May 19, 2025 • 18 mins
We explore a connection most clinicians overlook: the link between the feet and the pelvic floor. Whether you treat pelvic health directly or not, understanding this relationship can drastically improve patient outcomes, especially for those with chronic tightness, pain, or pelvic floor dysfunction. You'll learn how fascia, the nervous system, and postural mechanics all play a role—and why traditional Kegels alone often miss the mark.
What You’ll Learn:
- The fascial connections from feet → diaphragm → pelvic floor
- Why tight calves, foot swelling, or poor toe mobility may signal deeper pelvic or lymphatic issues
- How the homunculus explains the foot–genital sensory link
- How foot pressure and posture influence pelvic floor contraction
- Why traditional Kegels often miss the mark, especially for urinary leakage
- How to use weight distribution cues (big toe, pinky toe, heel) to improve pelvic floor recruitment
0:00 Introduction to Feet and Pelvic Floor Connection
01:00 Fascial Connections: The First Link
07:38 Homunculus: The Brain-Body Map
10:12 Kegels and Pelvic Floor Mechanics
14:34 Practical Tips for Clinicians
18:08 Conclusion and Final Thoughts
If you are a health or movement professional and want to stay in touch with future episodes, webinars, courses, events and more. Subscribe to my email list here
I’ll see you in a week!
Mark as Played
Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
(00:00):
Welcome back to TMI talk withDr.
(00:01):
Mary.
I'm your host, Dr.
Mary.
In this episode, we're gonna goover the three ways the feet and
pelvic floor related.
This is super crucial for allmovement and rehab and
healthcare professionals to knowin order to help efficiently
give our clients the resultsthat they deserve.
And.
We're gonna dive into each oneand how it affects us
clinically.
Even if you're not a internalpelvic health therapist, it's
(00:25):
super important that we knowthese things as a global
understanding of the pelvicfloor, even if we don't do those
internal assessments, because itcan still maximize our benefits
with our clients.
I personally don't do a ton ofinternal treatments.
I do a lot externally becausethat's where we'll find the.
Source of pelvic floordysfunction often is, is
(00:48):
understanding how the body ismoving.
So without further ado, we'regonna jump into the episode.
I hope you enjoy it.
Welcome back to TMI talk withDr.
Mary where we dive intonon-traditional forms of health
that were once labeled as tabooor dismissed as Woo.
I'm your host, Dr.
Mary.
I'm an orthopedic and pelvicfloor physical therapist who
(01:08):
helps health.
Movement and rehab professionalsintegrate whole body healing by
blending the nervous system intotraditional biomechanics to
maximize patient outcomes.
I use a non-traditional approachthat has helped thousands of
people address the deeper rootsof health that often get
overlooked in conventionalwestern training.
And now we are gonna be startingour next episode.
(01:30):
All right, so the first way yourfeet are connected to the pelvic
floor is gonna be through ourfascial connection.
So again, if you look at TomMeyer's work, you can google
some different pictures, butbasically the the tongue all the
way down to the feet, there's aconnection from the fascia.
But today we're gonna be talkingabout mainly the pelvic floor
(01:51):
and feet connection, but.
There's a connection directlyfrom the diaphragm to the pelvic
floor to the feet.
So that's gonna be the firstconnection.
And why does that matter?
Well, there's plenty otherfascia connections too, so
there's different planes offascia as well.
And so if you look at all ofthose different planes, you'll
(02:12):
see why there's that directconnection.
So first of all.
With that fascial connection,you've got other muscles around
that area too.
So if the fascia is restricted,the muscles along that area are
likely restricted.
So I would be looking atmobility all along the the
quads, so the thighs anteriortip along the posterior aspect.
(02:37):
So the gastroc and hamstrings,adductors.
Abductors looking at the faciaand how all that tissue is
moving around there.
In addition to the, we also havenerves underneath of there as
well, and so we know that thesciatic nerve comes out of the
hips and goes down into thefeet.
(02:59):
It actually.
Splits behind the knee, but justfor understanding how the nerves
come out of the back and intothe legs.
Just looking at that from thatperspective.
And so if we know that there's afascial connection from the
pelvic floor to the feet, weknow that underneath of that and
surrounding that are gonna benerves.
And muscles and lymph as well.
(03:21):
So we need to be looking at allof these things and how they
relate to the pelvic floor.
For example, if somebody hasreal, really tight gastrocs,
right, and maybe they're swollenin their feet or they're swollen
in their calves, their lymphreturn is probably limited,
actually.
It likely is.
And so what that means is weneed that gastroc, so we need
(03:43):
that calf to be pumping thatlymph back up into the pelvis,
into the thoracic duct, and upinto back into the bloodstream.
And so if their calves arereally tight, they're likely
limited in that lymphcirculation.
So you might see some pooling offluid around the pelvis.
(04:04):
You may not directly see it, butthey may feel their tissues may
just feel more full.
They may feel more warm.
They may complaint of heaviness.
They may feel like they're not.
C digesting well, they may feellike they're more constipated.
So it's super important thatwe're looking at how all of that
is connecting, because the morewe're getting that lymphatic
(04:28):
movement, the more that's gonnahelp with reducing the pressure
in the pelvis and help ourimmune system stay functional.
And with that, thinking aboutthe fascia mobility.
So a lot of times I find.
As, especially as PTs, you know,I'm not as familiar in other
professions if they do this, butI know in massage they don't as
(04:48):
much either because I've gottena lot of massages.
We ignore the abdomen,especially the lower abdomen.
We need to be assessing thisarea because if we're not
looking at how the tissues inthe abdomen are moving as.
Especially the visceral tissues.
So we've got the bladder there,the uterus, we've got the colon,
(05:09):
you've got a bunch of organsthere.
And if we're not looking at,those are how those are moving,
that's gonna affect the pelvis,which can affect our lymphatic
flow, which can affect our feet,right?
So all of that is gonna beinterconnected.
And those are all additionaltrainings to take, but it's,
it's very important that we'relooking at that because if you
(05:30):
think about the way the body isheld up, it's not, we don't have
our organs just sitting inthere.
They're being held up by fascia.
And fascia is a, is responsiveto the nervous system.
So if somebody's going intofight or flight that.
Fascia's not gonna be asflexible.
It's not gonna be as resilient.
It's not this stagnant tissuethat we were taught in school.
(05:52):
You're gonna start seeing moreinformation coming out about
this.
So we need to know as movementand and rehab professionals
about the fascia.
So now say if somebody'sdehydrated, the fascia's gonna
be dehydrated, so then we're notgonna get as much of that
resiliency in the tissues.
So maybe you'll see that theircalf isn't loosening up.
(06:15):
Maybe you'll see that theirhamstrings are always tight.
These are all things to look at,potentially the fascia to
understand.
And again, underneath of that,the, the nerve tension coming
out of the pelvis and into theposterior aspect of the leg.
And into the rest of the leg.
Right?
So we've got your femoral nerve,we've got your ator.
(06:36):
We've got a bunch of differentnerves coming out of the pelvis
and into the legs, and then theyall split off, right?
And become different nerves allthe way down the chain.
But they're all related, right?
You wouldn't say that.
A tree isn't related to itsroots, right?
There's a direct connection.
It just might be further away.
It just might have to travelmore, but it's still there.
And then we have electricalpulses that are bringing that
(06:59):
information to the differentparts of our body.
And now if our lymph isstagnant, we're not able to get
as much movement of flow throughthe muscles.
So the impulses.
So that electrical impulse isgonna be stagnant.
So you might hear this inEastern medicine almost as
stagnant energy.
And so the way that we look atthis in the rehab world is,
(07:22):
well, what tissues do we need tobe moving?
Let's pull out, let's startlooking beyond just the muscles
and bones and tendons.
We need to be looking at lymph.
We need to be looking at fascia.
If we're not looking at this,we're missing a lot.
And, um, not to shame anybody.
I mean, I've definitely ignoredthese areas for a long time, but
(07:44):
the more you wake up to them,you can realize, oh wow, these
are really fascinating ways tohelp our clients.
So the second way of the feetconnected to the pelvic floor is
through the homunculus.
So the homonculus is where weinterpret messages from
different parts of our body tothe brain.
(08:05):
And so when you look at theHomonculus, you will see that
the feet and genitals are rightnext to each other.
And so if we're gettingelectrical impulses and we're
getting synapses onto the feet,it's gonna overlap and get the
genital area as well.
This is why you'll findsometimes with the feet curl
(08:26):
with orgasm, you'll find thatsometimes people can, when they
engage their feet or their arch,they can engage their pelvic
floor a bit more.
So you'll see a drasticconnection with that simply
because of where it synapses onthe brain, pull it up.
It's really fascinating.
(08:46):
So you can use that as aclinician or movement
professional if somebody isreally having trouble in
engaging their pelvic floormuscles.
By the way, not all Kegels arecreated equal.
I'll jump into that in a second,but.
It might be helpful to start toget them to get, improve their
toe mobility, maybe the fascialmobility between their toes,
(09:06):
because the more movement andresilience we get in the feet,
the more movement and resiliencewe're gonna get in the pelvic
floor.
And so it's just important thatwe are looking at that so then
why are KE goals just not allcreated equal?
Well, I should have a wholenother podcast episode on this,
but this is important to know.
(09:27):
We should know this regardlessof if you treat the pelvic floor
internally or not, I treat thepelvic floor internally, but it
is such a small part of mysession because I know how the
full body works together, and sothat's why it's important If you
know how the full body workstogether and you don't want to.
Necessarily do internalassessments.
You can still do a lot for yourclients.
(09:49):
Just simply noticing thesethings.
'cause there are still someclients that don't want an
internal assessment.
So I have to treat themexternally based on their
symptoms.
So, and this will kind of gointo the third way that the
pelvic floor and feet arerelated, but in that third way.
The pressure on our feet aregoing to affect how we contract
(10:11):
our pelvic floor.
So if you shift your weightforward, so if you wanna stand
up or just do this later, ifyou're driving or whatever, the
way that we stand is gonnaaffect how our, we contract our
pelvic floor.
So let's talk about this for aminute.
Let's go back to what a pelvicfloor contraction is.
(10:32):
So if you look at the pelvicfloor, you'll see where the
lator anai is.
So the lator anai, there's gonnabe like this little U opening
right at the front of the pelvicfloor if you're treating
somebody that has a vagina.
And so in this.
You will see that a Kegeldoesn't necessarily help with
(10:56):
urinary incontinence, soaccidental leakage.
So pull up the anatomy and lookat it, because what you'll see
is that.
Oftentimes the traditional Kegelis gonna affect more of the
muscles around the anus than itwill the muscles around the
urethra.
There are different musclesaround the urethra than the ones
that are around the rest of thepelvic floor.
(11:18):
So go ahead and just look at theanatomy there.
So if you are contracting thepelvic floor more posterior than
the backside, you're likely onlyhelping with.
The muscles around the externalanal sphincter basically, and
the levator an I there.
But so what you're doing isyou're contracting more of that
aspect.
And if you look at the anatomy,you're actually not affecting
(11:40):
the front part of the pelvicfloor as much.
Not saying it's, it's notcontracting.
I don't believe you can trulyisolate any muscle group, but
you're not biasing the front asmuch.
And so that's gonna be in, youknow, a couple different ways.
Well, first of all.
When you're assessing, say, ifyou are assessing somebody
externally for a pelvic floor,you'll see they call it the
(12:01):
clitoral wink.
So if you're assessing somebodywith a vagina, you'll see it
kind of nods down and you canknow that they're contracting
more of that front of thatpelvic floor, but they'll get
most of their.
Feedback from when they areurinating.
So if they stop their urine.
So now we know, hey, if somebodyis having urinary incontinence,
(12:21):
a traditional Kegel isn't gonnabe as efficient.
What you're gonna need is thatdirect biofeedback for that
client.
So if they're peeing after a fewseconds of peeing, I want you to
try to get them to stop.
If they can't stop, it's likelybecause the muscles around the
urethra, so that externalurethral sphincter.
And the compressor urethra,those are not.
(12:46):
Efficiently blocking the flow.
And that's likely because one oftwo things, those muscles are
intrinsically, intrinsicallyweak.
They may be able to do it othertimes, but not maybe first thing
in the morning, simply becauseif you think about the, the
bladder is a balloon, right?
And then you have the opening,the bigger the balloon with the
bigger the water, the more forceit's gonna take for the urethra
(13:09):
and the compress, the externalurethral sphincter and the
compressed urethra to contract.
So they might be able to do itand they might not.
So my point is, if they're justdoing Kegels and activating that
posterior aspect of the pelvicfloor, they're not getting that
front aspect as much.
I.
And this also comes into playwith the feet.
(13:30):
So if they're standing up andhave them look at their feet
when they're standing, are theyturning their feet out?
Where is the pressure in theirfeet?
You can ask them.
I find most people are kind ofputting most of their pressure
through their heels.
But again, that's not everybody.
Everybody's a little bitdifferent.
Some people put it more on theirforefoot.
Um, but I would say look atthem.
(13:51):
Ask them where they're feeling,where their feet are, where is
most of the pressure?
I.
Look at the bottom of theirshoes.
What do their feet look like?
Where are they wearing more ontheir feet?
Because technically we wantequal distribution between the
big toe, the pinky toe, and theheel.
All right.
And so if we have equaldistribution during all of
those, it's gonna be easier tocontract the pelvic floor from
(14:14):
the front and the back.
Now if you start leaningforward, so you might even see
people, um, posting videos abouthow if somebody's having urinary
linkage.
Leaning more forward on theirtoes.
That's because that's helping toactivate more of the anterior
aspect.
So that front aspect of thepelvic floor.
Now when you shift back, theymight feel it more in that
backside, right?
(14:35):
And so you, some people may feelit a little bit differently, but
overall you'll notice that kindof shifting back and forth.
So if you have somebody that'sleaking during exercise, and
maybe you're not a mo, maybeyou're not a pelvic health
professional.
But you know, oh, well, maybethey need to be putting more of
their forefoot or their toes,more pressure in their toes, and
(14:57):
then have them do a contractionthere as if they are stopping
the flow of urine.
Right.
That's a really good cue forthem.
If they don't know, they canpractice that every time they
use the restroom.
I know an old wives tale, wewere told, oh, don't stop the
flow.
It's gonna cause this backup,and then they're gonna get UTIs.
(15:18):
It is the fastest and easiestway to get people to understand
their pelvic floor because it'sjust so easy to do.
I find that when I would givepeople vaginal weights, and I
still do that.
It's just, it's a whole effortto be able to do that.
So if you are working withsomebody that doesn't have as
much time, this is super key tohelp them with that.
(15:38):
So then they can start noticinghow they're standing, right?
So say if they're standing andthey're putting more forefoot,
more weight through, they'remaybe, maybe they're putting
more weight through theirforefoot or their heels.
Either way, kinda see how theyfeel.
Most often I see people are kindof shifted more, their pelvis is
more forward.
The thoracic spine is back, andnow we're kind of getting this
(16:00):
crunching motion in our lumbarspine, so we're getting extra
compression along the lumbarfacets.
And then now they're sneezing.
Well, now we don't have our ribsstacked over our pelvis, and
then our feet are unstable.
So our core muscles are reallytrying to figure out where they
are, what's going on.
So they're not likely gonna beas a able to contract.
(16:23):
So making sure that they'reaware of how it.
Feels.
What I'll do in the clinic, tobe honest, is I'll have them
stand how they normally standand I, I put pressure over their
shoulders and I have them and Ipush down and you'll see they
kind of get a little bit of agive.
Then I have them stand with ribsstacked over pelvis.
An equal distribution with thatbig toe, little toe and heel and
(16:45):
push down and they can feelimmediately that difference.
And so they've got that buy-inright there.
I find it super important thatpeople can feel it in their
bodies before we tell them to dosomething because trust goes way
up when you can show them thesereally cool tricks with their
body, but.
Anyways.
I hope you all enjoy this quickepisode.
I really think it's jam packedwith a lot of information to
(17:07):
help you with your clients, Iwill see you next week.
Thank you so much for listening.
Thank you so much for listeningto my podcast.
It would be a huge help if youcould subscribe and rate the
podcast.
It helps us reach more peopleand make a bigger impact.
I would also love it if youcould join my email list, which
is LinkedIn, the caption forpodcast updates, upcoming offers
(17:27):
and events.
You can also find me on TikTok,YouTube and Instagram at Dr.
Mary pt.
Thanks again.
Welcome back to TMI talk withDr.
(00:01):
Mary.
I'm your host, Dr.
Mary.
In this episode, we're gonna goover the three ways the feet and
pelvic floor related.
This is super crucial for allmovement and rehab and
healthcare professionals to knowin order to help efficiently
give our clients the resultsthat they deserve.
And.
We're gonna dive into each oneand how it affects us
clinically.
Even if you're not a internalpelvic health therapist, it's
(00:25):
super important that we knowthese things as a global
understanding of the pelvicfloor, even if we don't do those
internal assessments, because itcan still maximize our benefits
with our clients.
I personally don't do a ton ofinternal treatments.
I do a lot externally becausethat's where we'll find the.
Source of pelvic floordysfunction often is, is
(00:48):
understanding how the body ismoving.
So without further ado, we'regonna jump into the episode.
I hope you enjoy it.
Welcome back to TMI talk withDr.
Mary where we dive intonon-traditional forms of health
that were once labeled as tabooor dismissed as Woo.
I'm your host, Dr.
Mary.
I'm an orthopedic and pelvicfloor physical therapist who
(01:08):
helps health.
Movement and rehab professionalsintegrate whole body healing by
blending the nervous system intotraditional biomechanics to
maximize patient outcomes.
I use a non-traditional approachthat has helped thousands of
people address the deeper rootsof health that often get
overlooked in conventionalwestern training.
And now we are gonna be startingour next episode.
(01:30):
All right, so the first way yourfeet are connected to the pelvic
floor is gonna be through ourfascial connection.
So again, if you look at TomMeyer's work, you can google
some different pictures, butbasically the the tongue all the
way down to the feet, there's aconnection from the fascia.
But today we're gonna be talkingabout mainly the pelvic floor
(01:51):
and feet connection, but.
There's a connection directlyfrom the diaphragm to the pelvic
floor to the feet.
So that's gonna be the firstconnection.
And why does that matter?
Well, there's plenty otherfascia connections too, so
there's different planes offascia as well.
And so if you look at all ofthose different planes, you'll
(02:12):
see why there's that directconnection.
So first of all.
With that fascial connection,you've got other muscles around
that area too.
So if the fascia is restricted,the muscles along that area are
likely restricted.
So I would be looking atmobility all along the the
quads, so the thighs anteriortip along the posterior aspect.
(02:37):
So the gastroc and hamstrings,adductors.
Abductors looking at the faciaand how all that tissue is
moving around there.
In addition to the, we also havenerves underneath of there as
well, and so we know that thesciatic nerve comes out of the
hips and goes down into thefeet.
(02:59):
It actually.
Splits behind the knee, but justfor understanding how the nerves
come out of the back and intothe legs.
Just looking at that from thatperspective.
And so if we know that there's afascial connection from the
pelvic floor to the feet, weknow that underneath of that and
surrounding that are gonna benerves.
And muscles and lymph as well.
(03:21):
So we need to be looking at allof these things and how they
relate to the pelvic floor.
For example, if somebody hasreal, really tight gastrocs,
right, and maybe they're swollenin their feet or they're swollen
in their calves, their lymphreturn is probably limited,
actually.
It likely is.
And so what that means is weneed that gastroc, so we need
(03:43):
that calf to be pumping thatlymph back up into the pelvis,
into the thoracic duct, and upinto back into the bloodstream.
And so if their calves arereally tight, they're likely
limited in that lymphcirculation.
So you might see some pooling offluid around the pelvis.
(04:04):
You may not directly see it, butthey may feel their tissues may
just feel more full.
They may feel more warm.
They may complaint of heaviness.
They may feel like they're not.
C digesting well, they may feellike they're more constipated.
So it's super important thatwe're looking at how all of that
is connecting, because the morewe're getting that lymphatic
(04:28):
movement, the more that's gonnahelp with reducing the pressure
in the pelvis and help ourimmune system stay functional.
And with that, thinking aboutthe fascia mobility.
So a lot of times I find.
As, especially as PTs, you know,I'm not as familiar in other
professions if they do this, butI know in massage they don't as
(04:48):
much either because I've gottena lot of massages.
We ignore the abdomen,especially the lower abdomen.
We need to be assessing thisarea because if we're not
looking at how the tissues inthe abdomen are moving as.
Especially the visceral tissues.
So we've got the bladder there,the uterus, we've got the colon,
(05:09):
you've got a bunch of organsthere.
And if we're not looking at,those are how those are moving,
that's gonna affect the pelvis,which can affect our lymphatic
flow, which can affect our feet,right?
So all of that is gonna beinterconnected.
And those are all additionaltrainings to take, but it's,
it's very important that we'relooking at that because if you
(05:30):
think about the way the body isheld up, it's not, we don't have
our organs just sitting inthere.
They're being held up by fascia.
And fascia is a, is responsiveto the nervous system.
So if somebody's going intofight or flight that.
Fascia's not gonna be asflexible.
It's not gonna be as resilient.
It's not this stagnant tissuethat we were taught in school.
(05:52):
You're gonna start seeing moreinformation coming out about
this.
So we need to know as movementand and rehab professionals
about the fascia.
So now say if somebody'sdehydrated, the fascia's gonna
be dehydrated, so then we're notgonna get as much of that
resiliency in the tissues.
So maybe you'll see that theircalf isn't loosening up.
(06:15):
Maybe you'll see that theirhamstrings are always tight.
These are all things to look at,potentially the fascia to
understand.
And again, underneath of that,the, the nerve tension coming
out of the pelvis and into theposterior aspect of the leg.
And into the rest of the leg.
Right?
So we've got your femoral nerve,we've got your ator.
(06:36):
We've got a bunch of differentnerves coming out of the pelvis
and into the legs, and then theyall split off, right?
And become different nerves allthe way down the chain.
But they're all related, right?
You wouldn't say that.
A tree isn't related to itsroots, right?
There's a direct connection.
It just might be further away.
It just might have to travelmore, but it's still there.
And then we have electricalpulses that are bringing that
(06:59):
information to the differentparts of our body.
And now if our lymph isstagnant, we're not able to get
as much movement of flow throughthe muscles.
So the impulses.
So that electrical impulse isgonna be stagnant.
So you might hear this inEastern medicine almost as
stagnant energy.
And so the way that we look atthis in the rehab world is,
(07:22):
well, what tissues do we need tobe moving?
Let's pull out, let's startlooking beyond just the muscles
and bones and tendons.
We need to be looking at lymph.
We need to be looking at fascia.
If we're not looking at this,we're missing a lot.
And, um, not to shame anybody.
I mean, I've definitely ignoredthese areas for a long time, but
(07:44):
the more you wake up to them,you can realize, oh wow, these
are really fascinating ways tohelp our clients.
So the second way of the feetconnected to the pelvic floor is
through the homunculus.
So the homonculus is where weinterpret messages from
different parts of our body tothe brain.
(08:05):
And so when you look at theHomonculus, you will see that
the feet and genitals are rightnext to each other.
And so if we're gettingelectrical impulses and we're
getting synapses onto the feet,it's gonna overlap and get the
genital area as well.
This is why you'll findsometimes with the feet curl
(08:26):
with orgasm, you'll find thatsometimes people can, when they
engage their feet or their arch,they can engage their pelvic
floor a bit more.
So you'll see a drasticconnection with that simply
because of where it synapses onthe brain, pull it up.
It's really fascinating.
(08:46):
So you can use that as aclinician or movement
professional if somebody isreally having trouble in
engaging their pelvic floormuscles.
By the way, not all Kegels arecreated equal.
I'll jump into that in a second,but.
It might be helpful to start toget them to get, improve their
toe mobility, maybe the fascialmobility between their toes,
(09:06):
because the more movement andresilience we get in the feet,
the more movement and resiliencewe're gonna get in the pelvic
floor.
And so it's just important thatwe are looking at that so then
why are KE goals just not allcreated equal?
Well, I should have a wholenother podcast episode on this,
but this is important to know.
(09:27):
We should know this regardlessof if you treat the pelvic floor
internally or not, I treat thepelvic floor internally, but it
is such a small part of mysession because I know how the
full body works together, and sothat's why it's important If you
know how the full body workstogether and you don't want to.
Necessarily do internalassessments.
You can still do a lot for yourclients.
(09:49):
Just simply noticing thesethings.
'cause there are still someclients that don't want an
internal assessment.
So I have to treat themexternally based on their
symptoms.
So, and this will kind of gointo the third way that the
pelvic floor and feet arerelated, but in that third way.
The pressure on our feet aregoing to affect how we contract
(10:11):
our pelvic floor.
So if you shift your weightforward, so if you wanna stand
up or just do this later, ifyou're driving or whatever, the
way that we stand is gonnaaffect how our, we contract our
pelvic floor.
So let's talk about this for aminute.
Let's go back to what a pelvicfloor contraction is.
(10:32):
So if you look at the pelvicfloor, you'll see where the
lator anai is.
So the lator anai, there's gonnabe like this little U opening
right at the front of the pelvicfloor if you're treating
somebody that has a vagina.
And so in this.
You will see that a Kegeldoesn't necessarily help with
(10:56):
urinary incontinence, soaccidental leakage.
So pull up the anatomy and lookat it, because what you'll see
is that.
Oftentimes the traditional Kegelis gonna affect more of the
muscles around the anus than itwill the muscles around the
urethra.
There are different musclesaround the urethra than the ones
that are around the rest of thepelvic floor.
(11:18):
So go ahead and just look at theanatomy there.
So if you are contracting thepelvic floor more posterior than
the backside, you're likely onlyhelping with.
The muscles around the externalanal sphincter basically, and
the levator an I there.
But so what you're doing isyou're contracting more of that
aspect.
And if you look at the anatomy,you're actually not affecting
(11:40):
the front part of the pelvicfloor as much.
Not saying it's, it's notcontracting.
I don't believe you can trulyisolate any muscle group, but
you're not biasing the front asmuch.
And so that's gonna be in, youknow, a couple different ways.
Well, first of all.
When you're assessing, say, ifyou are assessing somebody
externally for a pelvic floor,you'll see they call it the
(12:01):
clitoral wink.
So if you're assessing somebodywith a vagina, you'll see it
kind of nods down and you canknow that they're contracting
more of that front of thatpelvic floor, but they'll get
most of their.
Feedback from when they areurinating.
So if they stop their urine.
So now we know, hey, if somebodyis having urinary incontinence,
(12:21):
a traditional Kegel isn't gonnabe as efficient.
What you're gonna need is thatdirect biofeedback for that
client.
So if they're peeing after a fewseconds of peeing, I want you to
try to get them to stop.
If they can't stop, it's likelybecause the muscles around the
urethra, so that externalurethral sphincter.
And the compressor urethra,those are not.
(12:46):
Efficiently blocking the flow.
And that's likely because one oftwo things, those muscles are
intrinsically, intrinsicallyweak.
They may be able to do it othertimes, but not maybe first thing
in the morning, simply becauseif you think about the, the
bladder is a balloon, right?
And then you have the opening,the bigger the balloon with the
bigger the water, the more forceit's gonna take for the urethra
(13:09):
and the compress, the externalurethral sphincter and the
compressed urethra to contract.
So they might be able to do itand they might not.
So my point is, if they're justdoing Kegels and activating that
posterior aspect of the pelvicfloor, they're not getting that
front aspect as much.
I.
And this also comes into playwith the feet.
(13:30):
So if they're standing up andhave them look at their feet
when they're standing, are theyturning their feet out?
Where is the pressure in theirfeet?
You can ask them.
I find most people are kind ofputting most of their pressure
through their heels.
But again, that's not everybody.
Everybody's a little bitdifferent.
Some people put it more on theirforefoot.
Um, but I would say look atthem.
(13:51):
Ask them where they're feeling,where their feet are, where is
most of the pressure?
I.
Look at the bottom of theirshoes.
What do their feet look like?
Where are they wearing more ontheir feet?
Because technically we wantequal distribution between the
big toe, the pinky toe, and theheel.
All right.
And so if we have equaldistribution during all of
those, it's gonna be easier tocontract the pelvic floor from
(14:14):
the front and the back.
Now if you start leaningforward, so you might even see
people, um, posting videos abouthow if somebody's having urinary
linkage.
Leaning more forward on theirtoes.
That's because that's helping toactivate more of the anterior
aspect.
So that front aspect of thepelvic floor.
Now when you shift back, theymight feel it more in that
backside, right?
(14:35):
And so you, some people may feelit a little bit differently, but
overall you'll notice that kindof shifting back and forth.
So if you have somebody that'sleaking during exercise, and
maybe you're not a mo, maybeyou're not a pelvic health
professional.
But you know, oh, well, maybethey need to be putting more of
their forefoot or their toes,more pressure in their toes, and
(14:57):
then have them do a contractionthere as if they are stopping
the flow of urine.
Right.
That's a really good cue forthem.
If they don't know, they canpractice that every time they
use the restroom.
I know an old wives tale, wewere told, oh, don't stop the
flow.
It's gonna cause this backup,and then they're gonna get UTIs.
(15:18):
It is the fastest and easiestway to get people to understand
their pelvic floor because it'sjust so easy to do.
I find that when I would givepeople vaginal weights, and I
still do that.
It's just, it's a whole effortto be able to do that.
So if you are working withsomebody that doesn't have as
much time, this is super key tohelp them with that.
(15:38):
So then they can start noticinghow they're standing, right?
So say if they're standing andthey're putting more forefoot,
more weight through, they'remaybe, maybe they're putting
more weight through theirforefoot or their heels.
Either way, kinda see how theyfeel.
Most often I see people are kindof shifted more, their pelvis is
more forward.
The thoracic spine is back, andnow we're kind of getting this
(16:00):
crunching motion in our lumbarspine, so we're getting extra
compression along the lumbarfacets.
And then now they're sneezing.
Well, now we don't have our ribsstacked over our pelvis, and
then our feet are unstable.
So our core muscles are reallytrying to figure out where they
are, what's going on.
So they're not likely gonna beas a able to contract.
(16:23):
So making sure that they'reaware of how it.
Feels.
What I'll do in the clinic, tobe honest, is I'll have them
stand how they normally standand I, I put pressure over their
shoulders and I have them and Ipush down and you'll see they
kind of get a little bit of agive.
Then I have them stand with ribsstacked over pelvis.
An equal distribution with thatbig toe, little toe and heel and
(16:45):
push down and they can feelimmediately that difference.
And so they've got that buy-inright there.
I find it super important thatpeople can feel it in their
bodies before we tell them to dosomething because trust goes way
up when you can show them thesereally cool tricks with their
body, but.
Anyways.
I hope you all enjoy this quickepisode.
I really think it's jam packedwith a lot of information to
(17:07):
help you with your clients, Iwill see you next week.
Thank you so much for listening.
Thank you so much for listeningto my podcast.
It would be a huge help if youcould subscribe and rate the
podcast.
It helps us reach more peopleand make a bigger impact.
I would also love it if youcould join my email list, which
is LinkedIn, the caption forpodcast updates, upcoming offers
(17:27):
and events.
You can also find me on TikTok,YouTube and Instagram at Dr.
Mary pt.
Thanks again.
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