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Ep 36: Pelvic Floor Health in Perimenopause: Key Symptoms, Hormonal Changes & Optimization — with Sarah Symmes
42 Plays11 days ago
We often think about pelvic floor health during pregnancy or after having a baby, focusing on tightening things up, preventing leaks, or recovering from everything our bodies can go through postpartum.
But pelvic floor health matters just as much during perimenopause.
In this episode, we’re joined by Sarah Symmes, a registered physiotherapist and founder of Centred Physiotherapy, to help us understand what’s really going on during perimenopause and how to optimize our pelvic floor health. We discuss common symptoms like leakage, pelvic pain, painful sex — and dig into other symptoms you may not have even related to pelvic floor health!
We also talk honestly about how pelvic floor conversations often centre on motherhood, and why this care is just as important for those who haven’t had children. Whether you’re already experiencing symptoms or want to be proactive before they start, this episode is packed with clarity, reassurance, and expert insight.
Where to find Sarah:
Website: www.centredphysiotherapy.com
Insta: @centredphysio
Facebook: https://www.facebook.com/centredphysio
Email: sarah@centredphysiotherapy.com
And here is a vimeo link to the umbrella breathing video: https://vimeo.com/1167560875/f3b8276b01?share=copy&fl=sv&fe=ci
Where to find us:
IG @whatsmyageagain.podcast / FB - What’s My Age Again Podcast
Email us at: wmaapod@gmail.com
Where to find Tanya:
IG @tlcholistic / FB @tlcholistic
Book with Tanya: https://tlcholistic.janeapp.com/locations/tlc-holistic
Join the TLC Community: https://www.patreon.com/tlcholistic
Where to find Kim:
IG @kimdesmarais.nutrition /FB @KimDesmarais
Book with Kim: Complimentary Connect Call
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Transcript
Podcast Introduction
00:00:00
Speaker
Welcome to What's My Age Again, the realest podcast for women who are done chasing trends and ready to feel empowered. Hi, I'm Kim. And I'm Tanya, holistic nutritionists and childhood best friends who've been there, done that, and bought the collagen.
00:00:16
Speaker
more than once. Each week we
Podcast Goals and Wellness Topics
00:00:18
Speaker
provide actionable steps that you can start today to help you thrive through every decade to come. We're cutting through the wellness noise to bring you honest conversations about aging, hormones, health, beauty, mindset, and everything in between.
00:00:33
Speaker
You see, we're also on a mission to age gracefully one WTF moment at a time. Backed by research and real life,
Pelvic Floor Health Focus
00:00:41
Speaker
we're here to share what actually works, what's a waste of time, and how to truly thrive through the messy, magical midlife transition.
00:00:49
Speaker
We're so happy you're here. Let's dive in. Hi, everybody. Welcome back to What's My Age Again. hi Tanya. Hey, Kim. How are you? I'm good. I'm really excited about today's episode, as usual. Tanya and i were thinking about this episode, and one thing is we tend to think about pelvic floor health during pregnancy, right? Or post-pregnancy to help tighten things up down there. And you know we think about issues like leakage, prolapse, And, you know, for me, the absolute car crash that happens after having a baby,
00:01:27
Speaker
right And for me, for someone who hasn't had a baby, i have to be totally honest, and i really don't think a lot about pelvic floor health. I mean, we can be with a group of my girlfriends and I say something funny and everybody starts peeing and saying, stop, you know? And then like, I'm like, okay, pelvic floor. But I'm starting to realize that, you Pelvic floor is a lot more than just these mainstream symptoms that come to mind.
00:01:55
Speaker
No, absolutely. And even just talking to Sarah before this, surprise everybody, we have our first guest here with us today. and
Introducing Sarah Symes
00:02:04
Speaker
we were talking before, you know, pressing record here, and even just some of the symptoms that she was talking about, I didn't associate it initially with pelvic floor. So I'm really, really excited today because Understanding and supporting our pelvic floor health is so important during perimenopause. So like I said, we are so lucky to have
Sarah's Path to Pelvic Health
00:02:25
Speaker
with us Sarah Symes, who is a registered physiotherapist to sort of help us understand these symptoms that we are experiencing, perhaps leakage, pain during sex, um and sort of dive deep into some of the myths that, you know, maybe we we think about pelvic floor health.
00:02:43
Speaker
Yeah, and I am personally super grateful, again, for someone who has never had a child. I actually didn't understand everything that goes behind pelvic floor and everything that I need to be doing and I need to be learning. as a woman who is 45 going through perimenopause. So whether you are experiencing some of these fun sounding symptoms that Kim is talking about, or you're not yet experiencing symptoms, or you actually don't even understand that you are and not equating it to pelvic floor, you are going to absolutely love this episode.
00:03:23
Speaker
Yes, so
Importance of Pelvic Floor Health
00:03:24
Speaker
today i am very excited that we are joined by Sarah Symes, a registered physiotherapist and founder of Centered Physiotherapy in Toronto. Sarah's expertise is orthopedic and pelvic health physiotherapy with a special focus on supporting women through pregnancy, postpartum, and perimenopausal transition, as well as pediatric pelvic health.
00:03:46
Speaker
She blends strength training, manual therapy, and nervous system-informed care, we love this, to help women feel confident, resilient, and at home in their bodies at every stage of life. We are so excited to have you
Anatomy of the Pelvic Floor
00:04:00
Speaker
here to talk about optimizing pelvic health during perimenopause. Welcome, Sarah. Hello. I'm so excited to be here. we are so excited.
00:04:10
Speaker
Super excited as a listener of the podcast. So I've listening along for so long. So it feels really full circle to be joining you both today. So thanks for having me. Thank you so much, Sarah. um So let's start off really easy.
00:04:27
Speaker
Tell us a little bit more about yourself, how you found yourself in the business that you're in, the passion that you have behind it. That's a great question, because when I went to physiotherapy school, I didn't even know that pelvic health physiotherapy was a thing. So I'm doing a job now that I didn't even know existed when I went into physio. um So I started my career in orthopedics working on, you know, typical sports injuries and sprains and strains and um found myself working with a lot of um pre and postnatal women and worked with some amazing pelvic health physios that were kind of encouraging me to come into this field.
00:05:10
Speaker
And then I experienced pelvic health physio after the birth of my first son. And it was really life-changing experiencing it from the patient side. And then that's when I decided I also wanted to go into pelvic physio. And just you know from that learning, it really was the missing piece
Role of a Pelvic Floor Physiotherapist
00:05:29
Speaker
in my practice that not only helps the clients that are here for those pelvic health-specific concerns, but also sometimes it's clients coming in with back pain or hip pain that they don't realize that pelvic floor connection.
00:05:45
Speaker
Wow, that hits home for me personally. um i had a hip injury and I say injury, but I had a bad hip and I didn't injure it. And it took me about eight months with a physio who I love to get back on track, but we never actually talked about pelvic floor. So I suspect that could have been a big part of it for me. And I am classically someone now who is definitely experiencing tighter hips, sore hips, glutes. And I'm like,
00:06:15
Speaker
Is this something could this be pelvic floor? So that's such an interesting point.
00:06:21
Speaker
Yeah, absolutely. And some of us don't really even understand, like Tanya said, like we don't we don't understand the symptoms necessarily that we're experiencing or equate it to this the pelvic floor. um and And some of us don't even really understand what the pelvic floor really is, right? Because we hear so much about it. But could you kind of walk us through that, like a little pelvic floor 101 for us, Sarah?
00:06:47
Speaker
Yes, I think this is such
Strategies for Optimal Pelvic Health
00:06:49
Speaker
a great place to start. And For a lot of clients, even when we're starting to work on the pelvic floor learning how to do a pelvic floor contraction, the biggest thing, feedback I get is people just unsure if they're doing it correctly.
00:07:04
Speaker
um So there's a lot of confusion out there. So we'll just start with overviewing where is the pelvic floor and what it is. So it's ah like a basket or hammock like group of muscles and connective tissue um that run from the base of the pelvis. And even if you're sitting right now in a chair, you can do just a little check in on your own body by just feeling into your sitting bones on either side. So that's the kind of the side to side border of where pelvic floor muscles are attaching. And if you do a little pelvic tilt, rocking your pelvis forward to feel where the pubic bone is, and then rocking your pelvis back to where the tailbone is, that's kind of the front and back of the pelvic floor. So the, those four corners kind of create like a diamond shape. That is where those muscles live.
00:07:57
Speaker
Wow, that's such a good explanation. We're all sitting here. I am rocking and forth and doing a pelvic tilt. So yeah, great explanation of that. I love that. Thank you. It's helped to have those landmarks to know kind of where where we are in the body.
00:08:12
Speaker
um And then for the the function of the pelvic floor, it's often described as the five S's. So the first one being support. So it's providing support for our pelvic organs. The second one, a tricky word, but it's our sphincteric function. So we're thinking here, our bowel and bladder control. We have the third S is our sexual function.
00:08:37
Speaker
The fourth being stability. So this is where the pelvic floor is really part of our deep core system. It's helping to support our posture. It's helping manage pressure when we cough, when we lift, when we run or exercise.
00:08:53
Speaker
um And then the last one is providing a sump pump function. So this is where those pelvic floor muscles are contracting and relaxing. and helping to circulate our blood and lym flat lymphatic fluid through the pelvic tissues. So that can be really important, especially through the perimenopause phase where our estrogen levels are changing and we can have some decreased blood flow to this area. Um, so the main thing that I love to share is that the pelvic floor is really not its own thing, just separate from the rest of the body. It's really part of our whole kind of core pressure system and really integral to our whole body function.
00:09:39
Speaker
Wow. Thank you for this list. Yeah. Like, so when I initially thought of pelvic health, I think of things like stability. That was my issue and why I saw Sarah in the first place. Sarah was actually my physiotherapist. um And, you know, you think about things like stability.
00:10:01
Speaker
You can think about things like sexual function and leakage, but I didn't realize the extent of this list. Yeah. And for someone like me, um the fifth one was actually life changing when we were talking about it before the podcast. So I am somebody who classically has had a lot of issues and still works a lot on my lymphatic system. And I'm all about, you know, supporting my lymphatic system. And it
Breathing and Strength Training
00:10:30
Speaker
looks like I potentially am missing a very big piece. And I had no idea about the sub pump. When I was reading that, I was like, like the sub pump in my mom's basement that goes off when it rains. Yeah.
00:10:44
Speaker
And I'm like, yeah, but in your body, as i you know what I mean? I started to look into, you know, your description and when you were chatting with us and like, I had no idea and I'm pretty sure that I'm probably not the only woman who has no idea. And again, this goes back to, it's not the classic symptoms per se. It's not just for women who've had kids. Yeah.
00:11:04
Speaker
Yes. And can I ask one question, Sarah, about the sump pump? Is it when your pelvic floor is too um relaxed or contracted that it has issues with the flow?
00:11:16
Speaker
It really could be either. So that pelvic floor needs to have elasticity and movement. It needs to move through that full excursion. So for someone who has a really tight pelvic floor that isn't moving, we're not getting that. If you think about you know, your bicep muscle in your arm, if you were to straighten your arm, it's going all the way straight. And then you bend your elbow and it's contracting all the way. Same thing with the pelvic floor, we need it to fully lengthen. and then that length helps it to create a nice good contraction up so we need it to be able to move both directions so interesting so kind of like looking at as any other muscle group and wanting to have a full range of motion is that a way that i can understand it better
00:12:02
Speaker
Yes, yes. I love talking about pelvic floor range motion. It gets me really excited because i think for a long time, we've just heard about Kegel exercises, and which are pelvic floor, isolated pelvic floor contractions. and you know, building strength. And I think people think a lot about contraction there, but it's important that our pelvic floor can move both well in both directions. And sometimes people have issues where their pelvic floor is too tight and it's having trouble lengthening. And then I have other people on the other side of the spectrum where they're really having trouble getting that contraction. So a big part
00:12:41
Speaker
of our job in pelvic physio is to help you find that unique prescription for you to get those muscles functioning well. And it's so hard to do when it's an area of our body that we're not really connected to. We don't know where it is. It's maybe
Digestive Health Connection
00:12:57
Speaker
a bit taboo to even be thinking about that area. So that's why i love doing what I do and helping people connect to that part of their body.
00:13:06
Speaker
Oh my gosh, Sarah, so many things we need to dig into that you just said. um But it's it's so true. Before meeting you, I really only thought about weak pelvic floor muscles. I didn't really realize that our pelvic floor can be too tight. So Before we dig into that, can you talk to us about like, what exactly does a pelvic floor physiotherapy therapist do?
00:13:32
Speaker
Yes. Okay. I love this question because I think when, We hear about pelvic physio. Sometimes they think people might think we're just focusing on the pelvis or we're just doing internal examinations, which could be maybe a little bit uncomfortable for someone.
Proper Toilet Habits
00:13:49
Speaker
um But really, we're going to look, we may use an internal exam if that's comfortable, but we also look externally. So we're looking at um how the whole body kind of connects to work with the pelvic floor. So often I'll start by looking at someone's posture, their breathing mechanics, their range of motion and strength around their hips and their core strength. And then sometimes we may do a specific internal exam to look at that pelvic floor specifically. um And when we work there, we're looking at strength, coordination, the tone of the muscles and how that pelvic floor really integrates with all the other things that I was mentioning before. um so that internal exam can be really valuable for giving us a lot of information, but it's not always necessary. So if someone is nervous and that part is a bit of a deal breaker for them, I still recommend, you know, either having a discovery call with a physio or booking that appointment and really talking to them about your concerns because we have so many different tools that we can use to help optimize your pelvic floor that may or may not involve the internal exam. um And the other thing I love to share is that there's never TMI in a pelvic physio session. We're here for
Sarah's Final Thoughts
00:15:12
Speaker
all the symptoms you might be feeling. You can guarantee we've heard it all. um And we're here to support you in a really positive
00:15:19
Speaker
um You know, nonjudgmental way. I love it. And it's so it's ah like for those of you listening, I cannot, you know, I cannot say enough how important this assessment is because, you know, right now you can look online for pelvic floor exercises, you can find information online.
00:15:39
Speaker
But it's not customized to you. Like I said, when I first went to Sarah, I didn't realize there was the tightness of the pelvic floor versus, you know, the weakness of the pelvic floor. And as you said, Sarah, what I love about you so much is you take a holistic approach. Like,
00:15:55
Speaker
As you were talking about hips, it's not just about the pelvic floor. Our body works in connection with itself and it causes weakness in other areas. So, or tightness or whatever it might be. So an assessment is so, so, so important. um No, I love this. Okay. Okay.
00:16:14
Speaker
Let's dig in deep because I know we've got so much information to cover here. When we're talking about women in perimenopause, because as you know, the intention of this, so many of us know like after baby, we really need to look at our pelvic floor health or during that stage of life. But what happens in perimenopause? Why is it so important for us to support our pelvic floor health during this time?
00:16:38
Speaker
So important. I think it's important um for clients, but I even think about it in terms of myself. So I didn't really know a whole lot about this phase. I was really focused on that pre and postnatal phase. I was in that phase myself. And then I had my last baby at 40. And all of a sudden, I went from ah postnatal and into perimenopause. And I always find my practice kind of mirrors the phases of life that I'm going through. so i've kind of dug into this area. um And sometimes as I was preparing for this, I was thinking of all of those changes that happen. And it started to feel like a little bit of a depressing list that we're dealing with. where
00:17:23
Speaker
um So I really wanted to frame today as some of those like positive approaches of ways you can optimize your pelvic health. through this period of time. um So i think if it feels okay, if we kind of dig through these different ways of optimizing it, then I'll sprinkle in some of the cages that you might be feeling, but it'll feel a little bit less scary.
00:17:49
Speaker
I love that. We love looking on the bright side of life. Listen, we we talk about it all the time in the podcast. we see the means, we feel the feels. The list of things that we're going through right now as women are absolutely deplorable, sometimes like a train wreck. But we always say that there is control and there are things that we can do. So I love that. So take it away and definitely sprinkle some sprinkle some optimism in there. That's my philosophy.
00:18:19
Speaker
Okay, so I've kind of come up with my top five ways to optimize your pelvic health. in perimenopause. So number one, I was just actually sharing this with a client today, this morning, that it's never too late. So often I'll see clients that maybe their kids are 20 and they think, oh, I should have gone to pelvic physio after i had ah had my baby and it might not have been available back then. um It's much more common now. So one of the important things I'll say is that you've not you've not missed your window.
00:18:53
Speaker
These are muscles that we're working on. They respond to load, just like any other area of the body that we can exercise. Our coordination can improve. our body awareness can improve and we can improve our strength there. So optimism number one, never too late. And that's really empowering. And i really appreciate learning the way now thinking about the pelvic floor, not even thinking about it, realizing that it is a muscle.
00:19:21
Speaker
right And like I never thought about it that way. And I'm with you on that never is it too late philosophy. And I know Kim is as well. And it's so motivational and beautiful to see people making changes that are impactful at any age. So it's really nice to hear again that like ladies, my friends specifically, your kids are there in their teens.
00:19:44
Speaker
We're still peeing a bit when we're laughing. You haven't missed the mark. Like it's not too late. And it also feels good to know um preventatively, you know, that someone for like myself, like it's not too late to start strengthening a muscle group that I didn't even really realize was a muscle group.
00:20:03
Speaker
Yes, we're going get that sump pump moving. We sure, sure are. So I love that. What's next on your list? Okay, so next, we're going to go a bit bold here, but we're going to get to know our vulva, get to know the vagina. So getting to know your own body and what is normal for you, and just tuning in to some of those changes that you might be feeling.
00:20:29
Speaker
So during perimenopause, our estrogen levels can be fluctuating and gradually declining. This is that, you know, can be a little bit of a downer here. but And that can affect our tissue elasticity, blood flow to the area. can change our vaginal pH. And sometimes people will start to notice more new bladder symptoms that they hadn't had. So, um, maybe some urgency, difficulty holding, ah you get home from a walk and you're getting the key in the door and all of a sudden you have to go and you can not make it in time.
00:21:03
Speaker
Um, and then sometimes also painful intercourse can start to happen because of those tissue changes. So this is often referred to genitourinary syndrome of menopause. So it's kind of ah this group of symptoms that can happen here. Interestingly, these kind of symptoms can also be associated with lactation as well. So sometimes it will happen in other periods of hormonal fluctuation.
00:21:32
Speaker
Um, so I like to start with, yeah, getting empowered, getting to know, even if you aren't having these symptoms, but you want to be preparing yourself for this phase of life, really get to know your baseline of what your tissues look like and how they feel. And then if you are noticing some of those tissue changes that might be including dryness, itchiness, pain, then we can um optimize that area just like we would any other tissues in our body. So we might be moisturizing our face or our body, but we can actually moisturize the vulvar region and the vaginal tissues. So there's some really specific
00:22:12
Speaker
different products out there. So we don't want to just use any kind of lotion. We want to use products that are designed for this area. They're designed to have a balanced pH for the vagina. And and there's different external kind of like a lip balm, but for your labia, there's also internal moisturizers that you would insert into the vagina. And they, most of them have a component of hyaluronic acid that is supporting those tissues. So those are the over-the-counter options. But you can also talk to your primary health care practitioner about vaginal estrogen. It's really supported in the research for improving that tissue quality and combating that vaginal atrophy is the is the term that we use for that that decrease in the the tissue health and the strength of the muscles.
00:23:07
Speaker
So that can really help with those urinary symptoms as well. So I think there's lots that we can do just over the counter, but then sometimes taking that step further and talking to your doctor or primary provider about if a prescription would be beneficial.
00:23:24
Speaker
So that's the kind of what you can add. Some things that I would take away from this area are when we're thinking of our hygiene, showering, washing, we wanna avoid things that are scented. We really don't wanna be using any soaps or cleansers in this area. um There is a little ah quote here, and I feel like Tanya, I know you love a good analogy. I wanted to share.
00:23:52
Speaker
that I don't know who originated this quote, but it's been around in public physio for a long time, but the vagina is a self-cleaning oven. So it does not need any products to help with the cleaning. we that those those products can actually cause more dryness and irritation of our tissues. So we want to avoid the soaps and the cleansers and the scents, and then we want to add some moisture to the area.
00:24:14
Speaker
So that's our tissue health. Can I tell you that this is like my favorite part of the podcast, the vagina as a self-cleaning eye? is first off absolutely brilliant so kudos to whoever made up that quote and secondly i am the moisturizing queen you all know this i like was putting lotion on my feet sleeping over at kim's house when i was seven years old so this is amazing sarah like why am i not moisturizing my vagina like why am i not doing that there's you know what i mean so
00:24:53
Speaker
Thank you so much. That's a light bulb for me anyways. i don't know if it's for any other women out there who are putting all these beautiful moisturizers and natural products all over your body. Why am I not doing it down there for those tissues? That's, you know, brilliant. And also, can I just circle back to the point that you made? Because this is something we've been talking about since day one on the podcast. And I think it's so important.
00:25:17
Speaker
sometimes ah us as women are looking so externally that we are not noticing what's happening internally. And I get clients all the time that their body's trying to communicate them for years and they're not noticing symptoms that are occurring. They're not really understanding or they're pushing it aside and saying, oh, this is a normal part of aging or this is normal. And it goes even further with, you know, pelvic floor. Like, first of all, you know,
00:25:46
Speaker
has have many women even looked at their vulva? you know do we even know I mean, I didn't even want to after the car crash that happened when I had my children. but getting to know your body is so important. And as you said, Sarah, understand what is changing. And we talked we talk to clients all the time about tracking tracking their period tracking you know symptoms that are occurring during menstruation so that we can sort of see how hormones are fluctuating the same is true with down there are things changing a bit are you experiencing different symptoms and and really being aware and understanding your body is so important so thank you so much for noting that too i think it's so important
00:26:27
Speaker
Yeah, that was a goodie. So where follows this one now? Because that's to be a tough one. The next one is a little bit boring. I'm sorry.
00:26:38
Speaker
But it's one of my favorites. So the next one is tuning into our breath. So it may sound really simple, but our diaphragm and our pelvic floor actually work together. So there is a really well-known physio, Julie Wiebe, out of the States and she's a researcher and educator. and she describes this analogy of the pelvic floor and the diaphragm um working together like a piston. So as we inhale, and if you are somewhere where you can tune into your body a little bit, um, just notice over your next few breaths that as we inhale, our diaphragm descends and our pelvic floor moves with it. So they move down. So that's that lengthening of the pelvic floor we were talking about. And then as we exhale, we get a nice recoil. So the diaphragm lifts and the pelvic floor lifts as well. So really this is often the first place I'll start is checking in on where people are breathing from. A lot of us tend to breathe up into our shoulders when we're stressed, or we think about a diaphragmatic breath and we really push out through our belly. And the way I like to describe it, or I've been taught to describe it
00:27:54
Speaker
is to think of it more like our breath is like an umbrella opening. so we're getting that movement forward into the, you know, gently a little bit into the belly, but also the sides of our ribs are opening, we're opening into the back. So we're getting that full 360 degree breathing. And as we inhale, we can feel that kind of relaxation or allowing that pelvic floor to descend. So I'll often start there. And the other thing I love about breathing is that in this phase of life, wait well, in lots of phases of life, but we can tend to be a little more stressed. We might not be sleeping well. So breathing not only helps the direct like movement of our pelvic floor, physiology of the pelvic floor, it also affects our whole body. So we can get more into that parasympathetic nervous system, more relaxation. and support our body from that side as well.
00:28:50
Speaker
So twofold approach of getting into our breathing. I love this, Sarah. And I bet you so many people who are listening just took a deep breath because this is probably the first deep breath they've taken all day. so thank you for that. And it's so interesting because you know I know so many of my clients, supporting nervous system is one thing you know as a holistic nutritionist, we do all the time. And I love that as a pelvic floor physiotherapy, or ah as a physiotherapist, you talk to this too, because I mean, even when you first started, you're like, this one sounds simpler, but honestly, it's the first one that goes off people's list when it's too simple, because because people are just like, like you said, running to the next, busy, we're in this phase of life where things just don't stop, and so often it's like, Even in my in my prescriptions or write-ups for people, I tell them, protocols, I tell them, take three deep breaths, even set your alarm, like make sure that you're taking these deep breaths every few hours because a lot of times we don't.
00:29:52
Speaker
And I love that, you you know, we talk about diaphragm breathing, but I love that you just connected because I didn't realize this also that as you're breathing, it's also... affecting your pelvic floor. And so understanding that is just so important and another why we should be doing this.
00:30:11
Speaker
And I'd like to add to that too. I think that exactly like you said, Kim, it's some you know the things that often fall off the list the most, but I also think it's the simplest things that have the most impact. But as human beings, we're searching for the next supplement or miracle you know treatment or whatever, when really,
00:30:32
Speaker
the thing that we need to do the most is these things. Like this is the most simple, yet probably one of the most effective things. So I love it. I mean, it's not as great as the self-cleaning oven as the vagina, like in terms of entertainment wise, but no, this hits deep and like, Super, super important. So I love that. um Okay, so what's your fourth?
00:30:56
Speaker
So next we're moving into building strength. And what's super exciting is I'm seeing lots of education and shift to promoting you know, women lifting heavier weights and, you know, feeling that resilience in their body. So that's, I think, really exciting. But sometimes that can be a little intimidating when you're seeing lots of information telling you, you got to lift heavy at this phase. And then you're not sure because you feel a little bit of pressure in your pelvic floor when you lift something. So what I really like to share is that, you know, lifting heavy, that's great that there's
00:31:31
Speaker
research to support that. And that's a great goal and it can feel really good in your body, but we can start gradually and we can just like anything in physio, we want to progressively load. We want to learn to have a good pressure management strategy. So sometimes when we're lifting something heavy, we actually are kind of bearing down onto the pelvic floor. So we can learn how to you know use our breath,
00:31:55
Speaker
get that nice pelvic floor support without putting excess pressure on the pelvic floor and being aware of the symptoms that you're feeling. um And then kind of coming back to, we touched on it a bit at the beginning of our conversation that strengthening the pelvic floor specifically, lot of people think of the Kegel exercise or the pelvic floor contraction, um and they can be great. I use them all the time in practice.
00:32:25
Speaker
even to help people just connect to the different zones of the pelvic floor. Believe it or not, we can contract the front, the middle, and the back of the pelvic floor. So I'll use that to help people connect to their body, kind of build a good baseline of strength. But what we really want to do is optimize that function of the pelvic floor in our everyday movements, in squats and lunges and things that are connecting to that um that strength training that we were talking about. So it's not all about just these isolated contractions. It's really connecting. i like to first connect to that area of your body. you know, build some strength and resilience there and then teach it how to do its job, um, through those functional activities or through the sports and activities that you want to be able to do. Um, so what it really comes down to is having that assessment so that you can develop that really unique pelvic floor prescription. It's not a one size fits all. Oh, just do this many Kegels per day. It's really, kind of connecting to what your body needs. Um,
00:33:34
Speaker
Yeah. I love that, Sarah. And to be honest, this relates to me so much because I, my first time, like when I went to physiotherapy, I realized that I was actually doing Kegels wrong. I was actually doing them incorrectly. And I had to learn, like, you know, you, what you do so well too is connect us with like where we feel the muscle and how we feel it so that it's understandable to figure out how to do these Kegels properly. And I think a lot of people are actually doing them wrong. And I love also that you you were talking a little bit about, you know, gradual load, because that's so, so, so important. And I'm sure many women out there are like understanding that, yeah, you can feel when you're lifting heavy or too heavy for you haven't gone gradual, you can feel that bearing down feeling that you just described.
00:34:27
Speaker
Absolutely. I think that is a key thing. Sometimes people come in and they're excited that, you know, I listened to a podcast or i read research that said I need to lift heavy and they want to get right into it. And that's amazing because I love people being excited to get active, but just having a plan to progressively get you there so that you're not causing increased pressure on the pelvic floor. And so you're not afraid. i don't want anyone ever feeling afraid to to lift because they think they might cause more pressure. So I think just getting that individual support can be really helpful for that.
00:34:59
Speaker
Absolutely. Getting the education. and love that. All right, we're at number five. Yes, I saved the best for last for you, ladies because I felt like this really fit well with your podcast and all your sharing on nutrition and diet. So for this one, we want to support our digestive health. So we might not even think that that's related, but a lot of clients I see have you know longstanding issues with constipation. And that creates, so just like x exercise can create pressure, you know, bearing down or being constipated can put pressure on your pelvic floor. It can also put pressure on your bladder to cause more urgency and bladder symptoms. And straining can also put pressure like causing more, you know, prolapse symptoms or bladder symptoms. So we really want to support that digestive health. There's so many um elements to that. So, you know, we're thinking things like you guys talk about with fiber and hydration, um movement and general exercise can be helpful for that. But one of the biggest things we work on is teaching people how to go to the bathroom.
00:36:10
Speaker
he yes yes And I have a three year old that I'm still working on toilet training right now or toilet learning, I should say. um And i we realize like sometimes we don't talk about how to sit on the toilet and how to get that proper positioning. So.
00:36:30
Speaker
Number one, we want to have a stool under our feet or something to elevate our feet a little bit so that your knees can be a little higher than your hips. There's actually a specific muscle that when we sit into more of a squat position, that muscle can relax and allow our stool to move through the rectum.
00:36:51
Speaker
When we are not in that squat position, that muscle is actually contracted and kind of closing the door. So it's hard to go. So if you can get. your feet up on a stool, have a nice upright posture and kind of lean your body forward so that your arms are resting on your legs. um That's getting us into a more optimal kind of alignment or position. And then coming back to my favorite topic of breathing, we want to try to get some nice diaphragmatic breaths so that we can actually get a lengthening of the pelvic floor. We want to let that door open. Sometimes when we're straining, we're actually
00:37:29
Speaker
tightening and closing, um, space. So we want to breathe so we can feel that opening and then getting into, sometimes we'll use different, um, or breath. So with little kids, I'll use the moo strategy.
00:37:47
Speaker
So making a o oo sound and you can feel how that connects. You feel your core tighten a little bit. Um, sometimes just blowing out, um, kind of breathing out will help to create that pressure down. So we want that pressure to help the stool move out, but we don't want to strain and we don't want to strain against our muscles that are kind of having opposite directions. So um hopefully that's not, I know there's, I said there's not TMI in pelvic physio, but I hope everybody's.
00:38:21
Speaker
No, I always joke with my clients. If we don't talk about poo within the first five minutes, like it's coming. Yes. Thank you. So working on those mechanics um is really important. And then, and then yeah, you guys, I think are the best for chatting about how to optimize your stool itself so that it's soft and kind of moving through the system there.
00:38:45
Speaker
Yeah, I love that. Everything leads back to the gut always. And Sarah, I'm pretty sure that everybody listening today, whether this is weird or you feel gratitude towards it, is going to think of you the next time we go poo.
00:39:03
Speaker
I'm going to. Like I'm going to literally think of all of these things. So whether or not you want that, I think that that's going to happen. But that was literally amazing. informative and so helpful for people who are struggling for constipation. And constipation is something that I tell my clients, like it's a 911. Meaning you don't wait till your next session. You 911 me and you get in because nevermind all of the other issues with toxins leaching back in, all of that, which we're not getting into now.
00:39:33
Speaker
I didn't realize until now, thank you, the pressure and how that ties in to the pelvic floor. So for me, this has been absolutely enlightening. Um,
00:39:47
Speaker
I'm so grateful and appreciative as I know Kim is as well. I've learned so much. And before we go, is there anything else, you know, that is the essence of what you do and during this time, during perimenopause that you want to say before we leave today?
00:40:05
Speaker
And also, Sarah, before you go on, tell people where they can find you. Okay. Yes. Trying to think there's one way to sum it up. um I think there's a lot of information out there and it can feel stressful and a little bit scary. And so I think exciting thing is there's so much information coming out now. So we're really have this opportunity to be so much more supported and that perimenopause and menopause, it's not the end of our pelvic health. That's really an invitation to optimize it. um And yeah, just getting, getting in to see someone and really creating that specific plan that's individual to you is really kind of the way I'd sum it up there. um Where to find me? So um my website is centeredphysiotherapy.com and centered is spelt R-E-D. So the Canadian centered.
00:41:01
Speaker
um I'm on Instagram at centeredphysio.com. And as well on Facebook. And yeah, if anybody needs help connecting with a pelvic physio, feel free to reach out to me because I love helping connect you with the person that's like right for you because there's so many different amazing practitioners out there with different niches. as So, and thank you so much for having me. This has been so much fun. My first podcast. It was such a pleasure. And like Tanya said, we are so grateful for you being here and giving us all of this amazing information. um I'm sure people may reach out.
00:41:38
Speaker
um And please do, if you have questions, Sarah is so, so full of wonderful information. um so thank you, Sarah. Thank you so much for being here today. Thank you guys. Thank you.
00:41:51
Speaker
All right, everyone. and We'll see you next week. Bye. Hey guys, thanks so much for hanging out with us today. If this episode resonated with you, we would love it if you would hit like, subscribe to the podcast and share it with a friend.
00:42:08
Speaker
We love to hear from you because let's be honest, this show is for you. If you have a topic you'd love us to tackle or want to learn more about something we talked about today, send us a message. We got you.
00:42:20
Speaker
Stay connected with us on social media at what's my age again, dot podcast for even more knowledge and inspiration between episodes. Kim and I aren't doctors or your healthcare practitioners.
00:42:33
Speaker
Everyone's body is unique, so always consult your own healthcare provider before starting something new.