June 2, 2025 • 50 mins
Hi Where's Your Bump At community,
In this episode, I am so blessed to be joined by my beautiful Osteopath Meg. Meg has been a huge source of support for me throughout my pregnancy and she is one of the first guests I had in mind when planning this series!
Meg talks us through the pelvic floor, what we should be doing to support the function on our pelvic floor (not just during pregnancy, but all the time!) and the best advice in the preparation for having a baby.
I loved this chat with Meg and hope you take away as much as I did.
All my love
Anna xxx
See omnystudio.com/listener for privacy information.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Speaker 1 (00:00):
Wanting to have kids is a huge life decision. But
once you're ready to embark on that journey, what do
you actually need to know? This podcast is the community
you never knew you needed from mums and mums to be.
We're about to embark on this learning journey together and
it's going.
Speaker 2 (00:18):
To be real.
Speaker 1 (00:18):
It's going to be raw and a completely non judgmental space.
You're listening to Where's your bump hat? And this is
Anamacavoy Staples. I'm going to be interviewing experts in the
field so that all of our burning questions can be answered,
from understanding our cycle to knowing what is the best
(00:41):
time to conceive, and so much more. We'll get into
the difference between natural verse c section births, strange pregnancy
symptoms and everything in between. Okay, Hello, we have my
osteopath Meg in the Judeo today to talk all things
(01:02):
of helvic floor and so much more.
Speaker 2 (01:04):
I'm so excited to have you on the show. Hello, Hello,
thank you for having me, Thank you for coming in.
It's so funny.
Speaker 1 (01:11):
I was just saying to Meg that she actually I
had an appointment with her the other week and she
was like feeling my tummy and she's like, yeah, I
think the baby's breach. And I was like, okay, you
found out, like told me way before anyone else, Like
they had to do a proper scam before anyone else
told me that. And they're like, the baby's breach and
I was like, yeah, I know. And they're like, how
do you know? And I was like, well, my Osteo told.
Speaker 2 (01:32):
Me is a wizard. She is. She's a magician.
Speaker 1 (01:37):
So I think that we should start from the beginning
as to why and how we even know each other.
And I guess to do that, I have to start
back in Oh, I'm going to say like two thousand
and six.
Speaker 2 (01:51):
Maybe I was.
Speaker 1 (01:53):
We didn't meet each other in two thousand and six,
but he was drunk. I was black out drunk in
two thousand and six and I fell off a bed
onto a concrete floor.
Speaker 2 (02:06):
And at the.
Speaker 1 (02:08):
Time it wasn't that painful, but I woke up in
the morning and I was in the most excruciating.
Speaker 2 (02:14):
Pain of my life. It was like my eyes opened and.
Speaker 1 (02:18):
All of the I don't even know what to call them,
just like every part of my body just shot to
my coxic bone.
Speaker 2 (02:27):
All of the pain. It so painful. Oh so painful.
Speaker 1 (02:32):
I was in Singapore at the time, had to pace
the aeroplane from Singapore to Melbourne on a night flight,
and I was like walking so slow and people thought
I was nuts and I felt nuts. And for the
next five to six years, I think I suffered with
really excruciating coxic pain.
Speaker 2 (02:55):
I saw a physio. They couldn't really do much about it.
Speaker 1 (02:58):
They gave me some exercises and and by the end
of it, they kind of just told me that I
would have to live with it and it would eventually
go away, which it did.
Speaker 2 (03:07):
But then that's right, yeah, eventually. But then I got pregnant.
Speaker 1 (03:14):
And when you get pregnant, I think everything kind of
well you've said to me, then everything, Yeah, things that
maybe were kind of an issue at one point in
your life, if they've not been fully fixed, I feel like,
come back when you can become pregnant. And I was
speaking to my sister in law and she was talking
about seeing an osteo and I've never seen an osteo.
Speaker 2 (03:38):
In my whole life until becoming pregnant.
Speaker 1 (03:41):
And anyway, I did a call out on social media
and was like, does anyone know good osteo? Who specializes
in coxic pain, and I swear to you now literally
there was like six seven people being like, Meg is
a magician, he needs to see her.
Speaker 2 (03:57):
She's going to.
Speaker 1 (03:58):
Solve all your problems. I was like, I'm sold the dream,
and they're right.
Speaker 2 (04:02):
You did.
Speaker 1 (04:04):
At three months pregnant, I was in excruciating coxic bone pain,
and since having sessions with you, I no longer have it,
which is.
Speaker 2 (04:13):
Shocking for me to even say. So, I guess let's
maybe talk through.
Speaker 1 (04:20):
Our appointments maybe and like what they entail because little PSA,
it's not what you're gonna think.
Speaker 2 (04:27):
Yeah, so I'm gonna pass. You can explain that. What
something that's really interesting that you touched on was so
many people forget old injuries that they've had, Like I'll
be taking a medical history, and I was like, not,
no surgeries, no injuries. And then I started assessing them.
I'm like, what has happened to you? And they're like, oh,
I had open heart surgery or I just broke. You
(04:49):
just forgot that. But not everyone that is pregnant or
even postpartum like has pain. So the people that do
have pain or just not recovering, how we would expect
I'm always thinking why, like, what else has happened in
your history that hasn't allowed you to fully recover? So
straight away with you taking your history, I was like,
(05:10):
have you fallen in your coxics? You're like, yeah, but
that was ages ago. And what can happen is in
that acute injury phase you can have a lot of tightness,
you can have a lot of inflammation, and that can
start to settle down. However, the thing that probably hasn't
happened is the joint. We haven't got that cocksix. It
is a joint, we haven't got that moving properly. So
(05:32):
then you're pregnant and the body is trying to expand
and soften and really prepare, and if that joint isn't moving,
it just gets more and more jammed. So from an
assessment treatment point of view, we really need to look
at the whole body, but also the peer with floor. Yeah,
and the power floor. It's a group of muscles and
(05:52):
it's like a hammock and it just sits at the
bottom of the pelvis, but it does it attaches onto
the cocxix. So if your cosix is stiff for not moving,
that can create public full tension, and then when you've
got that tension that's going to yank on the coxsix.
That can create more coxic stiffness, which is probably why
like you've had some treatment, you've done some stretches. It
(06:13):
can give short term relief, it can help get into
the muscles in the area, but nothing's actually dressing the
joint and getting that moving. So what I do as
a pelvic health osteopath is we need to assess that area.
And really the only the gold standard of assessing the
public floor is an internal vaginal assessment. For the COC six,
(06:34):
it's a little bit different. The only way to fully
check the mobility of the coxigs is internal rectal which
is what we did.
Speaker 1 (06:41):
Which is what we've done, and I would highly recommend
it because it's worked. And I think when you're in
that much pain, like I'm talking, you're standing up and
you're just in pain, or you sit down for ten
minutes and you have to stand up because it's so sore.
If someone's like I'm just gonna do actual assessment or
a vaginal assessment and it's potentially gonna help, you're like, absolutely,
(07:05):
go for gold please.
Speaker 2 (07:07):
And the people that are coming to us that have
been in this pain for so long. They'll do anything.
We just get people traveling from like so far and wide,
being like I've heard that you can do this thing.
Sometimes people don't believe us, Like I remember saying to you,
like you actually can get out of this pain. It's
not going to be like this fit of us. It's
(07:27):
not going to be like this about you whole pregnancy
and you're like yeah, okay, and then you're like, oh no,
it actually works, actually worked. I know.
Speaker 1 (07:34):
Well, I think when you've because I've obviously seen physios
in the past and they were kind of just like.
Speaker 2 (07:39):
You're just gonna have to learn to live with it.
Speaker 1 (07:41):
So I've been you know, I've had other techniques, or
I would be putting like heat packs, or I'd be
sitting on donuts and doing all of this other stuff.
But then the work that you've done has just completely
it's gone, it's alleviated, it's disappeared. I'm like literal magician,
And thank you to everyone who messaged me Meg, because
(08:01):
it worked.
Speaker 2 (08:02):
You guys were right.
Speaker 1 (08:03):
So I was like, we have to have you on
the podcast because you have helped me so much throughout
my pregnancy, and I think we go into pregnancy, well,
I've went into my pregnancy and I've known nothing. And
then you meet people throughout your journey and they kind
of inform you or help you, and you just want.
Speaker 2 (08:21):
To share the love. Yeah.
Speaker 1 (08:22):
Really, And I think a huge part of talking about
our pregnancy journeys that people get worried about.
Speaker 2 (08:33):
Is the pelvic floor.
Speaker 1 (08:35):
So I thought we start and talk about just the
basics of what what your pelvic floor is.
Speaker 2 (08:43):
Yeah, so the pelvic floor, it has a lot of
roles and a lot of people know of it is
this muscle that we need to do keegels and strengthen,
but it is so much more than that. So it
is supportive. So it supports our pelvic organs. We need
it for continence, we need it for sexual fununction, and
we need it for structural support. So we need to
(09:03):
look at it very holistically. And look, some people come
in they're like, oh, you know, having told I've got
a type public floor, and I'm like, that's like telling
me that you've got a headache. It's just a symptom.
What I want to know is like, why in you
do you have that symptom? Because it's going to be
completely one symtom is going to be completely different for
everyone else. And so when we're looking at pregnancy, there's
(09:24):
a couple of ways that I will look at someone
that's pregnant and the palvic floor, and part of that is,
you know, is your body aligned. We want to make
sure that as bulb grows, that your body is adapting
effectively to the baby. And even say with you, it's
like when you first came in, I was like, your
(09:45):
bumpy is really low and forward, and then we really
worked on not just the palvic floor, but your whole
body and your rib cage and making sure we had
enough space in your like your abdomen. We got you
doing some really cool fun exercises upside down. And then
you actually came back in two weeks later and I
was like, your bump is so different city in a
different position. So there's alignment and the biomechanics like what's
(10:10):
your body doing, how is baby growing, and how are
you adapting effectively to that? And then when we look
at birth, so it's like, right, how do we prepare
you for Some people will have a plant s's air
in birth. Some people have a vaginal birth. There's a
lot that's out of our control. There's a lot that
is in our control. And so when we're looking at
(10:32):
the palvic floor and the coxigs for the baby to
descend into the palverse and come out the other side,
we need that cox SIGs to get out of the way.
So anyone that has had a cocxix injury, whether in
pain or not, highly highly recommend getting your cocxix assessed
ideally rectily to assess that mobility and make sure it
(10:55):
gets out of the way. Then when we're looking just
at the pelvic floor during pregnancy for a vaginal birth
is the power floor has two roles. One role is
we need good tones, so good strength in that public floor,
and that encourages the baby's head to flex forward so
that the smallest part of the baby's head is presenting first.
(11:15):
And so for anyone that's had a vaginal birth, we
always want the smallest part, not the biggest part of
the baby's head to come through. And then the other
part is a passive role, So we need that palvly
floor to relax, get out of the way, and lengthen
so again so that the baby can come through, so
that in a nutshell, is what I'd be looking for
(11:36):
or assessing for the palblic floor to do during pregnancy,
vaginal birth and then well recovery as well. So we
want to make sure we've got good strength and ideally
we're bouncing back and getting back to postpartum goals.
Speaker 1 (11:50):
Yeah, so what happens if you do have a weak
pelvic floor then.
Speaker 2 (11:55):
So there's different things that we look for to actually
assess if the palvic floor is week we get people
coming in thinking they've got a week public floor and
it's actually got way too much tension. So look, kegels
can be great, and so pelvic floor which is a
pelvic floor strengthening exercise, But again we need to look
(12:15):
at right, when can you do a kegel effectively? Can
you use your breath? So are you doing it properly?
And then what are your goals? We've got to make
sure them functional. So people can lie down on their
back and do kegels or sit down and do kegels,
But how does that then look when you want to
go for a run. It's a completely different kind of
exercise or activities. So definitely I would recommend getting an
(12:38):
assessment and then making sure you're getting the appropriate exercises
to strengthen it. Yeah, yeah, I know that.
Speaker 1 (12:45):
We said you can have a week public floor. Can
you have it pelvic floor that's too tight?
Speaker 2 (12:52):
Absolutely okay. And again if we look at your situation,
you actually came in and said to me, when I
do a kegel, it hurts my coxis more. And for
me that was straight away, I was like, yes, because
you've got tightness.
Speaker 1 (13:05):
Yeah.
Speaker 2 (13:05):
So it's almost like going from muscles going from being
tight to tighter, and then it's going to create that pain.
And every time we're in pain, the palvist and the
pelvic floor, it's such a sensitive like sacred area, and
so it's a it's going to be very protective. So
if we're in pain in that area, whether that's pain
with sitting on your cocksix, pain with sex, the brain
(13:28):
goes that doesn't feel good, I'm going to tense up
more and then we get into this cycle of pain, tension,
more pain, more tension, and it's really hard to break
that cycle if you don't have someone address the palvip
floor properly.
Speaker 1 (13:40):
And I think it's so interesting because everything's so related.
Like when we've done our treatments, like all of it
just is so interconnective. And I think that's the interesting
thing about what you do, because you just know like
everything that's connected, and you know, it's almost like when
you push on a certain point that's really sore and
you get the referred pain.
Speaker 2 (13:59):
It's just very interesting. Another thing too on that is
when people are coming in for public palic floor tension
and that might look like, you know, symptom wise, it
might be pain with sex. Some people just feel it
like I feel like my public floor, I'm always clenching,
it's always tight. They might be constipated, and that's you know,
they can't relax their public floor to be able to
(14:20):
do a poop. Yeah. And one of the things that
I do do is I can assess the palvic floor,
but I can also treat the pelvic floor. And that's
quite a point of difference to other practitioners out there,
is we can feel for tension in the muscles and
the connective tissue and actually release it off, get you
to connect with your breath, and also have an understanding
of how to relax your palvic floor or breathe and
(14:43):
help to lengthen that pelvic floor. But I could spend
for some people it releases beautifully, and then other people.
I could spend hours and if it's not releasing off,
I'm like, well, there has to be another reason. And
that's where I would look at the ankle joint. I'd
get the ankle moving, go reassess the pelvic floor because
it's all connected. Yeah, look at the cocksix. Even for
(15:04):
some people it's looking at the jaw. I had this
one lady she'd had a massive fall to her cocksix
and she just couldn't even have sex with her partner.
It was so excruciating. I couldn't even do an internal
vaginal assessment on it because it was she was just
she was so tight and it was too painful. She
was really worried that it was going to be painful,
and I was like, look, we're not going to do
an assessment. Let's just see if we can treat your body,
(15:25):
get your whole wady to relax off. We treated a jaw,
I treated her cocksix bone, and then we're able to
go back and actually then at the end of the session,
I was able to do an internal vaginal assessment release
some of that tension so that she could then have
sex with the husband inside, so it's just so connected,
and just looking at the pelvic floor it just isn't enough. Yeah,
(15:47):
it's like a piece of the puzzle. For some people
it will be a little bit bigger, but for some
people it's just a small piece, and we've got a
look whole body.
Speaker 1 (15:54):
I think when we did our treatment, you spoke a
lot about the interconnectedness of the pelvic floor and asking
if I squeeze my bum when I stand, and I do,
and I also clench my jaw and normally I have
botox in my jaw to release it because I do
hold so much attension there. But obviously you can't get
botox when you're pregnant, so I've had started clenching again unknowingly.
(16:17):
But it's just good to even talk to someone to
just put that to front of mine, to be like, oh, yeah,
I need to release or if sometimes I'm starting to
get a migraine and I don't even realize I'm clenching
my jaw so bad. Okay, speaking about kegels, because you
mentioned it before. Every time someone says the word kegel,
I can instantly feel myself doing one.
Speaker 2 (16:38):
I feel like.
Speaker 1 (16:39):
Everyone who's listening is probably doing one too.
Speaker 2 (16:42):
Everyone relaxed.
Speaker 1 (16:46):
What is some misconceptions people have about keegels, Well, firstly,
what is a kegel for people who.
Speaker 2 (16:52):
Don't like atibation, So if you feel like it's like
a lift up, a squeeze up, it's like sucking urine
back up. Yeah, would be the main cues that would
give people. So that's what a chegel is. It's a
palic floor activation. More is more like I always joke
that we've got kegel culture. I'm like, okay, stop, just stop.
It's too much. Do too much. Keygels similar to this
(17:14):
concept right of like clenching the jaw with like our
traps are on, our shoulders are up to our ears,
we hold our breath, our bums are on, palvic floors
are on. So it's a nervous system tension, especially if
you're a busy person. Go go go, Like some people
are just going to be a little bit more active
through those areas. So there is great research. Kegels can
be great, great for strengthening our palvic floor and just
(17:37):
overall function, but not everyone needs to be doing them
all day every day, and they're not very functional. Like
people do their kegels and they're holding their breath, and
we know that the palvit floor it needs to be
in sync with our breath. The palpate floor has to
be able to lengthen to be able to contract. So
holding a muscle in a constant contracted state it can
(17:59):
create a dysfunction. So that would be the first thing.
More isn't more if someone has concerns, like if they've
got symptoms or they're just not sure where they're at,
Like you need to get assessed to know whether you
need to be doing those exercises and if you do,
like how many how long do you hold for? Are
you lying down? Are you standing? Are you on one leg?
(18:20):
Are you lunging? Are you squatting? Like it has to
be functional. Yeah, that would be the That would be
the main one. And then also just this idea of
again I always go back to looking at the whole body,
like you can't just look at the pelvic floor. Where
we can do better than that. How long should kegels
go for for everyone who's interested? Depends on the per
(18:41):
like it really depends.
Speaker 1 (18:43):
Yeah, I know that they say that if you're pregnant.
I just feel like it's in some ways common knowledge
that you should be doing your kegels to tighten the
pelvic floor.
Speaker 2 (18:52):
How accurate is that? Look, there's great, there's definitely great
research behind it because it again it aids in strength
of the public. But the power floor has to also
be able to relax. So some people can be again,
they can be really really strong, but if you can't
lengthen and connect and relax to your palblic floor, it's
gonna be tricky to have a vaginal birth. And when
(19:14):
you've got tension in the pallic floor and in that
paranal body, you can have you know, increased risk of
tearing and things like that. And then we look at
postpart and so again you need good tone in the
pelvic floor. We want those muscles to kind of bounce back.
So yes, you do need strength, but we also need
this ability to lengthen and let go. Yeah. Yeah, So
everyone's just so different. It's interesting. It's kind of like saying,
(19:36):
what glute exercise should I do? There are a million
exercises out there, and what one person does could be
really effective for their running, but then I might do
it and it might hurt me, or may I might
not be able to connect and get that glute firing.
Speaker 1 (19:50):
Yeah, and I think as it's a public exlaw, not
that it's taboo, but maybe it's just like this is
the one thing that you can do now.
Speaker 2 (19:56):
Yeah, go do them.
Speaker 1 (19:57):
Yeah.
Speaker 2 (19:58):
Yeah, almost, it's like we don't want to talk about it. Yeah.
And look, it's very like for a lot of women,
like it's very fearful. We hear so many bad stories
pregnancy and birth, Like there's just so much fear. And
so this is where I love love birth preparation because
you know, I listen to what women want, what makes
(20:20):
them feel safe, what makes them feel positive, and then
you can really support them and educate them to be
empowered to make these decisions. And so for some women
that is a vaginal birth in hospital, for some women
that is a home birth, for some people that is
a cesarean, depends on what medical issues pop up. So yeah,
(20:41):
it's just not a one size fits all.
Speaker 1 (20:43):
Yeah, let's talk more about birth preparation.
Speaker 2 (20:55):
Yeah, and where's your bump hat?
Speaker 1 (20:56):
Yeah, there's a lot of pregnant ladies listening or pretend
chili mums who are going to have their second, third,
fourth baby, whatever it might be. What is the best
things that we can do as mums to be to
prepare because it is scary.
Speaker 2 (21:13):
Yea other than to ya, I think one of the
first things I'll talk to So if someone comes in
for birth prep, they're coming in in twenty weeks, one
of the first things I start to talk about is
pain science and like mindfulness visualization stuff and addressing you know,
any fears that pop up or any concerns that they
(21:35):
might have, So that would be one of the first things.
And there's heaps of positive, fine, positive stories, positive birth experiences,
and when you're reading stuff or listening to podcasts, go
with what are lines for you? There is so much
information out there. Some can be quite science y, some
(21:55):
can be quite spiritual. But pick what suits you, pick
what suits your partner, so that you can start to
think about and kind of create a bit of a
birth map, so to be the first thing. Definitely, Like
we know that strength, exercise, mobility stuff's really good. Again,
it's kind of tailoring that to what you need. And
(22:17):
then palvic floor is so important. Again I explained before,
there's two roles. We need good tones, so there is
an element where we want good strength and tone in
the pelvic floor, but we need to make sure that
public floor can get out of the way when that
baby's head is descending through the palverse to come out.
One of the other things I'll assess women for is,
(22:39):
you know, do they have an effective push? Ideally we
want the body to have the fetal ejection reflex so
that you can push the baby out itself. Not all
women get that reflex. And knowing how to if a
woman is coached to push, knowing how to do that
(22:59):
effectively where it can be less strain on your pelvic
floor and making sure that push is really effective is
super important as well. Is there ways that or things
that women can do during birth to help them not
to tear? The position is really important. So there's a
couple of positions, so we know, like a deep squash,
(23:21):
you know there's more of a likelihood to tear in
that position. Being as active as possible is great. So
that's something I'll definitely go through with people because we
know that the more active you are, it really encourages
that they need to kind of move and get to
an optimal position. I always encourage women to stay off
their back as long as they can, just because we
(23:43):
need so our tailwines, our sacrum and our cocsis it
needs to get out of the way. It allows for
more space to open up through the pelverse. So if
we're flat on our back, that coxix and sacrum it
cannot move. So I'll give people strategies like I'll people
to put cushions under their bottom so that allows a
little bit of movement through, like through their bottom, through
(24:05):
that sacred sidelining, getting on all fours, kneeling and this
is all stuff that people might start practicing throughout their
pregnancy so it becomes familiar to the brain so that
when you're going into the hospital they're not you know,
you don't want it to be foreign and be thinking
what was that thing that that was meant to do?
I can't remember. And then peranial must massage is a
(24:28):
great tool for women from thirty five weeks onwards. It's
something they can It's tricky to do on yourself when
you're pregnant, so this is where I encourage partners. People
can come into the clinic. I can do it for
them to It's almost like you're trying to massage and
just soften that peraneum which is between the vagina and
the rectum. Get that to soften as much as possible
(24:49):
so that when that baby's head is crowning and coming through,
we want the power floor muscles to really slowly adapt, adapt, adapt,
rather than if it's super tight, we're more likely to tear.
Is that like outside of the vagina area internal well,
the paranal body is like where is that? It's a
(25:10):
bit of muscle and skin between the vagina and the rectum, right,
But to actually stretch it, it would be putting a
finger into the vagina and pulling back towards the rectum
or towards the cox eggs. And that's how it would
be like massage or stretched. Yeah, so from thirty five weeks,
that's thirty five weeks. A couple of times a week
about five minutes can make it into like a sexual thing.
(25:35):
Most part, I think it's like kinky time thinking I
feel like, no, this is serious. It's generation.
Speaker 1 (25:46):
How important is the public floor if you're opting for
a sea section or if you end up having an
emergency sea section.
Speaker 2 (25:53):
It's still super important. So this idea of the core
is it's our breath, so through our diaphragm, under our
rib cage, muscles, through our tummy and then our public
floor and they all work together, and so fur recovery,
like caesarean births, they're cutting through multiple layers of muscle
(26:14):
and connective tissue. It's a it's major abdominal surgery, and
I think we forget that and I always remind women
like people who tear the ACL and haven't knee reco
they g had a twelve month program on how to
like bounce back, and women who have caesareans you get
like a sheet of paper and it's like on your
merry way, good luck. It's nuts. Yeah. So there's a
(26:37):
lot of research that's come out that talks about a
three week abdominal wall assessment now and then we always
recommend internal public floor assessment around six to eight weeks.
Those two areas so core kind of our lower abdomen
round scar tissue and then the pelvic floor. They need
to work together. And so some women can still have
(26:59):
weakness in the pelvic floor from a cesarean birth and
you're still recovering, like the pregnancy is massive. You know
your body is changing and constantly adapting. That can still
put a lot of pressure on the pelvic floor. There's
a lot of hormonal changes that affect the pelvic floor.
So it's still an area that definitely needs to be
addressed postpartum. Recently, you told me or informed me.
Speaker 1 (27:23):
I think I've heard of it before, but I've never
really spoken about it, and that was AB separation. I
think we need to talk about this because I think
this is a concern for a lot of pregnant women. Firstly,
what is AB separation.
Speaker 2 (27:39):
So we have if we think of our six pack
muscles through the middle, We've got this sheath and it
expands and adapts, and it has to because you've got
this growing belly. But what we want to make sure
is that it's still strong and contracting effectively and efficiently.
So it really comes back again to the breath and
that core contraction. What we don't don't want to see, though,
(28:01):
is excessive strain of that area, and that's when some
women might get what we call coning. So when you're
rolling over in bed or getting in and out of
like a chair or the car, if anyone sees that
coning or the doming, it can be assigned that there's
too much pressure going to that area. So things throughout
(28:22):
pregnancy like compression garments and might be shorts, it might
be some tubu grip can be really beneficial, and then
again postpartum making, I definitely recommend people get that assessed.
It used to be about you know, how many fingerwits
and the depth of it. But what we now know
some people can still have quite a wide separation, but
(28:43):
they might contract really really well and their functions really good.
Whereas someone might have a really small gap, but we
get this kind of bulging through that area that again
we've got way too much pressure, way too much strain,
and then that can create just yeah, that issues down
the track.
Speaker 1 (29:01):
When you're talking about the cony, is that at the
top of the stomach. Yeah, usually, and so it kind
of like looks like old tepe almost teh little tepee.
And there's obviously different levels of ab separation that you
can get.
Speaker 2 (29:18):
I have a little bit. I think you said just
a tad really slightly, and it was more with you
we were talking about just like it's you're fine. It's
just making sure when you're doing those things like getting
up out of the bed, don't try and do like
a like an ub crunk, which I do to be
really safe. Roll to your side, you know, use your
arms to push up.
Speaker 1 (29:37):
Yeah, it's so funny because I didn't even realize I
was really doing it until Meg was like, oh, you're
doing that thing, and I've been doing it like getting
in and out of the car and like who yeah,
like an old man, honestly. And it's so funny because
it's just obviously innately in me with all of the extra.
Speaker 2 (29:55):
Weight and pressure.
Speaker 1 (29:58):
But also I hadn't really been in tensing my abdominal
muscle at all because I don't know why, but someone
told me that you shouldn't tense it during pregnancy, which
I think is misinformation or I've maybe have heard it
somewhere or on a TikTok.
Speaker 2 (30:11):
I don't know where someone's trying to do me dirty.
Speaker 1 (30:16):
But you are as opposed to tense your muscles during
pregnancy at times.
Speaker 2 (30:23):
Right, So we still want similar hopeful, we still want
a good core. Yeah, it's the constant contraction. So it's
like the breath holding, all this sucking in and again,
like women, even they may not be pregnant, so many
women breath hold and we suck our tummies in and
you can kind of see like some people will come
in and they might be presenting with just low back pain,
(30:45):
and straight away I'm like, I can tell I'll be
really narrow at the top underneath their ribs, and that
we call a pressure belly, So they're really tight under
their ribs, and then they almost have like a slight
kind of pooch ure a curve in their lower belly
lower down, and then that's a bit sign that they're
breath holding or they're only contracting the upper portion of
their abdominals. So it's still important, like it's like being fit,
(31:10):
still want to be fit, be toned, but it's making
sure we're not overdoing it. And so you might be
a little bit more conscious with say getting out of
a chair rolling over in bed that you activate your
abdominals and your core muscles. But it's not something that
we want to be doing all day every day. It's
like clenching the jaw. The jaw, if you do that
all day, that is going to get so sore, it's
(31:30):
going to give you a headache. It's going to lead
to dysfunction. Absolutely. Yeah.
Speaker 1 (31:35):
Okay, well this has been extremely interesting. I think we're
going to talk all about sexual dysfunction and sex next.
Let's talk about sexual function and the role that the
(31:56):
pelvic floor plays with sexual function.
Speaker 2 (32:00):
Yeah, this is always a really fun one and in
a nutshell, the palid flow it has to be able
to contract. This for women contract and relax. We need
good blood flow, we need good lubrication. But the biggest
part is does the palvic floor have the ability to
(32:21):
lengthen and relax for penetration to occur. So part of
that again, it comes back to this concept. We need
good tone, we need it to be strong, but we
also need to have this ability to lengthen and relax.
So for a lot of women where you know it
might be painful experience having sex, it can be indicative
(32:42):
of tension or you know. That's where I'd go back
and be like, all right, what else is in your
history that might indicate palvic floor tension? Have you fallen
onto COXYX? What's a nervous system like? You know? Have
they had trauma? Do they clunch their jaw? It's all
about the why for sexual function because everyone is just
so different. And it's not until these women come in
(33:03):
and I'm asking them lots of questions. You don't know
sometimes what you don't know? Yeah, and I'll talk about
you know, do you have this discomfort and they'll be like, no, no, no,
I'll come back in the next session and they're like,
I actually do like I've got Yeah, I do have
a lot of pain and that was became my normal.
And then we'll break that down, you know, I'll ask
whomen is it at the entrance of the vagina? Does
it feel deeper? Does it feel like something's hitting your cervix?
(33:24):
You know, could this person have endemetrio sis. There's so
many different reasons, but yeah, that is the role of
the pelvic floor. Sexual function in a nutshell.
Speaker 1 (33:36):
We obviously there's dysfunction when it comes to sex for women.
How would we describe that like sexual dysfunction?
Speaker 2 (33:46):
The biggest symptom of dysfunction would be pain. Pain. Yeah,
some women struggle with orgasm. They might have pain with
an orgasm. It can also be about their arousal, like
can they get around? It might be pain with lilitteral stimulation.
Speaker 1 (34:04):
After I had sepsis, every time I would orgasm it
would hurt.
Speaker 2 (34:08):
Interesting because it.
Speaker 1 (34:10):
Started from like a kidney infection. I don't know how
on Earth it's related. Well, it was UTIs into kidney infection,
intercepsis and I can probably explain that, can you, because
it was like maybe like maybe five months and is
this new normal?
Speaker 2 (34:27):
Okay? This is I love talking about this. So the
entrance of the vagina it's called the vestibule, and the
mucosa to the tissue through that area and then the embryologically,
so when we're developing utero, that tissue and the urethra
(34:47):
are the same. So when that tissue is sensitive, so
you've had a UTI, you've had an infection. There's this
cross talk between the two areas, so it can feel
painful in that tissue. So for example, if someone comes
in and they're like, I feel like I get these
chronic UTI's is something I hear of a lot, and
(35:09):
I'll say like, did you have do you always have
a positive culture when you get checked for a UTR
And they're like, no, it's not always positive, And that's
usually a hint for me that the urethra has had
infection in it. That cross talks with that tissue and
then the entrance of the vagina becomes hyper sensitive. So
(35:29):
we would put that in this category of volver dinner.
So you've got essentially it's a symptom. It just means
you've got pain in the vulver. There are subsets of
the vulvar, so we've got the clitorists, which would be
clittery dinner clural pain, and then the vestibule vestibulo dinner.
So you've probably in having this infection. It's hyper stimulated
(35:51):
those nerve endings and that mucosa and that tissue, so
that then when you have sex it's uncomfortable. The pelvic
floor muscles react because it's there so detective. You get
this tension. It's like even the apprehension, it's like you're
like clencher pelvic floor just thinking about it. Yeah, and
then it reiterates this pain tension cycle again. Hmmm, Yeah,
(36:13):
that's definitely what I was serious. Yeah, it's really common,
and so you kind of then left with this pattern
of you know, you've just got this chronic tension and
then add onto that you've falling on your cosix to
solve the problem. Seeing but I mean.
Speaker 1 (36:26):
We all have these issues and sometimes for example me,
obviously we had never met, so I wasn't like, oh,
I'm gonna go see Meg about this, or I'm gonna
go see and O'SO about this. You can help me
with this pelvic flaw issue or pain during orgasm. Sometimes
you just kind of eat it and you're just like, Okay,
this is how it is for now.
Speaker 2 (36:44):
Hopefully it goes away the amount if I had a
dollar every time I was told by a patient that
their doctor their health professional told them to just relax,
I'm like, it's like telling you to chill out. Sometimes
chill out it just does not help. Or haven't drink
like health professions telling someone to have it wine before
(37:06):
they have sex. I'm like, is the worst advice, Like
as if you haven't thought of that or try that,
and if it's a chronic issue, yeah, like we need
to we can do more, we can we can do better,
we can think better.
Speaker 1 (37:19):
Yeah yeah, okay, So what are some osteopathic techniques that
help improve pelvic f law sunction?
Speaker 2 (37:29):
One of the things, and this is a bit of
a bit of a point of difference, actually treat the
public floor. So if there is tension in the public floor,
I can actually feel it. So I've got my finger
in the vagina and it feels like I'm in a
bowl and I'm just feeling like where does that tension lie?
Is it in the muscle? The fashion, the connective tissue,
we can hold it, get you to connect with your
breath and actually release that off. And then there's just
(37:52):
so many other things. Sometimes it's not too you see
in OSTEO you actually fully understand how it is a
little bit different. But we do a lot of like
jointation and mobilization. I do a lot of work visceral work,
which is actually getting on the organs like the bladder
and the uterus and seeing if there's tension in those areas,
working on the gut, working on the diaphragms. It's a
(38:12):
real combination of you know, working on some soft tissue,
the joints, everything. Yeah, yeah, all of it. But I
would say in general, I personally am more hands on
and Ostropats I would say across the board are more
hands on. Some a bit more rehab focus, but that
is what I would be doing for like, yeah, the pelt,
(38:33):
floor and body, and say with your jaw, so I've
got a type out with floor, there's work. I can't
know if I've done that on you your jaw. Put
a glove on and come on to the inside of
your jaw and like release these muscles through here. And
sometimes that can be a game changer for some women,
like release the jaw and they're like, I just fell
my public full let go or unclenched for the first
time ever. Really Yeah, see that's so interesting connection. Yeah,
(38:58):
we know that people who have tension in their power
for there's like a high percentages that will clunch their jaw.
It just doesn't work the other way rounds. So just
because you're a jaw cluncher doesn't mean it doesn't.
Speaker 1 (39:07):
Stand I'm coming for Let's just say, for everyone who's pregnant,
what are we recommending sex wise, because obviously some people
feel comfortable having sex, some people don't.
Speaker 2 (39:20):
People think is it going to harm the baby? All
of these things, So some people will have medical issues
going on and they will be told not to have sex.
But it really depends sex is this event it's like
so physical, but then it's so like hormonal, mental, emotional.
You gotta want it to sort of fear a roused
(39:42):
and have that good lubrication. And some women will be
so aroused throughout pregnancy, and I don't have sex all
the time. Others don't want to be touched, so I
think that's a big factor. Yeah, But then also it
depends on how you're feeling physically, like you're able to
even get into certain positions where you're comfortable and can
(40:03):
relax and feel it's hard something we've a girl of pain,
so that they might even need to experiment with different
positions and try some new things. But you know, and
then we partners, some partners are just so fearful that
any form of penetration is going to hurt the baby,
which I just don't think.
Speaker 1 (40:21):
It's my partner for the first twelve weeks, he's like
the first twelve weeks, it's like it's a challenging time,
like we need to be super careful, so like no sex.
And then by the twelve weeks, I was like, okay,
I'm over sex. Now had your.
Speaker 2 (40:36):
Window, two sailing boats in the night, we see each other.
I've had a few pass though, where so spam has
there's something you know, I think it's like a prostera
gland and that can help bring on labor. Really sure
how true that is that is. But a girlfriend of mine,
(41:01):
she was like forty one weeks and she's like, get
this baby out of me. I was like, just had sex,
see what happens, And no joke like that night she
went to labor. It's true. It's true. Didn't call any
cart actually, and I'm sure she said that. On one of.
Speaker 1 (41:14):
She was like, I'm just gonna go have sex so
that the labor starts, and apparently it did.
Speaker 2 (41:17):
I don't know, then it must be true. There you go.
Speaker 1 (41:22):
In pregnancy, there is a risk of having prolapse, So
vaginal or rectal prolapse.
Speaker 2 (41:30):
Can you talk us through all of that? Itself is
not a risk factor having prolapse. Ah. A prolapse is
where a pelvic organ descends into the vagina, so it's
going into a space where it really shouldn't be. So
the front wall is the bladder, which is really common.
(41:51):
The back wall is the rectum. We can get a
uterus or cervix prolaps. That's the uterus coming down. There's
also an troca, which is actually the small intestline coming down,
but that's less common. So the pregnancy alone not a
risk factor. But yeah, a vaginal birth and then things
like an instrumental birth, so vacuum forceps definitely more of
(42:13):
a risk there too. So post birth is looking again,
I'd definitely encourage everyone to at least have an assessment
because some people cannot be symptomatic and they may be
getting back into exercise and not doing things correctly. They
may not have a strong core or a strong public flow,
(42:34):
and then they can start to get symptomatic for making
sure that they're doing the right things from the get go.
Most women will have a sensation of either a dragging
or a bulging feeling that can indicate that there may
be a prolapse present. And so something that I would
assess for is okay, like where is it? What is it?
(42:56):
But also how do we grade that and then coming
up with management strategies so they can improve, they can
get better. It's such a fear for a lot of women,
but a lot of the women that I see coming
into clinic they improve. Yeah, but yeah, the symptoms of
a prolapse vary. They do vary a lot. So for
(43:16):
some women, you know, constipation can be really common and
we can put a lot of that down to diet.
A lot of people get constipated and non laxatives post
whether it's vaginal births are and bath. But sometimes if
we've got a rectal prolapse and so we've got a
slight bulge of so we might have a small amount
of pho's still sitting in a little pocket in the
rectum and we're not fully evacuating, and it can feel
(43:39):
like constipation where it could be an indicator that there
is a rectal prolapse present. And then things like in continents,
so you know you're able to hold your e are
able to get to the toilet. Do you have any
kind of random leakage do you like with coffer or sneeze.
A good test that I'll always get everyone to do
postpartum is and you stop your Wii mid flow, you
(44:02):
should be able to stop it immediately hold for three seconds.
That's testing. It's a little bit of the public floor,
but it's more than urethral the sphincter.
Speaker 1 (44:09):
Okay, yeah, someone told me that that was part of
like the kegel exercise almost like.
Speaker 2 (44:15):
If you're wing, you like stop and try to tend similar.
Oh it's the same essentially, Yes, you are. It's like
a kegel, so you're activating your public floor. Yeah, but
it's a bit more targeted and it's a test for
the urethroal sphincter. Yeah.
Speaker 1 (44:29):
Yeah, speaking of like utiys and things like that. Whilst
we're on it, as well, because I had no idea
about this, but apparently, and you can correct me if
I'm wrong, but you WI, and then you could you
should be able to wait a little bit and then
there should be more WE that comes out and that
can really stop utiys.
Speaker 2 (44:50):
So when if you're doing a pulpful activation mid WII,
it's almost your wiis like a belt curve. So it
starts off slow, gets sort of to its full volume,
and then it kind of tapes off. So when you're
doing your activation, you want to do that in midstream. Yeah,
because the brain will recognize that there's a good decent
(45:13):
volume left and it needs to get rid of that.
If you only have a little bit of WE left,
the brain may not recognize that. So you may actually
retain a bit of that week and therefore you can
get back toial infection from that. So and you shouldn't
really hold it for much longer like three seconds no, okay, No,
So it's just like a one off thing. It would
just be a test, and if you're struggling with that test,
(45:38):
then that can become your homework. Yeah, so something I'll
give people against postpartum or you know what, if that's
coming with blooded complaints, I may still give them that
there's a bit of homework to try it. And if
someone can't do it, so say in the morning, they're like,
I was fine in the morning. And often that's when
the polic floor has a bit of contraction. Throughout the
day they're on their feet, the paler flour muscles might
(46:00):
get really tight and fatigued, and then they go to
do a wehe at the end of the day and
they're like, I could not hold on. That becomes their homework,
and always you would be all right, it's a three
second hold. You should do it straight away. If you're
struggling with that, part of your homework might be all right,
let's actually get you doing that. But we might get
you doing some kegels or probably floor activations. But again
(46:21):
they need to be functional, so you know, that might
be lying down to start off with. It's just like
an absolute baseline level, and then we might go all right,
let's get your standing and see if you can activate
your probably floor in a standing position. Yeah. Yeah.
Speaker 1 (46:33):
Moving into the third trimester of pregnancy, I'm struggling so
much more to hold my wheeze and now I'm kind
of I think I'm at two or three times a
night where I'm waking up in the middle of the
night to we what's normal.
Speaker 2 (46:48):
Like how often should we be waking up? Look, it's
everyone's going to be really different. And if you've got
it when you're pregnant and you've got bladder issues, it
might be frequency urgency. It's really hard to get on
top of because you've got more fluid in your body.
You're going you just it's one of those symptoms. You're
(47:10):
gonna go more at nighttime the baby kicks the bladder. Yeah,
you've got so much pressure going down. And we know too,
like the bladder responds to stretch receptors, So as your
bladder is filling up, sends that signal to the brain
bladder is full, you need to go to the toilet.
But now you've got a baby pushing on that. And
so when you've got those external factors and that pressure,
(47:30):
it can send that signal you need to do away. Yeah,
so you can be limited with what you can do
for that. You still need to make sure you're hydrated.
Sometimes what I find is women are drinking so much water,
but you're missing your electrolyte, so you're not absorbing it.
So sometimes I look at that. But if someone's got
bladder concerns, usually what I do is give them a
(47:51):
blaoder diary, because I want to know, over three days,
what are your patterns, what's the volume, what's your liquid input,
what's your output when you're pregnant. I'm never doing a
bladder diary because it's well, it's just too many, like
hormonal factors, catch from the baby. It's just not going
to be accurate. It would be more looking at postpart
and making sure you're recovering. If you're finding during your
(48:14):
pregnancy that you're coughing, laughing and you're doing a bit
of we that that stuff that we definitely want to manage,
and that can be you know, for some people, it
can be doing kegels. Sometimes people have so much tension.
And I always use my fist as example. It's like
if I squeeze my fist and then you say to me,
squeeze more, I'm like, I can't. It feels really weak.
(48:37):
So if my power fools already really really tight and
then I go to cough or sneeze and I need
more of a contract, I can't do it. And that's
where tension. Too much tension can create blood of leakage.
So it's looking at that too. Does that person actually
need to do some strengthening exercises or do we need
to focus on lengthening first. So those sorts of bladder habits, yes,
(48:58):
we definitely want to tackle, but the paying at not.
It's a tricky on. It's a trick huan. Yeah.
Speaker 1 (49:04):
I think for the longest time, I've just thought that
all pregnant women when they get to the end, are
a little bit incontinent.
Speaker 2 (49:13):
It's really common, Okay, not normal, but really common.
Speaker 1 (49:16):
Okay, So if we have this symptom, then we probably
should be working on it with an osteo or with
a specialist.
Speaker 2 (49:24):
Yeah. Because the thing too is, you know, if you
are getting some leaking, it's a pressure management issue. So
we've got so much pressure coming down. The public flow
can be contracting really well, but it just doesn't beat
the pressure from above. Yeah, and so we want to
manage that as much as possible so that postparton we
don't have issues. Yeah. You know, I had a lady
(49:45):
in last week actually, she came in for in her
last trimester, and I was like, you've got a blood
of prolapse, and she'd had this chronic cough and she
was severely constipated, so she's like coughing and straining. And
anyone that's been pregnant knows how awful I can feel
when all you're trying to do is like hold on
for your life, trying to keep yourself dry. It just
can be this constant, daily strained, strained strain, and that
(50:08):
can create a lot of weakness and dysfunction in the
public floor. Yeah, so you want to get that checked out, definitely.
You know where you're at, what should you be doing,
How should you be managing it appropriately. I don't know
if this is a good time to tell you, but
I coughed this morning. In a little bit, we came out.
We'll check that like the tiniest, tiniest look me.
Speaker 1 (50:33):
Thank you so much for coming on the podcast. It's
been a pleasure and I've learned so much. I'm sure
everyone else has learned so much, So thank you for
your time than having me.
Speaker 2 (50:40):
It's been really fun.
Wanting to have kids is a huge life decision. But
once you're ready to embark on that journey, what do
you actually need to know? This podcast is the community
you never knew you needed from mums and mums to be.
We're about to embark on this learning journey together and
it's going.
Speaker 2 (00:18):
To be real.
Speaker 1 (00:18):
It's going to be raw and a completely non judgmental space.
You're listening to Where's your bump hat? And this is
Anamacavoy Staples. I'm going to be interviewing experts in the
field so that all of our burning questions can be answered,
from understanding our cycle to knowing what is the best
(00:41):
time to conceive, and so much more. We'll get into
the difference between natural verse c section births, strange pregnancy
symptoms and everything in between. Okay, Hello, we have my
osteopath Meg in the Judeo today to talk all things
(01:02):
of helvic floor and so much more.
Speaker 2 (01:04):
I'm so excited to have you on the show. Hello, Hello,
thank you for having me, Thank you for coming in.
It's so funny.
Speaker 1 (01:11):
I was just saying to Meg that she actually I
had an appointment with her the other week and she
was like feeling my tummy and she's like, yeah, I
think the baby's breach. And I was like, okay, you
found out, like told me way before anyone else, Like
they had to do a proper scam before anyone else
told me that. And they're like, the baby's breach and
I was like, yeah, I know. And they're like, how
do you know? And I was like, well, my Osteo told.
Speaker 2 (01:32):
Me is a wizard. She is. She's a magician.
Speaker 1 (01:37):
So I think that we should start from the beginning
as to why and how we even know each other.
And I guess to do that, I have to start
back in Oh, I'm going to say like two thousand
and six.
Speaker 2 (01:51):
Maybe I was.
Speaker 1 (01:53):
We didn't meet each other in two thousand and six,
but he was drunk. I was black out drunk in
two thousand and six and I fell off a bed
onto a concrete floor.
Speaker 2 (02:06):
And at the.
Speaker 1 (02:08):
Time it wasn't that painful, but I woke up in
the morning and I was in the most excruciating.
Speaker 2 (02:14):
Pain of my life. It was like my eyes opened and.
Speaker 1 (02:18):
All of the I don't even know what to call them,
just like every part of my body just shot to
my coxic bone.
Speaker 2 (02:27):
All of the pain. It so painful. Oh so painful.
Speaker 1 (02:32):
I was in Singapore at the time, had to pace
the aeroplane from Singapore to Melbourne on a night flight,
and I was like walking so slow and people thought
I was nuts and I felt nuts. And for the
next five to six years, I think I suffered with
really excruciating coxic pain.
Speaker 2 (02:55):
I saw a physio. They couldn't really do much about it.
Speaker 1 (02:58):
They gave me some exercises and and by the end
of it, they kind of just told me that I
would have to live with it and it would eventually
go away, which it did.
Speaker 2 (03:07):
But then that's right, yeah, eventually. But then I got pregnant.
Speaker 1 (03:14):
And when you get pregnant, I think everything kind of
well you've said to me, then everything, Yeah, things that
maybe were kind of an issue at one point in
your life, if they've not been fully fixed, I feel like,
come back when you can become pregnant. And I was
speaking to my sister in law and she was talking
about seeing an osteo and I've never seen an osteo.
Speaker 2 (03:38):
In my whole life until becoming pregnant.
Speaker 1 (03:41):
And anyway, I did a call out on social media
and was like, does anyone know good osteo? Who specializes
in coxic pain, and I swear to you now literally
there was like six seven people being like, Meg is
a magician, he needs to see her.
Speaker 2 (03:57):
She's going to.
Speaker 1 (03:58):
Solve all your problems. I was like, I'm sold the dream,
and they're right.
Speaker 2 (04:02):
You did.
Speaker 1 (04:04):
At three months pregnant, I was in excruciating coxic bone pain,
and since having sessions with you, I no longer have it,
which is.
Speaker 2 (04:13):
Shocking for me to even say. So, I guess let's
maybe talk through.
Speaker 1 (04:20):
Our appointments maybe and like what they entail because little PSA,
it's not what you're gonna think.
Speaker 2 (04:27):
Yeah, so I'm gonna pass. You can explain that. What
something that's really interesting that you touched on was so
many people forget old injuries that they've had, Like I'll
be taking a medical history, and I was like, not,
no surgeries, no injuries. And then I started assessing them.
I'm like, what has happened to you? And they're like, oh,
I had open heart surgery or I just broke. You
(04:49):
just forgot that. But not everyone that is pregnant or
even postpartum like has pain. So the people that do
have pain or just not recovering, how we would expect
I'm always thinking why, like, what else has happened in
your history that hasn't allowed you to fully recover? So
straight away with you taking your history, I was like,
(05:10):
have you fallen in your coxics? You're like, yeah, but
that was ages ago. And what can happen is in
that acute injury phase you can have a lot of tightness,
you can have a lot of inflammation, and that can
start to settle down. However, the thing that probably hasn't
happened is the joint. We haven't got that cocksix. It
is a joint, we haven't got that moving properly. So
(05:32):
then you're pregnant and the body is trying to expand
and soften and really prepare, and if that joint isn't moving,
it just gets more and more jammed. So from an
assessment treatment point of view, we really need to look
at the whole body, but also the peer with floor. Yeah,
and the power floor. It's a group of muscles and
(05:52):
it's like a hammock and it just sits at the
bottom of the pelvis, but it does it attaches onto
the cocxix. So if your cosix is stiff for not moving,
that can create public full tension, and then when you've
got that tension that's going to yank on the coxsix.
That can create more coxic stiffness, which is probably why
like you've had some treatment, you've done some stretches. It
(06:13):
can give short term relief, it can help get into
the muscles in the area, but nothing's actually dressing the
joint and getting that moving. So what I do as
a pelvic health osteopath is we need to assess that area.
And really the only the gold standard of assessing the
public floor is an internal vaginal assessment. For the COC six,
(06:34):
it's a little bit different. The only way to fully
check the mobility of the coxigs is internal rectal which
is what we did.
Speaker 1 (06:41):
Which is what we've done, and I would highly recommend
it because it's worked. And I think when you're in
that much pain, like I'm talking, you're standing up and
you're just in pain, or you sit down for ten
minutes and you have to stand up because it's so sore.
If someone's like I'm just gonna do actual assessment or
a vaginal assessment and it's potentially gonna help, you're like, absolutely,
(07:05):
go for gold please.
Speaker 2 (07:07):
And the people that are coming to us that have
been in this pain for so long. They'll do anything.
We just get people traveling from like so far and wide,
being like I've heard that you can do this thing.
Sometimes people don't believe us, Like I remember saying to you,
like you actually can get out of this pain. It's
not going to be like this fit of us. It's
(07:27):
not going to be like this about you whole pregnancy
and you're like yeah, okay, and then you're like, oh no,
it actually works, actually worked. I know.
Speaker 1 (07:34):
Well, I think when you've because I've obviously seen physios
in the past and they were kind of just like.
Speaker 2 (07:39):
You're just gonna have to learn to live with it.
Speaker 1 (07:41):
So I've been you know, I've had other techniques, or
I would be putting like heat packs, or I'd be
sitting on donuts and doing all of this other stuff.
But then the work that you've done has just completely
it's gone, it's alleviated, it's disappeared. I'm like literal magician,
And thank you to everyone who messaged me Meg, because
(08:01):
it worked.
Speaker 2 (08:02):
You guys were right.
Speaker 1 (08:03):
So I was like, we have to have you on
the podcast because you have helped me so much throughout
my pregnancy, and I think we go into pregnancy, well,
I've went into my pregnancy and I've known nothing. And
then you meet people throughout your journey and they kind
of inform you or help you, and you just want.
Speaker 2 (08:21):
To share the love. Yeah.
Speaker 1 (08:22):
Really, And I think a huge part of talking about
our pregnancy journeys that people get worried about.
Speaker 2 (08:33):
Is the pelvic floor.
Speaker 1 (08:35):
So I thought we start and talk about just the
basics of what what your pelvic floor is.
Speaker 2 (08:43):
Yeah, so the pelvic floor, it has a lot of
roles and a lot of people know of it is
this muscle that we need to do keegels and strengthen,
but it is so much more than that. So it
is supportive. So it supports our pelvic organs. We need
it for continence, we need it for sexual fununction, and
we need it for structural support. So we need to
(09:03):
look at it very holistically. And look, some people come
in they're like, oh, you know, having told I've got
a type public floor, and I'm like, that's like telling
me that you've got a headache. It's just a symptom.
What I want to know is like, why in you
do you have that symptom? Because it's going to be
completely one symtom is going to be completely different for
everyone else. And so when we're looking at pregnancy, there's
(09:24):
a couple of ways that I will look at someone
that's pregnant and the palvic floor, and part of that is,
you know, is your body aligned. We want to make
sure that as bulb grows, that your body is adapting
effectively to the baby. And even say with you, it's
like when you first came in, I was like, your
(09:45):
bumpy is really low and forward, and then we really
worked on not just the palvic floor, but your whole
body and your rib cage and making sure we had
enough space in your like your abdomen. We got you
doing some really cool fun exercises upside down. And then
you actually came back in two weeks later and I
was like, your bump is so different city in a
different position. So there's alignment and the biomechanics like what's
(10:10):
your body doing, how is baby growing, and how are
you adapting effectively to that? And then when we look
at birth, so it's like, right, how do we prepare
you for Some people will have a plant s's air
in birth. Some people have a vaginal birth. There's a
lot that's out of our control. There's a lot that
is in our control. And so when we're looking at
(10:32):
the palvic floor and the coxigs for the baby to
descend into the palverse and come out the other side,
we need that cox SIGs to get out of the way.
So anyone that has had a cocxix injury, whether in
pain or not, highly highly recommend getting your cocxix assessed
ideally rectily to assess that mobility and make sure it
(10:55):
gets out of the way. Then when we're looking just
at the pelvic floor during pregnancy for a vaginal birth
is the power floor has two roles. One role is
we need good tones, so good strength in that public floor,
and that encourages the baby's head to flex forward so
that the smallest part of the baby's head is presenting first.
(11:15):
And so for anyone that's had a vaginal birth, we
always want the smallest part, not the biggest part of
the baby's head to come through. And then the other
part is a passive role, So we need that palvly
floor to relax, get out of the way, and lengthen
so again so that the baby can come through, so
that in a nutshell, is what I'd be looking for
(11:36):
or assessing for the palblic floor to do during pregnancy,
vaginal birth and then well recovery as well. So we
want to make sure we've got good strength and ideally
we're bouncing back and getting back to postpartum goals.
Speaker 1 (11:50):
Yeah, so what happens if you do have a weak
pelvic floor then.
Speaker 2 (11:55):
So there's different things that we look for to actually
assess if the palvic floor is week we get people
coming in thinking they've got a week public floor and
it's actually got way too much tension. So look, kegels
can be great, and so pelvic floor which is a
pelvic floor strengthening exercise, But again we need to look
(12:15):
at right, when can you do a kegel effectively? Can
you use your breath? So are you doing it properly?
And then what are your goals? We've got to make
sure them functional. So people can lie down on their
back and do kegels or sit down and do kegels,
But how does that then look when you want to
go for a run. It's a completely different kind of
exercise or activities. So definitely I would recommend getting an
(12:38):
assessment and then making sure you're getting the appropriate exercises
to strengthen it. Yeah, yeah, I know that.
Speaker 1 (12:45):
We said you can have a week public floor. Can
you have it pelvic floor that's too tight?
Speaker 2 (12:52):
Absolutely okay. And again if we look at your situation,
you actually came in and said to me, when I
do a kegel, it hurts my coxis more. And for
me that was straight away, I was like, yes, because
you've got tightness.
Speaker 1 (13:05):
Yeah.
Speaker 2 (13:05):
So it's almost like going from muscles going from being
tight to tighter, and then it's going to create that pain.
And every time we're in pain, the palvist and the
pelvic floor, it's such a sensitive like sacred area, and
so it's a it's going to be very protective. So
if we're in pain in that area, whether that's pain
with sitting on your cocksix, pain with sex, the brain
(13:28):
goes that doesn't feel good, I'm going to tense up
more and then we get into this cycle of pain, tension,
more pain, more tension, and it's really hard to break
that cycle if you don't have someone address the palvip
floor properly.
Speaker 1 (13:40):
And I think it's so interesting because everything's so related.
Like when we've done our treatments, like all of it
just is so interconnective. And I think that's the interesting
thing about what you do, because you just know like
everything that's connected, and you know, it's almost like when
you push on a certain point that's really sore and
you get the referred pain.
Speaker 2 (13:59):
It's just very interesting. Another thing too on that is
when people are coming in for public palic floor tension
and that might look like, you know, symptom wise, it
might be pain with sex. Some people just feel it
like I feel like my public floor, I'm always clenching,
it's always tight. They might be constipated, and that's you know,
they can't relax their public floor to be able to
(14:20):
do a poop. Yeah. And one of the things that
I do do is I can assess the palvic floor,
but I can also treat the pelvic floor. And that's
quite a point of difference to other practitioners out there,
is we can feel for tension in the muscles and
the connective tissue and actually release it off, get you
to connect with your breath, and also have an understanding
of how to relax your palvic floor or breathe and
(14:43):
help to lengthen that pelvic floor. But I could spend
for some people it releases beautifully, and then other people.
I could spend hours and if it's not releasing off,
I'm like, well, there has to be another reason. And
that's where I would look at the ankle joint. I'd
get the ankle moving, go reassess the pelvic floor because
it's all connected. Yeah, look at the cocksix. Even for
(15:04):
some people it's looking at the jaw. I had this
one lady she'd had a massive fall to her cocksix
and she just couldn't even have sex with her partner.
It was so excruciating. I couldn't even do an internal
vaginal assessment on it because it was she was just
she was so tight and it was too painful. She
was really worried that it was going to be painful,
and I was like, look, we're not going to do
an assessment. Let's just see if we can treat your body,
(15:25):
get your whole wady to relax off. We treated a jaw,
I treated her cocksix bone, and then we're able to
go back and actually then at the end of the session,
I was able to do an internal vaginal assessment release
some of that tension so that she could then have
sex with the husband inside, so it's just so connected,
and just looking at the pelvic floor it just isn't enough. Yeah,
(15:47):
it's like a piece of the puzzle. For some people
it will be a little bit bigger, but for some
people it's just a small piece, and we've got a
look whole body.
Speaker 1 (15:54):
I think when we did our treatment, you spoke a
lot about the interconnectedness of the pelvic floor and asking
if I squeeze my bum when I stand, and I do,
and I also clench my jaw and normally I have
botox in my jaw to release it because I do
hold so much attension there. But obviously you can't get
botox when you're pregnant, so I've had started clenching again unknowingly.
(16:17):
But it's just good to even talk to someone to
just put that to front of mine, to be like, oh, yeah,
I need to release or if sometimes I'm starting to
get a migraine and I don't even realize I'm clenching
my jaw so bad. Okay, speaking about kegels, because you
mentioned it before. Every time someone says the word kegel,
I can instantly feel myself doing one.
Speaker 2 (16:38):
I feel like.
Speaker 1 (16:39):
Everyone who's listening is probably doing one too.
Speaker 2 (16:42):
Everyone relaxed.
Speaker 1 (16:46):
What is some misconceptions people have about keegels, Well, firstly,
what is a kegel for people who.
Speaker 2 (16:52):
Don't like atibation, So if you feel like it's like
a lift up, a squeeze up, it's like sucking urine
back up. Yeah, would be the main cues that would
give people. So that's what a chegel is. It's a
palic floor activation. More is more like I always joke
that we've got kegel culture. I'm like, okay, stop, just stop.
It's too much. Do too much. Keygels similar to this
(17:14):
concept right of like clenching the jaw with like our
traps are on, our shoulders are up to our ears,
we hold our breath, our bums are on, palvic floors
are on. So it's a nervous system tension, especially if
you're a busy person. Go go go, Like some people
are just going to be a little bit more active
through those areas. So there is great research. Kegels can
be great, great for strengthening our palvic floor and just
(17:37):
overall function, but not everyone needs to be doing them
all day every day, and they're not very functional. Like
people do their kegels and they're holding their breath, and
we know that the palvit floor it needs to be
in sync with our breath. The palpate floor has to
be able to lengthen to be able to contract. So
holding a muscle in a constant contracted state it can
(17:59):
create a dysfunction. So that would be the first thing.
More isn't more if someone has concerns, like if they've
got symptoms or they're just not sure where they're at,
Like you need to get assessed to know whether you
need to be doing those exercises and if you do,
like how many how long do you hold for? Are
you lying down? Are you standing? Are you on one leg?
(18:20):
Are you lunging? Are you squatting? Like it has to
be functional. Yeah, that would be the That would be
the main one. And then also just this idea of
again I always go back to looking at the whole body,
like you can't just look at the pelvic floor. Where
we can do better than that. How long should kegels
go for for everyone who's interested? Depends on the per
(18:41):
like it really depends.
Speaker 1 (18:43):
Yeah, I know that they say that if you're pregnant.
I just feel like it's in some ways common knowledge
that you should be doing your kegels to tighten the
pelvic floor.
Speaker 2 (18:52):
How accurate is that? Look, there's great, there's definitely great
research behind it because it again it aids in strength
of the public. But the power floor has to also
be able to relax. So some people can be again,
they can be really really strong, but if you can't
lengthen and connect and relax to your palblic floor, it's
gonna be tricky to have a vaginal birth. And when
(19:14):
you've got tension in the pallic floor and in that
paranal body, you can have you know, increased risk of
tearing and things like that. And then we look at
postpart and so again you need good tone in the
pelvic floor. We want those muscles to kind of bounce back.
So yes, you do need strength, but we also need
this ability to lengthen and let go. Yeah. Yeah, So
everyone's just so different. It's interesting. It's kind of like saying,
(19:36):
what glute exercise should I do? There are a million
exercises out there, and what one person does could be
really effective for their running, but then I might do
it and it might hurt me, or may I might
not be able to connect and get that glute firing.
Speaker 1 (19:50):
Yeah, and I think as it's a public exlaw, not
that it's taboo, but maybe it's just like this is
the one thing that you can do now.
Speaker 2 (19:56):
Yeah, go do them.
Speaker 1 (19:57):
Yeah.
Speaker 2 (19:58):
Yeah, almost, it's like we don't want to talk about it. Yeah.
And look, it's very like for a lot of women,
like it's very fearful. We hear so many bad stories
pregnancy and birth, Like there's just so much fear. And
so this is where I love love birth preparation because
you know, I listen to what women want, what makes
(20:20):
them feel safe, what makes them feel positive, and then
you can really support them and educate them to be
empowered to make these decisions. And so for some women
that is a vaginal birth in hospital, for some women
that is a home birth, for some people that is
a cesarean, depends on what medical issues pop up. So yeah,
(20:41):
it's just not a one size fits all.
Speaker 1 (20:43):
Yeah, let's talk more about birth preparation.
Speaker 2 (20:55):
Yeah, and where's your bump hat?
Speaker 1 (20:56):
Yeah, there's a lot of pregnant ladies listening or pretend
chili mums who are going to have their second, third,
fourth baby, whatever it might be. What is the best
things that we can do as mums to be to
prepare because it is scary.
Speaker 2 (21:13):
Yea other than to ya, I think one of the
first things I'll talk to So if someone comes in
for birth prep, they're coming in in twenty weeks, one
of the first things I start to talk about is
pain science and like mindfulness visualization stuff and addressing you know,
any fears that pop up or any concerns that they
(21:35):
might have, So that would be one of the first things.
And there's heaps of positive, fine, positive stories, positive birth experiences,
and when you're reading stuff or listening to podcasts, go
with what are lines for you? There is so much
information out there. Some can be quite science y, some
(21:55):
can be quite spiritual. But pick what suits you, pick
what suits your partner, so that you can start to
think about and kind of create a bit of a
birth map, so to be the first thing. Definitely, Like
we know that strength, exercise, mobility stuff's really good. Again,
it's kind of tailoring that to what you need. And
(22:17):
then palvic floor is so important. Again I explained before,
there's two roles. We need good tones, so there is
an element where we want good strength and tone in
the pelvic floor, but we need to make sure that
public floor can get out of the way when that
baby's head is descending through the palverse to come out.
One of the other things I'll assess women for is,
(22:39):
you know, do they have an effective push? Ideally we
want the body to have the fetal ejection reflex so
that you can push the baby out itself. Not all
women get that reflex. And knowing how to if a
woman is coached to push, knowing how to do that
(22:59):
effectively where it can be less strain on your pelvic
floor and making sure that push is really effective is
super important as well. Is there ways that or things
that women can do during birth to help them not
to tear? The position is really important. So there's a
couple of positions, so we know, like a deep squash,
(23:21):
you know there's more of a likelihood to tear in
that position. Being as active as possible is great. So
that's something I'll definitely go through with people because we
know that the more active you are, it really encourages
that they need to kind of move and get to
an optimal position. I always encourage women to stay off
their back as long as they can, just because we
(23:43):
need so our tailwines, our sacrum and our cocsis it
needs to get out of the way. It allows for
more space to open up through the pelverse. So if
we're flat on our back, that coxix and sacrum it
cannot move. So I'll give people strategies like I'll people
to put cushions under their bottom so that allows a
little bit of movement through, like through their bottom, through
(24:05):
that sacred sidelining, getting on all fours, kneeling and this
is all stuff that people might start practicing throughout their
pregnancy so it becomes familiar to the brain so that
when you're going into the hospital they're not you know,
you don't want it to be foreign and be thinking
what was that thing that that was meant to do?
I can't remember. And then peranial must massage is a
(24:28):
great tool for women from thirty five weeks onwards. It's
something they can It's tricky to do on yourself when
you're pregnant, so this is where I encourage partners. People
can come into the clinic. I can do it for
them to It's almost like you're trying to massage and
just soften that peraneum which is between the vagina and
the rectum. Get that to soften as much as possible
(24:49):
so that when that baby's head is crowning and coming through,
we want the power floor muscles to really slowly adapt, adapt, adapt,
rather than if it's super tight, we're more likely to tear.
Is that like outside of the vagina area internal well,
the paranal body is like where is that? It's a
(25:10):
bit of muscle and skin between the vagina and the rectum, right,
But to actually stretch it, it would be putting a
finger into the vagina and pulling back towards the rectum
or towards the cox eggs. And that's how it would
be like massage or stretched. Yeah, so from thirty five weeks,
that's thirty five weeks. A couple of times a week
about five minutes can make it into like a sexual thing.
(25:35):
Most part, I think it's like kinky time thinking I
feel like, no, this is serious. It's generation.
Speaker 1 (25:46):
How important is the public floor if you're opting for
a sea section or if you end up having an
emergency sea section.
Speaker 2 (25:53):
It's still super important. So this idea of the core
is it's our breath, so through our diaphragm, under our
rib cage, muscles, through our tummy and then our public
floor and they all work together, and so fur recovery,
like caesarean births, they're cutting through multiple layers of muscle
(26:14):
and connective tissue. It's a it's major abdominal surgery, and
I think we forget that and I always remind women
like people who tear the ACL and haven't knee reco
they g had a twelve month program on how to
like bounce back, and women who have caesareans you get
like a sheet of paper and it's like on your
merry way, good luck. It's nuts. Yeah. So there's a
(26:37):
lot of research that's come out that talks about a
three week abdominal wall assessment now and then we always
recommend internal public floor assessment around six to eight weeks.
Those two areas so core kind of our lower abdomen
round scar tissue and then the pelvic floor. They need
to work together. And so some women can still have
(26:59):
weakness in the pelvic floor from a cesarean birth and
you're still recovering, like the pregnancy is massive. You know
your body is changing and constantly adapting. That can still
put a lot of pressure on the pelvic floor. There's
a lot of hormonal changes that affect the pelvic floor.
So it's still an area that definitely needs to be
addressed postpartum. Recently, you told me or informed me.
Speaker 1 (27:23):
I think I've heard of it before, but I've never
really spoken about it, and that was AB separation. I
think we need to talk about this because I think
this is a concern for a lot of pregnant women. Firstly,
what is AB separation.
Speaker 2 (27:39):
So we have if we think of our six pack
muscles through the middle, We've got this sheath and it
expands and adapts, and it has to because you've got
this growing belly. But what we want to make sure
is that it's still strong and contracting effectively and efficiently.
So it really comes back again to the breath and
that core contraction. What we don't don't want to see, though,
(28:01):
is excessive strain of that area, and that's when some
women might get what we call coning. So when you're
rolling over in bed or getting in and out of
like a chair or the car, if anyone sees that
coning or the doming, it can be assigned that there's
too much pressure going to that area. So things throughout
(28:22):
pregnancy like compression garments and might be shorts, it might
be some tubu grip can be really beneficial, and then
again postpartum making, I definitely recommend people get that assessed.
It used to be about you know, how many fingerwits
and the depth of it. But what we now know
some people can still have quite a wide separation, but
(28:43):
they might contract really really well and their functions really good.
Whereas someone might have a really small gap, but we
get this kind of bulging through that area that again
we've got way too much pressure, way too much strain,
and then that can create just yeah, that issues down
the track.
Speaker 1 (29:01):
When you're talking about the cony, is that at the
top of the stomach. Yeah, usually, and so it kind
of like looks like old tepe almost teh little tepee.
And there's obviously different levels of ab separation that you
can get.
Speaker 2 (29:18):
I have a little bit. I think you said just
a tad really slightly, and it was more with you
we were talking about just like it's you're fine. It's
just making sure when you're doing those things like getting
up out of the bed, don't try and do like
a like an ub crunk, which I do to be
really safe. Roll to your side, you know, use your
arms to push up.
Speaker 1 (29:37):
Yeah, it's so funny because I didn't even realize I
was really doing it until Meg was like, oh, you're
doing that thing, and I've been doing it like getting
in and out of the car and like who yeah,
like an old man, honestly. And it's so funny because
it's just obviously innately in me with all of the extra.
Speaker 2 (29:55):
Weight and pressure.
Speaker 1 (29:58):
But also I hadn't really been in tensing my abdominal
muscle at all because I don't know why, but someone
told me that you shouldn't tense it during pregnancy, which
I think is misinformation or I've maybe have heard it
somewhere or on a TikTok.
Speaker 2 (30:11):
I don't know where someone's trying to do me dirty.
Speaker 1 (30:16):
But you are as opposed to tense your muscles during
pregnancy at times.
Speaker 2 (30:23):
Right, So we still want similar hopeful, we still want
a good core. Yeah, it's the constant contraction. So it's
like the breath holding, all this sucking in and again,
like women, even they may not be pregnant, so many
women breath hold and we suck our tummies in and
you can kind of see like some people will come
in and they might be presenting with just low back pain,
(30:45):
and straight away I'm like, I can tell I'll be
really narrow at the top underneath their ribs, and that
we call a pressure belly, So they're really tight under
their ribs, and then they almost have like a slight
kind of pooch ure a curve in their lower belly
lower down, and then that's a bit sign that they're
breath holding or they're only contracting the upper portion of
their abdominals. So it's still important, like it's like being fit,
(31:10):
still want to be fit, be toned, but it's making
sure we're not overdoing it. And so you might be
a little bit more conscious with say getting out of
a chair rolling over in bed that you activate your
abdominals and your core muscles. But it's not something that
we want to be doing all day every day. It's
like clenching the jaw. The jaw, if you do that
all day, that is going to get so sore, it's
(31:30):
going to give you a headache. It's going to lead
to dysfunction. Absolutely. Yeah.
Speaker 1 (31:35):
Okay, well this has been extremely interesting. I think we're
going to talk all about sexual dysfunction and sex next.
Let's talk about sexual function and the role that the
(31:56):
pelvic floor plays with sexual function.
Speaker 2 (32:00):
Yeah, this is always a really fun one and in
a nutshell, the palid flow it has to be able
to contract. This for women contract and relax. We need
good blood flow, we need good lubrication. But the biggest
part is does the palvic floor have the ability to
(32:21):
lengthen and relax for penetration to occur. So part of
that again, it comes back to this concept. We need
good tone, we need it to be strong, but we
also need to have this ability to lengthen and relax.
So for a lot of women where you know it
might be painful experience having sex, it can be indicative
(32:42):
of tension or you know. That's where I'd go back
and be like, all right, what else is in your
history that might indicate palvic floor tension? Have you fallen
onto COXYX? What's a nervous system like? You know? Have
they had trauma? Do they clunch their jaw? It's all
about the why for sexual function because everyone is just
so different. And it's not until these women come in
(33:03):
and I'm asking them lots of questions. You don't know
sometimes what you don't know? Yeah, and I'll talk about
you know, do you have this discomfort and they'll be like, no, no, no,
I'll come back in the next session and they're like,
I actually do like I've got Yeah, I do have
a lot of pain and that was became my normal.
And then we'll break that down, you know, I'll ask
whomen is it at the entrance of the vagina? Does
it feel deeper? Does it feel like something's hitting your cervix?
(33:24):
You know, could this person have endemetrio sis. There's so
many different reasons, but yeah, that is the role of
the pelvic floor. Sexual function in a nutshell.
Speaker 1 (33:36):
We obviously there's dysfunction when it comes to sex for women.
How would we describe that like sexual dysfunction?
Speaker 2 (33:46):
The biggest symptom of dysfunction would be pain. Pain. Yeah,
some women struggle with orgasm. They might have pain with
an orgasm. It can also be about their arousal, like
can they get around? It might be pain with lilitteral stimulation.
Speaker 1 (34:04):
After I had sepsis, every time I would orgasm it
would hurt.
Speaker 2 (34:08):
Interesting because it.
Speaker 1 (34:10):
Started from like a kidney infection. I don't know how
on Earth it's related. Well, it was UTIs into kidney infection,
intercepsis and I can probably explain that, can you, because
it was like maybe like maybe five months and is
this new normal?
Speaker 2 (34:27):
Okay? This is I love talking about this. So the
entrance of the vagina it's called the vestibule, and the
mucosa to the tissue through that area and then the embryologically,
so when we're developing utero, that tissue and the urethra
(34:47):
are the same. So when that tissue is sensitive, so
you've had a UTI, you've had an infection. There's this
cross talk between the two areas, so it can feel
painful in that tissue. So for example, if someone comes
in and they're like, I feel like I get these
chronic UTI's is something I hear of a lot, and
(35:09):
I'll say like, did you have do you always have
a positive culture when you get checked for a UTR
And they're like, no, it's not always positive, And that's
usually a hint for me that the urethra has had
infection in it. That cross talks with that tissue and
then the entrance of the vagina becomes hyper sensitive. So
(35:29):
we would put that in this category of volver dinner.
So you've got essentially it's a symptom. It just means
you've got pain in the vulver. There are subsets of
the vulvar, so we've got the clitorists, which would be
clittery dinner clural pain, and then the vestibule vestibulo dinner.
So you've probably in having this infection. It's hyper stimulated
(35:51):
those nerve endings and that mucosa and that tissue, so
that then when you have sex it's uncomfortable. The pelvic
floor muscles react because it's there so detective. You get
this tension. It's like even the apprehension, it's like you're
like clencher pelvic floor just thinking about it. Yeah, and
then it reiterates this pain tension cycle again. Hmmm, Yeah,
(36:13):
that's definitely what I was serious. Yeah, it's really common,
and so you kind of then left with this pattern
of you know, you've just got this chronic tension and
then add onto that you've falling on your cosix to
solve the problem. Seeing but I mean.
Speaker 1 (36:26):
We all have these issues and sometimes for example me,
obviously we had never met, so I wasn't like, oh,
I'm gonna go see Meg about this, or I'm gonna
go see and O'SO about this. You can help me
with this pelvic flaw issue or pain during orgasm. Sometimes
you just kind of eat it and you're just like, Okay,
this is how it is for now.
Speaker 2 (36:44):
Hopefully it goes away the amount if I had a
dollar every time I was told by a patient that
their doctor their health professional told them to just relax,
I'm like, it's like telling you to chill out. Sometimes
chill out it just does not help. Or haven't drink
like health professions telling someone to have it wine before
(37:06):
they have sex. I'm like, is the worst advice, Like
as if you haven't thought of that or try that,
and if it's a chronic issue, yeah, like we need
to we can do more, we can we can do better,
we can think better.
Speaker 1 (37:19):
Yeah yeah, okay, So what are some osteopathic techniques that
help improve pelvic f law sunction?
Speaker 2 (37:29):
One of the things, and this is a bit of
a bit of a point of difference, actually treat the
public floor. So if there is tension in the public floor,
I can actually feel it. So I've got my finger
in the vagina and it feels like I'm in a
bowl and I'm just feeling like where does that tension lie?
Is it in the muscle? The fashion, the connective tissue,
we can hold it, get you to connect with your
breath and actually release that off. And then there's just
(37:52):
so many other things. Sometimes it's not too you see
in OSTEO you actually fully understand how it is a
little bit different. But we do a lot of like
jointation and mobilization. I do a lot of work visceral work,
which is actually getting on the organs like the bladder
and the uterus and seeing if there's tension in those areas,
working on the gut, working on the diaphragms. It's a
(38:12):
real combination of you know, working on some soft tissue,
the joints, everything. Yeah, yeah, all of it. But I
would say in general, I personally am more hands on
and Ostropats I would say across the board are more
hands on. Some a bit more rehab focus, but that
is what I would be doing for like, yeah, the pelt,
(38:33):
floor and body, and say with your jaw, so I've
got a type out with floor, there's work. I can't
know if I've done that on you your jaw. Put
a glove on and come on to the inside of
your jaw and like release these muscles through here. And
sometimes that can be a game changer for some women,
like release the jaw and they're like, I just fell
my public full let go or unclenched for the first
time ever. Really Yeah, see that's so interesting connection. Yeah,
(38:58):
we know that people who have tension in their power
for there's like a high percentages that will clunch their jaw.
It just doesn't work the other way rounds. So just
because you're a jaw cluncher doesn't mean it doesn't.
Speaker 1 (39:07):
Stand I'm coming for Let's just say, for everyone who's pregnant,
what are we recommending sex wise, because obviously some people
feel comfortable having sex, some people don't.
Speaker 2 (39:20):
People think is it going to harm the baby? All
of these things, So some people will have medical issues
going on and they will be told not to have sex.
But it really depends sex is this event it's like
so physical, but then it's so like hormonal, mental, emotional.
You gotta want it to sort of fear a roused
(39:42):
and have that good lubrication. And some women will be
so aroused throughout pregnancy, and I don't have sex all
the time. Others don't want to be touched, so I
think that's a big factor. Yeah, But then also it
depends on how you're feeling physically, like you're able to
even get into certain positions where you're comfortable and can
(40:03):
relax and feel it's hard something we've a girl of pain,
so that they might even need to experiment with different
positions and try some new things. But you know, and
then we partners, some partners are just so fearful that
any form of penetration is going to hurt the baby,
which I just don't think.
Speaker 1 (40:21):
It's my partner for the first twelve weeks, he's like
the first twelve weeks, it's like it's a challenging time,
like we need to be super careful, so like no sex.
And then by the twelve weeks, I was like, okay,
I'm over sex. Now had your.
Speaker 2 (40:36):
Window, two sailing boats in the night, we see each other.
I've had a few pass though, where so spam has
there's something you know, I think it's like a prostera
gland and that can help bring on labor. Really sure
how true that is that is. But a girlfriend of mine,
(41:01):
she was like forty one weeks and she's like, get
this baby out of me. I was like, just had sex,
see what happens, And no joke like that night she
went to labor. It's true. It's true. Didn't call any
cart actually, and I'm sure she said that. On one of.
Speaker 1 (41:14):
She was like, I'm just gonna go have sex so
that the labor starts, and apparently it did.
Speaker 2 (41:17):
I don't know, then it must be true. There you go.
Speaker 1 (41:22):
In pregnancy, there is a risk of having prolapse, So
vaginal or rectal prolapse.
Speaker 2 (41:30):
Can you talk us through all of that? Itself is
not a risk factor having prolapse. Ah. A prolapse is
where a pelvic organ descends into the vagina, so it's
going into a space where it really shouldn't be. So
the front wall is the bladder, which is really common.
(41:51):
The back wall is the rectum. We can get a
uterus or cervix prolaps. That's the uterus coming down. There's
also an troca, which is actually the small intestline coming down,
but that's less common. So the pregnancy alone not a
risk factor. But yeah, a vaginal birth and then things
like an instrumental birth, so vacuum forceps definitely more of
(42:13):
a risk there too. So post birth is looking again,
I'd definitely encourage everyone to at least have an assessment
because some people cannot be symptomatic and they may be
getting back into exercise and not doing things correctly. They
may not have a strong core or a strong public flow,
(42:34):
and then they can start to get symptomatic for making
sure that they're doing the right things from the get go.
Most women will have a sensation of either a dragging
or a bulging feeling that can indicate that there may
be a prolapse present. And so something that I would
assess for is okay, like where is it? What is it?
(42:56):
But also how do we grade that and then coming
up with management strategies so they can improve, they can
get better. It's such a fear for a lot of women,
but a lot of the women that I see coming
into clinic they improve. Yeah, but yeah, the symptoms of
a prolapse vary. They do vary a lot. So for
(43:16):
some women, you know, constipation can be really common and
we can put a lot of that down to diet.
A lot of people get constipated and non laxatives post
whether it's vaginal births are and bath. But sometimes if
we've got a rectal prolapse and so we've got a
slight bulge of so we might have a small amount
of pho's still sitting in a little pocket in the
rectum and we're not fully evacuating, and it can feel
(43:39):
like constipation where it could be an indicator that there
is a rectal prolapse present. And then things like in continents,
so you know you're able to hold your e are
able to get to the toilet. Do you have any
kind of random leakage do you like with coffer or sneeze.
A good test that I'll always get everyone to do
postpartum is and you stop your Wii mid flow, you
(44:02):
should be able to stop it immediately hold for three seconds.
That's testing. It's a little bit of the public floor,
but it's more than urethral the sphincter.
Speaker 1 (44:09):
Okay, yeah, someone told me that that was part of
like the kegel exercise almost like.
Speaker 2 (44:15):
If you're wing, you like stop and try to tend similar.
Oh it's the same essentially, Yes, you are. It's like
a kegel, so you're activating your public floor. Yeah, but
it's a bit more targeted and it's a test for
the urethroal sphincter. Yeah.
Speaker 1 (44:29):
Yeah, speaking of like utiys and things like that. Whilst
we're on it, as well, because I had no idea
about this, but apparently, and you can correct me if
I'm wrong, but you WI, and then you could you
should be able to wait a little bit and then
there should be more WE that comes out and that
can really stop utiys.
Speaker 2 (44:50):
So when if you're doing a pulpful activation mid WII,
it's almost your wiis like a belt curve. So it
starts off slow, gets sort of to its full volume,
and then it kind of tapes off. So when you're
doing your activation, you want to do that in midstream. Yeah,
because the brain will recognize that there's a good decent
(45:13):
volume left and it needs to get rid of that.
If you only have a little bit of WE left,
the brain may not recognize that. So you may actually
retain a bit of that week and therefore you can
get back toial infection from that. So and you shouldn't
really hold it for much longer like three seconds no, okay, No,
So it's just like a one off thing. It would
just be a test, and if you're struggling with that test,
(45:38):
then that can become your homework. Yeah, so something I'll
give people against postpartum or you know what, if that's
coming with blooded complaints, I may still give them that
there's a bit of homework to try it. And if
someone can't do it, so say in the morning, they're like,
I was fine in the morning. And often that's when
the polic floor has a bit of contraction. Throughout the
day they're on their feet, the paler flour muscles might
(46:00):
get really tight and fatigued, and then they go to
do a wehe at the end of the day and
they're like, I could not hold on. That becomes their homework,
and always you would be all right, it's a three
second hold. You should do it straight away. If you're
struggling with that, part of your homework might be all right,
let's actually get you doing that. But we might get
you doing some kegels or probably floor activations. But again
(46:21):
they need to be functional, so you know, that might
be lying down to start off with. It's just like
an absolute baseline level, and then we might go all right,
let's get your standing and see if you can activate
your probably floor in a standing position. Yeah. Yeah.
Speaker 1 (46:33):
Moving into the third trimester of pregnancy, I'm struggling so
much more to hold my wheeze and now I'm kind
of I think I'm at two or three times a
night where I'm waking up in the middle of the
night to we what's normal.
Speaker 2 (46:48):
Like how often should we be waking up? Look, it's
everyone's going to be really different. And if you've got
it when you're pregnant and you've got bladder issues, it
might be frequency urgency. It's really hard to get on
top of because you've got more fluid in your body.
You're going you just it's one of those symptoms. You're
(47:10):
gonna go more at nighttime the baby kicks the bladder. Yeah,
you've got so much pressure going down. And we know too,
like the bladder responds to stretch receptors, So as your
bladder is filling up, sends that signal to the brain
bladder is full, you need to go to the toilet.
But now you've got a baby pushing on that. And
so when you've got those external factors and that pressure,
(47:30):
it can send that signal you need to do away. Yeah,
so you can be limited with what you can do
for that. You still need to make sure you're hydrated.
Sometimes what I find is women are drinking so much water,
but you're missing your electrolyte, so you're not absorbing it.
So sometimes I look at that. But if someone's got
bladder concerns, usually what I do is give them a
(47:51):
blaoder diary, because I want to know, over three days,
what are your patterns, what's the volume, what's your liquid input,
what's your output when you're pregnant. I'm never doing a
bladder diary because it's well, it's just too many, like
hormonal factors, catch from the baby. It's just not going
to be accurate. It would be more looking at postpart
and making sure you're recovering. If you're finding during your
(48:14):
pregnancy that you're coughing, laughing and you're doing a bit
of we that that stuff that we definitely want to manage,
and that can be you know, for some people, it
can be doing kegels. Sometimes people have so much tension.
And I always use my fist as example. It's like
if I squeeze my fist and then you say to me,
squeeze more, I'm like, I can't. It feels really weak.
(48:37):
So if my power fools already really really tight and
then I go to cough or sneeze and I need
more of a contract, I can't do it. And that's
where tension. Too much tension can create blood of leakage.
So it's looking at that too. Does that person actually
need to do some strengthening exercises or do we need
to focus on lengthening first. So those sorts of bladder habits, yes,
(48:58):
we definitely want to tackle, but the paying at not.
It's a tricky on. It's a trick huan. Yeah.
Speaker 1 (49:04):
I think for the longest time, I've just thought that
all pregnant women when they get to the end, are
a little bit incontinent.
Speaker 2 (49:13):
It's really common, Okay, not normal, but really common.
Speaker 1 (49:16):
Okay, So if we have this symptom, then we probably
should be working on it with an osteo or with
a specialist.
Speaker 2 (49:24):
Yeah. Because the thing too is, you know, if you
are getting some leaking, it's a pressure management issue. So
we've got so much pressure coming down. The public flow
can be contracting really well, but it just doesn't beat
the pressure from above. Yeah, and so we want to
manage that as much as possible so that postparton we
don't have issues. Yeah. You know, I had a lady
(49:45):
in last week actually, she came in for in her
last trimester, and I was like, you've got a blood
of prolapse, and she'd had this chronic cough and she
was severely constipated, so she's like coughing and straining. And
anyone that's been pregnant knows how awful I can feel
when all you're trying to do is like hold on
for your life, trying to keep yourself dry. It just
can be this constant, daily strained, strained strain, and that
(50:08):
can create a lot of weakness and dysfunction in the
public floor. Yeah, so you want to get that checked out, definitely.
You know where you're at, what should you be doing,
How should you be managing it appropriately. I don't know
if this is a good time to tell you, but
I coughed this morning. In a little bit, we came out.
We'll check that like the tiniest, tiniest look me.
Speaker 1 (50:33):
Thank you so much for coming on the podcast. It's
been a pleasure and I've learned so much. I'm sure
everyone else has learned so much, So thank you for
your time than having me.
Speaker 2 (50:40):
It's been really fun.
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