvic floor prep during your pregnancy is to really
prep your pelic floor so you can one of the
reasons go back to your sex after childbirth without pain,
but also go back to the.
Speaker 2 (19:43):
Gym and all that good stuff. So where I was
going with that is when we.
Speaker 1 (19:48):
See a new client post partum and they come to
us after having childbirth, like usually there's some scar tissue,
maybe some severe scar tissue, and they're oftentimes incordinat of
the pelvic floor. So the pelic floor just loses its function.
They feel like they're blown out, like there is nothing there.
They feel weak as I'll get out, and so of
(20:09):
course they feel like they need to do kegels. But
the body is like magic, right, So after you have
a baby and everything opens up, what happens is reactively
the body compensates beautifully and the pelic floor tightens back
up to try and pull the pelvis together, because the
pelvis usually separates about five to nine millimeters right at
(20:29):
the pubic synthesis joint. So the blutes will tighten to
pull the pelvist together, the pelvic floor will tighten to
pull the pelvic floor to pull the pelvis together.
Speaker 2 (20:37):
The bones and then.
Speaker 1 (20:38):
The adductors, the inner thigh muscles, it'll they'll tighten to
pull the pelvic floor to pull the pelvis in the
pelvic bones back together. And so this is all a
compensatory pattern. And then you might think, oh, that's great,
my vagina's tight again. But again you'll still have that
blown out feeling or like that you're just completely weak,
that there's nothing there and that you need to keegel.
Speaker 2 (21:02):
But it's because there's no range of motion in the muscle.
Speaker 1 (21:05):
So all the strength of the pelvic floor actually comes
from the ecentric lengthening and elongating and opening up up
the pelic floor, because the more you can open up
is the more you can contract.
Speaker 2 (21:17):
But after we have kids.
Speaker 1 (21:19):
With that compensation and the body being a magical healer,
it already tightened up and came back together, and you
still feel really weak, and it's because you don't have
the opening motion. So the opening the eccentric motion is gone,
and so we have to restore that. And in order
to get the opening and elongation and the stretch back
(21:40):
to the tissue, we have to get rid of the
scar tissue that's probably holding it together and that's tightening
it down and not letting it open and expand.
Speaker 2 (21:49):
So hopefully that makes good sense.
Speaker 1 (21:52):
And the more that you get that range of motion back,
the better your sexual experience is going to be and
you won't have then and the pain upon initial penetration
and then with deeper thrusting. When people have pain and
discomfort with deeper thrusting, it often means that the third
layer of the.
Speaker 2 (22:10):
Pelt floor is really tight. What does that even mean?
Speaker 1 (22:13):
It just means that the deepest layer of your palt
floor including your hip muscles, tend.
Speaker 2 (22:19):
To be really tight.
Speaker 1 (22:20):
So what people will often say is they'll say, it
feels like my partner's hitting something, and it's really uncomfortable,
so I.
Speaker 2 (22:27):
Brace against it. Well, if you feel like your partner's
hitting something, most likely it's.
Speaker 1 (22:32):
Because your third layer or some muscles inside your palvic
floor that are really deep and connecting to your hips,
are very tight. Oftentimes we see it as this muscle
called the operator internus muscle, which is a hip muscle,
and it is it's a really important muscle, but when
it is tight and overworked, it is extremely painful and
(22:54):
it'll feel like your partner is hitting something. And so
a lot of times people will be like, oh, they're
hitting my cervix. Maybe I have uterine prolops and my
cervix is coming down out of my vagina and or
my bladder's coming down, and that's what they're hitting, and
that's really hurting.
Speaker 2 (23:10):
But for the most.
Speaker 1 (23:11):
Part, that is just the tension of the palviic floor
and your partner's not actually hitting your cervix, and your
partner's not actually hitting your bladder. Like, yes, the bladder
of course gets touched every single time. That your partner
goes in and out of you like, that's just par
for the course. The bladder is sitting on the anti
your wall the vagina, so there is gonna be contact there.
(23:33):
The cervix is sitting at the top of the vagina,
and so if your partner is really big, like you
will have some touching of the certifix.
Speaker 2 (23:42):
That should actually.
Speaker 1 (23:43):
Not be painful though, and so if it is, there
might be restrictions around the actual cervix itself.
Speaker 2 (23:50):
So you might be sitting there.
Speaker 1 (23:51):
Thinking, Okay, Alison, what is a palvic floor physical there
is actually gonna do to help change these muscles for me?
Speaker 2 (23:58):
Well, there's a lot of things. They're gonna teach you
how to work your pelt floor muscles.
Speaker 1 (24:02):
They teach you how to work your pelt floor muscles
by using some breath mechanics, by doing some stretching, by
learning how to truly work and engage your lower abdominal muscles.
Most people can't actually engage their lower abdominal muscles, and then,
especially after they grow a baby for ten months, it
is so hard to engage the lower apps and then
(24:25):
just forget about it. If they were cut with a
C section, that is one of the hardest things to
get back, and so if you don't have lower app control,
it's actually really hard because then the pelvic floor overworks
to compensate for that lower app control. So we got
to get the lower app control back, which side note
aesthetically helps flatten your stomach right, So we all want that,
(24:48):
or maybe you don't, but like, getting that control back
is going to be absolutely epic, and unloading the pelvic floor.
Unloading the palvit floor is then going to allow that
pelt floor muscle to be more high, more dynamic, have
more movement, And so we teach the palate floor how
to start moving again, along with training the lower abdomen
(25:09):
and restoring the rest of the core muscles. So we
got to get the diaphragm moving, We got to get
the back muscles and the glutes firing. Training your glutes
and getting hip extension back after you have kids is
very important because hip extension is one of the things
that we lose during the pregnancy process. As we grow
a baby, we have more anterior load and therefore our leg.
Speaker 2 (25:32):
Doesn't go as far behind our.
Speaker 1 (25:34):
Bodies, so we lose hip extension, which means that we
lose our glute activation, which is a big reason why
we have the moms have a flat butt phenomenon. But
when you have a flat and tight butt and the
butt is really weak, then it is there's a lot
of tension there. And if there's a lot of tension
there and you're gripping your butt a lot when you're
(25:54):
standing or doing other activities like even just like washing
the dishes, if you find yourself clenching your glutes, you're
also clenching your public floor further, which is then going
to mess up your palic floor range of motion, creating
a lot of generalized tightness, which is then going to
lead to that soliloquy of sex not feeling as good.
And so the more we can get that range of
motion and heal that the better. So back to what
(26:15):
the palvic floor physical therapist does on top of doing
all that other work, is they will do an internal
and external assessment of the pelvic floor muscles.
Speaker 2 (26:23):
So they'll look at all the pelvic muscles on the
outside of the palace.
Speaker 1 (26:26):
This includes the glutes, this includes the hip flexors, this
includes the abdomen, this includes.
Speaker 2 (26:32):
Everything that you can imagine that connects to the pealpast.
Speaker 1 (26:34):
Those muscles will be evaluated and make sure that your
compensation patterns can be broken up, and then we can
train the muscles to do the healthy movements that they
are supposed to be doing. That's all about, you know,
restoring our body's motion. And you know, I'm talking about
this often in like relationship to like healing after childbirth.
But the reality is, like a lot of people have
(26:54):
this pattern even without having kids. And so even if
you haven't had kids, if you have this tension power
and this is like a really common compensation, you don't.
Speaker 2 (27:02):
Just have to have kids. Having kids exacerbates this even further.
Speaker 1 (27:06):
But a lot of people who don't have children also
experience these issues and have these very similar patterns.
Speaker 2 (27:13):
And then we also look at the pelvis inside. And
when we look at the.
Speaker 1 (27:16):
Muscles on the inside of the pelvist, we do this
through looking at them intravationally. So we'll have a glum
finger and you'll be draped with sheets and we'll gently
insert a finger and test the different layers and muscles
of the pelvic floor itself. We'll be checking for a
scar tissue adhesions that are found within the pelvis and
(27:38):
really working to improve the extensibility of the tissue, which
means that we're just looking to stretch and open and
hydrate these muscles, making them very very healthy. We do
this on all three layers of the pelvic floor, and
you can also do this introrectally, and that's how you
assess mail anatomy is through the rectum and they're there
(28:00):
are certain conditions and diagnoses that will respond better to
interactal work, but a lot of times intervaginal work is
a lot more tolerable just because you don't have to
work through the anal sphincter, you know, and sometimes it's
hard for people to relax their anal sphincters and then
be able to relax.
Speaker 2 (28:17):
Their pelvic floor.
Speaker 1 (28:18):
So so yeah, working through the polic floor is absolutely essential,
and not everyone wants to do that fully understand.
Speaker 2 (28:27):
But if you can get.
Speaker 1 (28:28):
To a point where you're able to work through your
palvic floor and heal these muscles, fix any scar tissue,
it can epically improve your sexual experience and not to
mention it just gives you.
Speaker 2 (28:40):
A different connection to your body and.
Speaker 1 (28:42):
Allows you to use your core in a way that
you've never experienced. This is in a way that no
amount of planks, sit ups, crunches could ever train your core.
When you get this control of your public floor, you
will be able to engage your lower ads. You'll be
able to engage your core and allow your core to
(29:03):
function in new ways that you never knew existed. People
that experience like low back pain side joint pain usually
have really tightened pelvic floors because the pelvic floor is
spasming and tightening to try and protect the back and
protect the side joint pain. But a lot of times
it is creating even more pain patterns because of the compensation,
(29:26):
which then can lead to uncomfortable intercourse.
Speaker 2 (29:29):
So that's what we're looking at.
Speaker 1 (29:30):
So when someone comes in for a pelvic floor exam,
that's what we're going through.
Speaker 2 (29:36):
So it's an.
Speaker 1 (29:36):
Internal and external exam and we get healing, and it
takes the body time to heal.
Speaker 2 (29:42):
You know, if this is it just depends.
Speaker 1 (29:45):
It can be a six week experience to a six
month to a multiple year experience depending on how like
the severity of pain is.
Speaker 2 (29:51):
But just to improve your.
Speaker 1 (29:52):
Sex life, that can happen fast, Like just start getting
some motion, some blood flow here, start getting the pelvic
floor to function and actually do the movements that it
was trained to do, and you will have epic changes
to your sexual experience. And now you might be wondering,
like are there devices that can do this for me?
(30:13):
There are certain things like wands, there's certain things like
vaginal dilators, and they have their place. I find it
is already like most people don't know what they're feeling
when they feel their public floor, so it's really hard
to know, like where you're sticking a wand, Am I
actually putting this wand in a muscle that's going to release?
Speaker 2 (30:33):
And this wand would go in like intervaginally, and.
Speaker 1 (30:38):
So for that, just so someone doesn't hurt themselves further
or cause more pain, I always say, like it's most
ideal and gold standard. Find a pelvic floor physical therapist
that you know, that you like, that you trust can
help you get full function and range emotion of the
palic floor and you're gonna have to keep working on it.
When we have a maintenance program here a Bodymotion where
(31:01):
people come once a month just to help restore and
keep their range of motion.
Speaker 2 (31:05):
Of the public floor.
Speaker 1 (31:06):
Because the reality is is like life is stressful, Like
we just have the holidays, right and like my pelvic
floor was so tight, I started leaking some urine. Again,
That's what can happen when you have tension through your
pelvic floor and sex wasn't feeling super good. Then I
had a couple sessions of pelvic floor because I had
skipped a month. I had skipped my session in December,
and I had a couple of sessions and fixed just
(31:28):
like that.
Speaker 2 (31:28):
Pelvic floor is working and functioning way better.
Speaker 1 (31:31):
Even my lifts and my workouts are so much better
because my core engagement is better, and so all of
it is so related, and the best thing that you
really can do for yourself is like, learn how to
use your public floor.
Speaker 2 (31:45):
Get these muscles so extensible, work with someone.
Speaker 1 (31:48):
Who can help you achieve that goal, and like it
will play a huge role in your relationship and your
ability to stay sexually active with your partner.
Speaker 2 (31:57):
As our hormones change and we.
Speaker 1 (31:59):
Go through perimental and menopause and we lose a lot
of our estrogen and progesterone balances, what can happen is
we can lose hydration of the pelvic floor, We lose lubrication,
and that can make the muscles weaker because then they
go to that state that they were essentially in postpartum
where they.
Speaker 2 (32:16):
Just typing back up, they lose range of motion.
Speaker 1 (32:19):
The more you keep the health of your pelvic floor muscles,
the more you keep that range of motion, the more
you're actually going to keep natural lubrication independent of having
your estrogen and progesterone balanced.
Speaker 2 (32:32):
So the healthier this.
Speaker 1 (32:33):
Muscle is, the more dynamic it is, regardless of your
hormonal hormonal state. It actually can like if you keep
healthy during perimenopause and during menopause, then after menopause it's
going to stay in that healthy state as long as
you continue to work it.
Speaker 2 (32:48):
What happens to a lot of people, and this is
what we see in.
Speaker 1 (32:50):
The nursing homes right when they're in their like seventies, eighties,
and nineties, is they never had pelvic care after they
had babies or even just in general in their lives,
and so they're peeing their pants, they're in wheelchairs, they're
in diapers because their cores don't work, can't get their
core to work, no matter how much physical therapy they
do and how many you know times they've been to
(33:10):
physical therapists and trainers in their lives, and it's like
a lot of it just goes back to like they
never have this core function in the first place. Right,
So that had been to taken all the way back
to that fifth grade flash class. And if we can
just teach kids how their pelvic floors function and how
their genitaliam move, then we can give them like lifelong health, right, Like, yeah, well,
(33:34):
you still need maybe some help in keeping the range
of motion and absolutely, but like, if you can keep
your core functioning, you learn how to function your core
and like work your public floor and opening range of
motion when you're in fifth grade. Can you imagine what
that does for you when you go and have your babies.
And how do we teach this, Well, you teach this
by teaching someone how to have a bowel movement. When
(33:55):
you have a bowel movement and you learn how to
open your public floor by breathing and controlling your pelvic
floor and not just sitting there and pushing the poop out,
then you get to have amazing control of the opening.
Speaker 2 (34:09):
So then you get the eccentric motion.
Speaker 1 (34:11):
And when you learn how to do that, then all
of a sudden, you know how to have that range of.
Speaker 2 (34:15):
Motion of your public floor. So we just got to
teach kids how to poop.
Speaker 1 (34:18):
We also got to teach them how to pee so
they're not pushing their pee out because that is absolutely
detrimental to their pelvic organ positions and to different conditions
that can happen. And so we just have to teach
people how to have good vowel movements, how to have
good peas, and we'll be good to.
Speaker 2 (34:33):
Go, right.
Speaker 1 (34:36):
But the reality is is like also that is that
information received and whatever.
Speaker 2 (34:39):
It's a rabbit hole that I'm not going down. But
I absolutely think.
Speaker 1 (34:44):
That we can at least teach our own kids that
and we can start to make an impact in them
improving their public floor function just by teaching them how
to poop and how to be And you can check
out my YouTube channel. There's about a million videos about
how to have a bowel movement properly and how to
pee properly. So just a little side note for you there.
But I hope you have enjoyed this episode. I hope
(35:06):
you now have confidence that if you're not having orgasms,
you'll be able to one day. I hope that you
have confidence that if sex is not comfortable or not
your favorite thing, that you know what needs to be
done in order to help improve your experience. And I'm
just going to leave you on that note, so thank
you so much for being here with me today. I
(35:28):
have a great pleasure of bringing this information to women
across the world, and our goal is to change humanity,
to change women's health care, to change women's wellness so
that we can live freaking amazing lives and feel really
good in our own sinkin and feel really good in
(35:48):
our own skin. Because when we feel good in our skin,
then the impact that we can make to improve humanity
for the good is wild, right, It's the potential is endless,
and so I wish that for you. And get control
of your public floor. See a public expert physical therapist.
There is nothing better than having range of motion of
(36:11):
your public floor being able to enjoy your sex life.
Hello, and welcome to another episode of the Edmund's Mom's
(00:03):
Room podcast. I'm your host, doctor Alison Feldt, owner of
Body Motion Physical Therapy, mom of three, and founder of
af Wellness Coaching, where we help moms live fabulous, energetic
lives and relieve themselves of the chaos of mom life.
Speaker 2 (00:20):
So I am here to chat with you today.
Speaker 1 (00:24):
I'm putting on my hat as a pelvic expert physical therapist.
Speaker 2 (00:29):
And if you don't know Body Motion.
Speaker 1 (00:31):
Physical Therapy, we are a very specialized clinic helping people
through fertility, pregnancy, postpartum, through menopause, and we help people
restore their confidence, improve the function of their joints, improve
their core so they can lead absolutely epic lives right
and we want to do that by just like creating
(00:53):
true internal health, and we do that through public floor
physical therapy. So what this episode is about to it's
a little bit harder to talk about. I want to
answer the question of what to do if sex does
not feel good for you and or if you don't
enjoy sex. So we're gonna dive deep into it today.
And it's actually epically perfect that we're talking about this
(01:16):
today because I just finished at the gym, and after
I work out and get my lift in, I always
I always have oatmeal with my protein powder and with
creatine on it and the and then so I got
like a cup.
Speaker 2 (01:30):
Of hot water at the coffee shop and.
Speaker 1 (01:34):
I asked for it half filled so I can put
my oatmeal in here and cook it.
Speaker 2 (01:38):
And on the label it.
Speaker 1 (01:40):
Says cup of water hoe filled, And I was like,
that's so epic for a episode today about sex. So
I have a hoe filled cup of hot water and
it's really half filled and made my otmeal in it.
But anyways, I thought it was so fitting. So when
the lady handed it to me, I just couldn't help
but chuckle. Well and yeah, so here we are, let's
(02:03):
dive into it.
Speaker 2 (02:06):
I think it is really.
Speaker 1 (02:08):
Common for people to go through phases where sex doesn't
feel good for them. A it doesn't feel good or
B they just don't feel like having it. This is
really common throughout the postpartum journey. So after you have
a baby, your estrogen plummets, especially if you're breastfeeding. That
estrogen can stay depleted for a very long time and
that can have an impact on your sex drive. You
(02:30):
just will not have the libido that you probably did previously,
and now that libido can also be.
Speaker 2 (02:37):
Affected if you are on birth control.
Speaker 1 (02:39):
And that is a whole nother bag of worms that
we're not going to dive into as much today, but
I do want to talk to you about what to
do if you don't enjoy sex, how can you make
it better for you? On Christmas Eve, I got an
epic text from a client who is like, I just
had my first orgasm in my.
Speaker 2 (03:00):
Entire life, and that was the coolest thing to hear.
Speaker 1 (03:06):
Because when you restore the function of your pelvic floor,
you teach you can you can restore the function of
having an organism. A lot of people end up in
their forties, fifties, and sixties never having experienced the pleasure
of having an orgasm. And that's not great, right, Like,
if that was the case for men, we would have
(03:27):
a lot more solutions.
Speaker 2 (03:28):
Well, we absolutely did, right.
Speaker 1 (03:29):
We have a pill that can literally make it so
you can have sex if you lose the ability to
get an erection, right, But for females, we don't.
Speaker 2 (03:37):
Have that kind of option.
Speaker 1 (03:38):
We don't have that kind of ability to just go
pop uphill and.
Speaker 2 (03:43):
Make it so.
Speaker 1 (03:43):
We want to have sex and make it so sex
doesn't hurt. That's just not a thing for us. So
you might be wondering, okay, but why does sex hurt
for me? And there's a whole host of reasons. There
are different diagnoses. That's like dysporinea is one of them.
It's where you have pain with anything penetrative. You can
have volva dineo where your volva just kind of hurts
(04:04):
all the time, and then you can have vaginismus where
your pelvic floor muscles are literally in a spasm, making
it nearly impossible for something to enter.
Speaker 2 (04:13):
And if you spend any time in a heightened.
Speaker 1 (04:17):
Nervous state of your nervous system, then what can happen
is your pelvic floor can just be semi contracted. And
the reality is a lot of women are walking around
in their sympathetic nervous systems being activated, which causes a
reactive spasm and tightening of the pelvic floor, and that
pelvic floor just stays in that heightened, tight, alert state.
Speaker 2 (04:39):
And never lets go.
Speaker 1 (04:40):
Now you might think, okay, well that's great, my vagina's
going to be tight and it's going to make sex
feel really good for my partner. And it's going to
feel really good for me. But that's newsplash, not what
we're going for. A tight vagina does not feel good
for anybody. And I've addressed this on a few other episodes,
But when you have a tight pelvic floor, what happens
(05:05):
is you lose your blood flow to a lot of
those muscles, making them more fibrotic, making them less healthy
of a muscle so that they can't open and contract
as well, so then they become kind of dead. And
then that's when people often feel like their public floor
is super weak. And so when we get that kind
of public floor state, it can if you live in
(05:29):
that state for a long period of time, it can
just cause a lot of general tension and a lot
of fascial tightness, which can then create some scar tissue.
It can create some adhesions, It can create inflammation in
the tissue. And when we have all that, that can
make anything penetrative very uncomfortable.
Speaker 2 (05:48):
If we have that tension, that.
Speaker 1 (05:50):
Can create that pain with insertion, or even if it's
just uncomfortable feelings, it might feel a little burnie, you
might feel like you have to like especially warm up.
Speaker 2 (06:02):
That means that there's something going on in the pelvic floor.
Speaker 1 (06:04):
So if you are having pain with penetrative intercourse, whether
that's with the initial penetration or whether that's with deep thrusting,
that means that there's something wrong inside the peblic floor,
that the palic floor is just not optimized, it's not
working well for you.
Speaker 2 (06:19):
And you can.
Speaker 1 (06:20):
Work with a pelvic expert physical therapist to do some
hands on therapy to help improve the health of these
muscles and therefore you then can improve your ability to
enjoy the sexual experience. And there's nothing better, right, Like,
you want to be able to want to participate in
connect with your partner or whoever you're engaging with, and
(06:42):
if it is uncomfortable, it makes it a lot less desirable.
Speaker 2 (06:46):
Not to mention whoever you're.
Speaker 1 (06:47):
Engaging with, you know, might be like, well, I don't
want to hurt you, or I don't want you know,
I don't want to make this, you know, any worse
for you, and you don't seem like you're enjoying it,
And it has a major impact in relationships, and so
dealing with pelvic floor health and like healing the pelvic floor,
optimizing the pelvic floor can absolutely change the relationship you
(07:10):
have with your partner over the course of the years,
and I think it is one of the best things
that you can do for your partner. And so the
funny thing is is so so frequently and often when
when women like reach out and they're either like trying
to get pregnant or they are pregnant and they want
to prep for childbirth, husbands will be like, oh, why
(07:32):
are you doing this, Like this is just a waste
of money. Just fix yourself afterwards. But the reality is,
you get your pelvic floor healthy before you conceive or
during your pregnancy, you all of a sudden have this
like dynamic, healthy pelvic floor that's going to make intercourse
a lot more.
Speaker 2 (07:48):
Tolerable during the pregnancy.
Speaker 1 (07:51):
So if you want to be sexually active during the pregnancy,
some people do. Some people have incredible desire during the
pregnancy with all the rest of the hormones, and some
people have zero interest at all. Both are completely normal,
and so you want to be able to have a
healthy public floor because when it comes to the childbirth process,
then the pelic floor can open and expand baby can
(08:12):
leave the body with a lot more ease, and so
therefore the muscle can recover so much faster with that
childbirth experience, And so hopefully you see that, you know,
investing in your public floor wellness and your health is
so preventive in your fertility conception journey and then also
(08:32):
during the pregnancy itself. So these are just really important
essentials that I don't think men realize actually benefit them
because the less damage you have during the childbirth process,
it is going to be a heck of a lot
easier to get back to being intimate and having intercourse.
(08:52):
Because let me tell you, when you have tears in
scar tissue and you just experience significant trauma in the
public floor in the pelvis, not a lot of people
want to engage in sexual intimacy after that experience. And
when they do, they often go back to it and
are having to like grit their teeth and just kind
(09:14):
of like bear it. And a lot of times what
they'll do is, like during the intercourse experience, they'll tighten more.
Speaker 2 (09:21):
To try and like brace for it.
Speaker 1 (09:23):
But when we're tightening embracing for it, it actually makes
things worse. So one thing if you are experiencing discomfort
with intercourse that you can start to do now is
you can work on breathing through the intercourse experience. And
now I don't ever suggest it bearing through it, Like,
I just don't think that's a great pattern for the
(09:43):
brain to learn, because if your brain is gritting your
teeth and you're bracing during the intercourse experience, like yeah, sure,
you're doing it for connection with your partner or to
help please your partner. But if your brain is like
red flag, red flag, this is painful, that's gonna be
a pattern that is now lodged in the brain and
(10:06):
you're gonna have to rewire that once it feels good again.
So it's not something it's not like an exercise you
just want to push through and build the muscle up,
Like you just don't want to do that, because if
you do that, then you're telling your brain like this
is a painful experience and your body can't enjoy this experience.
Speaker 2 (10:23):
So then you're gonna have to get yourself back to enjoying.
Speaker 1 (10:26):
Like rewiring the brain to know that like, once it
feels good again, this is a safe experience.
Speaker 2 (10:33):
This is a pleasurable experience.
Speaker 1 (10:35):
But what happens is you have women and I see
this across generations that after childbirth, they never get really
interested in sex. Again, there's probably some trauma that happened
to the pelvic floor, whether that was some tearing, daring childbirth,
the use of fourceps, or they had a cesarean, and
cesarean absolutely causes a lot more restrictions through the pelvic
(10:57):
floor and tightness in the pelvic floor.
Speaker 2 (10:59):
And again, that type isn't good tightness.
Speaker 1 (11:01):
This isn't like, oh, we created a tight vagina and
this is super good for my partner. This is a
kind of tension that creates cement, that creates rigidity, that
creates fibrous beef turkey tissue that we want to soften
and heal because it's the softening and the healing and
the hydration of the tissue that makes the tissue feel
(11:24):
really good and feel like you have a really strong
vagina and strong pelvic floor. And so that is the goal.
And in order to help achieve that goal, we need
to be able to get rid of the scar tissue.
We have to heal the pelvic floor after we have babies. Now,
some people have painful intercourse and painful penetration even before
(11:47):
they have kids. Maybe they grew up in a world
where touching themselves was you know, off limits. There was
a lot of shame around the pelvic floor and the genitalia,
and so they just like they just closed it off
and like mentally disconnected. And when we do that, there's
a lot of tension through these areas, and that tension
(12:09):
can often lead to the diagnosis of badginismus, where you
just get that chronic spasming of all three layers of
the public floor, and we have to untrain that and
get the brain to be like, this is a safe area.
It is okay to touch my genitalia, It is okay
to engage with my partner, it is okay to have orgasm.
But if we don't have if we don't have that
(12:31):
mental mindset and this area is still off limits, it's
really hard to heal the poblic floor. So people come
here from all walks of life where they're in the
phase of they just want to be they just got
married and they just want to be intimate with their
partners to they are trying to conceive, but they literally
can't even insert anything.
Speaker 2 (12:53):
So they're finding it nearly.
Speaker 1 (12:55):
Impossible to be able to have sex during during their
ovulation cycles, and so then they work through that right,
And it's not just working through the muscle tension, it's
also working through the mindset of being able to accept
your body and accept the pelvic floor and like, learn
how these function, learn how the palic floor functions.
Speaker 2 (13:18):
I think a big.
Speaker 1 (13:19):
Reason that people never get, like we never get the
education in like fifth grade flash class when you learn
about sex of how your pelvic floor functions.
Speaker 2 (13:31):
We don't.
Speaker 1 (13:31):
No one ever teaches us like, Okay, your public floor
and your genitalia are actually muscles. And a lot of
times when we're in a heightened state of alertness, or
we're exercising, or we're stressing out over an exam, our
public floor has a lot of tension in it. And
in order to relieve the tension, we have to do
(13:51):
some deep breathing and allow the diaphragm to open, which
allows the pelvic floor to open.
Speaker 2 (13:57):
So you can do things.
Speaker 1 (13:58):
Called diaphragmatic breathing and that can help open up the
pelvic floor. Well, if we were only taught this in
fifth grade flash class or even earlier, then we would
realize like, oh, we have this control of our pelvic floor.
Speaker 2 (14:12):
Well, the pelvic floor is a deep.
Speaker 1 (14:14):
Core muscle, and is absolutely essential for the function of
our core as well.
Speaker 2 (14:18):
So if we live in this titan state of.
Speaker 1 (14:22):
Pelvic floor function, then we actually miss out on the
eccentric motion of the pelvic floor, which is a big
piece of where our shock absorption comes in from the core.
And so we have to have that shock absorption to
unload the joints and help keep our joints healthy, and
that helps keep us free of like si joint pain
(14:44):
or knee pain even and hit pain and neck pain.
The tigher our pelvic floor is, the less restricted it,
the more restricted it is, the less movement there is,
the less shock absorption happens, and the weaker the core
actually is, it becomes less functional and so so therefore
we have to train these muscles to have range of motion.
(15:04):
When you train the pelvic floor to have this epic
range of motion, then all of a sudden, sex becomes
really good.
Speaker 2 (15:10):
Orgasms become even better because if you have.
Speaker 1 (15:13):
To work really hard for your orgasm, a lot of
times it's because the pelvic floor is at such.
Speaker 2 (15:17):
A heightened state and already so contracted.
Speaker 1 (15:20):
But if you can have a relaxed pelvic floor and
you can get yourself to that opening where the muscle
can be fully open, elongated.
Speaker 2 (15:27):
And relaxed. Then there's a lot.
Speaker 1 (15:29):
More range of motion to build up for that orgasm,
and you don't have to work as hard at getting
that climax and getting that peak.
Speaker 2 (15:37):
State of arousal.
Speaker 1 (15:39):
And sometimes people have such tension that they're just in
a constant peak state of arousal and that when they
have like orgasm after orgasm after orgasm, and that is
actually very not comfortable because a lot of times they
can't even work out without having those orgasms. So they
really have to work on training and opening the pelvic
floor in order to get the range of motion, get
(16:00):
a blood flow, and take them out of that constant
climax state.
Speaker 2 (16:04):
And so you know, it works on both ends of
the spectrum.
Speaker 1 (16:08):
But the more range of emotion you have of your
pelic floor, the more control you can get of the
pelvic floor, the better the sexual experience is going to
be for you, and I hope I've made this clear,
but also for your partner.
Speaker 2 (16:20):
And of course, like the less pain you're.
Speaker 1 (16:23):
In, the more you want to engage with it, the
more that you enjoy it, that's.
Speaker 2 (16:27):
Also better for your partner.
Speaker 1 (16:29):
So I take it back to the men that you
know put a stop on their wives getting like good,
true holistic pelvic floor physical therapy, which is hands on
manual work of the pelvic floor and teaching the palvic
floor how to attain these new ranges of emotion and
these in these states of the pelvic floor and making
these muscles super healthy for prevention. That improves your sex life,
(16:54):
like the man's sex life.
Speaker 2 (16:56):
So why not have your woman come here into this
way right?
Speaker 1 (17:01):
And that baffles me every time, and I don't know
how to get the word out other than like, if
this is your husband, send him this podcast and hopefully
he will listen to it and be like, oh, my
sex life is going to improve.
Speaker 2 (17:15):
You're telling me that your.
Speaker 1 (17:16):
Vagina is actually gonna feel even better if you get
this range of motion, like hands down.
Speaker 2 (17:20):
I'm in right, Like who doesn't want that?
Speaker 1 (17:25):
But oftentimes, like just like females like men have been
sold keego culture and like just strengthening the pelvic floor
and work the pelvic floor and keego keegel. But let's
be real, like that doesn't help anyone if you have
tension in your pelic floor and you're already semi contracting.
Contracting even more is not helpful, and it's actually detrimental
(17:46):
and will make the sexual experience worse, will prevent you
from orgasming, and will also wear out your joints in
the long run. So do your fifty and sixty year
old self a favor and work through the pet floor restrictions. Now,
I do just want to like die, like talk a
little deeper into like the importance of this for relationships.
(18:09):
And I've said this multiple times on multiple platforms, and like,
I'm no relationship expert. I happen to be married for
the last ten years. But fuck it's hard, right, Like
there's no like sugarcoating. I have zero expertise in this.
I'm just like learning and failing forward, right and so
and we have three children, right, so it's like we
(18:29):
live the chaos and life of being married, and we
try to stay married, right and enjoy each other's company
and like remember why we got married in the first
place and all that all that stuff.
Speaker 2 (18:41):
I have zero expertise in this field.
Speaker 1 (18:43):
But what I will say is being an observer of
my patients and seeing them after they have their babies,
the transition from delivery we get to if we get
the pleasure of working with them during pregnancy. This is
this happens a lot less frequently. But what happens often
is when we see a new client post partum.
Speaker 2 (19:05):
And the reason, sorry, let me back up.
Speaker 1 (19:07):
The reason that happens a lot less frequently when they've
had pelvic work during pregnancy is because they heel so
much faster. They usually want to engage in sex more
frequently after delivery because there's just a lot less trauma
to the body, so they feel more ready to go.
They don't feel the pain that you might feel or
the pressure you might feel after having childbirth without any
(19:28):
pelvic floor prep. So that's really the value of doing
your pelvic floor prep during your pregnancy is to really
prep your pelic floor so you can one of the
reasons go back to your sex after childbirth without pain,
but also go back to the.
Speaker 2 (19:43):
Gym and all that good stuff. So where I was
going with that is when we.
Speaker 1 (19:48):
See a new client post partum and they come to
us after having childbirth, like usually there's some scar tissue,
maybe some severe scar tissue, and they're oftentimes incordinat of
the pelvic floor. So the pelic floor just loses its function.
They feel like they're blown out, like there is nothing there.
They feel weak as I'll get out, and so of
(20:09):
course they feel like they need to do kegels. But
the body is like magic, right, So after you have
a baby and everything opens up, what happens is reactively
the body compensates beautifully and the pelic floor tightens back
up to try and pull the pelvis together, because the
pelvis usually separates about five to nine millimeters right at
(20:29):
the pubic synthesis joint. So the blutes will tighten to
pull the pelvist together, the pelvic floor will tighten to
pull the pelvic floor to pull the pelvis together.
Speaker 2 (20:37):
The bones and then.
Speaker 1 (20:38):
The adductors, the inner thigh muscles, it'll they'll tighten to
pull the pelvic floor to pull the pelvis in the
pelvic bones back together. And so this is all a
compensatory pattern. And then you might think, oh, that's great,
my vagina's tight again. But again you'll still have that
blown out feeling or like that you're just completely weak,
that there's nothing there and that you need to keegel.
Speaker 2 (21:02):
But it's because there's no range of motion in the muscle.
Speaker 1 (21:05):
So all the strength of the pelvic floor actually comes
from the ecentric lengthening and elongating and opening up up
the pelic floor, because the more you can open up
is the more you can contract.
Speaker 2 (21:17):
But after we have kids.
Speaker 1 (21:19):
With that compensation and the body being a magical healer,
it already tightened up and came back together, and you
still feel really weak, and it's because you don't have
the opening motion. So the opening the eccentric motion is gone,
and so we have to restore that. And in order
to get the opening and elongation and the stretch back
(21:40):
to the tissue, we have to get rid of the
scar tissue that's probably holding it together and that's tightening
it down and not letting it open and expand.
Speaker 2 (21:49):
So hopefully that makes good sense.
Speaker 1 (21:52):
And the more that you get that range of motion back,
the better your sexual experience is going to be and
you won't have then and the pain upon initial penetration
and then with deeper thrusting. When people have pain and
discomfort with deeper thrusting, it often means that the third
layer of the.
Speaker 2 (22:10):
Pelt floor is really tight. What does that even mean?
Speaker 1 (22:13):
It just means that the deepest layer of your palt
floor including your hip muscles, tend.
Speaker 2 (22:19):
To be really tight.
Speaker 1 (22:20):
So what people will often say is they'll say, it
feels like my partner's hitting something, and it's really uncomfortable,
so I.
Speaker 2 (22:27):
Brace against it. Well, if you feel like your partner's
hitting something, most likely it's.
Speaker 1 (22:32):
Because your third layer or some muscles inside your palvic
floor that are really deep and connecting to your hips,
are very tight. Oftentimes we see it as this muscle
called the operator internus muscle, which is a hip muscle,
and it is it's a really important muscle, but when
it is tight and overworked, it is extremely painful and
(22:54):
it'll feel like your partner is hitting something. And so
a lot of times people will be like, oh, they're
hitting my cervix. Maybe I have uterine prolops and my
cervix is coming down out of my vagina and or
my bladder's coming down, and that's what they're hitting, and
that's really hurting.
Speaker 2 (23:10):
But for the most.
Speaker 1 (23:11):
Part, that is just the tension of the palviic floor
and your partner's not actually hitting your cervix, and your
partner's not actually hitting your bladder. Like, yes, the bladder
of course gets touched every single time. That your partner
goes in and out of you like, that's just par
for the course. The bladder is sitting on the anti
your wall the vagina, so there is gonna be contact there.
(23:33):
The cervix is sitting at the top of the vagina,
and so if your partner is really big, like you
will have some touching of the certifix.
Speaker 2 (23:42):
That should actually.
Speaker 1 (23:43):
Not be painful though, and so if it is, there
might be restrictions around the actual cervix itself.
Speaker 2 (23:50):
So you might be sitting there.
Speaker 1 (23:51):
Thinking, Okay, Alison, what is a palvic floor physical there
is actually gonna do to help change these muscles for me?
Speaker 2 (23:58):
Well, there's a lot of things. They're gonna teach you
how to work your pelt floor muscles.
Speaker 1 (24:02):
They teach you how to work your pelt floor muscles
by using some breath mechanics, by doing some stretching, by
learning how to truly work and engage your lower abdominal muscles.
Most people can't actually engage their lower abdominal muscles, and then,
especially after they grow a baby for ten months, it
is so hard to engage the lower apps and then
(24:25):
just forget about it. If they were cut with a
C section, that is one of the hardest things to
get back, and so if you don't have lower app control,
it's actually really hard because then the pelvic floor overworks
to compensate for that lower app control. So we got
to get the lower app control back, which side note
aesthetically helps flatten your stomach right, So we all want that,
(24:48):
or maybe you don't, but like, getting that control back
is going to be absolutely epic, and unloading the pelvic floor.
Unloading the palvit floor is then going to allow that
pelt floor muscle to be more high, more dynamic, have
more movement, And so we teach the palate floor how
to start moving again, along with training the lower abdomen
(25:09):
and restoring the rest of the core muscles. So we
got to get the diaphragm moving, We got to get
the back muscles and the glutes firing. Training your glutes
and getting hip extension back after you have kids is
very important because hip extension is one of the things
that we lose during the pregnancy process. As we grow
a baby, we have more anterior load and therefore our leg.
Speaker 2 (25:32):
Doesn't go as far behind our.
Speaker 1 (25:34):
Bodies, so we lose hip extension, which means that we
lose our glute activation, which is a big reason why
we have the moms have a flat butt phenomenon. But
when you have a flat and tight butt and the
butt is really weak, then it is there's a lot
of tension there. And if there's a lot of tension
there and you're gripping your butt a lot when you're
(25:54):
standing or doing other activities like even just like washing
the dishes, if you find yourself clenching your glutes, you're
also clenching your public floor further, which is then going
to mess up your palic floor range of motion, creating
a lot of generalized tightness, which is then going to
lead to that soliloquy of sex not feeling as good.
And so the more we can get that range of
motion and heal that the better. So back to what
(26:15):
the palvic floor physical therapist does on top of doing
all that other work, is they will do an internal
and external assessment of the pelvic floor muscles.
Speaker 2 (26:23):
So they'll look at all the pelvic muscles on the
outside of the palace.
Speaker 1 (26:26):
This includes the glutes, this includes the hip flexors, this
includes the abdomen, this includes.
Speaker 2 (26:32):
Everything that you can imagine that connects to the pealpast.
Speaker 1 (26:34):
Those muscles will be evaluated and make sure that your
compensation patterns can be broken up, and then we can
train the muscles to do the healthy movements that they
are supposed to be doing. That's all about, you know,
restoring our body's motion. And you know, I'm talking about
this often in like relationship to like healing after childbirth.
But the reality is, like a lot of people have
(26:54):
this pattern even without having kids. And so even if
you haven't had kids, if you have this tension power
and this is like a really common compensation, you don't.
Speaker 2 (27:02):
Just have to have kids. Having kids exacerbates this even further.
Speaker 1 (27:06):
But a lot of people who don't have children also
experience these issues and have these very similar patterns.
Speaker 2 (27:13):
And then we also look at the pelvis inside. And
when we look at the.
Speaker 1 (27:16):
Muscles on the inside of the pelvist, we do this
through looking at them intravationally. So we'll have a glum
finger and you'll be draped with sheets and we'll gently
insert a finger and test the different layers and muscles
of the pelvic floor itself. We'll be checking for a
scar tissue adhesions that are found within the pelvis and
(27:38):
really working to improve the extensibility of the tissue, which
means that we're just looking to stretch and open and
hydrate these muscles, making them very very healthy. We do
this on all three layers of the pelvic floor, and
you can also do this introrectally, and that's how you
assess mail anatomy is through the rectum and they're there
(28:00):
are certain conditions and diagnoses that will respond better to
interactal work, but a lot of times intervaginal work is
a lot more tolerable just because you don't have to
work through the anal sphincter, you know, and sometimes it's
hard for people to relax their anal sphincters and then
be able to relax.
Speaker 2 (28:17):
Their pelvic floor.
Speaker 1 (28:18):
So so yeah, working through the polic floor is absolutely essential,
and not everyone wants to do that fully understand.
Speaker 2 (28:27):
But if you can get.
Speaker 1 (28:28):
To a point where you're able to work through your
palvic floor and heal these muscles, fix any scar tissue,
it can epically improve your sexual experience and not to
mention it just gives you.
Speaker 2 (28:40):
A different connection to your body and.
Speaker 1 (28:42):
Allows you to use your core in a way that
you've never experienced. This is in a way that no
amount of planks, sit ups, crunches could ever train your core.
When you get this control of your public floor, you
will be able to engage your lower ads. You'll be
able to engage your core and allow your core to
(29:03):
function in new ways that you never knew existed. People
that experience like low back pain side joint pain usually
have really tightened pelvic floors because the pelvic floor is
spasming and tightening to try and protect the back and
protect the side joint pain. But a lot of times
it is creating even more pain patterns because of the compensation,
(29:26):
which then can lead to uncomfortable intercourse.
Speaker 2 (29:29):
So that's what we're looking at.
Speaker 1 (29:30):
So when someone comes in for a pelvic floor exam,
that's what we're going through.
Speaker 2 (29:36):
So it's an.
Speaker 1 (29:36):
Internal and external exam and we get healing, and it
takes the body time to heal.
Speaker 2 (29:42):
You know, if this is it just depends.
Speaker 1 (29:45):
It can be a six week experience to a six
month to a multiple year experience depending on how like
the severity of pain is.
Speaker 2 (29:51):
But just to improve your.
Speaker 1 (29:52):
Sex life, that can happen fast, Like just start getting
some motion, some blood flow here, start getting the pelvic
floor to function and actually do the movements that it
was trained to do, and you will have epic changes
to your sexual experience. And now you might be wondering,
like are there devices that can do this for me?
(30:13):
There are certain things like wands, there's certain things like
vaginal dilators, and they have their place. I find it
is already like most people don't know what they're feeling
when they feel their public floor, so it's really hard
to know, like where you're sticking a wand, Am I
actually putting this wand in a muscle that's going to release?
Speaker 2 (30:33):
And this wand would go in like intervaginally, and.
Speaker 1 (30:38):
So for that, just so someone doesn't hurt themselves further
or cause more pain, I always say, like it's most
ideal and gold standard. Find a pelvic floor physical therapist
that you know, that you like, that you trust can
help you get full function and range emotion of the
palic floor and you're gonna have to keep working on it.
When we have a maintenance program here a Bodymotion where
(31:01):
people come once a month just to help restore and
keep their range of motion.
Speaker 2 (31:05):
Of the public floor.
Speaker 1 (31:06):
Because the reality is is like life is stressful, Like
we just have the holidays, right and like my pelvic
floor was so tight, I started leaking some urine. Again,
That's what can happen when you have tension through your
pelvic floor and sex wasn't feeling super good. Then I
had a couple sessions of pelvic floor because I had
skipped a month. I had skipped my session in December,
and I had a couple of sessions and fixed just
(31:28):
like that.
Speaker 2 (31:28):
Pelvic floor is working and functioning way better.
Speaker 1 (31:31):
Even my lifts and my workouts are so much better
because my core engagement is better, and so all of
it is so related, and the best thing that you
really can do for yourself is like, learn how to
use your public floor.
Speaker 2 (31:45):
Get these muscles so extensible, work with someone.
Speaker 1 (31:48):
Who can help you achieve that goal, and like it
will play a huge role in your relationship and your
ability to stay sexually active with your partner.
Speaker 2 (31:57):
As our hormones change and we.
Speaker 1 (31:59):
Go through perimental and menopause and we lose a lot
of our estrogen and progesterone balances, what can happen is
we can lose hydration of the pelvic floor, We lose lubrication,
and that can make the muscles weaker because then they
go to that state that they were essentially in postpartum
where they.
Speaker 2 (32:16):
Just typing back up, they lose range of motion.
Speaker 1 (32:19):
The more you keep the health of your pelvic floor muscles,
the more you keep that range of motion, the more
you're actually going to keep natural lubrication independent of having
your estrogen and progesterone balanced.
Speaker 2 (32:32):
So the healthier this.
Speaker 1 (32:33):
Muscle is, the more dynamic it is, regardless of your
hormonal hormonal state. It actually can like if you keep
healthy during perimenopause and during menopause, then after menopause it's
going to stay in that healthy state as long as
you continue to work it.
Speaker 2 (32:48):
What happens to a lot of people, and this is
what we see in.
Speaker 1 (32:50):
The nursing homes right when they're in their like seventies, eighties,
and nineties, is they never had pelvic care after they
had babies or even just in general in their lives,
and so they're peeing their pants, they're in wheelchairs, they're
in diapers because their cores don't work, can't get their
core to work, no matter how much physical therapy they
do and how many you know times they've been to
(33:10):
physical therapists and trainers in their lives, and it's like
a lot of it just goes back to like they
never have this core function in the first place. Right,
So that had been to taken all the way back
to that fifth grade flash class. And if we can
just teach kids how their pelvic floors function and how
their genitaliam move, then we can give them like lifelong health, right, Like, yeah, well,
(33:34):
you still need maybe some help in keeping the range
of motion and absolutely, but like, if you can keep
your core functioning, you learn how to function your core
and like work your public floor and opening range of
motion when you're in fifth grade. Can you imagine what
that does for you when you go and have your babies.
And how do we teach this, Well, you teach this
by teaching someone how to have a bowel movement. When
(33:55):
you have a bowel movement and you learn how to
open your public floor by breathing and controlling your pelvic
floor and not just sitting there and pushing the poop out,
then you get to have amazing control of the opening.
Speaker 2 (34:09):
So then you get the eccentric motion.
Speaker 1 (34:11):
And when you learn how to do that, then all
of a sudden, you know how to have that range of.
Speaker 2 (34:15):
Motion of your public floor. So we just got to
teach kids how to poop.
Speaker 1 (34:18):
We also got to teach them how to pee so
they're not pushing their pee out because that is absolutely
detrimental to their pelvic organ positions and to different conditions
that can happen. And so we just have to teach
people how to have good vowel movements, how to have
good peas, and we'll be good to.
Speaker 2 (34:33):
Go, right.
Speaker 1 (34:36):
But the reality is is like also that is that
information received and whatever.
Speaker 2 (34:39):
It's a rabbit hole that I'm not going down. But
I absolutely think.
Speaker 1 (34:44):
That we can at least teach our own kids that
and we can start to make an impact in them
improving their public floor function just by teaching them how
to poop and how to be And you can check
out my YouTube channel. There's about a million videos about
how to have a bowel movement properly and how to
pee properly. So just a little side note for you there.
But I hope you have enjoyed this episode. I hope
(35:06):
you now have confidence that if you're not having orgasms,
you'll be able to one day. I hope that you
have confidence that if sex is not comfortable or not
your favorite thing, that you know what needs to be
done in order to help improve your experience. And I'm
just going to leave you on that note, so thank
you so much for being here with me today. I
(35:28):
have a great pleasure of bringing this information to women
across the world, and our goal is to change humanity,
to change women's health care, to change women's wellness so
that we can live freaking amazing lives and feel really
good in our own sinkin and feel really good in
(35:48):
our own skin. Because when we feel good in our skin,
then the impact that we can make to improve humanity
for the good is wild, right, It's the potential is endless,
and so I wish that for you. And get control
of your public floor. See a public expert physical therapist.
There is nothing better than having range of motion of
(36:11):
your public floor being able to enjoy your sex life.
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