October 16, 2024 • 59 mins
Unlock the secrets to empowering your pelvic health in a candid chat with Kim Vopni, a renowned book author, restorative exercise specialist, public speaker, dedicated to breaking societal taboos around women's health.
In this episode, we shine a light on the often overlooked yet critical aspect of women’s health: the pelvic floor. From the societal stigmas to the historical neglect of women's health research, we delve into how knowledge and conversation can transform lives.
Learn the intricate details of pelvic floor dysfunction and the impact of psychological and physical factors like fear, trauma, and poor posture. We tackle symptoms such as incontinence and pelvic organ prolapse, offering innovative solutions like Kim's comprehensive Buff Muff method. She shares her expertise on why traditional Kegels might not be enough and highlights the need for a dynamic fitness routine that incorporates pelvic floor health. Understand the foundational role of the pelvic floor in core strength and spinal stability and how informed fitness can elevate overall wellbeing.
Gain actionable insights into optimizing pelvic health across all stages of life. From rapid improvements in incontinence through tailored exercises and lifestyle changes to the significance of regular pelvic floor physiotherapy check-ups, this episode is packed with tangible advice. Kim debunks common myths and emphasizes the ongoing commitment required for long-term wellness. We explore the benefits of diverse exercises, and movement practices like yoga and Pilates, Pfilates (pelvic floor pilates). Tune in to transform how you perceive and manage your pelvic health.
EXPLICIT CONTENT - RELATING TO WOMEN'S HEALTH,BODY.
DISCLAIMER: THIS EPISODE IS FOR INFORMATIONAL PURPOSES ONLY. THIS IS NOT TO BE CONSTRUED AS MEDICAL ADVICE, NOR IS IT A SUBSTITUTE FOR MEDICAL ADVICE. PLEASE CONSULT YOUR DOCTOR FOR INDIVIDUAL NEEDS.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Vai Kumar (00:10):
Welcome to Freshleaf Forever, a podcast that gives
you fascinating insights weekafter week.
Here's your host, vaikumar.
Hey folks, welcome to anotherepisode on podcast Freshleaf
Forever.
Have you wondered why pelvichealth is seldom discussed?
(00:34):
Well, that's why our guest, kimWapneyV, is here with us today
on the show.
With us today on the showbecause we both strongly feel
it's time for pelvic health tobe discussed and offered to
women at all stages of life.
It's time to break throughtaboos and redefine how we think
(00:58):
about women's health, and notjust like bladder leakage
women's health and not just likebladder leakage, which
oftentimes is considered justpart of being a woman.
But there's so much morechallenges that women face when
it comes to pelvic health.
Our guest, Kim Vopni, is arestorative exercise specialist.
(01:23):
She's a public speaker, a bookauthor in fact, multiple book
author and she's also the hostof a thriving podcast, between
Two Lips, where she bringsguests and thought leaders to
address several matterspertaining to pelvic health.
(01:43):
She is also a certifiedpersonal trainer, a certified
pre and postnatal fitnessconsultant, a certified Pfilates
instructor and a hypopressivemethod trainer.
She is a certified menopausesupport practitioner as well.
(02:03):
So it's with great joy that Ibring Kim Vopni here to podcast
Freshleaf Forever.
Let's get to the episode.
Hey Kim, welcome to the podcast.
How are you doing today?
Kim Vopni (02:19):
I'm doing well.
Thanks so much for having me.
Vai Kumar (02:21):
Well, I guess a lot of women's topics.
Whatever women go through,definitely, they remain silent
for the most part, and first ofall, I want to start by thanking
you for your work.
So, when it comes to women'shealth, like I said, a lot of
topics are considered taboo.
(02:42):
So why, would you say, pelvichealth is so significant, kim?
Kim Vopni (02:51):
Well, thank you for having me on your show and for
the support and kind words.
I really appreciate that, andpodcasts like yours are a way of
helping break down this tabooand getting this information
into the hands of of morelisteners and um empowering them
.
So the I mean there's the, theumbrella of women's health,
(03:11):
which has historically alwaysbeen underserved, I would say I,
you know, women haven't beenincluded in research until
really fairly recently.
And, uh, and that's reallyshocking when you think about it
, and one of my favorite theguests that I've had on my
podcast, dr Stacey Sims, has theterm women are not small men
(03:33):
and we deserve our own researchand we shouldn't just be, you
know, because we're a smallerperson, to just back off the
dose of a drug or something likethat.
So there's the women's healthumbrella, and then there's
pelvic health, which is, I wouldsay, even more underserved,
(03:54):
starting to become more.
In the years that I've beendoing this, but because there's
discomfort with even saying theword vagina there is, you know,
(04:23):
I've had multiple posts takendown from social media for you
know, saying that it isinappropriate because I use the
word vagina and or sex, or youknow, it's kind of mind boggling
when you really think of it.
Thankfully there's been someprogress and now I can use the
term vagina openly.
But there's a culturalperpetuation of shame and taboo
and embarrassment and we don'ttalk about that and in, for
instance, my mother's generationso I'm 53 and my mom will be 80
(04:46):
this year and that generationwas very much you don't talk
about that and you just justcarry on and it's not discussed.
My mom thankfully she was veryopen with my brother and I.
She's a.
She was an operating room nurse.
She was very.
She told us the proper terms.
She was an operating room nurse.
(05:06):
She told us the proper terms.
She told us about the body.
She taught us things.
At the time it feltuncomfortable when you're
learning it with your brother,but I'm thankful that she
planted that seed of normalizingour bodies and being able to
identify parts and not usingcode names or strange names to
name something like a vagina oran anus or rectum or something
(05:28):
like that.
So I think that is kind of partof what has a few things that
have kind of perpetuated orcreated this taboo or don't feel
comfortable talking about it,what I see now social media has
played a big role feelcomfortable talking about it,
what I see now.
Social media has played a bigrole.
I feel like the youngergeneration is much more open to
(05:49):
conversations around things thatare uncomfortable to talk about
.
So, there's, there's a lot morevoice being brought to, to
differences and and that type ofthing.
So I'm, I'm, I applaud that andI'm super excited because I
think generations to come willbe more informed much earlier on
(06:09):
and I feel like there will be,as a result, less, less
suffering.
Vai Kumar (06:14):
Yeah, I mean when you said you know, even some of
your social media posts andstuff were taken down earlier.
Yeah, whatever, when you sayvagina, it's misconstrued for
something inappropriate that youare putting out to the digital
world and digital community,right?
Yeah, you're trying to do theright things in terms of
propagating awareness, in termsof educating people on women's
(06:39):
health.
Yeah, sometimes we just have tofight the hard battles, but I
think it's worth it.
So what role does tightness ofthe pelvic floor play, then,
when it comes to women's health,or anyone's health, say, right
from constipation?
A tight pelvic floor, I believe, is like a hindrance, right?
(06:59):
So what would you say to that,kim?
Kim Vopni (07:03):
Yeah, the pelvic floor is a group of muscles, so
it's not just one muscle, it isa collection of muscles and it's
this you know some peopledescribe it as a hammock or a
sling.
It's the muscles that connect,they attach at the pubic joint,
the tailbone and the two sitbones on our side.
So those four points sort ofmake a bit of a diamond shape.
(07:25):
And the muscles that close offthe base of our pelvis is
considered the pelvic floor andits roles are to support our
spine and pelvis, to support ourinternal organs, to manage our
continence, play a role in oursexual functioning and also work
in relationship with ourbreathing diaphragm for things
like circulation and movinglymph, basically moving things
(07:49):
through our body.
So these are really importantjobs and we've never been told
any of this.
We might have heard the termKegels.
We don't appreciate that, likeother muscles in our body, they
like to be taken through a rangeof motion, they like to be
strengthened, they like to belengthened and we need a balance
(08:13):
of length and strength in orderfor those muscles to do all the
jobs that they need to do.
And what is now?
Now, I personally don't workwith people, I don't do internal
evaluations, I'm a personaltrainer and I apply fitness
techniques to the whole body,but specific to the pelvic floor
(08:35):
.
And then there are therapists,pelvic floor physical therapists
, who can do internal evaluationand treatment, and my
colleagues in that space willtell me that it is becoming
increasingly common for peopleto have tightness in the pelvic
floor, and there are certainthings that can contribute to
that fear shame, uh like trauma,either psychological trauma,
(08:59):
trauma, uh, that could bephysical, from a fall, maybe
surgeries, um uh, pain, um like.
I can go on and on the.
There's a long list ofcontributors to what can
contribute to tightness.
There's also then the symptomsthat people experience, such as
(09:20):
incontinence, so that's whereurine or gas or stool would leak
out of the body without uswanting it to come out.
That symptom can thenindirectly also create tension,
because when we're afraid ofleaking, whether it's gas, stool
or urine, the muscles are kindof on high alert.
(09:41):
We are on high alert, ournervous system is on guard.
Same if we have anothercondition called pelvic organ
prolapse, where the bladder,uterus rectum can start to shift
out of their optimal position.
Part of the role of the pelvicfloor is to support those organs
, and if we have this sense ofvulnerability and feeling like
something's going to fall out.
We're going to be guarding.
(10:02):
So the symptoms from pelvicfloor dysfunction.
We could have those symptomsbecause of tension, or we could
develop tension because of thosesymptoms, or again because of
all the other things that I'vealready listed.
So, kind of getting to the rootcause as to why do we have this
tension, and then knowing thatwe have an option, an
(10:23):
opportunity, lots ofopportunities to let go of that
tension.
But if we have muscles that areoveractive, non-relaxing, not
lengthening appropriately, ifthey're held in sort of a short,
tight state, then their abilityto react at the right time if
we laugh, cough, sneeze or jump,react with the right amount of
(10:46):
force needed to offset thatincrease in pressure from that
activity is going to be hindered.
So that's like very kind ofhigh level how tension can
interfere with the function ofthat group of muscles.
Vai Kumar (11:03):
Okay, you mentioned fear.
You mentioned a lot ofpsychological trauma and factors
like that.
We all live in a virtual worldnow.
Could prolonged sitting also bea root cause of all the pelvic
floor dysfunction?
Potentially can that build upover time.
Kim Vopni (11:21):
Yeah, yeah, I'm glad you brought that up.
It didn't say it on the listthere.
But posture how we holdourselves through the day, and
prolonged sitting so prolongedsitting can be can hinder us in
many, many ways.
But usually if you're sittingin ideal posture and you're and
and that and you spend yourwhole day there, that's better
(11:42):
than sitting with poor posturethe whole day, but it's still
not moving that much.
We benefit from a diversity ofmovement, as does the pelvic
floor, rather than being static,and our whole body would
benefit from more movement.
But most people, over time, asthey're sitting, they start to
slouch, their tailbone starts tokind of, they lose the
(12:04):
curvature in their low back,their pelvis is tilting
underneath them, they're hunchedover usually.
So all of that is interferingwith the relationship of the
diaphragm and the pelvic floorthat I spoke about earlier.
So we're not breathing as well,we're not breathing as deeply,
we're not getting thatsynergistic movement of the
pelvic floor with our breath.
The muscles are adapting to ashorter state, so over time they
(12:26):
are starting to develop moretension.
Even the footwear that we wear,even the clothing that we wear,
like there's so many differentinfluences to the pelvic floor
and I don't want to say that weall have to have, you know,
flowy clothes and walk barefootfor the rest of our life.
(12:48):
Of course we want to be stylishsometimes and that's fine, but
just being aware of how thethings we put on our body and
the things that we put in ourbody, how they influence how we
feel, how we function, how ourmuscles can react, so, yes,
1000% sitting, especiallysitting with poor posture, can
definitely be an influentialrole.
Vai Kumar (13:08):
And even when you said flowy clothing or whatnot,
you know how much we subjectourselves to.
Whatever is not ideal is isagain that's.
That's a huge component to howwe feel, or what we subject
ourselves to.
Right, spinal stability peopledon't realize spinal stability
(13:29):
and pelvic floor function arerelated.
Also correct, it has a hugebearing on it, is that right?
Kim Vopni (13:36):
Yeah, the pelvic floor attaches to the base of
our spine, which is the tailbone, and to the pubic joint and to
sits bones.
As I mentioned, it's thefoundation of our core.
We've all heard of coreexercise and core fitness and
workouts and that's been abuzzword in fitness for years,
but never in that conversation.
I've taken many differentfitness certifications.
(13:58):
Never once was the pelvic floorever mentioned in any of that
core conversation.
And yeah, that's a majorfunction and role of the pelvic
floor is to provide control totransferring loads from upper
body to lower body movement.
You know, keeping everythingcontained and held, so to speak,
(14:21):
within the pelvis is a reallyimportant job.
Vai Kumar (14:32):
Okay.
Okay, you mentioned Kegelsearlier.
I used to always think when itcame to the pelvic area, that
was the be all and end all of it.
Obviously not, so I guess therecomes your buff muff method.
Can you help listenersunderstand why you came up with
that and what does it helpaddress Kim?
Kim Vopni (14:51):
Yeah, a Kegel exercise.
So there was a doctor named DrArnold Kegel who witnessed in
his patient population that,after giving birth, women
struggled with the control oftheir pelvic floor.
They didn't have that samecapacity for function as they
did before, and so he used abiofeedback device that helped
(15:14):
women see this group of muscles.
I don't mean like physicallysee it, but they could see on a
screen.
It would register this movementof them contracting and
relaxing, because the pelvicfloor is inside us.
We can't, you know, stand infront of the mirror like we do
and flex our bicep muscle andsee it.
(15:34):
So it's.
We need visualization, we needcues, we need things like
biofeedback to help us connectwith this group of muscles.
So he, he's the, the, theperson who came up with the
Kegel exercise, which is avoluntary activation and lift
and release of the pelvic floor,and so that has been kind of
(15:54):
the what, what is thought tohave been the only exercise
available to us.
If any people had heard anythingabout the pelvic floor, it was
usually Kegels, and that was it.
If any people had heardanything about the pelvic floor,
it was usually kegels and thatwas it.
We've never been taught how todo them correctly, we might have
been given a brochure.
We go to google.
We see things like it's themuscles used to stop the flow of
urine, so sometimes people willpractice on the toilet, and so
(16:17):
we have evidence to show thatkegels work when they're done
correctly and consistently.
We also have evidence to showthat Kegels are most often done
incorrectly, not our fault.
We've never been taught, as Imentioned.
Vai Kumar (16:29):
Oh, I knew it was.
I thought he, like you said,you know sit.
Oftentimes I was told yeah, youcan practice it best when
you're trying to urinate sittingon the toilet.
You know it's a contraction andrelaxation of those muscles.
So, yeah, I guess there's moreto it now and relaxation of
those muscles.
Kim Vopni (16:45):
So, yeah, I guess there's more to it now.
Yeah, and that's a way that wecan identify the muscles.
If you can stop the flow ofurine, then that's a start into
being able to access that groupof muscles.
But you definitely don't wannapractice on the toilet.
We just wanna sit and pee Oncein a blue moon.
If you wanna test to see if youcan stop your flow of urine, go
for it, but don't practice yourcontract and relax while you're
(17:06):
trying to pee.
That will create other issues,especially infection and
mind-body disconnect, and it'snot going to serve you.
But the limitation with Kegelsis the general recommendation is
three sets of 10, 10 secondholds three times a day and
that's done either lying down orseated.
And there's a couple ofchallenges there.
(17:28):
One, not very many people aregoing to commit to doing
something three times in a day,and the other is it's a static
exercise, sitting or lying down,and we are.
We should be upright and movingmore than we are, but we need
the pelvic floor to be able torespond to the times we're
(17:49):
moving and oftentimes leaking orfeeling vulnerability from
prolapse or pelvic pain ishappening when we're moving.
So we need to train the pelvicfloor in a way that it can
respond to those movements thatwe do, appropriately React, at
the right time, with the rightamount of force to manage our
continents, support our organs,support our spine and pelvis and
(18:10):
and if we only did thisexercise sitting down, we were
missing out on an opportunityfor that retraining of the
reaction time and that type ofthing.
So that was, you know, comingfrom a fitness background and
looking at all of the fitnessprinciples that I use to train
people and train all the othermuscle parts in the body, I just
(18:33):
took that same philosophy andapplied it to the pelvic floor.
I said this is a group ofmuscles type one and type two
muscle fibers, like the rest ofour body.
Let's train it in a similarcapacity.
So that's where I developed apelvic floor fitness routine
that is very much a whole bodyapproach.
It's not just a sit and dothree sets of 10, 10 second hold
(18:54):
Kegels every single day.
So it helps with diversity ofmovement, it helps with bones
and muscle and heart health helpall the other things that we
benefit from, and it also helpsum with compliance because,
again, three sets of 10, 10second holds three times a day.
(19:15):
Very few people are committingto that and the long-term, the
long-term likelihood of somebodycarrying on with that is very
low.
But if you build it into aworkout, a fitness routine, it's
it's more fun, it's moreengaging.
Vai Kumar (19:33):
How is it similar to Pilates?
Or how is this something youknow different?
Are we talking?
You know different elementshere.
Kim Vopni (19:42):
I do a lot of resistance training, so there
are some movements that would besimilar to what you would see
in a Pilates class or a yogaclass.
There's also cardio.
There's also high intensityinterval training.
There's lifting heavy weights.
It's kind of a.
It's all the things I like.
(20:03):
I don't like one thing.
I like a diversity of things and, just like our gut health, we
benefit from a diversity offoods.
Our, our body benefits from adiversity of movement.
So, uh, some exercises you willprobably have seen before in
other classes or other types ofmovement modalities, and some of
(20:24):
them might be new to you, anduh, and then we just apply
fitness principles ofstrengthening and lengthening.
We always there's a hugeemphasis on releasing because,
again, most people are coming inwith more tension than what
would be considered optimal.
So we always release tensionfirst, then we go into an
activation, then we do a releaseagain.
We're aiming for around a15-ish, 10 to 15 minute workout,
(20:50):
at least initially.
As people continue on with meand as they're progressing, we
might do a few longer workouts,but I try to keep things in a
reasonable timeframe so peoplecan do it and fit it into their
busy lifestyle and it's notsomething that I'm asking you to
add on to something else.
I'm trying to cover it, as thisis your fitness routine for
(21:10):
your heart and your bones andyour brain and your pelvic floor
and and all the things.
Vai Kumar (21:15):
So it's a whole, whole body and it's more like a
wellbeing routine that youincorporate.
And is this like a app thatpeople sign up for?
And is this like a 21 or 28 daything that, if I'm not mistaken
?
Kim Vopni (21:31):
I do have a 28 day challenge, so I used to run that
challenge just on its own andnow I've incorporated into kind
of a bigger program.
But people can access itthrough the Buff Muff app app or
they can.
Once they're a member, they canlog in through a web browser as
well if they prefer.
And the general, I guess, yes,it's whole body.
(21:55):
They come in and they get a bitof education to start out with,
and some people get a littlebit impatient with that because
they're like where are theexercises?
And the exercises are coming.
But I want to also establishthat it is not just about
exercise.
Pelvic health, as with our wholebody, health, is way more than
just a couple of exercises.
(22:17):
It's our posture, it's ourbreath, it's what we're
consuming, how much water, howhydrated we are, our hormonal
status, our stress, our sleep,it's all of these things, and so
I'm not an expert in everysingle one of those, but I bring
in some experts and otherpeople who can highlight the
(22:38):
importance of how to sleepbetter, how to poop better, you
know all these types of things,knowing that, indirectly, that's
all going to help support ouroverall health and our pelvic
health as well.
And so then they, they do.
They learn a series of basicexercises, how to coordinate
that into movement, and do a fewworkouts.
Then they do a 28 day challenge.
(22:58):
That's the 10 to 15 minuteworkout every day for 28 days to
help establish that routine.
And if people want more, theycan choose to come and progress
to the level two challenge.
This is where they would jointhe membership and they have
access to coaching and thecommunity forum and way more
workouts, way more, just waymore stuff to keep them
(23:20):
progressing.
Vai Kumar (23:21):
That's wonderful when it comes to breaking the stigma
that's there in society aboutwomen's health, because a lot of
times it almost seems likewomen are kind of, you know,
being in pain feels like it'ssomething to be endured, right,
oh yeah, it's normal, it's partof the process.
So, oh, my mom had it.
(23:42):
So then I think, ok, maybethat's the norm, I'm probably
supposed to just not say muchabout it.
So what challenges did you see,kim, in terms of getting people
to even feel and understandthat, okay, that doesn't have to
be a norm.
And then for you, for them to,you know, kind of feel that,
(24:05):
okay, you know now, like forthem to cross the bridge, okay.
So what were some of thechallenges that you faced?
And convincing people that, hey, you know what this is, what is
the cause of this?
This is what is the cause ofthis.
Kim Vopni (24:20):
I'd still feel that, um, that that resistance from
people.
There still is a reluctance onsome level, having done this for
so long.
Once you get testimonials andword of mouth, that definitely
helps people trust that this issomething that has the
possibility to work.
But there's many people who arestuck in that I've tried
(24:43):
everything and maybe they aren't.
They think they've triedeverything, but they may just
not be aware of all of the otheroptions or opportunities that
exist.
So I'm trying to come in andopen up some doors and people
can then choose what feels bestfor them, if anything but, um,
but I still I have.
I've been doing this for 20years and I would say that it is
(25:06):
.
It takes a little bit lessconvincing now, but it still
takes some convincing.
There's still people that don'tnecessarily one.
They don't trust stuff on theinternet, which I get it.
There's lots of scams, but youhave to go after.
Yeah, yeah, exactly.
And then two some people havehad very negative experiences
with their care team or careproviders To go after the it's,
(25:30):
it's.
They don't want to work.
Sometimes people just want thequick fix and a big you know.
People say, oh, you talk toomuch and you ramble and you do
all this stuff on all of myposts and I think, cause there's
(25:52):
a lot to say and there's a lotmore that I want to get across
to people to help themunderstand not that I'm creating
a big to-do list for them, butthere's all of these
opportunities for change andthat the body is an incredible
adaptable thing that we have andif we give it the right inputs,
change is always possible.
(26:13):
So it's easier said than done,but, um, but I just keep, I keep
preaching and the more word ofmouth and testimonials I get, it
kind of helps build thecommunity a little bit stronger.
The other thing I actually feelin some ways, a lot more
resistance from the medicalworld.
(26:36):
With all due respect, we needmedicine and when we need
pharmaceuticals and when we needsurgery, they are incredible
and we are so fortunate to havethem.
I don't view them as our bestfirst line of defense for
preventive health, for pelvichealth.
They can, if we do end upneeding surgery, go down that
(26:59):
path.
But so many people are sentdown that road much too early
and haven't done that root causeinvestigation.
So I really want to try to getall of the information out and
people recognize that it's notjust about a couple exercises
and that there is hope and thereis opportunity for change.
It does require some commitmentfrom you, from the person.
(27:19):
There is some work to be done,but it doesn't take hours a day.
Vai Kumar (27:23):
It's really quite simple to implement and
hopefully, yeah, just want togive people a chance for them to
kind of heal themselves, right,because our body is like such a
powerful tool, like themind-body connection.
If we are able to tap into that, I think we can just overcome
so many issues.
I think we can just overcome somany issues.
Let's just dive a little deeper.
(27:45):
So pelvic floor dysfunction westarted off saying it can even
right from everything fromconstipation, right Sexual
function, bladder leakage, fecalincontinence.
What other things do you see?
And how do you think people areable to overcome these?
(28:09):
And what kind of would you sayif you were to say, oh, there is
just much more to it than justthose terminology alone?
What is happening behind thescenes when it comes to why the
pelvic floor is contributing toall of these?
Kim Vopni (28:28):
A big shift that I'm seeing now, because the majority
of the people who are in mycommunity are in that sort of
perimenopause, postmenopausetransition and there's a
significant hormonal shift thatis happening, and a major one is
(28:48):
estrogen.
So once we reach our menopause,we're now in a low estrogen
state and we will stay in thatstate unless we are replenishing
or replacing our hormones withhormone therapy.
And there's a whole category ofmenopause called genitourinary
syndrome of menopause, which isspecific to the vulva, the
(29:09):
vagina, the pelvis, the bladder.
The symptoms that could begenital, urinary or sexual, and
there's a host of symptoms undereach of those brackets, so to
speak, and statistics arebetween 50 to 80% of women will
experience at least one of thosesymptoms, but generally more.
(29:31):
And that could be thinning ofthe tissue, dryness and this is
around the vulva and the vagina.
Thinning of the tissue, burning, itching, irritation, pain, and
that could be pain withinsertion, it could be pain with
touch, it could just be painwith no touch.
(29:52):
We may have urinary symptomslike urgency, so feeling like
all of a sudden you have to getto the bathroom and you don't
feel like you can make it ontime.
Urinary frequency, feeling likeyou're always needing to go to
the bathroom Urinaryincontinence we talked about.
So the leaking that can happenwith exertion, pain, sometimes
(30:12):
with pain around the bladder,utis that's a significant risk
of a low estrogen state in thevagina is increased risk of UTIs
and then sexual symptoms.
So we may have we're morelikely to experience different
types of infection and insert ofsex in particular can be very
(30:35):
painful.
And I cannot tell you everysingle day multiple people who
have been post-menopause foryears being treated by care
providers who are stillstruggling with pain and have
never been offered vaginalestrogen.
It blows my mind.
We have so much evidence aboutthe efficacy.
(30:57):
It is the gold standard.
We have evidence about thesafety no cancer risks, no blood
clot risks.
We have evidence about thesafety no cancer risks, no blood
clot risks.
But then we're strugglingagainst the mainstream medical
system that has black boxwarnings that tell you that you
are going to get cancer, you aregoing to get blood clots and
all these crazy diseases.
So people are afraid of takingthis incredibly beneficial
(31:18):
therapy and there's severaldoctors right now petitioning
the FDA to change that becauseit is not evidence-based as it
pertains to vaginal estrogen.
So that's something that Iconsider to be almost like an
essential nutrient.
It's not a nutrient, but I'musing that term as we reach our
menopause for the rest of ourlife.
So the hormonal piece issignificant and it's something
(31:41):
again, I urge people, especiallywhen they're younger, get
informed about hormones, aboutour cycle, about hormone therapy
, so you can then be armed tomake the best decision and work
with a practitioner to findwhat's best for you.
But vaginal estrogen is onething, that is, it plays such a
role in so many aspects of,again, genital urinary sexual
(32:06):
symptoms, so that's somethingthat we can't overlook.
Vai Kumar (32:09):
Okay, and it seems like one in three women suffer
from incontinence, right?
Is it like so is there help forwomen across all age groups?
Or how is it like?
How do you think people respondwhen you see firsthand, you
(32:31):
know, when they startimplementing movement of the
pelvic floor muscles and all ofthe routine that you are talking
about?
What kind of a transformativeexperience is it for women, and
does it apply to women of allage groups?
Kim Vopni (32:48):
Short answer yes, it doesn't matter I've had.
The oldest member in mycommunity is 93.
You can make change at any age.
Of course, if we can interveneearlier, that's even better, if
we can mitigate some of thesethings from happening in the
first place.
But yeah, statistically,anywhere between 30, 40% of
women will experienceincontinence.
(33:08):
I do think that is much higherbecause that is reported cases
and so many people just don'ttalk about this with their
doctors and suffer in silencewith it.
So I think that is higherProlapse wise 50% of women
who've given birth have somedegree of prolapse super common,
so very common.
(33:30):
Not openly talked about orscreened for, yet influences so
many women's lives.
When they have the rightinformation and they can make
changes that they didn't evenknow, like taking vaginal
estrogen, like addressingconstipation, like addressing
sleep, like addressing theirposture or their footwear, like
(33:51):
starting exercise all of thosethings it can happen pretty
quickly.
So in my community there arepeople within days are not like,
are sleeping through the nightagain, because they didn't know
that there was behaviors, theydidn't know that dehydration was
playing a role, they didn'tknow how they could overcome
these signals.
They just thought I've got thesignal.
(34:12):
I need to respond, and there'sways that we can retrain the
bladder so very quickly within.
You know, I've seen it as fourdays, I'd say.
The most common is around thetwo to three week mark, the most
significant change where peopleare like I don't have to wear
incontinence pads anymore andI'm having enjoyable sex again,
and I don't have the bother ofthe bulge as much as I used to.
(34:34):
It's usually around the likefour to six week mark.
The other thing that I see,though, is people, once they get
to that point, they think great, I'm cured, I don't need to do
this anymore.
But, as I said before, this isa lifelong.
This is not a quick fix.
We need to be consistent withit, or it will return, just like
(34:55):
we brush our teeth in betweenseeing dentist visits.
If we don't have a cavity, wedon't stop brushing our teeth,
we carry on with thatmaintenance program, and the
same applies to the pelvic floor.
Vai Kumar (35:06):
Yeah, it's a constant process, you know you said yeah
, brushing teeth again.
You know we all wear retainersif we got braces right, so
otherwise the teeth start tomove back.
So I guess you know greatdental analogy there.
What about distinction in termsof we talked about you touched
upon organ prolapse, rightPeople who have given birth?
(35:29):
What about prenatal, postpartumand menopause stages?
Is there like differences incondition that you notice in
terms of what kind of help womenneed and in terms of organ
prolapse, do people even realizethey have something going on?
(35:49):
Again, it's a question of a lotof us women, I think, enduring
stuff we are all so great at.
We just don't seem to have thatattention that we need to give
ourselves much more, as we doothers right in the family or,
you know, in the social circle.
(36:09):
Well, we always seem to carefor others much more than
putting ourselves in theforefront.
So what about anything in termsof signs that people should
watch for and what should justtell them that hey, that's an
SOS?
And in terms of these differentage groups the prenatal,
postpartum and menopausal whatkind of a distinction do you see
(36:33):
in terms of what they gothrough with the pelvic floor
functionality overall?
Kim Vopni (36:40):
Yeah, functionality overall.
Yeah, so, signs and symptomsobviously, leaking urine is an
urgency.
Low back pain is one.
Pelvic pain, painful sexconstipation, feeling like you
(37:00):
have something inside yourvagina, like if you're a tampon
wearer, feeling like yourtampon's not sitting quite
correct, feeling likesomething's going to fall out,
feeling heaviness or pressure,especially as the day goes on.
Seeing or feeling a bulgearound the opening of the vagina
.
Those are some of the morecommon signs and symptoms.
But even there are some peoplewho have a bulge very close to
(37:23):
the opening, who have nosymptoms and have no idea.
So symptoms do not indicateseverity.
They aren't always indicativeof what the problem is, and
that's part of the reason why Irecommend everybody see a pelvic
floor physiotherapist once ayear, even if you have no
symptoms, and especially if youdo no symptoms, and especially
(37:45):
if you do.
So that's who we go to forscreening and helping evaluate
function, looking for thingsthat could potentially become a
bigger problem down the road.
In terms of prenatal, postpartummenopause, when I first started
this work it was in theprenatal space.
My intention was getting thisinformation to women ahead of
time, before childbirth.
It's well established thatpregnancy and childbirth are
(38:09):
they greatly increase our riskfor pelvic floor dysfunction.
So if we have this knowledge,if we're doing pelvic floor
exercise, if we're understandingposture, if we understand
breath and, in particular forpregnant women, if we are
looking at birth positions andtraining for birth, training the
pelvic floor to respondappropriately during childbirth,
could we mitigate some of theserisks.
(38:32):
So that's kind of where Istarted.
And a first-time mom, afirst-time pregnant mom unless
they were starting to experiencethings like pubic joint pain or
low back pain, they're notreally that motivated, to be
completely honest, about doingpelvic floor exercise.
They don't yet have a problemto overcome, so it was a harder
sell.
Then, on the postpartum side, Ihad started a second company
(38:57):
called Belly Zinc where wemanufactured a postpartum wrap,
so embracing what many culturesdo around the world that honor
and revere this postpartumrecovery phase, whereas in North
America it's a sprint back tothe gym and to not look pregnant
as quickly as possible.
So we wanted to change that andwe designed a postpartum wrap
(39:18):
and coupled it with arestorative exercise program.
We wanted pregnant women topurchase it, so they had it for
immediately after they gavebirth.
And what?
In both of those instances, themost common customer we had was
the second or third time.
Mom, who had already beenthrough it, who had now, is
(39:42):
experiencing problems, wishingthey had done things differently
the first time, and now theywant to do something different
the second time.
Vai Kumar (39:49):
Realize it.
Kim Vopni (39:50):
Yes, yeah.
And so there's the diastasis,or diastasis, which is where the
two six pack muscles in theabdomen, that the outermost
abdominal muscles, theconnective tissue that holds
them in place at the midline,thins and stretches and those
muscles move away from themidline and can create some
(40:10):
challenges for some people.
And then all the other symptomsthat we were talking about.
The other thing with postpartumis we go into a low estrogen
state after the birth of ourbaby.
We go into a low estrogen stateafter the birth of our baby and
that is a glimpse into that lowestrogen state of menopause.
The difference is we will,postpartum, come out of that and
(40:32):
we will go back to our normalkind of fluctuations of estrogen
Postmenopause.
We go down and we stay down,unless we are supplementing with
hormones to some extent.
So those are kind of a few ofthe nuances there, but my hope
is that in my lifetime itbecomes more the norm for pelvic
(40:55):
floor physical therapy as partof your pregnancy.
I wrote a book called Prepare toPush so training for your birth
, honoring your recovery and notsprinting back to the gym.
We need to do exercise, we needto do movement and we're going
to train when we're pregnant formotherhood, or lifting a car
seat, for lifting a stroller,for doing that while you have a
(41:18):
baby on your side, or a toddleror diaper bag, or whatever it is
that you're training for, butbring it into real life
situations and movements.
So we're we're training forlife.
What we're doing in the gymshould make life easier to, if
that makes sense, um, and thepelvic floor.
When it's working well, it willallow us to do that with more
(41:38):
freedom and more success.
Vai Kumar (41:40):
Pelvic floor is often what holds us back.
Yeah, and posture right.
You're lifting so much you'relifting a baby.
All of a sudden you're carryinga car seat and you don't know
what else has happened to yourorgans during the process of
childbirth and labor.
What about supplements?
I heard you mentioned that.
So creatinine, collagen and allof this in terms of menopausal
(42:03):
women.
What kind of a significance dothese have in terms of building
strength and in terms of youknow, all the elasticity and
everything?
Kim Vopni (42:14):
right now there's really no research as it
pertains to creatine in thepelvic floor or collagen in the
pelvic floor.
There's some studies with floor, there's some studies with
vitamin D, there's some studieswith sea buckthorn oil.
So I'm hopeful at some point inmy life that there will be
research about these.
(42:34):
But if we look at creatine isone of the most I think it is
the most researched supplementin the world and it's for muscle
and we thought of it.
You know, the people who usedto take it were the young
bodybuilders.
But, now there's more and morestudies coming out to show that
this is really a beneficialsupplement for anybody and
(42:56):
especially post menopause women.
There's some evidence for bonesupport, for muscle support.
There's even some cool researchregardless of stage of life but
from a brain health perspectivethat's typically in higher
doses.
But I look at the literaturethat exists with creatine and
muscle and again I'm saying thepelvic floor is a group of
(43:19):
muscles, so we can hypothesizethat if it's having this
influence on other muscles inour body, could it not arguably
have the same thing, the sameaction, within our pelvic floor?
So creatine, I love creatine.
I'm a huge supporter ofsupplementing with creatine
(43:40):
everybody, especiallypostmenopausal women, with
creatine everybody, especiallypostmenopausal women.
The other one is collagen,which there's.
I've been taking collagen for anumber of years and there is
some research about people whohave experienced certain types
of pelvic floor dysfunction, whohave deficiencies of certain
types of collagen.
But there is no research aboutsupplementing with collagen as
(44:04):
it pertains to overcoming pelvicfloor challenges.
But again, like creatine, I'mlooking at this saying well, if
we have studies about how it caninfluence skin, hair, nails and
the different.
So that's mainly type one andtype three collagen.
That's the same type ofcollagen that we have in our
pelvic floor structures.
So if supplementing is helpingthe other type one and type
three collagen that's the sametype of collagen that we have in
our pelvic floor structures.
(44:25):
So if supplementing is helpingthe other type one and type
three, could it arguably nothelp the pelvic floor as well?
Again, hypothesizing I never inmy body, I was never able to say
oh, I took creatine or collagenand I noticed that I was able
to do more Kegels or you know,overcome.
(44:47):
I was never symptomatic enoughto notice a significant change.
However, looking at theliterature and the research, for
all of the other reasons whyit's beneficial for my whole
body, I'm I take thosereligiously.
The other one, uh, vitamin d,that there's oodles and oodles
of research about vitamin d forso many things of health, uh,
(45:10):
our health, but also with pelvicfloor so that's something else
are anyways deficient in vitaminright, right, exactly.
So vitamin d is on there.
Sea buckthorn oil is.
Oral intake ofabuckthorn oilhas been shown to help with
post-menopause vaginal like thedryness that we experience in
(45:31):
that low estrogen state, so it'snot going to.
I don't promote it.
As a way you know you don'tneed estrogen if you're taking
seabuckthorn oil.
I definitely think the majorityof women would benefit from
being on estrogen.
Taking C buckthorne oil, Idefinitely think the majority of
women would benefit from beingon estrogen, and we also have
this additional C buckthorne oilfor those that maybe have been
without estrogen for a long timeand they're really still
(45:53):
struggling with some level ofdryness or irritation.
C buckthorne oil orally issomething that I do recommend as
well.
Vai Kumar (46:01):
Okay, what about fecal incontinence, say, in
conditions like IBD,inflammatory bowel disease and
things like that?
I personally wrestle with IBD.
I have managed it pretty well.
I can relate to all the thingsthat you're talking about
because I do a mix of yoga andPilates and I know how magically
(46:23):
my pelvic floor movement andyou know, using those muscles
and incorporating strength andflexibility has resulted in a
phenomenal transformation for meand I did not.
Little did I know that KimWalkney existed up until
recently, that you know.
(46:43):
I got in touch with you, butthank you for coming on this
show again to create thisawareness.
But I guess, from a fecalincontinence standpoint and
blood circulation, lubrication,everything you know all the flow
how is all this movementimpacting and improving stuff
(47:06):
for people?
Can you talk a little aboutthat, kim?
Kim Vopni (47:10):
The principles of overcoming fecal incontinence
really are similar to, if notexactly the same as, overcoming
urinary incontinence, that thepelvic floor is responsible for
the opening of the urethra, theopening of the vagina, the
opening of the anus it's managesall three, and so the
principles of creating lengthand strength in that group of
(47:34):
muscles as a whole.
We might tweak cues orvisualization or certain poses
like exercises that somebody maydo their pelvic floor muscle
training in, but really thefundamentals posture, breathing,
avoiding constipation,activating and relaxing the
pelvic floor remains the same.
(47:56):
People who have additionallayers like, as you say, with
IBS or C or D or whichever oneor other types of even
autoimmune conditions, it's.
But exercise still is indicatedfor pretty much every single
person in the world, regardlessof what they're dealing with.
(48:18):
So the pelvic floor, again, isnot immune to that.
And when we are activating andtaking the muscles through range
of motion with whole bodymovement, by nature we are
increasing blood flow andcirculation.
And when we impart a load thatthe body needs to adapt to,
including the pelvic floor,that's how we get stronger.
(48:41):
So the diversity of movement isimportant, the sets and reps
and load is important, but justfundamentally moving, not
staying static is going toimprove the function of the
pelvic floor.
Vai Kumar (48:57):
Okay, Okay, what about, specifically?
Would you say a particular formof exercise is beneficial, Say
I just asked you something aboutPilates earlier.
Whatever you incorporate, is itlike?
I know you have talked a lotabout breath, you know getting
the breath right, getting allthe movement and getting the
(49:19):
strengthening part.
So I see whatever you do as acombination of everything.
Is that a fair assessment, ordo you just focus specifically
on more of yoga-like movementsor you focus more on like
weight-bearing exercises?
Is that something that you canthrow light on?
Kim Vopni (49:39):
I really, I like a lot of different things.
I don't think that there's onething People will often
gravitate towards.
You know, I really love yoga, Ireally love Pilates, I really
love whatever.
So doing what you love is alsoimportant.
If you're doing an activitythat you really hate, that's not
going to serve you in many ways.
So finding things that you dolike, but in trying to do some
(50:02):
different things within there.
But one thing that I would sayI do emphasize is resistance
training.
I think that the more and moreresearch is coming out about how
important our muscles are, how,from a longevity perspective,
reducing our fall risk, all ofthat it's so, so important to
(50:24):
have muscle mass, to have strongmuscles, to have supple muscles
.
So resistance training is a bigpart of what I do, but I
balance it out with some yogaand some stretching and other
types of things as well.
But I would say, if I was topick one thing that I focus on,
it would be resistance training.
Vai Kumar (50:44):
Your pelvic floor, yeah yeah.
Then there's pregnancy fitness.
There's the inside story.
Why don't you talk about all ofthese?
You know whatever these bookscover, and then we'll go for
(51:04):
some rapid fire or quicktakeaways for different sets of
people and you know we'll justcome to a closure on this
wonderful conversation.
Kim Vopni (51:13):
All right.
So my first book was calledPrepare to Push, and that was
again looking at how we canapply the principles of training
and specificity to childbirth.
We need to train for childbirth.
The next book was the InsideStory and that was kind of
looking at the main categoriessort of like prenatal or
(51:35):
pregnancy, motherhood, menopauseas three main life stages that
majority of people will gothrough.
Everybody will go throughmenopause who reaches midlife.
The next was pregnancy fitness.
So that was with my twobusiness partners in Bellies Inc
.
We were commissioned by HumanKinetics to create almost like a
manual about fitness andpregnancy.
(51:57):
So that was, uh, that was thatone.
And then the last, most recentone was in 2020.
That was it's called yourpelvic floor and it's more of a
um, it's a, it's a book for theconsumer to understand a lot of
what we talked about here whatthe pelvic floor is, how it
works, what are some commonsigns and symptoms that things
are not going well, and then, ofcourse, what we can do about it
(52:20):
through the various life stagesthat we go through.
Vai Kumar (52:23):
Okay, okay, perfect.
Quick tips and takeaways.
What should prenatal womenfocus on?
Kim Vopni (52:32):
Learning to release tension in the pelvic floor,
paying attention to theirposture and training in the more
common birth positions so thatthey build strength and pelvic
floor, like building theresponse of the pelvic floor in
those various birth positions,like sidelining, sidelining or
(52:54):
squatting or kneeling, that typeof thing.
Vai Kumar (52:58):
Okay, and then women of childbearing age.
What do you see as a challengewhen it comes to people being
able to get pregnant and issomething relating to movement
and our lifestyle that'simpeding?
Again, we have talked a lotabout pelvic floor as the focus.
Would you say anythingspecifically to them in terms of
(53:21):
emphasizing movement andanything else that may be very
significant?
Kim Vopni (53:26):
yeah, sometimes there can be.
You know that stuck tension caninterfere with fertility.
So when we're optimizing theblood flow and the circulation,
that can sometimes create a morefavorable environment for
fertility.
Vai Kumar (53:41):
Okay, what about teens?
They experience so much of, Imean, menstrual pain, and there
is just a lot of agony there aswell.
Again, that's a topic thatagain seems to be more of
endured than addressed, right?
So what would you say to that,kim?
Kim Vopni (54:04):
That's a great time to start seeing a pelvic floor
physical therapist.
Sometimes the pain can be as aresult of muscular tension.
Sometimes it can be, from youknow, a position like an organ
that's not in the right position.
Sometimes it can beendometriosis related.
Um, so they, your pelvic floorPT can help you screen for other
(54:26):
conditions but also introducethat concept of I help you
manage this really importantgroup of muscles.
And if you're experiencing painduring your cycle, one aspect
could be muscle function.
So we can look at that togetherand then you'd have some
strategies and tools to helprelease the tension which can
help mitigate cramping for somepeople.
Vai Kumar (54:48):
And we have talked so much about the pelvic floor.
We talked about spinal mobility, spinal stability, everything.
What about hip rotations andreleasing tension in the hips?
Is that contributing in any wayto any of this?
Kim Vopni (55:03):
that's happening below 1000% and it's a huge part
of what I do is is working onmobility within our hips and
building strength in the lateralhips so that we can transfer
loads, we can walk, we reduceour fall risk.
Um, it's often there's a coupleof stretches that I have in my
program that one of them iscalled the stacked butterfly,
(55:23):
which nobody really likes thatone because it's tough and it
sort of highlights how tight weare and we think about how many
hip replacements and kneereplacements we have.
A lot of it is to do with thewear and tear on the joints from
poor posture, from tightness inthe muscles that's not allowing
that freedom of movement.
So that is a huge part.
Vai Kumar (55:44):
Okay, can people, even in the osteopenia and
osteoporosis range because weaddressed it in a very broad
sense earlier in terms of peopleof all age groups, but even
specifically somebody you knowin the osteopenia or
osteoporosis category, still canthey benefit from all of this
in terms of the buildingstrength, the program, and so
(56:09):
definitely, like I said,whatever I've been doing has
resulted in a better bonedensity in my case.
So I can personally attest towhatever movement or whatever
strengthening of the pelvicfloor brings about.
But just wanted to ping you onthat.
What about menopausal women?
What should they focus on, kim?
Kim Vopni (56:31):
Vaginal estrogen and pelvic floor exercise and seeing
a pelvic floor physicaltherapist once a year.
Vai Kumar (56:37):
Okay, awesome.
So I think we have just offereda lot of pointers here in terms
of why women should not justsilently endure whatever they
have been going through and Iguess anyone, be it a woman, be
it a young girl, be it a womanof childbearing age, menopausal
(56:59):
women or even men of all ages, Ithink the pelvic floor, the hip
, mobility, all of the functionand movement, I think we cannot
underscore it any better.
So, no silent suffering off thepelvic floor is the biggest
takeaway for me from thispodcast and anybody who's
wanting to learn more vaginacoachcom is my website.
Kim Vopni (57:43):
If you put vagina coach into Google, you'll find
me somewhere on social media.
Instagram is typically whereI'm most active.
I also have a YouTube channelwith some free resources.
My podcast is between two lipsanother area for some free
information, and you can alsofind links to my books on my
website at VaginaCoachcom.
Vai Kumar (57:59):
Awesome, awesome.
Thank you so much for joiningus today.
Such a pleasure talking to youand I'm sure listeners of both
of these podcasts can just getto know more of each other and
I'm sure they can mutuallybenefit from a lot of
information that we are puttingout.
Listeners, as always, followthe podcast, rate the podcast,
(58:21):
leave a review from your podcastapp of choice, follow me on
Instagram, @vaipkumar, andYouTube for the podcast and for
all things digital media andlifestyle.
Until next time with yetanother interesting guest and
yet another interesting topic.
It's me Vai, along with thewonderful Kim, saying so long.
Thank you.
Welcome to Freshleaf Forever, a podcast that gives
you fascinating insights weekafter week.
Here's your host, vaikumar.
Hey folks, welcome to anotherepisode on podcast Freshleaf
Forever.
Have you wondered why pelvichealth is seldom discussed?
(00:34):
Well, that's why our guest, kimWapneyV, is here with us today
on the show.
With us today on the showbecause we both strongly feel
it's time for pelvic health tobe discussed and offered to
women at all stages of life.
It's time to break throughtaboos and redefine how we think
(00:58):
about women's health, and notjust like bladder leakage
women's health and not just likebladder leakage, which
oftentimes is considered justpart of being a woman.
But there's so much morechallenges that women face when
it comes to pelvic health.
Our guest, Kim Vopni, is arestorative exercise specialist.
(01:23):
She's a public speaker, a bookauthor in fact, multiple book
author and she's also the hostof a thriving podcast, between
Two Lips, where she bringsguests and thought leaders to
address several matterspertaining to pelvic health.
(01:43):
She is also a certifiedpersonal trainer, a certified
pre and postnatal fitnessconsultant, a certified Pfilates
instructor and a hypopressivemethod trainer.
She is a certified menopausesupport practitioner as well.
(02:03):
So it's with great joy that Ibring Kim Vopni here to podcast
Freshleaf Forever.
Let's get to the episode.
Hey Kim, welcome to the podcast.
How are you doing today?
Kim Vopni (02:19):
I'm doing well.
Thanks so much for having me.
Vai Kumar (02:21):
Well, I guess a lot of women's topics.
Whatever women go through,definitely, they remain silent
for the most part, and first ofall, I want to start by thanking
you for your work.
So, when it comes to women'shealth, like I said, a lot of
topics are considered taboo.
(02:42):
So why, would you say, pelvichealth is so significant, kim?
Kim Vopni (02:51):
Well, thank you for having me on your show and for
the support and kind words.
I really appreciate that, andpodcasts like yours are a way of
helping break down this tabooand getting this information
into the hands of of morelisteners and um empowering them
.
So the I mean there's the, theumbrella of women's health,
(03:11):
which has historically alwaysbeen underserved, I would say I,
you know, women haven't beenincluded in research until
really fairly recently.
And, uh, and that's reallyshocking when you think about it
, and one of my favorite theguests that I've had on my
podcast, dr Stacey Sims, has theterm women are not small men
(03:33):
and we deserve our own researchand we shouldn't just be, you
know, because we're a smallerperson, to just back off the
dose of a drug or something likethat.
So there's the women's healthumbrella, and then there's
pelvic health, which is, I wouldsay, even more underserved,
(03:54):
starting to become more.
In the years that I've beendoing this, but because there's
discomfort with even saying theword vagina there is, you know,
(04:23):
I've had multiple posts takendown from social media for you
know, saying that it isinappropriate because I use the
word vagina and or sex, or youknow, it's kind of mind boggling
when you really think of it.
Thankfully there's been someprogress and now I can use the
term vagina openly.
But there's a culturalperpetuation of shame and taboo
and embarrassment and we don'ttalk about that and in, for
instance, my mother's generationso I'm 53 and my mom will be 80
(04:46):
this year and that generationwas very much you don't talk
about that and you just justcarry on and it's not discussed.
My mom thankfully she was veryopen with my brother and I.
She's a.
She was an operating room nurse.
She was very.
She told us the proper terms.
She was an operating room nurse.
(05:06):
She told us the proper terms.
She told us about the body.
She taught us things.
At the time it feltuncomfortable when you're
learning it with your brother,but I'm thankful that she
planted that seed of normalizingour bodies and being able to
identify parts and not usingcode names or strange names to
name something like a vagina oran anus or rectum or something
(05:28):
like that.
So I think that is kind of partof what has a few things that
have kind of perpetuated orcreated this taboo or don't feel
comfortable talking about it,what I see now social media has
played a big role feelcomfortable talking about it,
what I see now.
Social media has played a bigrole.
I feel like the youngergeneration is much more open to
(05:49):
conversations around things thatare uncomfortable to talk about
.
So, there's, there's a lot morevoice being brought to, to
differences and and that type ofthing.
So I'm, I'm, I applaud that andI'm super excited because I
think generations to come willbe more informed much earlier on
(06:09):
and I feel like there will be,as a result, less, less
suffering.
Vai Kumar (06:14):
Yeah, I mean when you said you know, even some of
your social media posts andstuff were taken down earlier.
Yeah, whatever, when you sayvagina, it's misconstrued for
something inappropriate that youare putting out to the digital
world and digital community,right?
Yeah, you're trying to do theright things in terms of
propagating awareness, in termsof educating people on women's
(06:39):
health.
Yeah, sometimes we just have tofight the hard battles, but I
think it's worth it.
So what role does tightness ofthe pelvic floor play, then,
when it comes to women's health,or anyone's health, say, right
from constipation?
A tight pelvic floor, I believe, is like a hindrance, right?
(06:59):
So what would you say to that,kim?
Kim Vopni (07:03):
Yeah, the pelvic floor is a group of muscles, so
it's not just one muscle, it isa collection of muscles and it's
this you know some peopledescribe it as a hammock or a
sling.
It's the muscles that connect,they attach at the pubic joint,
the tailbone and the two sitbones on our side.
So those four points sort ofmake a bit of a diamond shape.
(07:25):
And the muscles that close offthe base of our pelvis is
considered the pelvic floor andits roles are to support our
spine and pelvis, to support ourinternal organs, to manage our
continence, play a role in oursexual functioning and also work
in relationship with ourbreathing diaphragm for things
like circulation and movinglymph, basically moving things
(07:49):
through our body.
So these are really importantjobs and we've never been told
any of this.
We might have heard the termKegels.
We don't appreciate that, likeother muscles in our body, they
like to be taken through a rangeof motion, they like to be
strengthened, they like to belengthened and we need a balance
(08:13):
of length and strength in orderfor those muscles to do all the
jobs that they need to do.
And what is now?
Now, I personally don't workwith people, I don't do internal
evaluations, I'm a personaltrainer and I apply fitness
techniques to the whole body,but specific to the pelvic floor
(08:35):
.
And then there are therapists,pelvic floor physical therapists
, who can do internal evaluationand treatment, and my
colleagues in that space willtell me that it is becoming
increasingly common for peopleto have tightness in the pelvic
floor, and there are certainthings that can contribute to
that fear shame, uh like trauma,either psychological trauma,
(08:59):
trauma, uh, that could bephysical, from a fall, maybe
surgeries, um uh, pain, um like.
I can go on and on the.
There's a long list ofcontributors to what can
contribute to tightness.
There's also then the symptomsthat people experience, such as
(09:20):
incontinence, so that's whereurine or gas or stool would leak
out of the body without uswanting it to come out.
That symptom can thenindirectly also create tension,
because when we're afraid ofleaking, whether it's gas, stool
or urine, the muscles are kindof on high alert.
(09:41):
We are on high alert, ournervous system is on guard.
Same if we have anothercondition called pelvic organ
prolapse, where the bladder,uterus rectum can start to shift
out of their optimal position.
Part of the role of the pelvicfloor is to support those organs
, and if we have this sense ofvulnerability and feeling like
something's going to fall out.
We're going to be guarding.
(10:02):
So the symptoms from pelvicfloor dysfunction.
We could have those symptomsbecause of tension, or we could
develop tension because of thosesymptoms, or again because of
all the other things that I'vealready listed.
So, kind of getting to the rootcause as to why do we have this
tension, and then knowing thatwe have an option, an
(10:23):
opportunity, lots ofopportunities to let go of that
tension.
But if we have muscles that areoveractive, non-relaxing, not
lengthening appropriately, ifthey're held in sort of a short,
tight state, then their abilityto react at the right time if
we laugh, cough, sneeze or jump,react with the right amount of
(10:46):
force needed to offset thatincrease in pressure from that
activity is going to be hindered.
So that's like very kind ofhigh level how tension can
interfere with the function ofthat group of muscles.
Vai Kumar (11:03):
Okay, you mentioned fear.
You mentioned a lot ofpsychological trauma and factors
like that.
We all live in a virtual worldnow.
Could prolonged sitting also bea root cause of all the pelvic
floor dysfunction?
Potentially can that build upover time.
Kim Vopni (11:21):
Yeah, yeah, I'm glad you brought that up.
It didn't say it on the listthere.
But posture how we holdourselves through the day, and
prolonged sitting so prolongedsitting can be can hinder us in
many, many ways.
But usually if you're sittingin ideal posture and you're and
and that and you spend yourwhole day there, that's better
(11:42):
than sitting with poor posturethe whole day, but it's still
not moving that much.
We benefit from a diversity ofmovement, as does the pelvic
floor, rather than being static,and our whole body would
benefit from more movement.
But most people, over time, asthey're sitting, they start to
slouch, their tailbone starts tokind of, they lose the
(12:04):
curvature in their low back,their pelvis is tilting
underneath them, they're hunchedover usually.
So all of that is interferingwith the relationship of the
diaphragm and the pelvic floorthat I spoke about earlier.
So we're not breathing as well,we're not breathing as deeply,
we're not getting thatsynergistic movement of the
pelvic floor with our breath.
The muscles are adapting to ashorter state, so over time they
(12:26):
are starting to develop moretension.
Even the footwear that we wear,even the clothing that we wear,
like there's so many differentinfluences to the pelvic floor
and I don't want to say that weall have to have, you know,
flowy clothes and walk barefootfor the rest of our life.
(12:48):
Of course we want to be stylishsometimes and that's fine, but
just being aware of how thethings we put on our body and
the things that we put in ourbody, how they influence how we
feel, how we function, how ourmuscles can react, so, yes,
1000% sitting, especiallysitting with poor posture, can
definitely be an influentialrole.
Vai Kumar (13:08):
And even when you said flowy clothing or whatnot,
you know how much we subjectourselves to.
Whatever is not ideal is isagain that's.
That's a huge component to howwe feel, or what we subject
ourselves to.
Right, spinal stability peopledon't realize spinal stability
(13:29):
and pelvic floor function arerelated.
Also correct, it has a hugebearing on it, is that right?
Kim Vopni (13:36):
Yeah, the pelvic floor attaches to the base of
our spine, which is the tailbone, and to the pubic joint and to
sits bones.
As I mentioned, it's thefoundation of our core.
We've all heard of coreexercise and core fitness and
workouts and that's been abuzzword in fitness for years,
but never in that conversation.
I've taken many differentfitness certifications.
(13:58):
Never once was the pelvic floorever mentioned in any of that
core conversation.
And yeah, that's a majorfunction and role of the pelvic
floor is to provide control totransferring loads from upper
body to lower body movement.
You know, keeping everythingcontained and held, so to speak,
(14:21):
within the pelvis is a reallyimportant job.
Vai Kumar (14:32):
Okay.
Okay, you mentioned Kegelsearlier.
I used to always think when itcame to the pelvic area, that
was the be all and end all of it.
Obviously not, so I guess therecomes your buff muff method.
Can you help listenersunderstand why you came up with
that and what does it helpaddress Kim?
Kim Vopni (14:51):
Yeah, a Kegel exercise.
So there was a doctor named DrArnold Kegel who witnessed in
his patient population that,after giving birth, women
struggled with the control oftheir pelvic floor.
They didn't have that samecapacity for function as they
did before, and so he used abiofeedback device that helped
(15:14):
women see this group of muscles.
I don't mean like physicallysee it, but they could see on a
screen.
It would register this movementof them contracting and
relaxing, because the pelvicfloor is inside us.
We can't, you know, stand infront of the mirror like we do
and flex our bicep muscle andsee it.
(15:34):
So it's.
We need visualization, we needcues, we need things like
biofeedback to help us connectwith this group of muscles.
So he, he's the, the, theperson who came up with the
Kegel exercise, which is avoluntary activation and lift
and release of the pelvic floor,and so that has been kind of
(15:54):
the what, what is thought tohave been the only exercise
available to us.
If any people had heard anythingabout the pelvic floor, it was
usually Kegels, and that was it.
If any people had heardanything about the pelvic floor,
it was usually kegels and thatwas it.
We've never been taught how todo them correctly, we might have
been given a brochure.
We go to google.
We see things like it's themuscles used to stop the flow of
urine, so sometimes people willpractice on the toilet, and so
(16:17):
we have evidence to show thatkegels work when they're done
correctly and consistently.
We also have evidence to showthat Kegels are most often done
incorrectly, not our fault.
We've never been taught, as Imentioned.
Vai Kumar (16:29):
Oh, I knew it was.
I thought he, like you said,you know sit.
Oftentimes I was told yeah, youcan practice it best when
you're trying to urinate sittingon the toilet.
You know it's a contraction andrelaxation of those muscles.
So, yeah, I guess there's moreto it now and relaxation of
those muscles.
Kim Vopni (16:45):
So, yeah, I guess there's more to it now.
Yeah, and that's a way that wecan identify the muscles.
If you can stop the flow ofurine, then that's a start into
being able to access that groupof muscles.
But you definitely don't wannapractice on the toilet.
We just wanna sit and pee Oncein a blue moon.
If you wanna test to see if youcan stop your flow of urine, go
for it, but don't practice yourcontract and relax while you're
(17:06):
trying to pee.
That will create other issues,especially infection and
mind-body disconnect, and it'snot going to serve you.
But the limitation with Kegelsis the general recommendation is
three sets of 10, 10 secondholds three times a day and
that's done either lying down orseated.
And there's a couple ofchallenges there.
(17:28):
One, not very many people aregoing to commit to doing
something three times in a day,and the other is it's a static
exercise, sitting or lying down,and we are.
We should be upright and movingmore than we are, but we need
the pelvic floor to be able torespond to the times we're
(17:49):
moving and oftentimes leaking orfeeling vulnerability from
prolapse or pelvic pain ishappening when we're moving.
So we need to train the pelvicfloor in a way that it can
respond to those movements thatwe do, appropriately React, at
the right time, with the rightamount of force to manage our
continents, support our organs,support our spine and pelvis and
(18:10):
and if we only did thisexercise sitting down, we were
missing out on an opportunityfor that retraining of the
reaction time and that type ofthing.
So that was, you know, comingfrom a fitness background and
looking at all of the fitnessprinciples that I use to train
people and train all the othermuscle parts in the body, I just
(18:33):
took that same philosophy andapplied it to the pelvic floor.
I said this is a group ofmuscles type one and type two
muscle fibers, like the rest ofour body.
Let's train it in a similarcapacity.
So that's where I developed apelvic floor fitness routine
that is very much a whole bodyapproach.
It's not just a sit and dothree sets of 10, 10 second hold
(18:54):
Kegels every single day.
So it helps with diversity ofmovement, it helps with bones
and muscle and heart health helpall the other things that we
benefit from, and it also helpsum with compliance because,
again, three sets of 10, 10second holds three times a day.
(19:15):
Very few people are committingto that and the long-term, the
long-term likelihood of somebodycarrying on with that is very
low.
But if you build it into aworkout, a fitness routine, it's
it's more fun, it's moreengaging.
Vai Kumar (19:33):
How is it similar to Pilates?
Or how is this something youknow different?
Are we talking?
You know different elementshere.
Kim Vopni (19:42):
I do a lot of resistance training, so there
are some movements that would besimilar to what you would see
in a Pilates class or a yogaclass.
There's also cardio.
There's also high intensityinterval training.
There's lifting heavy weights.
It's kind of a.
It's all the things I like.
(20:03):
I don't like one thing.
I like a diversity of things and, just like our gut health, we
benefit from a diversity offoods.
Our, our body benefits from adiversity of movement.
So, uh, some exercises you willprobably have seen before in
other classes or other types ofmovement modalities, and some of
(20:24):
them might be new to you, anduh, and then we just apply
fitness principles ofstrengthening and lengthening.
We always there's a hugeemphasis on releasing because,
again, most people are coming inwith more tension than what
would be considered optimal.
So we always release tensionfirst, then we go into an
activation, then we do a releaseagain.
We're aiming for around a15-ish, 10 to 15 minute workout,
(20:50):
at least initially.
As people continue on with meand as they're progressing, we
might do a few longer workouts,but I try to keep things in a
reasonable timeframe so peoplecan do it and fit it into their
busy lifestyle and it's notsomething that I'm asking you to
add on to something else.
I'm trying to cover it, as thisis your fitness routine for
(21:10):
your heart and your bones andyour brain and your pelvic floor
and and all the things.
Vai Kumar (21:15):
So it's a whole, whole body and it's more like a
wellbeing routine that youincorporate.
And is this like a app thatpeople sign up for?
And is this like a 21 or 28 daything that, if I'm not mistaken
?
Kim Vopni (21:31):
I do have a 28 day challenge, so I used to run that
challenge just on its own andnow I've incorporated into kind
of a bigger program.
But people can access itthrough the Buff Muff app app or
they can.
Once they're a member, they canlog in through a web browser as
well if they prefer.
And the general, I guess, yes,it's whole body.
(21:55):
They come in and they get a bitof education to start out with,
and some people get a littlebit impatient with that because
they're like where are theexercises?
And the exercises are coming.
But I want to also establishthat it is not just about
exercise.
Pelvic health, as with our wholebody, health, is way more than
just a couple of exercises.
(22:17):
It's our posture, it's ourbreath, it's what we're
consuming, how much water, howhydrated we are, our hormonal
status, our stress, our sleep,it's all of these things, and so
I'm not an expert in everysingle one of those, but I bring
in some experts and otherpeople who can highlight the
(22:38):
importance of how to sleepbetter, how to poop better, you
know all these types of things,knowing that, indirectly, that's
all going to help support ouroverall health and our pelvic
health as well.
And so then they, they do.
They learn a series of basicexercises, how to coordinate
that into movement, and do a fewworkouts.
Then they do a 28 day challenge.
(22:58):
That's the 10 to 15 minuteworkout every day for 28 days to
help establish that routine.
And if people want more, theycan choose to come and progress
to the level two challenge.
This is where they would jointhe membership and they have
access to coaching and thecommunity forum and way more
workouts, way more, just waymore stuff to keep them
(23:20):
progressing.
Vai Kumar (23:21):
That's wonderful when it comes to breaking the stigma
that's there in society aboutwomen's health, because a lot of
times it almost seems likewomen are kind of, you know,
being in pain feels like it'ssomething to be endured, right,
oh yeah, it's normal, it's partof the process.
So, oh, my mom had it.
(23:42):
So then I think, ok, maybethat's the norm, I'm probably
supposed to just not say muchabout it.
So what challenges did you see,kim, in terms of getting people
to even feel and understandthat, okay, that doesn't have to
be a norm.
And then for you, for them to,you know, kind of feel that,
(24:05):
okay, you know now, like forthem to cross the bridge, okay.
So what were some of thechallenges that you faced?
And convincing people that, hey, you know what this is, what is
the cause of this?
This is what is the cause ofthis.
Kim Vopni (24:20):
I'd still feel that, um, that that resistance from
people.
There still is a reluctance onsome level, having done this for
so long.
Once you get testimonials andword of mouth, that definitely
helps people trust that this issomething that has the
possibility to work.
But there's many people who arestuck in that I've tried
(24:43):
everything and maybe they aren't.
They think they've triedeverything, but they may just
not be aware of all of the otheroptions or opportunities that
exist.
So I'm trying to come in andopen up some doors and people
can then choose what feels bestfor them, if anything but, um,
but I still I have.
I've been doing this for 20years and I would say that it is
(25:06):
.
It takes a little bit lessconvincing now, but it still
takes some convincing.
There's still people that don'tnecessarily one.
They don't trust stuff on theinternet, which I get it.
There's lots of scams, but youhave to go after.
Yeah, yeah, exactly.
And then two some people havehad very negative experiences
with their care team or careproviders To go after the it's,
(25:30):
it's.
They don't want to work.
Sometimes people just want thequick fix and a big you know.
People say, oh, you talk toomuch and you ramble and you do
all this stuff on all of myposts and I think, cause there's
(25:52):
a lot to say and there's a lotmore that I want to get across
to people to help themunderstand not that I'm creating
a big to-do list for them, butthere's all of these
opportunities for change andthat the body is an incredible
adaptable thing that we have andif we give it the right inputs,
change is always possible.
(26:13):
So it's easier said than done,but, um, but I just keep, I keep
preaching and the more word ofmouth and testimonials I get, it
kind of helps build thecommunity a little bit stronger.
The other thing I actually feelin some ways, a lot more
resistance from the medicalworld.
(26:36):
With all due respect, we needmedicine and when we need
pharmaceuticals and when we needsurgery, they are incredible
and we are so fortunate to havethem.
I don't view them as our bestfirst line of defense for
preventive health, for pelvichealth.
They can, if we do end upneeding surgery, go down that
(26:59):
path.
But so many people are sentdown that road much too early
and haven't done that root causeinvestigation.
So I really want to try to getall of the information out and
people recognize that it's notjust about a couple exercises
and that there is hope and thereis opportunity for change.
It does require some commitmentfrom you, from the person.
(27:19):
There is some work to be done,but it doesn't take hours a day.
Vai Kumar (27:23):
It's really quite simple to implement and
hopefully, yeah, just want togive people a chance for them to
kind of heal themselves, right,because our body is like such a
powerful tool, like themind-body connection.
If we are able to tap into that, I think we can just overcome
so many issues.
I think we can just overcome somany issues.
Let's just dive a little deeper.
(27:45):
So pelvic floor dysfunction westarted off saying it can even
right from everything fromconstipation, right Sexual
function, bladder leakage, fecalincontinence.
What other things do you see?
And how do you think people areable to overcome these?
(28:09):
And what kind of would you sayif you were to say, oh, there is
just much more to it than justthose terminology alone?
What is happening behind thescenes when it comes to why the
pelvic floor is contributing toall of these?
Kim Vopni (28:28):
A big shift that I'm seeing now, because the majority
of the people who are in mycommunity are in that sort of
perimenopause, postmenopausetransition and there's a
significant hormonal shift thatis happening, and a major one is
(28:48):
estrogen.
So once we reach our menopause,we're now in a low estrogen
state and we will stay in thatstate unless we are replenishing
or replacing our hormones withhormone therapy.
And there's a whole category ofmenopause called genitourinary
syndrome of menopause, which isspecific to the vulva, the
(29:09):
vagina, the pelvis, the bladder.
The symptoms that could begenital, urinary or sexual, and
there's a host of symptoms undereach of those brackets, so to
speak, and statistics arebetween 50 to 80% of women will
experience at least one of thosesymptoms, but generally more.
(29:31):
And that could be thinning ofthe tissue, dryness and this is
around the vulva and the vagina.
Thinning of the tissue, burning, itching, irritation, pain, and
that could be pain withinsertion, it could be pain with
touch, it could just be painwith no touch.
(29:52):
We may have urinary symptomslike urgency, so feeling like
all of a sudden you have to getto the bathroom and you don't
feel like you can make it ontime.
Urinary frequency, feeling likeyou're always needing to go to
the bathroom Urinaryincontinence we talked about.
So the leaking that can happenwith exertion, pain, sometimes
(30:12):
with pain around the bladder,utis that's a significant risk
of a low estrogen state in thevagina is increased risk of UTIs
and then sexual symptoms.
So we may have we're morelikely to experience different
types of infection and insert ofsex in particular can be very
(30:35):
painful.
And I cannot tell you everysingle day multiple people who
have been post-menopause foryears being treated by care
providers who are stillstruggling with pain and have
never been offered vaginalestrogen.
It blows my mind.
We have so much evidence aboutthe efficacy.
(30:57):
It is the gold standard.
We have evidence about thesafety no cancer risks, no blood
clot risks.
We have evidence about thesafety no cancer risks, no blood
clot risks.
But then we're strugglingagainst the mainstream medical
system that has black boxwarnings that tell you that you
are going to get cancer, you aregoing to get blood clots and
all these crazy diseases.
So people are afraid of takingthis incredibly beneficial
(31:18):
therapy and there's severaldoctors right now petitioning
the FDA to change that becauseit is not evidence-based as it
pertains to vaginal estrogen.
So that's something that Iconsider to be almost like an
essential nutrient.
It's not a nutrient, but I'musing that term as we reach our
menopause for the rest of ourlife.
So the hormonal piece issignificant and it's something
(31:41):
again, I urge people, especiallywhen they're younger, get
informed about hormones, aboutour cycle, about hormone therapy
, so you can then be armed tomake the best decision and work
with a practitioner to findwhat's best for you.
But vaginal estrogen is onething, that is, it plays such a
role in so many aspects of,again, genital urinary sexual
(32:06):
symptoms, so that's somethingthat we can't overlook.
Vai Kumar (32:09):
Okay, and it seems like one in three women suffer
from incontinence, right?
Is it like so is there help forwomen across all age groups?
Or how is it like?
How do you think people respondwhen you see firsthand, you
(32:31):
know, when they startimplementing movement of the
pelvic floor muscles and all ofthe routine that you are talking
about?
What kind of a transformativeexperience is it for women, and
does it apply to women of allage groups?
Kim Vopni (32:48):
Short answer yes, it doesn't matter I've had.
The oldest member in mycommunity is 93.
You can make change at any age.
Of course, if we can interveneearlier, that's even better, if
we can mitigate some of thesethings from happening in the
first place.
But yeah, statistically,anywhere between 30, 40% of
women will experienceincontinence.
(33:08):
I do think that is much higherbecause that is reported cases
and so many people just don'ttalk about this with their
doctors and suffer in silencewith it.
So I think that is higherProlapse wise 50% of women
who've given birth have somedegree of prolapse super common,
so very common.
(33:30):
Not openly talked about orscreened for, yet influences so
many women's lives.
When they have the rightinformation and they can make
changes that they didn't evenknow, like taking vaginal
estrogen, like addressingconstipation, like addressing
sleep, like addressing theirposture or their footwear, like
(33:51):
starting exercise all of thosethings it can happen pretty
quickly.
So in my community there arepeople within days are not like,
are sleeping through the nightagain, because they didn't know
that there was behaviors, theydidn't know that dehydration was
playing a role, they didn'tknow how they could overcome
these signals.
They just thought I've got thesignal.
(34:12):
I need to respond, and there'sways that we can retrain the
bladder so very quickly within.
You know, I've seen it as fourdays, I'd say.
The most common is around thetwo to three week mark, the most
significant change where peopleare like I don't have to wear
incontinence pads anymore andI'm having enjoyable sex again,
and I don't have the bother ofthe bulge as much as I used to.
(34:34):
It's usually around the likefour to six week mark.
The other thing that I see,though, is people, once they get
to that point, they think great, I'm cured, I don't need to do
this anymore.
But, as I said before, this isa lifelong.
This is not a quick fix.
We need to be consistent withit, or it will return, just like
(34:55):
we brush our teeth in betweenseeing dentist visits.
If we don't have a cavity, wedon't stop brushing our teeth,
we carry on with thatmaintenance program, and the
same applies to the pelvic floor.
Vai Kumar (35:06):
Yeah, it's a constant process, you know you said yeah
, brushing teeth again.
You know we all wear retainersif we got braces right, so
otherwise the teeth start tomove back.
So I guess you know greatdental analogy there.
What about distinction in termsof we talked about you touched
upon organ prolapse, rightPeople who have given birth?
(35:29):
What about prenatal, postpartumand menopause stages?
Is there like differences incondition that you notice in
terms of what kind of help womenneed and in terms of organ
prolapse, do people even realizethey have something going on?
(35:49):
Again, it's a question of a lotof us women, I think, enduring
stuff we are all so great at.
We just don't seem to have thatattention that we need to give
ourselves much more, as we doothers right in the family or,
you know, in the social circle.
(36:09):
Well, we always seem to carefor others much more than
putting ourselves in theforefront.
So what about anything in termsof signs that people should
watch for and what should justtell them that hey, that's an
SOS?
And in terms of these differentage groups the prenatal,
postpartum and menopausal whatkind of a distinction do you see
(36:33):
in terms of what they gothrough with the pelvic floor
functionality overall?
Kim Vopni (36:40):
Yeah, functionality overall.
Yeah, so, signs and symptomsobviously, leaking urine is an
urgency.
Low back pain is one.
Pelvic pain, painful sexconstipation, feeling like you
(37:00):
have something inside yourvagina, like if you're a tampon
wearer, feeling like yourtampon's not sitting quite
correct, feeling likesomething's going to fall out,
feeling heaviness or pressure,especially as the day goes on.
Seeing or feeling a bulgearound the opening of the vagina
.
Those are some of the morecommon signs and symptoms.
But even there are some peoplewho have a bulge very close to
(37:23):
the opening, who have nosymptoms and have no idea.
So symptoms do not indicateseverity.
They aren't always indicativeof what the problem is, and
that's part of the reason why Irecommend everybody see a pelvic
floor physiotherapist once ayear, even if you have no
symptoms, and especially if youdo no symptoms, and especially
(37:45):
if you do.
So that's who we go to forscreening and helping evaluate
function, looking for thingsthat could potentially become a
bigger problem down the road.
In terms of prenatal, postpartummenopause, when I first started
this work it was in theprenatal space.
My intention was getting thisinformation to women ahead of
time, before childbirth.
It's well established thatpregnancy and childbirth are
(38:09):
they greatly increase our riskfor pelvic floor dysfunction.
So if we have this knowledge,if we're doing pelvic floor
exercise, if we're understandingposture, if we understand
breath and, in particular forpregnant women, if we are
looking at birth positions andtraining for birth, training the
pelvic floor to respondappropriately during childbirth,
could we mitigate some of theserisks.
(38:32):
So that's kind of where Istarted.
And a first-time mom, afirst-time pregnant mom unless
they were starting to experiencethings like pubic joint pain or
low back pain, they're notreally that motivated, to be
completely honest, about doingpelvic floor exercise.
They don't yet have a problemto overcome, so it was a harder
sell.
Then, on the postpartum side, Ihad started a second company
(38:57):
called Belly Zinc where wemanufactured a postpartum wrap,
so embracing what many culturesdo around the world that honor
and revere this postpartumrecovery phase, whereas in North
America it's a sprint back tothe gym and to not look pregnant
as quickly as possible.
So we wanted to change that andwe designed a postpartum wrap
(39:18):
and coupled it with arestorative exercise program.
We wanted pregnant women topurchase it, so they had it for
immediately after they gavebirth.
And what?
In both of those instances, themost common customer we had was
the second or third time.
Mom, who had already beenthrough it, who had now, is
(39:42):
experiencing problems, wishingthey had done things differently
the first time, and now theywant to do something different
the second time.
Vai Kumar (39:49):
Realize it.
Kim Vopni (39:50):
Yes, yeah.
And so there's the diastasis,or diastasis, which is where the
two six pack muscles in theabdomen, that the outermost
abdominal muscles, theconnective tissue that holds
them in place at the midline,thins and stretches and those
muscles move away from themidline and can create some
(40:10):
challenges for some people.
And then all the other symptomsthat we were talking about.
The other thing with postpartumis we go into a low estrogen
state after the birth of ourbaby.
We go into a low estrogen stateafter the birth of our baby and
that is a glimpse into that lowestrogen state of menopause.
The difference is we will,postpartum, come out of that and
(40:32):
we will go back to our normalkind of fluctuations of estrogen
Postmenopause.
We go down and we stay down,unless we are supplementing with
hormones to some extent.
So those are kind of a few ofthe nuances there, but my hope
is that in my lifetime itbecomes more the norm for pelvic
(40:55):
floor physical therapy as partof your pregnancy.
I wrote a book called Prepare toPush so training for your birth
, honoring your recovery and notsprinting back to the gym.
We need to do exercise, we needto do movement and we're going
to train when we're pregnant formotherhood, or lifting a car
seat, for lifting a stroller,for doing that while you have a
(41:18):
baby on your side, or a toddleror diaper bag, or whatever it is
that you're training for, butbring it into real life
situations and movements.
So we're we're training forlife.
What we're doing in the gymshould make life easier to, if
that makes sense, um, and thepelvic floor.
When it's working well, it willallow us to do that with more
(41:38):
freedom and more success.
Vai Kumar (41:40):
Pelvic floor is often what holds us back.
Yeah, and posture right.
You're lifting so much you'relifting a baby.
All of a sudden you're carryinga car seat and you don't know
what else has happened to yourorgans during the process of
childbirth and labor.
What about supplements?
I heard you mentioned that.
So creatinine, collagen and allof this in terms of menopausal
(42:03):
women.
What kind of a significance dothese have in terms of building
strength and in terms of youknow, all the elasticity and
everything?
Kim Vopni (42:14):
right now there's really no research as it
pertains to creatine in thepelvic floor or collagen in the
pelvic floor.
There's some studies with floor, there's some studies with
vitamin D, there's some studieswith sea buckthorn oil.
So I'm hopeful at some point inmy life that there will be
research about these.
(42:34):
But if we look at creatine isone of the most I think it is
the most researched supplementin the world and it's for muscle
and we thought of it.
You know, the people who usedto take it were the young
bodybuilders.
But, now there's more and morestudies coming out to show that
this is really a beneficialsupplement for anybody and
(42:56):
especially post menopause women.
There's some evidence for bonesupport, for muscle support.
There's even some cool researchregardless of stage of life but
from a brain health perspectivethat's typically in higher
doses.
But I look at the literaturethat exists with creatine and
muscle and again I'm saying thepelvic floor is a group of
(43:19):
muscles, so we can hypothesizethat if it's having this
influence on other muscles inour body, could it not arguably
have the same thing, the sameaction, within our pelvic floor?
So creatine, I love creatine.
I'm a huge supporter ofsupplementing with creatine
(43:40):
everybody, especiallypostmenopausal women, with
creatine everybody, especiallypostmenopausal women.
The other one is collagen,which there's.
I've been taking collagen for anumber of years and there is
some research about people whohave experienced certain types
of pelvic floor dysfunction, whohave deficiencies of certain
types of collagen.
But there is no research aboutsupplementing with collagen as
(44:04):
it pertains to overcoming pelvicfloor challenges.
But again, like creatine, I'mlooking at this saying well, if
we have studies about how it caninfluence skin, hair, nails and
the different.
So that's mainly type one andtype three collagen.
That's the same type ofcollagen that we have in our
pelvic floor structures.
So if supplementing is helpingthe other type one and type
three collagen that's the sametype of collagen that we have in
our pelvic floor structures.
(44:25):
So if supplementing is helpingthe other type one and type
three, could it arguably nothelp the pelvic floor as well?
Again, hypothesizing I never inmy body, I was never able to say
oh, I took creatine or collagenand I noticed that I was able
to do more Kegels or you know,overcome.
(44:47):
I was never symptomatic enoughto notice a significant change.
However, looking at theliterature and the research, for
all of the other reasons whyit's beneficial for my whole
body, I'm I take thosereligiously.
The other one, uh, vitamin d,that there's oodles and oodles
of research about vitamin d forso many things of health, uh,
(45:10):
our health, but also with pelvicfloor so that's something else
are anyways deficient in vitaminright, right, exactly.
So vitamin d is on there.
Sea buckthorn oil is.
Oral intake ofabuckthorn oilhas been shown to help with
post-menopause vaginal like thedryness that we experience in
(45:31):
that low estrogen state, so it'snot going to.
I don't promote it.
As a way you know you don'tneed estrogen if you're taking
seabuckthorn oil.
I definitely think the majorityof women would benefit from
being on estrogen.
Taking C buckthorne oil, Idefinitely think the majority of
women would benefit from beingon estrogen, and we also have
this additional C buckthorne oilfor those that maybe have been
without estrogen for a long timeand they're really still
(45:53):
struggling with some level ofdryness or irritation.
C buckthorne oil orally issomething that I do recommend as
well.
Vai Kumar (46:01):
Okay, what about fecal incontinence, say, in
conditions like IBD,inflammatory bowel disease and
things like that?
I personally wrestle with IBD.
I have managed it pretty well.
I can relate to all the thingsthat you're talking about
because I do a mix of yoga andPilates and I know how magically
(46:23):
my pelvic floor movement andyou know, using those muscles
and incorporating strength andflexibility has resulted in a
phenomenal transformation for meand I did not.
Little did I know that KimWalkney existed up until
recently, that you know.
(46:43):
I got in touch with you, butthank you for coming on this
show again to create thisawareness.
But I guess, from a fecalincontinence standpoint and
blood circulation, lubrication,everything you know all the flow
how is all this movementimpacting and improving stuff
(47:06):
for people?
Can you talk a little aboutthat, kim?
Kim Vopni (47:10):
The principles of overcoming fecal incontinence
really are similar to, if notexactly the same as, overcoming
urinary incontinence, that thepelvic floor is responsible for
the opening of the urethra, theopening of the vagina, the
opening of the anus it's managesall three, and so the
principles of creating lengthand strength in that group of
(47:34):
muscles as a whole.
We might tweak cues orvisualization or certain poses
like exercises that somebody maydo their pelvic floor muscle
training in, but really thefundamentals posture, breathing,
avoiding constipation,activating and relaxing the
pelvic floor remains the same.
(47:56):
People who have additionallayers like, as you say, with
IBS or C or D or whichever oneor other types of even
autoimmune conditions, it's.
But exercise still is indicatedfor pretty much every single
person in the world, regardlessof what they're dealing with.
(48:18):
So the pelvic floor, again, isnot immune to that.
And when we are activating andtaking the muscles through range
of motion with whole bodymovement, by nature we are
increasing blood flow andcirculation.
And when we impart a load thatthe body needs to adapt to,
including the pelvic floor,that's how we get stronger.
(48:41):
So the diversity of movement isimportant, the sets and reps
and load is important, but justfundamentally moving, not
staying static is going toimprove the function of the
pelvic floor.
Vai Kumar (48:57):
Okay, Okay, what about, specifically?
Would you say a particular formof exercise is beneficial, Say
I just asked you something aboutPilates earlier.
Whatever you incorporate, is itlike?
I know you have talked a lotabout breath, you know getting
the breath right, getting allthe movement and getting the
(49:19):
strengthening part.
So I see whatever you do as acombination of everything.
Is that a fair assessment, ordo you just focus specifically
on more of yoga-like movementsor you focus more on like
weight-bearing exercises?
Is that something that you canthrow light on?
Kim Vopni (49:39):
I really, I like a lot of different things.
I don't think that there's onething People will often
gravitate towards.
You know, I really love yoga, Ireally love Pilates, I really
love whatever.
So doing what you love is alsoimportant.
If you're doing an activitythat you really hate, that's not
going to serve you in many ways.
So finding things that you dolike, but in trying to do some
(50:02):
different things within there.
But one thing that I would sayI do emphasize is resistance
training.
I think that the more and moreresearch is coming out about how
important our muscles are, how,from a longevity perspective,
reducing our fall risk, all ofthat it's so, so important to
(50:24):
have muscle mass, to have strongmuscles, to have supple muscles
.
So resistance training is a bigpart of what I do, but I
balance it out with some yogaand some stretching and other
types of things as well.
But I would say, if I was topick one thing that I focus on,
it would be resistance training.
Vai Kumar (50:44):
Your pelvic floor, yeah yeah.
Then there's pregnancy fitness.
There's the inside story.
Why don't you talk about all ofthese?
You know whatever these bookscover, and then we'll go for
(51:04):
some rapid fire or quicktakeaways for different sets of
people and you know we'll justcome to a closure on this
wonderful conversation.
Kim Vopni (51:13):
All right.
So my first book was calledPrepare to Push, and that was
again looking at how we canapply the principles of training
and specificity to childbirth.
We need to train for childbirth.
The next book was the InsideStory and that was kind of
looking at the main categoriessort of like prenatal or
(51:35):
pregnancy, motherhood, menopauseas three main life stages that
majority of people will gothrough.
Everybody will go throughmenopause who reaches midlife.
The next was pregnancy fitness.
So that was with my twobusiness partners in Bellies Inc
.
We were commissioned by HumanKinetics to create almost like a
manual about fitness andpregnancy.
(51:57):
So that was, uh, that was thatone.
And then the last, most recentone was in 2020.
That was it's called yourpelvic floor and it's more of a
um, it's a, it's a book for theconsumer to understand a lot of
what we talked about here whatthe pelvic floor is, how it
works, what are some commonsigns and symptoms that things
are not going well, and then, ofcourse, what we can do about it
(52:20):
through the various life stagesthat we go through.
Vai Kumar (52:23):
Okay, okay, perfect.
Quick tips and takeaways.
What should prenatal womenfocus on?
Kim Vopni (52:32):
Learning to release tension in the pelvic floor,
paying attention to theirposture and training in the more
common birth positions so thatthey build strength and pelvic
floor, like building theresponse of the pelvic floor in
those various birth positions,like sidelining, sidelining or
(52:54):
squatting or kneeling, that typeof thing.
Vai Kumar (52:58):
Okay, and then women of childbearing age.
What do you see as a challengewhen it comes to people being
able to get pregnant and issomething relating to movement
and our lifestyle that'simpeding?
Again, we have talked a lotabout pelvic floor as the focus.
Would you say anythingspecifically to them in terms of
(53:21):
emphasizing movement andanything else that may be very
significant?
Kim Vopni (53:26):
yeah, sometimes there can be.
You know that stuck tension caninterfere with fertility.
So when we're optimizing theblood flow and the circulation,
that can sometimes create a morefavorable environment for
fertility.
Vai Kumar (53:41):
Okay, what about teens?
They experience so much of, Imean, menstrual pain, and there
is just a lot of agony there aswell.
Again, that's a topic thatagain seems to be more of
endured than addressed, right?
So what would you say to that,kim?
Kim Vopni (54:04):
That's a great time to start seeing a pelvic floor
physical therapist.
Sometimes the pain can be as aresult of muscular tension.
Sometimes it can be, from youknow, a position like an organ
that's not in the right position.
Sometimes it can beendometriosis related.
Um, so they, your pelvic floorPT can help you screen for other
(54:26):
conditions but also introducethat concept of I help you
manage this really importantgroup of muscles.
And if you're experiencing painduring your cycle, one aspect
could be muscle function.
So we can look at that togetherand then you'd have some
strategies and tools to helprelease the tension which can
help mitigate cramping for somepeople.
Vai Kumar (54:48):
And we have talked so much about the pelvic floor.
We talked about spinal mobility, spinal stability, everything.
What about hip rotations andreleasing tension in the hips?
Is that contributing in any wayto any of this?
Kim Vopni (55:03):
that's happening below 1000% and it's a huge part
of what I do is is working onmobility within our hips and
building strength in the lateralhips so that we can transfer
loads, we can walk, we reduceour fall risk.
Um, it's often there's a coupleof stretches that I have in my
program that one of them iscalled the stacked butterfly,
(55:23):
which nobody really likes thatone because it's tough and it
sort of highlights how tight weare and we think about how many
hip replacements and kneereplacements we have.
A lot of it is to do with thewear and tear on the joints from
poor posture, from tightness inthe muscles that's not allowing
that freedom of movement.
So that is a huge part.
Vai Kumar (55:44):
Okay, can people, even in the osteopenia and
osteoporosis range because weaddressed it in a very broad
sense earlier in terms of peopleof all age groups, but even
specifically somebody you knowin the osteopenia or
osteoporosis category, still canthey benefit from all of this
in terms of the buildingstrength, the program, and so
(56:09):
definitely, like I said,whatever I've been doing has
resulted in a better bonedensity in my case.
So I can personally attest towhatever movement or whatever
strengthening of the pelvicfloor brings about.
But just wanted to ping you onthat.
What about menopausal women?
What should they focus on, kim?
Kim Vopni (56:31):
Vaginal estrogen and pelvic floor exercise and seeing
a pelvic floor physicaltherapist once a year.
Vai Kumar (56:37):
Okay, awesome.
So I think we have just offereda lot of pointers here in terms
of why women should not justsilently endure whatever they
have been going through and Iguess anyone, be it a woman, be
it a young girl, be it a womanof childbearing age, menopausal
(56:59):
women or even men of all ages, Ithink the pelvic floor, the hip
, mobility, all of the functionand movement, I think we cannot
underscore it any better.
So, no silent suffering off thepelvic floor is the biggest
takeaway for me from thispodcast and anybody who's
wanting to learn more vaginacoachcom is my website.
Kim Vopni (57:43):
If you put vagina coach into Google, you'll find
me somewhere on social media.
Instagram is typically whereI'm most active.
I also have a YouTube channelwith some free resources.
My podcast is between two lipsanother area for some free
information, and you can alsofind links to my books on my
website at VaginaCoachcom.
Vai Kumar (57:59):
Awesome, awesome.
Thank you so much for joiningus today.
Such a pleasure talking to youand I'm sure listeners of both
of these podcasts can just getto know more of each other and
I'm sure they can mutuallybenefit from a lot of
information that we are puttingout.
Listeners, as always, followthe podcast, rate the podcast,
(58:21):
leave a review from your podcastapp of choice, follow me on
Instagram, @vaipkumar, andYouTube for the podcast and for
all things digital media andlifestyle.
Until next time with yetanother interesting guest and
yet another interesting topic.
It's me Vai, along with thewonderful Kim, saying so long.
Thank you.
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