Welcome to the mum Rick podcast a place where you can feel normal get helpful information and laugh your ass off. Hopefully without peeing your pants. I'm your host Erica and I have two kiddos. I am not a mom expert but I do have a zillion hours of therapy under my belt and no filter. I'm on my own journey to find happiness and I want to help you on the way to yours. So I'm here today with Rachel Solomon a public forum. Therapist and we are going to talk about all of the questions and concerns and jiggity details of what actually happens why you should be going and what's actually going on down there after you have kids or even before you have kids. So thank you Rachel for so graciously coming on and you know spending some of your day to talk to us about this such an important topic. Yeah. Thank you for having me maybe before we jump in you can just do a quick little introduction about yourself. Who you are what you do? Yeah, so, my name is Rachel Salman. I got my undergraduate degree actually in chemistry from Georgia Tech and then I went on to get my doctorate in physical therapy from Mercer University. And then I actually really didn't have a huge interest in women's health at the time and I in PT school. You really don't get any women's health information you get like a maybe a half a day lecture some thing on public for physical therapy. I know it's crazy. And so you get like a couple hours and so I really didn't think I had much interest in it and then I had a child and so very quickly learned how the bounce-back thing I think is just this huge myth and thing that really damages like postpartum at damages. I think Mom's mentality and I was super active before I gave birth and so I like fell into Trap of I'm going to bounce back and all my patients and all the people that I worked with and everyone is like, oh my gosh, you're gonna bounce back to me. No problem and you're just have this beautiful strong pregnancy and labor is going to be a breeze and then you know in a couple weeks, you're just gonna be back to normal. And so I totally totally fell for that and when I realized obviously postpartum that that wasn't going to happen. I got really frustrated with myself. It's already a really hard time anyways, and then it got really frustrated with myself. Able to move the way that I want it to move and that was kind of my like Outlet anyways, and so when I couldn't exercise I think that took a toll on my mental health too. I've got really lucky in that. I have a really good friend who's a public for PT. And so I reached out to her and I was like Hey like this is what's going on. Like is this normal was this normal? Like what am I supposed to feel and she was just an amazing resource to me? And so I was like, okay. I need to find someone in my area and she lived a decent ways away. So it's like I'm going to find someone my area who does this? Quickly realized there was like no one here who does there's only one other public for physical therapists here. And so I looked at or I called and got their information and realize very quickly that she had a very long waiting lists like okay, like I don't have that like I need my vagina to be fixed now things like I just want to feel normal like everyone told me that I was going to and so I was like, you know what? I'm just going to go do it myself. I'm going to just figure it out because I feel like as a physical therapist. We should know how to do this. And so I was like, I'll just go figure it out myself. And so that's what I did through the Herman and Wallace public Rehab Institute who is fabulous for anyone looking to go more into this field. They were wonderful. So I did my public for training through them and then I have my strength and conditioning certification as well. So I kind of combined all of that to help women, especially postpartum women get back to exercise and get back to moving the way that they want to move a mile of that. It's not necesarily. There's so many horror stories about what happens with your pelvic floor in birth, and it may be depending on how you deliver as well. Everyone has such a unique experience, but it's not necessarily just about you know, fixing these major issues like we were just talking about how I was just at the gym trying to do jumping jacks and I had to do modified jumping jacks because I kept peeing might like not even peeing my pants just dribbling and I don't really want to I don't want to dribble and you shouldn't and it's not normal to and I think that as moms too. We really normalized it. Yeah, and it's obviously when you're a mom you just kind of tend to take care of everything else. You don't really take care of you because that's what you think your duty as a mom is and moms sympathize with that on each other, which I think is fabulous to have that support. But in terms of like the leaking and stuff like that, I hear Mom's all the time and they're like, oh, yeah, but your mom like it just happens like it's the price we pay and it's like no no. No, this is not normal. It's never normal and it should never be your new normal. The second you have those symptoms like realizing you can do something about it as a game changer. I talked to most people in there. Like I didn't realize that there were options. So I never looked into it. I just kind of felt like though I just am going to do this for the rest of my life. Well, it's crazy because you mean having only like one pelvic floor PT in your area. It's it just goes to show that yeah, but these problems are common, but they don't need to be normal and write it normalization of fixing the mom. Holistically not judge. Yes said to have not just breastfeeding but like yeah the Giants take their toll to oh, yeah, and I think a lot of people don't understand like their muscles. There's 11 muscles down there. And so yeah, I crazy. All right. That's why I'm saying like a four hour lecture during PT school like that just doesn't cover it and it's not to blame PT school. Like I just it's obviously a specialty kind of subsets. So there does need to be additional education there, but there's less than muscles down there. Like that's a lot of muscle and for some Any other muscle in the body, we you know anytime you injure it or anytime you have surgery you get sent to physical therapy. And for some reason with the pelvic floor, it's never even mentioned like it's just never brought up. Most people don't know we exist when they find out we exist. They're like no way and like my going to a comment for physical therapist. Like that's a joke. They're going to make me lift weights with my vagina. Like that's not it at all. And so there's 11 muscles down there and they're also so important even in a totally quote normal birth. With whatever that is because I don't think there's any really normal birth. But any normal birth those muscles stretch to two hundred and fifty percent of their resting length. So if I were to take your hamstring and stretch it to 2.5 times its normal length and then go to the doctor and say hey, this is what happened. They would send you the pelvic floor to physical therapy, right? But for some reason the public our yeah, we just don't really like you'll be fine like take some Motrin you'll heal like it'll get back to normal in a pearl. It was a lot of women, but for some women they do feel like they get back to normal without that. And so I think that we have just kind of said like, okay. Well it can get back to normal but like it should be so standard for every single woman who has a child whether it's C-section or vaginal like they should be sent physical therapy because there is muscle trauma there. There's no way you can have 10 months of pregnancy and papa baby out and not have some kind of muscle dysfunction afterwards. No, and it's so the in the comment about hurting another muscle in your body. Really interesting because I've had a lot of surgeries like I've had my knees done twice. I've had hip surgery. Like I had a breast reduction. I've had a lot of relatively major surgeries and I have spent hours and hours and hours in PT afterwards. Oh, yeah months. Yeah and even when I'm doing if I do decide to do an internal assessment, like I tell patients all the time and like listen like this is exactly what I would do on an external muscle. The only difference is these muscles are interior like the easiest way that I can. To them is an internal exam and so having people understand that these are just muscles and they're just internal. That's the only difference. I think it makes a lot more sense to people when they realize like that's what we're treating and so it just I think for some reason the internal aspect like freaks people out, but it's exactly the same as any other muscle in the body and that's why I think that we should be the specialist on this because we are Specialists on every other muscle and so for some reason I just think that people don't realize that there's even muscles down there. So when they realize that they're like, oh that makes sense why I would go through a physical therapist because it's muscle muscle related. So let's sort of take a step back and talk about what actually happens in public for video because that stigma around it and yeah the idea and the of the concept of the unknown of not knowing what to expect and you're in this sort of fragile stage often when you go if you have a newborn or things aren't working right or you're sleep deprived and that all of a sudden You're going to go meet this stranger like all you can think about is I'm just shoving their hands up to you. Yes, exactly. I actually have patience call and they'll say like hey, I need to know what's going to happen because I don't really get it and I'm not coming until you kind of explain to me what happened. So we explain this all the time, but honestly, the first visit is really whatever you want it to be like if you find a good physical therapist. It should be what you want it to be and for some people that means that the first day I meet you. I just talked for an hour. Like you tell me your history. You tell me what's going on. You tell me, you know, what's been bothering you what you'd like to work on what your goals are and we just spend the entire hour just talking and you get to know me and I get to know you and then that way next time I see you. I don't feel like such a stranger and that's totally fine. Like if that's what that individual patient needs and that's what we as PT should be willing to do for most people they get here and they're kind of okay, they kind of understand like hey, there's probably going to be some internal exam so You do with this. So if they come in then usually what we do in that situation, obviously, it's not all their paperwork. They let me know like are you having pain or you having other symptoms like leaking or heaviness or things like that? We hit them back. We stalk I probably spend about half the time just talking about like what's going on? Like what are these symptoms? Like coming from? What? How are they bothering you? How can I change this? And then the second half is more like my exam where I will actually check the muscle and see like how its functioning. So in most cases what I'll do is check strength. I'll check. Check endurance. Just like we do any other muscle and kind of see like, okay, what does your people actually look like when I asked you to do a cake? What are you doing it correctly? How long can you hold that Kangol? Are you breathing when you're doing your kegels? Are you squeezing your butt cheeks. Are you squeezing your thighs or I actually using your internal muscles without compensating elsewhere will check for things like that suspect. I like a table separation if it's a C-section or even if you had some tearing will check things like your Scar Tissue because that needs to be At least just like it does anywhere else. So we'll check things like that. But I always tell people before we do internal exam. We do not have to do internal exam. Like if I have someone who just doesn't feel comfortable day one with internal. We don't do it. Like there's so many things that we can do that are external that we can still get a good kind of feel for that muscle function without actually having to work internally. And so if I have someone who's got like tons of sensitivity down there are maybe they're on their period or maybe they just don't feel comfortable. With internal that day no big deal we can still do an exam and we can still kind of figure out what we need to work on. What's tight what's not what's restricted what good movement looks like what your posture looks like all those kind of things so that we can put that into the picture and then maybe if you decide like later on down the road like I think I'm okay with an internal exam. That doesn't freak me out any more than you do it, but there's no speculums. There's no like literally the only tool that I use is my finger and I can just tell like whether or not you're able to pull or push. Or what the muscles feel like the same way. I wouldn't external muscle. So there's none of the scary big stuff that you would think and I know for me the first time I went to public for fizzy. I've been to a few different ones for a few different things over the course of two kids, but it was at that point. I was I had in my first newborn and I was so tired and I just everyone had seen everything for me personally. I was like just happy to be lying down without a child around me. I almost fell asleep. Yeah, I know for a lot of women like by the time they get to me in this is unfortunate. But the sad Truth by the time they get to me. I'm kind of their last resort. Yeah, like they've been sent to Urology. They've been sent to the OB/GYN. They've been sent to their Primary Care they've been sent to Ortho. They've been sent everywhere. And so by the time they get to me they've had so many tests done and so much in base of work done that when we do the internal exam and I finished and I'm like, okay we're done with that part. They look at me. Like what do you mean you're done like that? Was it because I've been through So much and especially like if it's with bladder like Urology where they do all the testing or they fill the bladder and empty the bladder and see what it can do and see what it can't like our testing here is so minimally invasive compared to some of the other stuff that they've done and I know when I had my son like, I mean, you're just like facing the door you're like spread eagle and there's all these people coming in and out and you're like waiting and they're stitching you up and you're like, I don't know who these people are. Like, where's my child? So for me, it was like like it's fine. I don't really Care what you see down there and that's how most moms are but by the time they get to me, but everyone's different and so I give everyone the freedom to kind of choose how they want their first session to go and that's what any good PT should do so that leaves an interesting point to from your perspective. So if you compare the situation to actually deliver your child, I am 0% concerned what my OB thinks about seeing my vagina or what the nurses think about. We find a but for some reason I guess because I wasn't In the Heat of the Moment. Yeah, I was so nervous about this like random person more. So the second times the second experience. I went I was pregnant. So I was like, okay. I'm so hyper aware of what's going on. Yeah from your friend back to have you've chosen career and vaginas. Well, yeah. Yeah your take on Mike. I'm like, do I need what if I have my period like no, no, no. No, I was conscious about my big giant like yeah my vagina. Normal, yeah, you're looking the bottom line is there's like no normal. Like I think if you go even as like about four PT, if you go to the training on the first day of the continuing education pretty much the first thing you do like all day long is just look at different but John has like seriously like the first maybe 15 slides are just different vaginas and like what they look like and vulvas and how they're shaped differently and how they look different and how they might be colored different or things like that and how those are all considered normal. There's like nothing that freaks me out about that. I really honestly don't worry about any of that. And once I like figure out where we're at and not to be wise and make sure everything looks like find there's nothing that's of any type of concern in terms of infection or anything most of the internal exam. I'm not looking down there like it's not something where I'm like standing like in between your legs like looking into your legs the whole time that we're doing manual like most of them off to the side once I like make sure that there's nothing concerning their then I I can still feel the muscle I can still access the muscle and see how it's working and be off to the side so that I'm not actually just like staring at you and you don't feel uncomfortable most of the time. I'm just talking about like hey, would you do this weekend or like hey what you got going on tonight or things like that? So anyone who's like self-conscious about that? I would tell you like that doesn't freak us out at all. We are so used to vaginas and vulvas and all the things that people are like scared to say that it doesn't like we're to South at all whether or not The shave that day. No, not really. I mean at this point, like I said, I've had a child and having been to those courses and things like that. That's like all you look at and then the more you treat obviously the more comfortable you get with it, but I would definitely tell people like don't worry about what it looks like. I know I was terrified to look down there like after I had mine I was like, I'm just not even going to look I don't even want to know what it looks like. You haven't done I've lived now. He'll beat you to have this month. So I have looked now so I know now what it looks like. Like but probably for the first year I was like, I'm not even gonna I don't even know anyone know what's what I have your aunt looked at my vagina in five years. I have a lot of women who don't they have no idea. Yeah, and I don't I get it. I completely get it. And so I was telling like, hey, it looks normal. They just so you know, like everything looks fine. And that doesn't freak me out and then they're like, okay good to know just look normal. Okay, so I have like, I'll treat like friends and stuff like that and they're like is this going to be weird that you've like see you treat done there? Yeah, that's but it doesn't like to me. It's just I mean, it's a body part. Like it's just another nigga need a part right? It's like it's that's where the muscle is. So that's where we are. So it doesn't doesn't weird me out at all. So they're probably thinking way less about it than you are. So if you're trying to like get yourself together and make sure everything is clean and like like neatly shaven and all that stuff. Like it's really fun. Like we're not we're not thinking that much about it. I love that so much because I think that's probably the biggest concern for most women is that they're self-conscious. Yeah, of course. Yeah, and I it's totally understandable. You just went through this huge change and you're probably feeling different and feeling weird and things especially like early was part on their swollen and there's Scar Tissue. Sometimes the stitches are still there. So it's like terrifying that someone would be in and or around that but like that's just part of what we do. So it's not anything. I promise promise promise that your for a more worried about it than we are. So when is the best or most appropriate time to be seeking help from Physiotherapist is it when you're pregnant. Is it like six weeks after what is your time frame? I absolutely recommend it while you're pregnant because we can help minimize the amount of things like AB separation or symptoms like prolapse we can work so much on pain or like any just just Comfort. There's so many discomforts and pains and random things that come with pregnancy that I think we've been taught like. Hey, once you're not pregnant anymore, like this will go away and sometimes you're like, wha On 4 months pregnant like I still have a long ways to go. So do I just deal with the sciatica or this like SI joint pain until I have this baby and I think that generally that has been the recommendation like no go away when you're not pregnant anymore. So I absolutely absolutely recommend public for or just even just physical therapy in general as long as your PT has some kind of training and modifications for pregnancy because obviously there's things like I don't want you doing tons of exercises laying on your back for a full hour if you don't have So as long as your PT has some kind of awareness of modifications for that. They don't even have to be like specifically public for certified and they can probably help you in regards to pain. But I also recommend it during pregnancy just because one the app separation like your abs are getting way pushed apart by this human that's in your body and separating them. So the more we can minimize that the better and then the easier that recovery process will be to we can work on public for function while You're pregnant. So the easiest way to think about it is public Force kind of like a hammock. So it's sitting like this babies like on top of it and as baby gets bigger and bigger it starts to kind of like sock more and more. There's more weight on it. You have a soda. Yeah. So you have this opportunity to strengthen the pelvic floor with a weight on top of it which the weights about to come out. So once the weights out if you're fabulous at cables and public for contraction and relaxation with a weight on top of it. Think about how much easier that is when that baby gets here. Opposed to having 10 months where that hammock is just getting saggy or and so you're inside you're in the muscles getting more and more and more stressed and losing more and more and more strength as opposed to being able to go to a public or PT during pregnancy and work on strengthening it and holding it up so that it's not as weak. It's not as stretched by the time that you do go postpartum and then images things like safe lifting like people ask me that question all the time. They're like, what should I avoid? Like, there's not a good set of guidelines out there in terms of like hey, don't do one two and Three it's kind of like well, if you were doing it before you can do it now, but just be careful what you do and it's like well, I mean as especially if you've already got kids like you have to live you have I mean, you can't just stop living life. So helping people modify and learn what's safe and what's not and how to adjust to that during pregnancy I think is a huge deal to I'm going to take a really quick minute to talk to you about the fresh 20 because this podcast cannot exist without ads and sponsors and the fresh 20 has been a system that I've been using my house for a long time. And I love it. It makes meals and dinners. So so so so much easier now what it is. It's every Friday. I get delivered in my inbox of meal plan of five meals for dinners. It includes the meal prep guide for the week daily meal prep guide as well as a grocery list which includes the Ingredients and how much everything costs then? My sneaky little hack is I take that shopping list and I actually order all of the things on Instagram, but I don't need to leave my house. I just do it for my phone and they get delivered a few hours later then Sunday afternoon. I spent about half an hour to 40 minutes prepping all the ingredients for the week putting them in containers in the fridge and when it kind of comes time to actually make my meals on the weekdays, all I need to do really is cook the Protein and assemble them. It's super easy and I'm actually signed up for the annual classes subscription. So I have access to all of the different recipes and meal plans from all of the archives. Now, if you want to sign up I have more information at mom break dot see a slash the fresh 20. I also have a coupon code that is Mom break and it'll give you 15% off at checkout. Seriously guys. This has been a game changer for me at dinners. I love love. Of it. So to get all the information you need go to mum break dot see a slash the fresh 20 / the fresh to zero. Well, I love the idea of strengthening that like public for hammock as well. Like you said because with my second pregnancy my hamon have real week. Yeah. Yeah. Absolutely. That makes sense. They kept saying well your body remembers how to do it. But my back feels like I'm pooping out of bowling ball for low five months and it's hence pressure down there all the time. So that's something that and that's actually why I ended up seeking. Yeah public for PT because I was just it felt like there was a bowling ball sitting on China. All day and it's yeah, I still had a toddler to take care of at home with sucked. Right and those symptoms to are symptoms of prolapse as that heaviness that you go down there and we say the word prolapse and it freaks people out because they think that it's like this is O only menopausal women have prolapse and that means now you're like 80 years old and like you said Google like Google if you Google prolapse good care very much. Like yeah. It's like you're done for you have to have surgery. That's the only way to fix it. There's really nothing you can do about it. And that's all there is. And so it's terrifying. So I'm always careful with that word. I think that there's validation in the word because it helps you understand like hey, these symptoms are coming from XYZ, but I'm careful on it because you can be totally functional and have absolutely no symptoms and still be considered to have prolapse the prolapse itself like the diagnosis. There's not like good objective measurements for it. And so some of the research will say like, oh two percent of women have prolapse and some of it will say like oh 96% of women half Left afterwards because there's no good like measure of what that means and you can have people who are have awful prolapse, but don't have symptoms and you can have people who have a little bit of prolapse but are like having a ton of difficulty with function. It just totally depends and so like that heaviness. That's what I had when I tried to run again postpartum, which I did way too early. But anyways, that's like a different story. And so I went back to the doctor for my follow-up and I was like, hey, I'm having my heaviness. I'm having that pressure down here. Like this just doesn't feel right for me. And that was it. Like we didn't we didn't talk any more about it. We didn't do any kind of exam like she did an internal exam but I think I was laying down like that's a non gravity resisted position. So, of course like my organs aren't pressing down and laying on my back. I think there was yeah so there was no like functional prolapse assessment and so I basically went and listed symptoms of prolapse and was like, hey, this is what I'm having. And we didn't talk about it at all. Like we it was just going like well, you'll get better. It's what it is. That's it. And that was a hell and this is super common. Like it's pretty normal experience the people of had yeah, which is terrifying because like I said, I went home and I just like anyone else I Googled it and you're like, well, I just screwed myself up like now I know this is probably exactly and I mean seriously how terrifying is that the here as a new mom like my organs are falling on my body. That's horrifying and so that's when I reached out to my friend and I was like, these are my symptoms and she was like, yeah, you just did too much probably too soon back off a little bit. Try this this and this I have no problems now, it's like none but had I not had her already as a friend and like knew that she did public for PT that was not recommended by my doctor was not recommended by my OB, I wouldn't have known anything about it. And then if I went to Google it was like, well, there's nothing you can do. I mean there wasn't even a mental mention of pt on Google. It was just like Sorry, you messed up too late. Now. You're screwed. Every time you go to the bathroom or going to be thinking that your uterus stitches loose we can out. It was just terrifying I have like I said zero symptoms smell like fun, but it's because I knew her and so I think a big part of this which is why I'm so grateful for people like you who are getting this word out that this exists is just people knowing that it does exist. And then once they know it exists and they can seek it out. But if you don't exist, you can't speak it out. You don't know what you're asking for exactly. Exactly. So what are some of the other Major and common things that you see with new moms. Let's say specifically coming into your office. What are they struggling with? A lot of Newmont will one time. How do I find time to exercise? So a lot of what we'll do here is I will show them different exercises that are safe and that will feel good to them and help them get stronger, but they're using baby as their Assistance or like how can we lift baby more like in a safe way. How can we lift baby in a car seat in a safe way so that that at least if you don't have time to set aside Like a full-on exercise routine at least when you're doing things like being a mom you're doing them well and using the right muscles so that you actually are getting stronger. Anyways, the other thing is a lot of leaking and like I said the problem with that is that we normalize it we just kind of say like, oh, yeah, you just deal with that. Like that's just part of it just by some fancy underwear does suck ass. I'm gonna swear black leggings on a day, you know, you're going to be jumping a lot. Like are you kidding? Like no, I'm 28. I'm not doing that. That's not gonna work for me. The pain would sex after baby. You have a fun terrifying for people and puts a lot of stress on a lot of relationships like feeling like they can't perform the way that they want to and then that intimacy portion gets gone. And I even sometimes we'll have husbands come in and like sit with their wives like during treatment and be like listen to what I'm telling her regards of sensitivity or in regards of muscle tension and things like that so that they can get on board and be on the same page and then to like the observation Lap stuff we kind of already talked about that's another thing that I think is pretty common and fearful for moms when they come in like hey, I feel like I've lost his baby weight. But why do I still have like the mom belly? Like, why does why is it still soft here when it wasn't soft here before? So helping them figure out like what the actual source of that is and if we can kind of make that tension across the core greater. Can we get that to pull back in and heal appropriately? Yeah, cuz I was just and I guess I could come the the solution or the source of that problem. Well problem the source of that could come from a bunch of different things. Right because I have like Flappy skin. Yeah. Yeah, some people do it could just be genetics. It could just be that I hadn't had what's the fancy word diet, right separation is this is right - yeah, we just said Dr. Tell God. Yeah, Dr. Dee is easier you could be okay. So it could be things that are actually fixed or have a solution. Yeah, exactly. And so especially if you're really early postpartum like No, when I was pregnant, I did tons of add work because I thought like oh my abs are going to be super weak. And so I did tons and tons of app work and a lot of it I shouldn't have been doing because I was forcing more separation in the times and of course now, I know that but at the time I didn't and that's part of why I do this now is because I'm like if I as a physical therapist and as a female, did it know this like how does the general population know what to do and what not to do and if you look online, it'll be like, oh yeah planks are safe, but then the Article you read it'll be like no, they're not and then it'll be like, oh, yeah, you can do crunches and then that smells like no don't do crunches. Like what the heck am I supposed to, you know, actually listen to and then the OBGYNs they're fabulous at what they do, but their job is to make sure that you're medically stable. And so they as long as you're medically stable, they're not going to give you a list of things like hey, you can do this this and this but you shouldn't do this this and this so helping moms with that AB separation afterwards and hoping and realize like what's hurting and what's helping. I'm helping them decide if they might need to use something like a belt that they can wrap around postpartum or not helping them decide like hey, am I safe to go back to running or am I not with things like prolapse? Like what can I do? Should I be lifting more than this? Wait if they need a pessary like there's so many different things that we help with postpartum that I think most women just kind of think that there's not any help. Yeah. I didn't and I it's not even that I didn't think there was help for I never Associated public. Or physiotherapy with almost 90% of these issues you're talking about I Associated it with kegels and leaking China's. Yes. Yes, I hear all the time. People say well, my doctor already told me to do kegels. I'm already working on that. So like I don't really see need to come to what's the point if you're just gonna do exactly and I'm like there one there so many women who keep those are not appropriate for if they've got tight restricted public Force if they had a traumatic birth experience that's caused a lot of that restriction a lot of that tightness I have Women who are really good at strength. Like they have really strong cables, but they can't hold it. So like yeah, you've got a great capable, but you can only hold it for two seconds. Well, guess what happens when your bladder fills? You probably hold it hold it for about 2 seconds. So like just figuring out like our cables even appropriate for you. And then I have women who will come in and doing are doing the opposite of a cable. So they'll think like I'll say well if you're gonna do a cable which you do and they'll show me what they're doing and it's the opposite so I think There's a study that actually talked about like hey this doctor recommended like just verbal like hey go home do Kinko's and see if this gets better and out of the women that went home and did their kegels 40% of them were doing them incorrectly. So almost half of the women were even doing them. Right and then out of that 40 percent 25 percent of those people are actually doing them backwards. So like instead of like lifting up they were bearing down and that was promoting even worsening symptoms. So not only are they doing Wrong, but they're doing something that's going to make their symptoms worse and then they go back to the doctor and a few weeks and they say hey, I've been doing my kegels. I'm doing what you told me to do, and I'm not any better. So then the doctor will say like hey, okay. Well then I guess we need to do surgery. Like, why would we send you to PT because I told you to cables and it didn't work and psyche but they're not doing like verbal instruction of cables doesn't work. Like it just doesn't. Oh my gosh, that's so you just kind of blew my mind. And if anyone who's listening right now isn't doing a Kegel or What you're doing how these older again my mind is a lot like trying out a bunch of different versions as you shocked. Yeah, but it's crazy. And I you funny because I remember so well when I was walk through how to do it properly. Yeah, I strike. I really truly struggled with yeah. I was doing it wrong first. I couldn't grasp the movement that I was supposed to do and it was death. I did she had to draw me a picture. No. Yeah. Yeah, it takes like I will spend maybe even sometimes the first like four or five sessions. Just getting someone to do a proper cable. Sometimes that takes like internal assessment. Sometimes we use things like biofeedback that can tell you like. Hey you're doing it or no, you're not. It's everyone's really really different. But that's why to if you come in like during pregnancy, we can do internal exam during pregnancy as long as it's clear by your doctor. So as long as your doctor's fine with it, I mean, like people are having sex when they're pregnant. So what difference is like my finger going to make versus your partner. So having people come in and say like hey, that's a correct cable like what you're doing. Doing right now is fabulous. Then they know what it feels like so that when they come back and see me postpartum. I'm like, hey you had this before so we know we have it because a lot of times that mind-muscle connection gets totally disconnected during birth. And so you come in and you're like am I doing it and I'm like no, I think nothing's happening. But I know that you know how to do this because I saw you break during pregnancy so it comes back faster and then that's something that you can be working on like in the interim while you're peeling between when you have baby and when you actually get back in, The clinic so that that way you're not just going like for six weeks. Whatever it is that your doctor ways to clear you. You're not going all that time was just no muscle function at all. It's something you can go ahead and get started on because you know what, it feels like and you know where to pick it up. So so it's six weeks sort of that magical your prove to come see you that's like typically when it tends to be it's different for every doctor like some doctors want to wait eight weeks and it depends sometimes on C-section versus vaginal, but it's usually just kind of up to the doctor depends on Stitches. And things like that and so usually six weeks is where we get clearance to move forward. But the problem that I have with the six feet point is that I know for me postpartum in this might be different than other people's experiences at six weeks. It was kind of just like hey go like go you're trying to yeah, and you're like, okay, but I wasn't I wasn't cleared to do that like yesterday. So like why is today this magical day where midnight struck and it's been six weeks and now I can go do whatever I want to do. And this is like the general guideline is like hey just ease back into it. But that means something totally different for everyone. Like I was exercising a lot before so for me to ease back into things was like I'm going to go on a light Jog and I'll just do interval jogging like probably a minute on a minute off. We're like for someone else it might be like, hey, I'm gonna work on some sitting to standing today and there was no one to guide what easing back into it and what that meant to do it safely. And so I set myself back like a lot because I pushed too hard because again, I fell into this trap of you're going to bounce back your active. You know the body like you're young and it's going to just be totally fine and great. And even when I had symptoms like easing back into it if I talked about it with people is coming. Oh, yeah, of course you had like a not at all. Yeah like you I mean, what do you expect you're going to the gym and you're doing heavy squats? Like, of course, you're going to have a little bit of leaking. There's like no, but I don't want that for me. And for my mental health and like if this is my escape and this exercise is like where I go to keep my sanity and then I get here and I'm constantly reminded of like all these things that are setting me back. I don't want that for me and so like figuring out what that took to fix that and then figuring out that that wasn't available to so many women was just like a total like mind-blowing experience because it's like I I just thought you have the baby and like you just go back to normal and I'm like if I fell for that trap, I know so many. Other people are falling for that trap to it's terrifying it is and it's it's so easy to and I was in a very similar situation to you with my first I like I ran my first ever half marathon when I was pregnant with my first I was doing kettlebell swings until I was 35 weeks pregnant. Yeah, but of course, I went back into a boot camp at two weeks after having this baby and I was not in hindsight. I'm not ready to them so much that just said Erica get the frick out of the gym. Yeah it on the couch. Yeah bottle your beer. But exactly it's a mental health Escape for me. So right maybe instead of going to do kettlebell swings I go for a light walk with the stroke rate and there are so many things that we can do is new moms that we can do to exercise and to stay moving. I just didn't know any of them at the time. I'm so like that education and that understanding of what's appropriate and what's not I think that there's also another extreme of like women who are afraid to do anything because there is no good guidance out there. Like you can't just Google like hey, can I do this at 6 weeks postpartum like that? There's just nothing a guideline like that. And so there's so many women who avoid like anything at all and I know like a lot of the trainer's I've worked with and things like that. They hesitate so much to give women heavy exercise of because their postpartum but if you're lifting a baby you're lifting a car seat and think about if you've got to you've got one on each hip like you are squatting. You're lifting your In all these things that I think traditionally we've been told like hey hold off on that. Like don't don't worry about getting back to that. It will come like in a year. It's like no you're doing that like day to postpartum you're picking up a car seat. You're putting them in the car. You're lifting your twin your twisting like there's all this stuff that you have to be able to do and like if you're telling me that I can't do it. Like what am I supposed to do with my baby? And so teaching women how to do it safely and use their bodies well and make sure that every muscle that needs. Needs to be engaged is engaged in working the way that it's supposed to is so important but that again is something that's not really talked about. It's kind of like you go to your follow-up and they make sure again you're medically stable and then it's kind of like, all right. Good luck. See you later. God's be in your favor. Exactly. It's crazy. And I think it ties back to this whole new generation of super mom and I I'm I hate that word so much because I don't think it puts pressure on moms and exactly people say it to me sometimes because they see me doing a cleaning video or they see me exercising but I'm like button cool. I'm going to the gym because otherwise, you know, I would yell at my child. I'm not leaving because I have anxiety. I just doing what I have to give in my set of situations got myself, you know circumstances to do the best that I can and I mean, that's amazing. Yeah, but I'm not Super it's super mom doesn't exist and it's and there are days where you feel so good about everything you're doing and you're like, I have it all together. Like everyone's packed and ready and everything's in line. And then there's days where you like have a setback and understanding like that's normal and okay and life goes on and we're not going to like focus on that. We're going to focus on what we can do and not on what we can't do and so understanding that I think is super super important and understanding that it's okay to not have it all together all the time. But I think again we're bombarded with Dot and I was bombarded with like the oh, you're going to be fine. You're going to bounce back. No problem. And so you start to believe that you're like, oh, yeah, like I'm going to be different. Like if anyone's going to be able to meet me. I work out all the time School therapist. Of course, I'm going to just bounce back and it was like this real shock when I didn't and that I couldn't set out of bed. Like I could it took me like 30 minutes to get up and down the stairs like you have absolutely no ABS at all and you're just like this is not what I thought it was going to be and so that on top of just the already there stress of like a new mom and I'm not sleeping and I'm trying to nurse and no one told me that that was going to like be painful and like I like everyone's like makes it seem like this just instinctual thing and I think you guys are going to open up and the lights going to come down and it's just beautiful and eventually it was like eventually it got easier but like those first six weeks nursing was not a good experience for me and for us like it was hard. And so that on top of I can't move how I thought I was gonna be able to move by now. I thought I was me back in the gym at 6 weeks. I thought I was going to be like pretty much back to normal and I wasn't that her like that was really hard on top of everything else that's already going on. So I think understanding that it's okay to not be there and it's totally normal to not be there if I had had I think someone who could have guided me out. What I could do. I would have been able to focus on that like okay this week. We started adding some squats. I'm going to add in some squats. At home. I'm going to hold my baby as I wait. I'm going to engage my hips away. I'm supposed to I'm going to engage My Hope for the Rams supposed to and at least that way I know moving forward but I didn't I didn't feel that way. I felt like so many days. I was moving backwards because I was because I didn't know what I was doing. And so if I had had something where I felt like I could have been making progress. I think that would have helped my mental health a little bit during that time. No, I think that it's so hard for doctors and Healthcare professionals to I think everyone's scared to say Publicly you can do this for you can't do this because it's so it's so individual. There's not one completely completely and that's why it's so important. I think to get in with a provider who can tell you like. Hey for you personally, this is safe. But for this person who's exactly the same amount plus Partners you are this is not safe right now and saying, okay. Well if this is not safe, here's something you can do that is safe. You don't just have to sit back and wait and wait wait, like watch time pass my you feel like you're going to be growing weaker. Yeah like but at 5 weeks and six days don't do it because it's you're not ready yet. Like I just think having someone who can individualize your program to you and watch you do the movement and watch you just move and see how you feel and assess that is huge huge huge and would have been a game-changer. I'm curious to get your perspective and your professional experience on C-section versus vaginal delivery because I suspect there's a lot of common uncommon problems, but there's also ones that are unique to eat. So yeah, I'm curious because I'm only had two vaginal delivery. So I can't speak to the C-sections but I'm gonna freeze how they compare. Yeah, so c-section and vaginal I typically and when I'm thinking about recovery, I'm thinking a little bit longer for C-section just because I think any time you have to cut through the tissue there's gonna be a little bit more healing time Associated there and mow so bees won't clear for a C-section or at least most ones around here won't until about 8 weeks and sometimes for bad weather clear like four to six weeks. So that little healing magical time frame that I kind of like already don't like anyways, but it's a little bit longer usually for C-section just because there is that cutting of the tissue. So that's a little bit different the vaginal deliveries. We have to work a lot because there's usually some degree of tearing of the vaginal delivery. Even if it's not that grade 3 grade for severe tear there's usually at minimum a grade 1 or grade to tear so they're still tearing in the muscle there. There's a lot more I won't say a lot more but there is a decent amount of pelvic floor Focus. Sighs you birth a child through the pelvic floor. So like I said in that quote normal birth, you get two hundred fifty percent stretch for terrifying to fifty percent stretch of the Common Core muscles, but if you have a C-section, you're probably not getting that because you're not birthing the child through the birth canal that doesn't mean that pelvic floor doesn't need Focus because again, we talked about that like hammock and that may be sitting on top of it. That's still happening for those full 10 months prior to birth. So the public for usually so Needs work, but it doesn't have the tearing and things like that that a vaginal birth with and then C-section. You've got the scar tissue just in a different place. You've been kind of the abdomen area and they've cut through that fascia that connects our muscles and helps with that mind-muscle connection. So that a lot of that is just Scar Tissue Massage over the front area, whether it's a vertical or horizontal cut depending on like whether it was emergency or what and then re-establishing that deep core connection to the belly like it's not just six pack muscles. And I have woman who Focus only on six pack muscles and that will set you back even further and make that like Mom belly even worse because it just separates the ABS even more. So there's a lot more focus on the abdomen area. I think with C-section just because that's obviously where you were cut but I think like once you get to about three months out, I feel like the treatment has largely the same because those muscles work together like deep core and pelvic floor work together. So once we figure out like where the deficit is, then we have to combine them and so about three months out if I can get get went in and get them going then it pretty much looks the same from that point for Royal about that's so helpful. Yeah. Now terms of one piece of advice you want to leave for women. What would you guide women in or make suggestions about this space and this area? Um, listen to your body. It's so important like your body is amazing and I think sometimes we forget that because it doesn't feel that way like you don't feel amazing postpartum like it's not this maybe are some women that felt that way but it's not this beautiful magical like everything's just perfect and the birds are outside singing like that's just not a thing like a lot for a lot of women and so Bobby like understanding that if you're having symptoms that you are feeling those symptoms are not head like you're not making them up and understanding that like there is resources out there that you can like find and go dig into there are so many amazing women on his Instagram. Now, that's Instagrams the coolest thing because there's so much good information there that wasn't available. I think prior to X all we had was just Google and Google is terrifying but So many really strong women out there who have been through it and can help and you just reach out to them and like say hey this is what's going on. Like what do you think and they're willing to respond and respond with good information that makes sense for you and your body. So just listening to your body and listening to it as it heals I think is so so important but then to keeping in mind like you're a lot stronger than you think you are. Yes your postpartum. Yes, like things I guess tissues are a little bit more vulnerable than they normally would be but you're not some like fragile butterfly like you your body is so cool. And the fact that you can have a baby and pick it up and look it around and put it on your body and walk around with it. Like that's crazy that amount of muscle work in the amount of like just going to work your body's having to do during that time. I think like I said that other extreme end of like just be careful and avoid everything because you're not going to heal properly because you're just this fragile thing that he's just in the corner during pregnancy to like any You saw me exercise during pregnancy. I can't tell you how many like unwarranted comments I got about how I was going to cause a miscarriage and like oh my gosh, my baby's going to come out way too small cause I'm not eating enough like that, but you're not this fragile being like yes, you need to be cleared by your doctor. And yes, you need make sure you're doing safe things. But listen to your body and listen to your doctor and then take it from there. Like you are so much stronger. I think than we've been taught like during pregnancy and after pregnancy. I love that so so much. I think it's such an important message. Because women are so freaking strong we can so cool. Yeah, it's so so so so cool what your body can do but you do have to listen to it and not just like push past symptoms and then of course make sure it's safe. But if it's safe, like just let those comments like brush-off. I had people all the time commenting like Elena shaky shouldn't be exercising like you're going to have this baby six weeks early because you're just walking so much one locator walk. Like I'm walking like I walk everywhere. So there's so much misinformation out there. Out there, so being your own Advocate and finding the correct information and finding people who have good accurate information is so important and then listening to your symptoms like just because something says something safe online doesn't mean it's safe for you specifically. So listen to your body and then adjust accordingly. I love it. Where can people find you online or ask you questions if you happen to have any so you can find me online. Let me like actually wrote it down. Our Facebook is be MPT Columbus North so that's benchmark. Oh therapy Columbus North so you can message me on there. That's probably the easiest way to get to me. I used to have like a little sticks to Graham thing, but then life happened and I don't know how you do it because keeping up with Instagram and like content stuff is exhausting like it's so hard. I think it's super underestimated so Props to you, but I don't really have one anymore. I think there's one up but I don't really use it so you can message me on there, but I might not get back to you for like a couple months. There's like so many good people on Instagram though and Happy to send you a list of people that I like love on Instagram in terms of like healing and postpartum stuff so that you can get it out to whoever you feel like needs it but there's so much wonderful stuff out there. I do my friend that I talked about that is public or physical therapist. Her Instagram is the pelvis Pro and she has wonderful information out there about like posture and how to carry your baby and I will hold them. So I probably sent them like her way from now. Sorry Mercy, but you can message me at So that the clinic Facebook that's probably the easiest way to get to me for right now. Perfect. So I'll get all the links from you and then I'll throw them in the description below. So people can hunt you down because I'd love your perspective and your take on things. It's so refreshing to have someone to just genuinely cares so much about women's health and making sure all the appropriate information that's out there. So thank you solutely. Thank you so much for having me and for getting the word out because like I said, you can't advocate for it. If you don't know that it exists. So I hope that even if we just teach one person that like hey, maybe I should go. For this that's super important amazing. Thank you. Alright. Thank you.
Let’s chat about your PELVIC FLOOR! Yup, that’s right, something that’s oh so important, but doesn’t get the proper credit it deserves when you grow tiny human inside of you. So, this week, I chat with pelvic floor physiotherapist, Rachel Selman all about:   What exactly happens at pelvic floor physio? Should people feel uncomfortable or awkward? What do you think when she see somebody’s vagina? Should people go to a pelvic floor physio while pregnant? How soon should people go after delivering? Is there a difference between vaginal birth and caesarian? What are the most common issues she sees? If you’d like to reach out to Rachel, message her Facebook page: https://www.facebook.com/BMPTColumbusNorth As promised, here are a few of her Instagram pelvic floor physio inspirations: @the.vagina.whisperer @madison.cleckler @tobirthandbeyondpodcast @popuplift @thedowntheredoc @thepelvispro All about Rachel: Rachel graduated with honors from the Georgia Institute of Technology with her bachelors degree in chemistry. She then went on to Mercer University where she earned her doctorate in physical therapy. Since then, she has attended post-graduate training for certification in dry needling through the Spinal Manipulation Institute and achieved the title of certified strength and conditioning coach through the National Strength and Conditioning Association. She underwent additional training through the Herman and Wallace Pelvic Rehabilitation Institute to specialize in women’s health physical therapy. She is passionate about treating the source of pain rather than chasing the symptoms to ensure long-term results and encourage life-long activity. All about Mom Break: You can find me, Erica from Mom Break, on Instagram (www.instagram.com/mom.break) or at my website (www.mombreak.ca). 