387 | Pelvic Floor Therapy for Abdominal Surgery Patients with Dr. Joselyn Wallace

[00:00:05] Welcome to the Optimal Body Podcast. I'm Dr. Jen.

[00:00:08] And I'm Dr. Dom. And we are doctors of physical therapy, bringing you the body tips and physical therapy pearls of wisdom to help you begin to understand your body, relieve your pains and restrictions, and answer your questions.

[00:00:19] Along with expert guests, our goal of the Optimal Body Podcast is really to help you discover what optimal means within your own body. Let's dive in.

[00:00:28] I'm excited for you to listen to this next interview with Dr. Joselyn Wallace, a doctor of physical therapy dedicated to redefining the care people receive before and after pelvic surgeries.

[00:00:40] Having had four abdominal surgeries herself, totaling over 60 fibroids removed, she saw the lack of support firsthand and is on a mission to change it.

[00:00:49] She specializes in helping individuals with gynecological and pelvic floor disorders recover from surgeries like hysterectomies, endo excision, myomectomy, and other pelvic surgeries.

[00:01:01] And if any of this sounds like people, friends, or family members you know, please pass this episode along.

[00:01:07] Jocelyn, thank you so much for taking time and being here with us today.

[00:01:12] I am excited about this conversation because it's something we haven't had on the podcast yet, talking about abdominal surgeries, pelvic health, hysterectomies, endometriosis, just all the things of how this impacts so many women.

[00:01:27] And I think there's a lack of support like you've kind of pointed out.

[00:01:30] And so, you know, just getting a better idea of how we can support people and understanding your own journey through it too, I think is going to be huge.

[00:01:38] So thank you so much for being here.

[00:01:40] Yeah, absolutely.

[00:01:41] Thank you so much for having me and giving me the platform to spread this message.

[00:01:45] It's really the forgotten population.

[00:01:46] And I love to see how much pelvic health has grown just in my career span, but there's still so many women being missed.

[00:01:53] Yes.

[00:01:54] That's what I'm here to talk about.

[00:01:55] Absolutely.

[00:01:56] And like you said, I think it's being more and more talked about.

[00:01:59] And I love how many pelvic health and women's health therapists, physical therapists, especially we've had on this podcast.

[00:02:06] But I want to hear a little bit about your journey because, I mean, I know even right in your Instagram bio, it says that you had a significant amount of fibroids, 60 plus fibroids removed and have had four abdominal surgeries.

[00:02:20] And so I want to understand a little bit about that story.

[00:02:24] Like what were these surgeries for?

[00:02:26] Or did that have anything to do with your interest in being in pelvic health and educating in pelvic health?

[00:02:33] Yes, absolutely.

[00:02:34] So I've had horrible periods my whole life.

[00:02:36] And like so many women have heard or been taught it's normal, nothing we can do about it.

[00:02:42] And while I was in physical therapy school, I found out I had fibroids and I had my first surgery to remove fibroids while I was in physical therapy school.

[00:02:49] I had to miss a rotation and go through all of that over that experience.

[00:02:53] And I was in a conversation with the one professor I had that had any pelvic floor experience.

[00:02:59] And as I imagine you both experience as well, the amount of pelvic health education we get in school is very minimal.

[00:03:06] This was the only person I had to talk about this.

[00:03:09] And she didn't know what a myomectomy was, which was the open abdominal surgery that I had to remove a fibroid or to remove multiple fibroids.

[00:03:17] So that's where that's what lit the spark.

[00:03:20] It was that moment when I was like, OK, this is really underserved.

[00:03:24] And that's what had me starting to learn about pelvic health.

[00:03:27] So then when I got out of school, I started getting the necessary certifications, taking the necessary coursework.

[00:03:33] And along that time also started to have fibroids come back.

[00:03:37] So I ended up having a second surgery, another open myomectomy.

[00:03:41] So it's like a C-section incision, same idea.

[00:03:44] And in that surgery, they removed 47 fibroids.

[00:03:47] By that time, I was a practicing physical therapist.

[00:03:51] I was in pelvic health already.

[00:03:52] So I got to apply a lot of what I had learned to myself.

[00:03:56] And the recovery was worlds different, worlds different.

[00:04:00] I got back to exercise more seamlessly, not faster.

[00:04:03] I always say that speed is not the goal.

[00:04:06] It's not a race, but easier with less setbacks, with less discomfort, with a better journey to lifting.

[00:04:11] And then was able to conceive my daughter a few months after that surgery.

[00:04:17] So I had a C-section almost a year to the day from the day that I had the fibroids removed.

[00:04:22] And then I had a hysterectomy about 11 weeks ago, as of right now, because the fibroids came back in pregnancy.

[00:04:28] Oh, my goodness.

[00:04:28] What a journey that you've really been on.

[00:04:31] And can we talk about the difference of that first time you had the surgery to the second time when you had so much more knowledge?

[00:04:40] What was it that you applied that was different?

[00:04:43] I just want to take a quick pause from the episode.

[00:04:46] And truly, this is one of the most exciting and crazy times in life because our second baby boy just joined and became the fourth,

[00:04:56] I guess, fifth member of our family because I can't forget our dog.

[00:04:59] And that's incredible.

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[00:06:18] Yeah, great question.

[00:06:19] So I'm a lifter, especially my first surgery.

[00:06:22] I was really into powerlifting.

[00:06:24] I was doing powerlifting competitions.

[00:06:25] And a lot like postpartum,

[00:06:27] the only advice that they give you after these surgeries is rest six weeks

[00:06:30] and then ease back into it.

[00:06:32] It's always six weeks, no matter what the person,

[00:06:35] no matter what their job is, what their activity is,

[00:06:37] it's always six weeks.

[00:06:38] So I just tried to ease back into it.

[00:06:40] I just got back to the barbell and started progressively lifting

[00:06:44] with no attention to my core after having...

[00:06:47] That was the biggest incision I've had was for that first surgery.

[00:06:50] So with no attention given to my core strength and my pelvic floor,

[00:06:53] no understanding of my pelvic floor.

[00:06:55] So I dealt with a lot of symptoms of pelvic floor tension,

[00:06:58] urinary frequency, abdominal pain,

[00:07:01] all kinds of funny things happening in my squat,

[00:07:04] back pain after I would squat and deadlift

[00:07:06] because my core just wasn't ready for it.

[00:07:08] And I wasn't given any tools to measure that readiness.

[00:07:11] The second time around,

[00:07:12] I focused a lot on rehabilitating my abdominal wall,

[00:07:15] paying attention to the signals from my pelvic floor

[00:07:18] to know when it was ready to be loaded again.

[00:07:21] And it was a much easier, smoother transition into activity.

[00:07:26] Wow.

[00:07:27] I think that the thing that's the craziest to me,

[00:07:30] and we talk about this a lot with people we have on the podcast

[00:07:34] who are in their area of expertise,

[00:07:36] often because of something significant that happened in their own life.

[00:07:40] And it's because they found out like,

[00:07:42] you were a PT student.

[00:07:43] You were around professors who have been in the field for years, decades,

[00:07:48] and you still felt underserved in this situation.

[00:07:51] And it makes you think about the average person who has that surgery

[00:07:55] and the only advice they get is the wait six weeks

[00:07:58] and ease back into whatever.

[00:08:00] See ya, good luck.

[00:08:02] It just makes you have so much compassion for those types of people

[00:08:06] that get no advice and are three, four, five,

[00:08:10] 10 years out from the surgery or procedure they had

[00:08:14] and are still having issues.

[00:08:16] So, what can somebody be doing?

[00:08:19] It was a myomectomy you said you had, correct?

[00:08:22] Yes.

[00:08:22] So, say they have an open abdominal surgery like that.

[00:08:26] What can somebody be doing in those first six weeks?

[00:08:30] Because I know especially for somebody who's active,

[00:08:32] who is powerlifting like you or somebody who's-

[00:08:34] Or a mom.

[00:08:35] A mom, an avid runner.

[00:08:37] Yeah, a mom, an athlete of life.

[00:08:40] What can somebody be doing in those first six weeks

[00:08:42] rather than just sitting on their hands and not doing anything?

[00:08:46] Yeah.

[00:08:46] So, the common advice is to go for walks.

[00:08:48] And I always say if you can walk,

[00:08:49] you can start some form of rehab plan.

[00:08:52] So, things to start getting the abdominal mobility back.

[00:08:55] A lot of people after a big incision like that

[00:08:57] will feel like kind of hunched over,

[00:08:59] like the abdomen's really tight,

[00:09:00] they can't stand up straight.

[00:09:02] So, a lot of gentle movement to help restore their mobility,

[00:09:05] breath work, and exercises to help just feel the core contracting again.

[00:09:10] Not like hard core exercises,

[00:09:11] but breathing and things like that

[00:09:13] to help find and establish that connection.

[00:09:16] People often develop pelvic floor tension after surgeries like this.

[00:09:20] So, breath work and lengthening exercises.

[00:09:22] So, I love giving things like adductor rock backs

[00:09:25] or just rock backs on hands and knees

[00:09:28] in the quadruped position,

[00:09:29] things like that just to help restore length,

[00:09:31] restore mobility, get people moving.

[00:09:33] And then when they're ready,

[00:09:35] when their core is ready to tolerate the pressure,

[00:09:38] starting to do things like just simple glue bridges,

[00:09:41] simple glute exercises.

[00:09:42] I give a lot of single leg RDLs,

[00:09:45] stuff like that to start getting the stability

[00:09:47] in that mind-body connection back.

[00:09:49] So, then when you do start loading again,

[00:09:51] it feels much more seamless.

[00:09:54] It feels much more doable

[00:09:56] when you've been connected to your body in that way.

[00:09:58] So, one of the best ways to find resources on this

[00:10:01] if someone isn't able to, you know,

[00:10:03] access a practitioner to give them custom exercises,

[00:10:06] follow any postpartum program,

[00:10:08] any C-section program that's so similar.

[00:10:11] And there's not a lot of resources out

[00:10:13] specific to these other surgeries

[00:10:15] like myomectomies and other abdominal surgeries,

[00:10:17] but there's so many resources out there for C-sections now.

[00:10:20] And it's really quite similar

[00:10:22] as far as what the body needs to put back together after.

[00:10:26] I mean, what's crazy to me too is like,

[00:10:28] as far as we've gotten with pelvic health,

[00:10:31] you know, to know that we're still not

[00:10:35] prescribing physical therapy,

[00:10:37] pelvic floor rehab after,

[00:10:39] but you get a rotator cuff surgery,

[00:10:42] you get any knee surgery,

[00:10:43] you get any other kind of orthopedic surgery done

[00:10:46] and you're prescribed physical therapy.

[00:10:49] But with a major abdominal surgery

[00:10:51] that is going to affect our entire core,

[00:10:53] which means it's going to affect how we move

[00:10:55] and breathe and how we're doing our everyday life,

[00:10:58] we don't get recommended physical therapy.

[00:11:01] And I think that's just so sad.

[00:11:03] And I hope any OB listening right now

[00:11:06] or doctor listening can start to make that change

[00:11:10] within their own practice.

[00:11:11] When it comes to people who are experiencing fibroids,

[00:11:16] you know, maybe they haven't yet gone

[00:11:18] to get abdominal surgery

[00:11:21] or get them removed at this point,

[00:11:23] but are there things that they should be looking at

[00:11:26] just physically,

[00:11:27] whether it's pelvic related

[00:11:29] or core related, movement related

[00:11:31] that they could be doing to just in general

[00:11:34] start to support their body?

[00:11:35] Absolutely.

[00:11:36] So fibroids can cause a lot of

[00:11:38] what they call bulk symptoms.

[00:11:39] So a lot like being pregnant,

[00:11:41] a lot of urinary frequency,

[00:11:42] a lot of pelvic pressure.

[00:11:44] Sometimes people's abdomen

[00:11:45] will be really distended,

[00:11:47] really stretched out from the bulk of the fibroids.

[00:11:49] For example, my uterus was the size

[00:11:52] of a 20 week pregnancy for years,

[00:11:54] for almost my entire 20s,

[00:11:55] besides the small period I got in between surgeries.

[00:11:58] So that does a lot of the same things to the body.

[00:12:01] So core strengthening

[00:12:02] and just being in touch with the core

[00:12:04] and being able to recognize

[00:12:07] when something that someone is doing

[00:12:09] might be putting more strain than necessary

[00:12:11] and being able to adapt exercises

[00:12:13] to help make sure

[00:12:15] that you're still strengthening in a safe way.

[00:12:17] People develop a lot of bowel and bladder issues.

[00:12:20] So just the education to know that,

[00:12:22] no, you shouldn't push and strain really hard

[00:12:25] to go to the bathroom.

[00:12:26] You shouldn't have to push to empty your bladder.

[00:12:28] You shouldn't have to like

[00:12:29] and hold and push pressure down

[00:12:31] to do any of that sort of stuff.

[00:12:33] And that fibroids can cause prolapse

[00:12:36] even for someone that's never had a baby.

[00:12:38] So being able to recognize

[00:12:40] when you're feeling that vaginal bulging,

[00:12:42] vaginal pressure feeling

[00:12:43] that you can get help

[00:12:45] even without having surgery.

[00:12:46] There are things that you can do to improve that.

[00:12:51] You kind of mentioned earlier

[00:12:52] that with abdominal surgery

[00:12:54] or with some of these things going on

[00:12:57] like fibroids,

[00:12:58] people can tend to develop

[00:12:59] a chronically tight pelvic floor.

[00:13:02] And I want to touch on that a little bit

[00:13:04] because I don't think

[00:13:05] the average person out there is aware.

[00:13:08] You know, I think that's the problem in general.

[00:13:10] Like you just aren't aware

[00:13:11] that you have a chronically tight pelvic floor.

[00:13:13] You don't think that's the issue.

[00:13:15] There's still this kind of underlying paradigm

[00:13:18] that in order to treat the pelvic floor

[00:13:20] or do pelvic floor rehab,

[00:13:22] we need to be doing kegels

[00:13:24] or strengthening the pelvic floor.

[00:13:26] I even kind of in my journey,

[00:13:29] I was having inguinal hernias

[00:13:30] from the time I was about 16, 17 years old.

[00:13:34] And I had multiple surgeries,

[00:13:36] one to put mesh in

[00:13:37] and one that was exploratory

[00:13:38] because I was still having symptoms after the fact.

[00:13:41] And I think through that,

[00:13:43] I developed a chronically tight pelvic floor

[00:13:45] through my late teens, early 20s

[00:13:47] that I really didn't start to address

[00:13:49] until after I met Jen, really.

[00:13:52] And she made me more aware of like,

[00:13:54] I think you have some pelvic floor stuff going on

[00:13:56] that we need to address here.

[00:13:59] And it can be scary

[00:14:00] because you're having all these symptoms.

[00:14:01] I was dealing with pelvic and lower abdominal pain.

[00:14:04] I was dealing with urinary urge

[00:14:06] and frequency incontinence issues.

[00:14:09] I was dealing with all sorts of things

[00:14:11] that as someone in their early 20s,

[00:14:13] I'm like, what the heck is going on with me?

[00:14:15] And what is this going to be like when I'm 70?

[00:14:18] You know, so how can somebody start

[00:14:22] to develop an understanding of,

[00:14:24] is my pelvic floor tight?

[00:14:26] Do I need to start doing lengthening exercises?

[00:14:29] I mean, you just named a lot of the symptoms.

[00:14:31] So lower abdominal pain, tailbone pain,

[00:14:34] lower back pain.

[00:14:35] I call it a thong distribution for the lower back pain.

[00:14:38] So like where a thong would lie,

[00:14:40] it's usually across that area

[00:14:42] when it's pelvic floor related.

[00:14:44] Urinary frequency, trouble emptying the bladder,

[00:14:47] constipation, vaginal pressure.

[00:14:50] Those can all be symptoms of pelvic floor tightness,

[00:14:53] pelvic floor tension.

[00:14:54] The best way to help learn how to release that

[00:14:57] and relieve that is with a pelvic floor therapist,

[00:14:59] of course.

[00:15:01] But there are tons of YouTube videos,

[00:15:03] tons of resources out there

[00:15:05] that will talk you through lengthening the pelvic floor

[00:15:07] and being able to feel like,

[00:15:09] oh yeah, maybe I am clenching all the time.

[00:15:11] Maybe there is something to this.

[00:15:13] And once you feel it,

[00:15:14] that's the first step to being able to start

[00:15:16] to release it.

[00:15:17] Yeah.

[00:15:18] I mean, just that awareness factor

[00:15:20] is really everything.

[00:15:22] And it's the hardest thing

[00:15:24] because you don't know what to be aware of

[00:15:25] that you don't know.

[00:15:27] Yeah.

[00:15:27] And sometimes you've been in that state for so long,

[00:15:29] you've never felt anything else.

[00:15:31] So sometimes it really does take

[00:15:33] being with someone to help them walk you through it

[00:15:36] so you can feel what it means to relax

[00:15:39] and lengthen and elongate your pelvic floor again.

[00:15:41] Are there some exercises or tricks

[00:15:44] or things that you can talk through right now

[00:15:47] that you kind of recommend starting to pay attention to?

[00:15:50] Like, what does it mean to do lengthening

[00:15:53] of the pelvic floor?

[00:15:54] Can we do that on the call right now?

[00:15:57] Yeah.

[00:15:57] One of my favorite cues is to think about

[00:15:59] breathing in through your nose

[00:16:00] and trying to find the air going down

[00:16:02] towards your sit bones.

[00:16:04] In my experience,

[00:16:05] that's one of the first places

[00:16:06] that people are able to cue into

[00:16:07] is just feeling,

[00:16:08] can you get the air down there?

[00:16:09] Does it feel like it stops like in your ribs

[00:16:11] or in your belly?

[00:16:12] Or can you feel air going down there?

[00:16:15] And then can you feel it front to back?

[00:16:17] So can you feel the air going down

[00:16:18] towards the vagina?

[00:16:19] Can you feel it going down towards the anus?

[00:16:21] Can you feel it filling your pelvic bowl?

[00:16:23] And then if someone has a hard time,

[00:16:26] if they have a hard time feeling that,

[00:16:28] sometimes people do better

[00:16:29] with having something inside

[00:16:30] like a pelvic wand or dilator

[00:16:32] or something to give them that tactile feedback

[00:16:34] to feel it.

[00:16:36] Sometimes people do well

[00:16:37] trying in like a bathtub or hot tub.

[00:16:39] To kind of unweight the body

[00:16:41] and help them feel the motion better.

[00:16:43] I also really love hinging movements

[00:16:45] like single leg hinging,

[00:16:48] especially with like your butt facing a wall,

[00:16:50] trying to sit back and feel a stretch,

[00:16:52] feel length happening in that region.

[00:16:55] So those are some of the things I commonly use.

[00:16:58] Yeah.

[00:16:59] And you mentioned earlier the adductor rock back,

[00:17:01] which I think is another really cool one

[00:17:02] that can help kind of feel the opening

[00:17:04] in your lower pelvic region.

[00:17:07] And something that I found really helped me

[00:17:10] was having some external like biofeedback

[00:17:14] or some external feedback,

[00:17:15] whether that be a rolled up towel

[00:17:17] or a rolled up pillow that I would just sit on.

[00:17:19] And then I could almost feel when I breathe

[00:17:21] my pelvic floor press down into that pillow.

[00:17:24] I'm not sure if you ever recommend people

[00:17:26] try stuff like that.

[00:17:27] Yeah.

[00:17:27] And I've used foam rollers in that way as well.

[00:17:29] And there's a new product

[00:17:30] that I just found out about called a cooch ball.

[00:17:32] Oh, it's like it's just a soft ball

[00:17:35] that looks like a cool way to achieve a similar thing.

[00:17:38] Oh, amazing.

[00:17:39] That's so funny.

[00:17:40] I usually use the therapy ball from Tune Up Fitness

[00:17:43] just on one side and then the other side, you know.

[00:17:45] And I love the gorgeous ball.

[00:17:47] I recommend that all the time,

[00:17:48] especially because it's kind of dual purpose.

[00:17:50] You can use it for a lot of time.

[00:17:52] People need a lot of abdominal release as well.

[00:17:54] But then you can use it for so many different exercises

[00:17:56] as a Pilates ball.

[00:17:58] I mean, I and I love this conversation

[00:18:00] and ways that we're getting people

[00:18:01] to be aware of the pelvic floor.

[00:18:03] That's opposite of kegels

[00:18:04] because that's typically what is heard.

[00:18:08] And like I remember I was even watching,

[00:18:10] I think it was like the Sex and the City movie potentially.

[00:18:16] And she was like, oh yeah,

[00:18:18] because I do my 100 kegels a day.

[00:18:19] And that's why like you should be doing that.

[00:18:21] And it's like, why is this still a thing

[00:18:24] that's being talked about

[00:18:25] as if that's what the magic fix for everything?

[00:18:28] And it's just so sad.

[00:18:30] We all know Sex and the City is the best place to get.

[00:18:32] A lot of women are going to be watching it.

[00:18:34] Yeah.

[00:18:35] Don't get your pelvic health advice

[00:18:37] from Sex and the City if you're listening.

[00:18:39] Yeah, it's so wrapped up in like tighter being better

[00:18:42] and that your vagina is just all about sexual pleasure

[00:18:46] for the opposite sex.

[00:18:47] There's so much wrapped into the way

[00:18:49] that we're educated about our bodies

[00:18:51] and the way we think about our bodies

[00:18:53] that needs a whole lot of undoing.

[00:18:55] I know.

[00:18:56] When in reality,

[00:18:57] if you holistically take care of your core,

[00:19:01] abdomen, pelvic floor,

[00:19:02] it will improve sexual performance and experience

[00:19:06] for yourself and your partner,

[00:19:08] I would argue as well.

[00:19:10] Like, can you talk about

[00:19:11] like sexual performance considerations

[00:19:13] when people are having these major surgeries

[00:19:16] and rehabbing back?

[00:19:18] What are some things that people should be aware of?

[00:19:20] Like if they're having pain during sex

[00:19:22] or, you know, just finding apprehension

[00:19:24] when thinking about going back to being intimate?

[00:19:27] Yeah.

[00:19:27] So speaking to a too tight pelvic floor,

[00:19:30] a lot of the problems that people will encounter

[00:19:31] is pain with penetration,

[00:19:33] trouble having an orgasm.

[00:19:35] So they'll find that they have to tense their whole body

[00:19:37] to be able to have an orgasm

[00:19:39] or they just can't anymore.

[00:19:40] And that can often be a sign of the muscles being too tight

[00:19:43] because they need to be able to lengthen

[00:19:45] to then contract,

[00:19:46] to bring blood to the area,

[00:19:48] to create arousal,

[00:19:49] to experience orgasm.

[00:19:50] A lot of that comes from your pelvic floor.

[00:19:53] So that can be a big sign

[00:19:55] that tension has come on board.

[00:19:57] I also work with a lot of people

[00:19:59] who've had hysterectomies.

[00:20:00] So they're often in the age

[00:20:02] where they're also perimenopausal or menopausal

[00:20:04] and they're also dealing with the hormonal side

[00:20:07] of the sexual experience at the same time.

[00:20:09] So they might be experiencing dryness,

[00:20:12] sensation changes anywhere in the vulvar area.

[00:20:14] It could be vaginal,

[00:20:15] it could be clitoral,

[00:20:16] anywhere in that area.

[00:20:17] So they're often dealing with the hormonal side of that as well.

[00:20:22] Alongside the physical changes

[00:20:26] and the mental health struggles

[00:20:28] that can all come along with that.

[00:20:29] So it's not always just physical.

[00:20:32] Yeah.

[00:20:33] And so what should people be doing?

[00:20:35] And I mean,

[00:20:37] I guess we already talked about a lot of pelvic floor

[00:20:39] lengthening exercises and all that.

[00:20:42] Are there additional things that people can be

[00:20:44] talking to their partner about

[00:20:46] or easing into themselves?

[00:20:48] Yeah.

[00:20:48] I think especially on the mental side,

[00:20:50] like you brought up,

[00:20:51] when you're having intimacy issues,

[00:20:53] it's not just a physical problem.

[00:20:55] Yeah.

[00:20:56] Yeah.

[00:20:57] So as far as communicating with your partner,

[00:21:00] I think having a conversation

[00:21:01] about what the expectations

[00:21:03] are going to be going back to sex

[00:21:05] after these kinds of surgeries,

[00:21:08] talking about how it's probably

[00:21:09] not going to be as simple as just,

[00:21:11] okay, six weeks,

[00:21:12] go back to normal,

[00:21:13] communicating about

[00:21:15] what you need from your partner

[00:21:16] to feel safe again.

[00:21:18] So there's all kinds of,

[00:21:19] a lot of,

[00:21:19] something that a lot of people deal with

[00:21:21] is fear around having sex

[00:21:22] after these surgeries,

[00:21:23] especially after hysterectomies,

[00:21:25] because typically when someone

[00:21:27] has a hysterectomy now,

[00:21:28] they remove the cervix as well.

[00:21:29] So they close up the top of the vagina

[00:21:31] and that's called a vaginal cuff.

[00:21:33] So people are really fearful

[00:21:35] of something happening to that,

[00:21:36] especially with penetrative sex.

[00:21:38] So communicating with your partner

[00:21:40] about how are you going to communicate

[00:21:42] around how it feels?

[00:21:43] Are you going to limit

[00:21:44] the depth of penetration

[00:21:45] for a certain period of time?

[00:21:47] Are you going to have a safe word?

[00:21:49] Like how are you going to manage

[00:21:50] this activity,

[00:21:51] especially for someone

[00:21:52] that is feeling anxious

[00:21:54] about returning to it?

[00:21:56] So having upfront communication

[00:21:58] about that,

[00:21:59] I think can be really,

[00:22:00] really powerful.

[00:22:01] And then it's not all just about

[00:22:02] being able to lengthen

[00:22:04] the pelvic floor again,

[00:22:06] but being able to just feel safe

[00:22:07] in your body again,

[00:22:08] feeling safe to communicate

[00:22:10] sexual issues with your doctor.

[00:22:12] A lot of people just don't even

[00:22:14] bring this stuff up

[00:22:15] to their surgeons

[00:22:16] because they don't know

[00:22:17] that they can.

[00:22:18] They don't trust that their surgeon

[00:22:19] can help them.

[00:22:20] So having a plan before surgery

[00:22:22] of like, okay,

[00:22:23] who are you going to ask for help

[00:22:24] if you do encounter problems?

[00:22:25] Do you trust your surgeon?

[00:22:27] If not,

[00:22:27] do you need to find

[00:22:28] a menopause specialist

[00:22:29] or a urogynecologist

[00:22:31] or somebody that has

[00:22:32] more sexual medicine training

[00:22:34] so you have someone safe

[00:22:35] to communicate that with?

[00:22:36] Or do you need to work

[00:22:38] with a sex counselor

[00:22:39] or someone like that?

[00:22:40] So thinking through those things

[00:22:41] before even choosing

[00:22:42] to have one of these surgeries,

[00:22:44] I think can be really powerful.

[00:22:45] That's super helpful

[00:22:47] to bring up

[00:22:48] and just something

[00:22:49] to put into the awareness

[00:22:50] of people

[00:22:51] to get them thinking

[00:22:52] about options

[00:22:54] that they have as well

[00:22:55] and how they can get help.

[00:22:56] People don't even realize

[00:22:57] that they're sexual professionals

[00:22:59] that can help you with this,

[00:23:00] not just pelvic floor therapists.

[00:23:02] Right, exactly.

[00:23:03] And having a team

[00:23:04] to help support you better

[00:23:05] through this is everything.

[00:23:08] I want to shift

[00:23:09] into endometriosis as well

[00:23:11] because I know

[00:23:12] this is something

[00:23:12] that a lot of women deal with

[00:23:15] and it can cause pelvic pain.

[00:23:17] I'm sure similar to fibroids

[00:23:19] in terms of that pelvic pressure

[00:23:21] and stuff,

[00:23:22] but what are some recommendations

[00:23:23] that if someone does get diagnosed

[00:23:25] with endometriosis,

[00:23:27] what is some physical recommendations

[00:23:28] that you can recommend?

[00:23:29] I think having a pelvic floor therapist

[00:23:32] on your team

[00:23:33] after being diagnosed with endo

[00:23:35] is really, really important.

[00:23:36] It can manifest

[00:23:37] in so many different ways

[00:23:39] and sometimes

[00:23:40] a pelvic floor therapist

[00:23:41] is key

[00:23:41] for lessening people's suffering,

[00:23:43] especially when they have

[00:23:44] later stages

[00:23:45] of endometriosis

[00:23:46] that can start to affect

[00:23:47] the entire body,

[00:23:48] the abdominal wall,

[00:23:49] the diaphragm.

[00:23:50] It can just impact so much.

[00:23:53] But something that I think

[00:23:55] people like anybody

[00:23:56] could benefit from

[00:23:57] is looking at the way

[00:23:58] that you think about exercise

[00:24:00] and is all or nothing thinking

[00:24:02] trapping you into this idea

[00:24:05] that if you can't go do

[00:24:06] that high intensity HIIT class

[00:24:08] you wish you could do

[00:24:09] that you can't do anything.

[00:24:10] Because a lot of people

[00:24:12] with endos struggle with

[00:24:13] half of the month,

[00:24:15] they feel like they can't do anything

[00:24:16] because they can't measure up

[00:24:17] to what they can do on a good day.

[00:24:19] There's always an in-between

[00:24:21] and being able to find

[00:24:23] that in-between

[00:24:23] can be so life-giving

[00:24:25] to people in the short term

[00:24:27] just being able to manage

[00:24:28] mental and physical health

[00:24:29] with exercise

[00:24:30] but also in the long term

[00:24:32] because endos

[00:24:33] are forever disorder

[00:24:34] and living with it

[00:24:36] over a lifetime

[00:24:37] and having it cut

[00:24:38] your activity level

[00:24:39] in half or worse

[00:24:40] can have huge impacts

[00:24:42] on these women

[00:24:42] as they age.

[00:24:44] So being able to find

[00:24:45] what works for you

[00:24:46] on good days

[00:24:47] and bad days

[00:24:48] I think is one of the

[00:24:49] most important things

[00:24:50] women with endo can do.

[00:24:51] And I think that

[00:24:52] brings back up again

[00:24:54] like the emotional toll

[00:24:55] that these things take

[00:24:56] and I like that

[00:24:57] you know

[00:24:58] in the previous answer

[00:24:59] you had

[00:25:00] you brought up

[00:25:00] people who can help

[00:25:01] on the emotional side

[00:25:02] talking about intimacy

[00:25:04] but just

[00:25:04] in general

[00:25:05] for all of this

[00:25:07] similar to

[00:25:08] you brought up

[00:25:08] rotator cuff

[00:25:09] or something earlier

[00:25:10] like a rotator cuff injury

[00:25:11] for an athlete

[00:25:12] is devastating

[00:25:13] emotionally

[00:25:14] you know

[00:25:15] and we have sports psychologists

[00:25:17] for that

[00:25:17] the same way

[00:25:18] when somebody's having

[00:25:19] pelvic floor

[00:25:20] pelvic health issues

[00:25:21] that can be devastating

[00:25:23] to their life

[00:25:23] and their identity

[00:25:24] as an athlete

[00:25:25] a mover

[00:25:26] a mother

[00:25:26] a partner

[00:25:27] we have to have

[00:25:29] emotional help

[00:25:30] and support for that

[00:25:30] so I think

[00:25:32] again we can't

[00:25:32] emphasize those points

[00:25:34] enough.

[00:25:34] Another thing

[00:25:35] that we haven't

[00:25:35] touched on yet

[00:25:36] when it comes to

[00:25:37] abdominal surgeries

[00:25:38] is scar tissue

[00:25:40] that you know

[00:25:42] happens as a result

[00:25:43] of the incisions

[00:25:45] and the surgery

[00:25:46] what kind of

[00:25:47] recommendations

[00:25:48] do you have

[00:25:48] for people

[00:25:49] on dealing

[00:25:50] with and helping

[00:25:51] scar tissue

[00:25:52] heal in a way

[00:25:53] that can be

[00:25:54] the most beneficial

[00:25:54] for their

[00:25:55] long-term health?

[00:25:56] I believe

[00:25:57] that the best

[00:25:58] thing you can do

[00:25:59] for scar tissue

[00:26:00] is early movement

[00:26:01] so starting

[00:26:02] to ease

[00:26:03] into any

[00:26:04] positions

[00:26:04] that are restricted

[00:26:05] so I do

[00:26:06] a lot of

[00:26:06] gentle extensions

[00:26:07] a lot of

[00:26:08] like thoracic

[00:26:09] open books

[00:26:10] and rotational

[00:26:10] movements

[00:26:11] things to make

[00:26:12] sure that the

[00:26:13] skin is moving

[00:26:14] well from

[00:26:15] the very beginning

[00:26:16] without doing

[00:26:17] any kind of

[00:26:17] aggressive stretching

[00:26:18] of the incisions

[00:26:19] of course

[00:26:20] we don't have

[00:26:21] great research

[00:26:22] about how to

[00:26:23] avoid deeper

[00:26:24] internal adhesions

[00:26:26] around the organs

[00:26:27] but I think

[00:26:29] trying to keep

[00:26:29] whole body

[00:26:30] inflammation down

[00:26:31] is something that

[00:26:32] over time

[00:26:33] will be discovered

[00:26:34] to impact

[00:26:35] these things

[00:26:36] so a lot of

[00:26:36] these issues

[00:26:37] fibroids

[00:26:38] endometriosis

[00:26:39] they do create

[00:26:40] systemic inflammation

[00:26:41] which can't be

[00:26:42] good for scar tissue

[00:26:43] just logically

[00:26:44] so I think

[00:26:46] monitoring your

[00:26:47] inflammation

[00:26:48] is really

[00:26:48] important

[00:26:49] it's something

[00:26:49] that I do

[00:26:50] I have my

[00:26:51] high sensitivity

[00:26:51] C-reactive

[00:26:52] protein monitored

[00:26:53] every time I

[00:26:54] get blood work

[00:26:55] and it gets

[00:26:56] high when my

[00:26:56] fibroids are

[00:26:57] growing

[00:26:57] it gets

[00:26:57] better when

[00:26:58] my fibroids

[00:26:58] are gone

[00:26:59] so being able

[00:27:00] to pay attention

[00:27:01] to those things

[00:27:02] and learn what

[00:27:03] works for your

[00:27:03] body as far as

[00:27:04] decreasing

[00:27:05] whole body

[00:27:05] inflammation

[00:27:06] and then I

[00:27:07] love scar

[00:27:08] massage

[00:27:08] a caveat

[00:27:09] that I like

[00:27:10] to tell people

[00:27:11] with scar

[00:27:11] massage

[00:27:12] is that it

[00:27:12] needs to be

[00:27:13] done long

[00:27:13] term

[00:27:14] it's not

[00:27:14] something you

[00:27:14] do for the

[00:27:15] first 6 to

[00:27:16] 12 weeks

[00:27:17] it's something

[00:27:17] you do for

[00:27:18] 2 years

[00:27:18] bare minimum

[00:27:19] so it's not

[00:27:20] about being

[00:27:20] really intense

[00:27:21] with it

[00:27:22] or having

[00:27:22] some complex

[00:27:23] routine

[00:27:24] but just

[00:27:24] doing a

[00:27:25] little bit

[00:27:25] for a long

[00:27:26] time

[00:27:27] can be the

[00:27:28] most powerful

[00:27:28] for helping

[00:27:30] to address

[00:27:31] your scars

[00:27:32] and make sure

[00:27:32] that your scar

[00:27:33] mobility is good

[00:27:33] and it doesn't

[00:27:34] affect you

[00:27:35] long term

[00:27:35] and then just

[00:27:36] educating people

[00:27:37] that there are

[00:27:38] professionals

[00:27:38] that have

[00:27:39] training in this

[00:27:39] massage therapists

[00:27:41] there's lymphatic

[00:27:42] drainage specialists

[00:27:43] pelvic floor

[00:27:44] therapists

[00:27:44] there's a lot

[00:27:45] of people

[00:27:45] that have

[00:27:46] training in

[00:27:47] working on

[00:27:47] abdominal scars

[00:27:48] that can help

[00:27:49] you and it's

[00:27:50] never too late

[00:27:50] to be 20 years

[00:27:52] after your surgeries

[00:27:53] and they can

[00:27:54] still do something

[00:27:54] to help

[00:27:55] I think that

[00:27:55] last point

[00:27:56] especially is so

[00:27:57] important to

[00:27:58] remember to tell

[00:27:58] people because so

[00:27:59] often it's like

[00:28:00] I didn't have

[00:28:01] this information

[00:28:01] you know when I

[00:28:02] got my surgery

[00:28:04] or whatever it

[00:28:05] may be and so

[00:28:05] they feel

[00:28:06] helpless and so

[00:28:07] really reminding

[00:28:09] people it's

[00:28:09] never too late

[00:28:10] to I mean

[00:28:11] you could either

[00:28:12] not work on it

[00:28:13] or you can start

[00:28:13] working on it

[00:28:14] like what's

[00:28:14] going to be

[00:28:15] more beneficial

[00:28:16] you know

[00:28:16] probably doing a

[00:28:18] little bit to

[00:28:18] start to help

[00:28:19] and try

[00:28:20] something new

[00:28:22] how early

[00:28:23] do you recommend

[00:28:24] scar tissue

[00:28:26] massage

[00:28:27] is it directly

[00:28:28] on it

[00:28:28] is it around

[00:28:29] it like

[00:28:30] what should

[00:28:30] people be

[00:28:31] thinking in

[00:28:31] terms of

[00:28:32] protocol

[00:28:32] yeah I like

[00:28:33] to start with

[00:28:34] what they call

[00:28:34] indirect techniques

[00:28:35] usually around

[00:28:37] two to four

[00:28:37] weeks depending

[00:28:38] on healing

[00:28:39] and how someone's

[00:28:39] feeling

[00:28:40] so indirect

[00:28:41] techniques

[00:28:41] where you're

[00:28:42] working around

[00:28:42] the scar

[00:28:43] so they might

[00:28:44] be doing

[00:28:44] just some

[00:28:45] gentle circles

[00:28:46] to help reduce

[00:28:47] swelling and

[00:28:48] inflammation

[00:28:48] gentle touch

[00:28:49] if they're having

[00:28:50] any kind of

[00:28:51] sensation changes

[00:28:52] so I'll have

[00:28:53] people like

[00:28:54] take a washcloth

[00:28:54] or a clean

[00:28:55] toothbrush or

[00:28:56] something like

[00:28:56] that in the

[00:28:58] shower usually

[00:28:58] is how it works

[00:28:59] the best for

[00:28:59] people and just

[00:29:00] gently touch

[00:29:01] the skin

[00:29:01] around the

[00:29:02] incisions

[00:29:02] especially if

[00:29:03] they're numb

[00:29:04] or the sensation

[00:29:05] feels dull

[00:29:06] or they feel

[00:29:07] hypersensitive

[00:29:07] like they lean

[00:29:09] against the

[00:29:09] countertop

[00:29:09] and it like

[00:29:10] zaps and

[00:29:10] feels uncomfortable

[00:29:11] I'll usually

[00:29:12] do nerve work

[00:29:13] with those

[00:29:13] people

[00:29:14] and then as

[00:29:15] it gets a

[00:29:16] little bit

[00:29:16] more healed

[00:29:17] so usually

[00:29:18] around six

[00:29:19] to ten

[00:29:19] weeks depending

[00:29:20] we'll start

[00:29:21] working into

[00:29:22] more direct

[00:29:22] techniques

[00:29:23] so that's

[00:29:24] where you're

[00:29:24] actually touching

[00:29:25] the scar

[00:29:25] so I'll usually

[00:29:26] start with things

[00:29:27] that don't

[00:29:27] stretch the scar

[00:29:28] so like

[00:29:29] just massage

[00:29:30] over the scar

[00:29:30] sometimes people

[00:29:31] will say that

[00:29:32] they feel

[00:29:32] golf balls

[00:29:33] or tenderness

[00:29:34] or lumpiness

[00:29:35] underneath

[00:29:35] their incisions

[00:29:36] so working

[00:29:37] through on

[00:29:38] those areas

[00:29:38] and then as

[00:29:39] it's really

[00:29:40] healing and

[00:29:41] it's like

[00:29:41] really fully

[00:29:42] closed

[00:29:42] then starting

[00:29:44] techniques like

[00:29:45] myofascial release

[00:29:46] and things where

[00:29:46] you put a little

[00:29:47] stretch a little

[00:29:47] pull on that

[00:29:48] scar if

[00:29:49] mobility is

[00:29:50] restricted

[00:29:50] it isn't

[00:29:51] always especially

[00:29:52] when people

[00:29:53] start early

[00:29:53] sometimes they

[00:29:55] have no

[00:29:55] mobility

[00:29:56] restrictions

[00:29:56] and that's

[00:29:57] not something

[00:29:57] they need to

[00:29:58] get to

[00:29:58] and I think

[00:29:59] something you

[00:29:59] said earlier

[00:30:00] that you

[00:30:02] know is a

[00:30:03] huge point

[00:30:04] with the

[00:30:04] internal

[00:30:06] healing

[00:30:06] and the

[00:30:07] internal

[00:30:07] adhesions

[00:30:08] that might

[00:30:08] develop

[00:30:09] and how

[00:30:10] beneficial

[00:30:11] movement

[00:30:11] can be

[00:30:11] because like

[00:30:12] you said

[00:30:12] there's not

[00:30:13] many ways

[00:30:14] we can do

[00:30:14] direct

[00:30:16] incision

[00:30:16] massage

[00:30:17] or scar

[00:30:18] tissue

[00:30:18] massage

[00:30:19] on those

[00:30:19] there are

[00:30:20] some

[00:30:20] like we

[00:30:21] said

[00:30:21] with the

[00:30:21] cordial

[00:30:21] ball

[00:30:22] there are

[00:30:22] abdominal

[00:30:22] techniques

[00:30:23] that you

[00:30:23] can do

[00:30:23] to work

[00:30:25] on the

[00:30:25] fascia

[00:30:25] but movement

[00:30:27] we know

[00:30:28] that we

[00:30:29] move internally

[00:30:30] when we

[00:30:30] move our

[00:30:31] body

[00:30:31] and getting

[00:30:32] the ability

[00:30:34] to move

[00:30:34] normally

[00:30:34] and have

[00:30:35] all of our

[00:30:35] internal organs

[00:30:36] and internal

[00:30:37] fascial planes

[00:30:37] move normally

[00:30:38] I think

[00:30:39] movement is

[00:30:40] massive

[00:30:41] another thing

[00:30:42] that I feel

[00:30:43] like we

[00:30:43] will get

[00:30:44] people commenting

[00:30:45] on when Jen

[00:30:46] puts up

[00:30:46] you know

[00:30:46] posts about

[00:30:47] whether it's

[00:30:47] scar tissue

[00:30:49] or posts

[00:30:50] you know

[00:30:50] about when you

[00:30:51] had your c-section

[00:30:51] Jen

[00:30:52] is the sensation

[00:30:53] like you mentioned

[00:30:54] and how sensation

[00:30:55] can change

[00:30:56] dramatically

[00:30:56] depending on

[00:30:58] you know

[00:30:58] what type of

[00:30:59] incision they had

[00:31:00] and where that

[00:31:01] is

[00:31:01] how long

[00:31:02] can people

[00:31:02] feel sensory

[00:31:03] changes

[00:31:05] around that

[00:31:05] incision

[00:31:06] and I think

[00:31:07] this might

[00:31:08] play into

[00:31:08] why you say

[00:31:09] it's important

[00:31:09] to do it

[00:31:10] for a minimum

[00:31:11] of two years

[00:31:12] yeah

[00:31:12] it can last

[00:31:13] for years

[00:31:14] my abdomen

[00:31:15] was almost

[00:31:15] completely numb

[00:31:16] from the belly

[00:31:17] button down

[00:31:17] after my first

[00:31:18] myomectomy

[00:31:19] I didn't do

[00:31:20] the best

[00:31:20] choosing

[00:31:21] of a surgeon

[00:31:22] the first time

[00:31:23] so it was not

[00:31:24] the best experience

[00:31:24] I did better

[00:31:25] the second time

[00:31:26] around

[00:31:26] my abdomen

[00:31:27] was almost

[00:31:28] completely numb

[00:31:29] and my sensation

[00:31:29] just started

[00:31:30] to come back

[00:31:31] probably a year ago

[00:31:32] and it's almost

[00:31:33] completely normal now

[00:31:34] and that was

[00:31:35] that first surgery

[00:31:36] was in 2016

[00:31:37] so eight years ago

[00:31:39] wow

[00:31:39] it can take years

[00:31:41] I mean

[00:31:42] that's so huge

[00:31:43] to know

[00:31:43] and I think

[00:31:44] also I appreciate

[00:31:45] too

[00:31:46] it's not about

[00:31:46] how fast

[00:31:47] you get back

[00:31:48] into it

[00:31:48] it's not about

[00:31:49] how quickly

[00:31:49] because a lot

[00:31:50] of people are like

[00:31:51] well when can I

[00:31:52] start the scar massage

[00:31:53] and when can I do

[00:31:54] and it's like

[00:31:54] but it's more

[00:31:55] about the long-term

[00:31:56] game

[00:31:56] so like

[00:31:57] don't rush

[00:31:58] into it

[00:31:59] and that's how

[00:32:00] I felt

[00:32:00] that's how I felt

[00:32:01] after my c-section

[00:32:02] it was like

[00:32:03] oh people are

[00:32:04] recommending after two weeks

[00:32:05] like no

[00:32:05] I'm gonna wait

[00:32:06] a little longer

[00:32:07] I'm gonna do work

[00:32:07] way above my scar

[00:32:09] right now

[00:32:09] because I don't even

[00:32:10] feel comfortable

[00:32:11] getting close to it

[00:32:11] and so it took me

[00:32:13] you know

[00:32:13] between six and eight weeks

[00:32:15] to start to get closer

[00:32:16] and then 12 weeks

[00:32:17] until I was touching on it

[00:32:18] and I had no problem

[00:32:20] with that

[00:32:20] I don't have any

[00:32:21] mobility issues

[00:32:22] and I'm still working

[00:32:23] through it

[00:32:26] that it's the long-term game

[00:32:29] it's the gentle

[00:32:30] how am I moving

[00:32:31] into this long-term

[00:32:33] rather than looking

[00:32:34] for that quick fix

[00:32:35] looking for like

[00:32:36] what do I need to do

[00:32:37] immediately

[00:32:37] and I just

[00:32:38] love that reminder

[00:32:40] for people

[00:32:40] because it's not about

[00:32:42] you know

[00:32:42] how quickly

[00:32:43] it's about

[00:32:43] how well

[00:32:44] how much

[00:32:46] that you can feel

[00:32:47] long-term

[00:32:48] better

[00:32:49] within your body

[00:32:50] yeah

[00:32:50] absolutely

[00:32:51] and you can do it

[00:32:52] really fast

[00:32:52] and you know

[00:32:53] be hitting the gym

[00:32:54] and lifting 200 pounds

[00:32:55] at two months

[00:32:57] postpartum

[00:32:57] or two months

[00:32:58] post-surgery

[00:32:59] but what's that

[00:32:59] gonna matter

[00:33:00] if you start

[00:33:01] to develop back pain

[00:33:02] five years later

[00:33:03] and now

[00:33:03] a decade has passed

[00:33:05] and you can't stay active

[00:33:06] the way that you want to

[00:33:07] it's all about

[00:33:08] the long game

[00:33:09] always

[00:33:09] we're not in a race

[00:33:10] against each other

[00:33:11] and I think especially

[00:33:12] with social media

[00:33:13] and all of the attention

[00:33:15] that pelvic health

[00:33:15] is getting

[00:33:16] and all the attention

[00:33:17] some athletes

[00:33:17] have gotten

[00:33:18] with how fast

[00:33:19] they're getting back to it

[00:33:20] especially postpartum

[00:33:21] it's becoming a race

[00:33:22] amongst women

[00:33:23] and that's not

[00:33:24] that's not the point

[00:33:25] of any of this

[00:33:26] the point is

[00:33:27] so we can

[00:33:27] age well

[00:33:28] and move well

[00:33:29] for the rest of our lives

[00:33:30] not bounce back

[00:33:31] or get back to it

[00:33:32] as quickly as possible

[00:33:33] right

[00:33:34] totally agree

[00:33:35] so we've talked

[00:33:36] a ton about

[00:33:37] rehab

[00:33:38] and what to do

[00:33:39] post-surgery

[00:33:40] what can people

[00:33:41] be doing

[00:33:42] say they know

[00:33:43] they have

[00:33:43] an upcoming

[00:33:44] abdominal surgery

[00:33:45] whether

[00:33:45] c-section

[00:33:47] myomectomy

[00:33:47] hysterectomy

[00:33:48] what can they be doing

[00:33:50] prevent

[00:33:50] like preventatively

[00:33:51] or prehab

[00:33:53] essentially

[00:33:53] prepping their body

[00:33:55] strengthening

[00:33:56] their core

[00:33:56] especially

[00:33:57] if any of the

[00:33:58] incisions

[00:33:59] are going to be

[00:33:59] happening on the core

[00:34:00] and that includes

[00:34:01] laparoscopic surgeries

[00:34:03] so laparoscopic surgeries

[00:34:04] get the reputation

[00:34:05] as being minimally invasive

[00:34:07] I consider this

[00:34:08] you know

[00:34:08] really a marketing term

[00:34:10] yes it can be

[00:34:11] a little easier

[00:34:11] to have a smaller incision

[00:34:13] but you're still

[00:34:13] in a hysterectomy

[00:34:15] you're still getting

[00:34:15] your uterus removed

[00:34:16] and your vagina

[00:34:17] reconstructed

[00:34:18] I don't see anything

[00:34:19] minimally invasive

[00:34:20] about that

[00:34:21] whatsoever

[00:34:22] it's still a really

[00:34:23] major surgery

[00:34:24] so strengthening

[00:34:25] your core

[00:34:26] learning about

[00:34:27] pelvic floor function

[00:34:28] because a lot of

[00:34:29] people that are

[00:34:29] preparing for these

[00:34:30] kinds of surgeries

[00:34:31] are having

[00:34:32] bowel and bladder

[00:34:33] problems

[00:34:33] are having a lot

[00:34:34] of pain

[00:34:35] so what do they

[00:34:35] need to do

[00:34:36] to make sure

[00:34:36] they can protect

[00:34:37] themselves as much

[00:34:38] as possible

[00:34:38] so that goes back

[00:34:40] to like not pushing

[00:34:40] to go to the bathroom

[00:34:41] dealing with constipation

[00:34:43] so as women

[00:34:44] we often

[00:34:45] you know

[00:34:45] just push through

[00:34:46] things

[00:34:46] we could suffer

[00:34:47] through it

[00:34:47] so women will be

[00:34:48] constipated

[00:34:49] and just dealing

[00:34:49] with it

[00:34:50] when really

[00:34:50] it would be

[00:34:51] better for your pelvic floor

[00:34:52] to take the stool softeners

[00:34:53] or eat the prunes

[00:34:55] or do what you need to do

[00:34:56] to not be constipated

[00:34:57] like we know you're tough

[00:34:58] we know you can push through it

[00:35:00] that's not good for you

[00:35:01] long term

[00:35:01] it doesn't set you up

[00:35:02] well for your surgery

[00:35:03] so making sure

[00:35:04] that you're

[00:35:05] just getting educated

[00:35:06] about those kinds of things

[00:35:07] and then getting as active

[00:35:09] as you can be

[00:35:10] within the realm

[00:35:11] of what your symptoms

[00:35:12] you know

[00:35:13] realistically allow

[00:35:14] but activity

[00:35:15] and movement

[00:35:16] really

[00:35:21] after surgery

[00:35:22] and that could be

[00:35:23] as simple

[00:35:23] as a mobility routine

[00:35:25] a little bit of core strengthening

[00:35:26] even if it's stuff

[00:35:27] where you just have to be

[00:35:28] lying down

[00:35:29] and doing simple

[00:35:30] Pilates type of movements

[00:35:31] anything

[00:35:32] anything

[00:35:33] anything

[00:35:33] counts

[00:35:33] and really does

[00:35:34] make a difference

[00:35:35] yeah

[00:35:36] I love that

[00:35:37] and I will add one more thing

[00:35:38] a squatty putty

[00:35:40] like

[00:35:42] life changes

[00:35:43] after you've had a squatty putty

[00:35:44] now I like

[00:35:45] if I'm in a public restroom

[00:35:46] I'm like pulling around

[00:35:47] the trash can

[00:35:48] and putting my feet up

[00:35:49] it's just so much better

[00:35:51] to

[00:35:51] to go to the bathroom

[00:35:53] with your feet lifted

[00:35:55] knees up above your hips

[00:35:56] yeah

[00:35:57] absolutely

[00:35:57] that's a must

[00:35:58] just for every human being

[00:35:59] yeah

[00:35:59] and it also reminds me

[00:36:00] no hovering over the toilet

[00:36:02] to go to the bathroom

[00:36:03] even in public places

[00:36:05] a lot of people

[00:36:06] don't realize

[00:36:06] that that can

[00:36:08] worsen symptoms

[00:36:09] of fibrous

[00:36:10] like if someone is having

[00:36:11] those pressure symptoms

[00:36:12] that can trigger it

[00:36:13] and make it worse

[00:36:14] and sometimes people

[00:36:15] don't realize

[00:36:15] that that's not something

[00:36:16] you should be doing

[00:36:17] right after the surgery

[00:36:18] so they'll go out

[00:36:19] for their first lunch

[00:36:20] or whatever

[00:36:20] in a public place

[00:36:21] and do that

[00:36:22] and then have spasms

[00:36:23] and pain

[00:36:24] and it can be

[00:36:24] a pretty big step back

[00:36:25] so getting some

[00:36:26] if you're a germaphobe

[00:36:28] getting some

[00:36:28] disposable toilet covers

[00:36:29] they make them pre-packaged

[00:36:30] that you can stick

[00:36:31] in your purse

[00:36:32] and take those out with you

[00:36:33] especially right after surgery

[00:36:35] that is a great recommendation

[00:36:37] oh my goodness

[00:36:39] Jocelyn

[00:36:39] I feel like we've hit

[00:36:40] a lot of

[00:36:41] really important topics

[00:36:43] that people

[00:36:44] are

[00:36:45] having to deal with

[00:36:46] on a daily basis

[00:36:47] and not really getting

[00:36:48] the support they need

[00:36:49] so I really just appreciate

[00:36:50] your education

[00:36:52] in this space

[00:36:53] you're leading by example

[00:36:55] because that is

[00:36:56] exactly what you're doing

[00:36:57] you're

[00:36:57] you've had the hysterectomy

[00:36:59] you've had the previous

[00:37:00] abdominal surgeries

[00:37:00] and here you are

[00:37:01] showing that you can get

[00:37:02] back to lifting

[00:37:03] you can get back

[00:37:03] to activity

[00:37:04] and you can feel different

[00:37:06] and feel better

[00:37:06] within your body

[00:37:07] so you're really leading

[00:37:09] by example

[00:37:09] and I just appreciate it

[00:37:11] we'll have your Instagram

[00:37:12] linked up

[00:37:12] so people can follow

[00:37:13] your journey

[00:37:14] and continue to learn

[00:37:15] from you

[00:37:15] but I know that you also

[00:37:16] support people

[00:37:18] virtually

[00:37:19] so can you tell us

[00:37:20] a little bit about that

[00:37:22] yeah absolutely

[00:37:23] so I work with

[00:37:24] people that have had

[00:37:25] these surgeries

[00:37:26] typically I start

[00:37:27] working with people

[00:37:28] about a week

[00:37:29] after their surgeries

[00:37:30] and it's a virtual

[00:37:31] program

[00:37:32] so we meet

[00:37:33] via Zoom

[00:37:34] I work with people

[00:37:34] all over the world

[00:37:35] and then in between

[00:37:37] our Zoom meetings

[00:37:37] they get programming

[00:37:39] and they get

[00:37:39] their homework

[00:37:40] essentially of what

[00:37:41] they need to be doing

[00:37:41] to guide their recovery

[00:37:43] then above and beyond

[00:37:44] that they get the

[00:37:44] support that they need

[00:37:46] to seize the moment

[00:37:47] of getting better

[00:37:48] and having their

[00:37:49] symptoms relieved

[00:37:50] and take advantage

[00:37:51] of that

[00:37:52] to take back

[00:37:53] their life

[00:37:54] get their activity

[00:37:54] level back

[00:37:55] get back to the sports

[00:37:56] that they want to do

[00:37:57] so my big passion

[00:37:59] is guiding people

[00:38:00] through that process

[00:38:01] with the support

[00:38:01] that all of us

[00:38:02] really deserve

[00:38:03] amazing

[00:38:03] and I think

[00:38:04] the most important

[00:38:05] thing is just

[00:38:05] empowering those people

[00:38:06] like you said

[00:38:07] to take control

[00:38:08] back into their life

[00:38:09] is there a website

[00:38:10] or somewhere

[00:38:11] that people will go

[00:38:12] to be able to learn

[00:38:13] more about those services

[00:38:14] yes so I have a website

[00:38:16] and then you can schedule

[00:38:17] a free consultation

[00:38:18] a free call

[00:38:19] on my website

[00:38:20] there's buttons

[00:38:20] on every page

[00:38:22] fantastic

[00:38:23] so we'll have that

[00:38:24] we'll have all that

[00:38:25] linked in the show

[00:38:25] notes of this episode

[00:38:26] so Jocelyn

[00:38:27] thank you so much

[00:38:28] for coming on

[00:38:29] and giving us

[00:38:29] your time

[00:38:30] and your expertise

[00:38:31] yeah thank you

[00:38:32] so much for having me

[00:38:32] it's a huge honor

[00:38:35] thanks so much

[00:38:36] for joining us

[00:38:36] for another interview

[00:38:37] really touched

[00:38:38] on some major topics

[00:38:40] that a lot of people

[00:38:41] out there are dealing

[00:38:41] with but just don't

[00:38:42] have the proper

[00:38:43] resources or education

[00:38:45] to know what to do

[00:38:46] if you know

[00:38:47] anybody out there

[00:38:48] who's been dealing

[00:38:49] with fibroids

[00:38:49] or has had a major

[00:38:50] abdominal surgery

[00:38:51] please consider

[00:38:52] passing this episode

[00:38:53] along to them

[00:38:53] also consider leaving

[00:38:54] a rating and review

[00:38:55] on your favorite

[00:38:56] podcasting platform

[00:38:57] and remember

[00:38:57] if you're looking

[00:38:58] to get into

[00:38:59] a movement community

[00:39:00] or have movement

[00:39:01] plans to know

[00:39:02] what to do

[00:39:03] on a day-to-day basis

[00:39:04] we have the

[00:39:05] Gen Health platform

[00:39:05] there are 12 plans

[00:39:07] that you can choose

[00:39:07] from based on

[00:39:08] what you want

[00:39:09] to focus on

[00:39:09] in your body

[00:39:10] you get a free week

[00:39:11] by going to

[00:39:12] gen.health

[00:39:13] backslash free trial

[00:39:14] you can find that

[00:39:14] link down in the

[00:39:15] show notes as well

[00:39:16] and of course

[00:39:16] we will see you

[00:39:17] next time

[00:39:17] on the Optimal Body Podcast

[00:39:19] you