Life Boost with Amelia

Ep. 77 | From Sciatica to Gut Health: Is your pelvic floor holding the secret to better health? with Dr. Courtney of The Female Athlete Doc

• Amelia Knight Pinkston • Season 2 • Episode 77

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In this episode, we explore the often overlooked but crucial pelvic floor, revealing how its dysfunction can manifest in surprising symptoms from back pain to urinary and gut health issues and that stubborn lower belly “pooch”. Join Dr. Amelia and orthopedic and pelvic health physical therapy specialist, Dr. Courtney, as we connect the dots between your pelvic health and overall well-being, debunk common myths, and discuss practical, evidence-based techniques to strengthen and heal from the comfort of your home. Learn why addressing pelvic floor health is essential for preventing injuries, managing stress, and maintaining a balanced body. 

00:59 Understanding the Pelvic Floor

03:19 Signs and Symptoms of Pelvic Floor Dysfunction

10:10 The Importance of Breathing for Pelvic Floor Health

14:48 Core Exercises and Pelvic Floor Connection

24:44 Strength Training and Progressive Overload

28:04 The Power of Progressive Overload

29:28 Understanding Stress and Holistic Health

30:35 Pelvic Floor Health and Urinary Frequency

37:58 Bowel Movements and Pelvic Floor Dysfunction

42:57 Empowerment Through Knowledge and Healing

47:38 Final Thoughts and Resources

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Disclaimer: The information provided in this podcast is for educational and informational purposes only and is not intended as medical, mental health, or professional advice. I am a certified health and life coach, not a licensed medical or mental health professional. Please consult with a healthcare provider before making any changes to your physical or mental health routines. If you are experiencing a crisis, seek help from a qualified professional or contact emergency services.

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Welcome to the Life Boost with Amelia podcast where we're changing the narrative around what true health and success look like. They should give you energy, not drain it. I'm your host, Dr. Amelia multi-passionate integrative health and life coach, entrepreneur, and recovered burnout veterinarian. Together, we'll explore the science behind how your brain and body work, including the unconscious mind while also connecting with what your heart needs in order to stand up to the norm of feeling stuck on a hamster wheel-working hard yet feeling exhausted and not where you want to be- and instead live a life that makes you excited to get out of bed in the morning and in love with who you see when you look in the mirror. The reality is if you do what everyone else is doing, you're not going to feel good. Let's break the norm.

amelia:

Today we are talking about the pelvic floor and I have been wanting to have an episode on this topic for a while because the pelvic floor is a really great example of how everything in the body is connected. And yet, because of our siloed approach to healthcare, it's largely being missed and ignored, which is a problem. Because as you're about to learn today, if you have pelvic floor dysfunction, it could be contributing to weird signs you've been struggling with for a while because you haven't actually been addressing the root issue. I feel like the pelvic floor is a lot like what gut health used to be in that like we were ignoring it and if you were thinking about it, maybe you took a probiotic. I feel like that's what the pelvic floor is to like, Kegels. And so thankfully I have my guest Dr. Courtney with me today so that you can start connecting the dots and understanding why your pelvic floor deserves some love and attention. Dr. Courtney is based out of Phoenix, Arizona, and she's a passionate pelvic floor physical therapist with a deep commitment to women's health. Her mission is to empower women to heal their pelvic health and overall wellness through accessible evidence based techniques that can be done from the comfort of their home. She loves educating and spreading awareness about the importance of strength training and progressive overload for pelvic floor health in both preventative care and as a treatment method for pelvic floor dysfunction. Welcome, Courtney. Thank you for being here.

Courtney:

Thank you for having me. I'm so excited to be here to talk about all things pelvic health.

amelia:

Yes. So let's dive in. I honestly had no idea that pelvic floor therapy was even a thing until a few years ago when I was actually taking a gut health course and they were talking about root causes of constipation and they were talking about pelvic floor dysfunction and that you could have therapy for that. And so that was the first time it even was on my radar at all. And then a little while later, I was dealing with foot pain from running and hiking. And I was just trying to get to the root of what was causing it and went down a lot of rabbit holes. And that's when I really started realizing how important the pelvic floor is for just having an overall balanced body and preventing injuries. And it's so much more than something to just be thinking about with childbirth. And so before we even dive into what the pelvic floor is, can you go over what are some signs of pelvic floor dysfunction, especially those that might be surprising to some people?

Courtney:

Oh, absolutely. There are a laundry list of signs of pelvic floor dysfunction. You can go anywhere from urinary issues to bowel issues to reproductive issues. And in terms of outside of the pelvic floor, you can have symptoms that Show up in like low back, right? Low back pain, hip pain, tailbone pain, piriformis syndrome, sciatica, there's glute dysfunction, right? There's a lot of outside of the pelvis issues that, can start in the pelvic floor and a lot of that deals back with like pelvic floor tension, right? So sometimes with symptoms of like urinary issues, like leakage urinary urgency, urinary frequency, like frequently going to the bathroom once an hour, once every 30 minutes urgency. So the urgency to get to the restroom, like not able to make it on time, have to rush to get there, not able to control that. You can have leakage with coughing, laughing, sneezing, running, jumping, lifting and then bowel issues. So like constipation, anywhere from like diarrhea. So we'll see people with IBS, IBD, Crohn's, different types of digestive conditions that result in pelvic floor issues because of the bowels. Yeah, issues like hemorrhoids and anal fissures, and then you have prolapse, right? So pelvic organ prolapse, where you can have the bowels or the bladder or the uterus collapse into the pelvic cavity. So there's a lot of different symptoms that I could go on and on about all of them. But that's just a gist of what we're talking about in terms of what is pelvic floor dysfunction? Anything down there that is not normal is pelvic floor dysfunction.

amelia:

Yeah, thank you for going over that because I think that really just goes to show how broad those signs can be and I think for someone dealing with like glute issues or sciatica or back pain, they may not be thinking about the pelvic floor at all. So that's great just to plant that seed. And so can you go over what is the pelvic floor?

Courtney:

Yeah. So the pelvic floor is a group of muscles that sit like a hammock or a sling at the bottom of the pelvis. So when you look at the pelvis, there's a big inlet and a big outlet, right? So the inlet is the top half of the. of the pelvis when you're looking down into, if you were to look down into your body, like the pelvis, that big inlet at the very bottom of that is where you're going to find the pelvic floor muscles. And so they have five major important functions a sump pump, they have sexual function, they have stability of the pelvic bones provide support to the pelvic organs, and then sphincteric function. So it helps Maintain continence, right? So those functions alone they're major functions that people dismiss or don't look about, and they're like, they're not thinking that there's a group of muscles down there that keep you dry. They don't think about, okay, underneath the organs, what's holding those organs up, right? Or the sump pump function, which is helping with like inflammation and swelling. So if we were talking about female menstrual cycles, right? There's a lot of veins and nerves and arteries down there that supply the pelvic floor, give it good blood flow, take away blood flow. And if we have muscles that are not functioning correctly, you can see things like swelling, or what we call like swelly belly, inflammation, right? You might get pain, poor range of motion to those muscles, and then when you're not having good function of those muscles, that's when symptoms start to arise. And oftentimes it can either start with the organs or can start with the pelvic floor muscles or can start outside of the pelvis and make its way into the pelvis, into the pelvic floor's response. So they're just a group of muscles, just like any other muscle in the body, but they sit underneath our very vulnerable organs of our body. And that's why they're not really talked about because they're inside of the body. You have pelvic floor muscles on the outside too, but. The inside of the pelvic floor muscles are not seen so people don't really think about them. They don't talk about them and Quite frankly, that's why pelvic floor dysfunction is rising in our Population of women and no one's talking about it

amelia:

Yeah, it really does seem like it's a catch 22 because not only can you not see those muscles and you're not talking about it, but then so many of the signs of dysfunction I feel like also are topics that a lot of people are uncomfortable talking about too.

Courtney:

taboo. So taboo

amelia:

yeah, that's wild,

Courtney:

It's like talking about not talking about your cycle growing up. It's nobody talks about your female cycle, like, when you get it. Oh my gosh, I remember being so embarrassed. I stayed over with a girlfriend a bunch of girlfriends 5th grade, whatever, 6th grade. And I woke up with it. And some of the girls that were there were, like, the older sisters of my friend group. And they already had their cycles. But I was I remember waking up so embarrassed wiping and having that first sign of blood and you're like, oh my gosh I gotta go home. I can't talk about this. Meanwhile, you're with a bunch of girls and it's nobody talks about it. And then you grow up and now like everyone talks about their cycle, right? Especially now in today's age, like we talk about the luteal phase and the flicular phase and when you're in the luteal phase, it's like the worst time of your life. And then now it's like pelvic floor dysfunction. Obviously, everyone's starting to talk about it now with the rise of social media, but it's such a taboo topic that it's still embarrassing, but it doesn't have to be. It doesn't have to be. And when we do talk about it, it's still that like taboo thing of hee, yeah, you had a baby. Like it's normal to pee after you have a baby because doctors give you that glorification of yeah, it's just a side effect of being a mom. And it's like, who's saying this? And then that's where people are still like making jokes about it, maybe with their girlfriends. Yeah, I pee too when I jump. And it's no, we have to stop that. It's not normal. It's common, but it's not normal.

amelia:

yes, oh my gosh, I so agree with that normalizing things that should not be normal and are not okay, and I really like looking at things from a nervous system perspective because I think that really is at the root of everything, and I think a big root issue in our culture and world is that we're just normalizing living in survival mode. And I see that related to pelvic floor health too. in that so many of us are just living in this chronic state of stress and in survival mode. And that is impacting the way that we're breathing. We're just having these shallow like chest breathing. When in reality that could be contributing to pelvic floor dysfunction. So can you talk a little bit about how is the pelvic floor related to how we're breathing and how is that contributing to issues?

Courtney:

Oh yeah, absolutely. So when you want to think about the pelvic floor, it's a group of muscles that are connected to your core, your bigger core and the core itself. And when you normally talk about core, people are like, Oh, six pack abs, right? No, not at all. Literally not at all. Your real core is the base of the core. If you want to think about your core like a can, like a soda can, soda pop, whatever. The bottom of the can is your pelvic floor. The top of the can is your diaphragm. The front of the can is your abdominal deep layer, your transverse abdominus. And then the back of the can is your multifidi. The multifidi in the back of the can are like your spinal stabilizer muscles that connect from segment to segment of your spine. So that alone, those four muscle groups make up your core. So the diaphragm is your breathing muscle, the one at the top, right? So if your diaphragm is the breathing muscle and it's connected to your core. with the pelvic floor, they're all intertwined. So when you're breathing, it's like just breathing itself, you get passive range of motion to the abdominal wall and the pelvic floor muscles, and probably to some extent your back muscles, but I would say a lot of it is mirrored. All of the movement from your diaphragm is mirrored with the pelvic floor. If you're inhaling, your pelvic floor is also, as you inhale, it's like a deep diaphragmatic breath not a shallow breath, a diaphragmatic breath, through the bottom of the abdomen, through the ribcage, right? You inhale, the diaphragm drops, the pelvic floor drops. And when the pelvic floor drops, that's when you have relaxation or lengthening of that muscle. That's range of motion, right? When you contract a muscle and you relax a muscle, it shortens and it lengthens. And just like breathing, you get lengthening of the pelvic floor when you inhale. And then as you exhale, your pelvic floor recoils back up into its resting position passively. It's not like an active contraction. All of this is passive. You get that recoil back up and that's where it goes back into more of that supportive, relaxed, or not relaxed, supportive, like semi contracted state that it's providing support. So just by breathing, you're getting amazing passive range of motion to the pelvic floor. But the problem is most people don't know how to breathe correctly. So they're not getting range of motion to the pelvic floor and that can lead to a cycle of chronic overactivity or like what we call like an overactive pelvic floor or a tense pelvic floor or a tight pelvic floor And so just by breathing like that's like the number one thing I give my patients when I'm working with them The first thing that I go over like during an assessment I'm like, let's go through breathing and they never like literally one out of ten that I work with are like Oh I breathe like this oh, I can feel it move. Most people don't. They don't, they can't feel their pelvic floor and it feels very unnatural to breathe through their diaphragm to get that range of motion to the pelvic floor.

amelia:

Yeah, that was really eye opening to me when I started paying attention to how I was breathing and I was like, oh, I am not doing it right. I'm not breathing like 360 degrees at all. And it's so interesting that something that's supposed to be so natural. It's just not right at all and is causing issues.

Courtney:

I think a lot of it relates back to the nervous system, like you mentioned, like anxiousness or stressed, and we go to more of that shallow chest breathing and we stick there, and unfortunately that's not the normal way to do it. That's normal, for exercise. Like when you're actually exercising, you're going to need to recruit those accessory muscles. But when you're actually at rest and functioning day to day diaphragmatic breathing is how you breathe. And as a culture of women For so long, we were taught to suck in our stomachs and, think skinny and wear tight compressive clothing. And that alone is contributing to our inability to take deeper breaths because you can't if you're, like, sucking in your stomach or wearing compressive leggings because it doesn't feel good to take a deep breath because then you're pushing out against something that's really tight. So there's Indirect ways that we're not breathing correctly that have nothing really to do with the fact that we don't know how to breathe correctly.

amelia:

Yeah, so. I would love to dive into that topic a little bit of the, like the insecurities and women sucking in, because that was really eyeopening to me realizing that for women who are struggling with that lower belly pooch, that can actually be Not needing to lose a couple extra pounds, that could be related because of that unconscious sucking in, and maybe their pelvic floor not working, and crunches may be the opposite of what they need, right?

Courtney:

Exactly. Exactly. Women tend to stay on the train of ab exercises and Russian twists and crunches and sit ups and I don't know, decline sit ups and leg raises and stuff. And sometimes they overdo those exercises and they're not even using their deep core muscles. They're using their rectus abdominis or their obliques, which then, or their upper abs, which then become overactive and can contribute to that illusion of having a mommy pooch. That's what they call it, or a lower belly pooch or whatever you want to say. And that gripping of the abdominal wall is contributing to the illusion, but also contributing to a lot of pelvic floor issues down below because it's pressure mismanagement and then you get over activity in those muscles So those are the only muscles that become active and then your deeper cord Layer never really becomes active never gets stronger and then your pelvic floor never gets stronger and it becomes a cycle that most people don't really realize is like Yes, like that's contributing to all the issues and a lot of older women population have pelvic floor issues because of the way they exercised when they were younger, the way they were told certain things, and even our generation as millennials I never grew up with somebody telling me Don't suck it in use your deeper core, right? I wasn't a dancer or a gymnast or anything, but those specific populations, that sport in general, a lot of pelvic floor dysfunction. A lot of clients that I work with now are, like, past gymnasts, past ballet dancers and they have the worst of the pelvic floor issues, I would say. And then you get the postpartum women as well, but,

amelia:

right. Yeah, one visual that helps me is thinking about if you were to squeeze a balloon in the middle. If you're just trying to do crunches or sucking it in, and then it's the, kind of causing pressure for underneath.

Courtney:

Oh, above and below. Yeah.

amelia:

Yeah with working out, both of the things we just spoke about, like with breathing and the core, there are things that people should be thinking about that maybe they're not, right? When you're working out, say you're doing strength training, the way that you're breathing is important, right? Making sure you're not holding your breath. Can you talk a little bit about that?

Courtney:

Oh, yeah. So when we specifically like breath holding patterns it becomes like a very subconscious thing, like we don't realize that we're doing it. And when it comes to specifically lifting heavy, we really don't realize we're doing it because holding your breath provides some level of stability to the spine and to the core and people tend to hold their breath thinking that it's giving them spinal stability and that core contraction that they need to lift heavy. So if you're working out with a weight lifting belt for example, or like lifting heavier weights, like That's when you're going to employ that more like Holding and like bearing down breath holding pattern. But really what you want to focus on especially as a female like a lot of weight lifting techniques and lifting techniques are employed by men and women are not small men. So we can't apply the same techniques to women, especially child bearing women who are either pregnant or have had babies. And that breathing technique is so important as we realize how connected the pelvic floor is with our breath. And so if we want to approach fitness with a cautious mindset of like I want to be preventative for pelvic floor dysfunction like just by thinking about what I said earlier about the biomechanics of how to breathe and how to get that pelvic floor to move like Why would you hold your breath? Like you're literally going against the natural ability of the body biomechanics standpoint of getting that pelvic floor to support you. So I don't think it's ignorance. It's more so like just not knowing like what you don't know, you don't know kind of thing. And when you learn better, you do better. And that's really all pelvic floor preventative medicine is. It's like, when you know better, you have to do better. Because we're only getting older and as women who approach perimenopause, menopause, and we lose our good hormones that like support our estrogen function and keep our pelvic floor really healthy, we're going to lose that. And so if we can really be preventative in our twenties and our thirties and forties and be mindful of how the pelvic floor moves, specifically with our breath, specifically with exercise. That's when we can really mitigate the risk of developing pelvic floor issues. So back to your original question, when we do exercise, you really need to focus on exhaling and not holding your breath because just by biomechanics, your pelvic floor becomes more supportive when you exhale. If you bear down and hold your breath, you're putting your pelvic floor at a vulnerable lengthened state with the ability to over time... the body adapts to stress imposed upon it, right? That's like Wolff's Law. And if we just continue to do what we do over time, again and again, That's what's inevitably going to happen, right? Like we're going to strain those muscles, we're going to make them weaker, and symptoms will present itself. If not now, when you're 25, maybe not when you're 30, maybe not when you're 40, but maybe when you're postpartum and baby 2, 3, 4, whatever, and maybe when you're 50. That's when those issues start to come. So a lot of women need to understand this now from a preventative standpoint, but also as a treatment method. If you do have pelvic floor dysfunction, you can still utilize these techniques to help you Get rid of your symptoms.

amelia:

yeah. Yeah, thank you for going over that. So really it's like on the effort, people want to be exhaling. Yeah, okay. And if they are wanting to be strengthening their core and maybe they have been doing just like a lot of crunches or that kind of thing what are a couple exercises that you think are actually helpful if they're wanting to either be proactive and preventing pelvic floor issues and just having a nice strong pelvic floor, or if they're already starting to deal with, Some signs of dysfunction

Courtney:

Yeah, there's a lot of great exercises out there, and I tell all of my clients, I'm like, every exercise is a core exercise, as long as you learn to engage the core muscles. They're muscles just like every other muscle in your body there's a specific technique on how to engage the muscles, right? It's just learning the mind and muscle connection. And so if you want to do squats, if you want to do deadlifts, if you want to do an overhead press, like you want to run, you just need to learn to engage your core. And a lot of people don't really know what that means. And so I can say, okay, yes, there are specific exercises that target isolate those muscles. That's a good starting point. So things like maybe a payloff press, a dead bug or a bird dog, right? Like those are the most basic exercises, like maybe like a bear crawl hold. Basic. But those exercises can be full body exercises if you don't even engage your deep core. So it's really not a specific exercise, maybe it's just easier to engage the deep core in those exercises, but every exercise is a core exercise. You shouldn't be just going through your training and not engaging your muscles. That's not training. That's exercising. And even then, that's still debatable. You're just moving your body at that point. You're flailing your limbs around. We need to have that mind to muscle connection with basically all muscles in our body, right? Like, there's a point between training and physically moving your body. And physically moving your body has good benefits if that's your goal, right? But if my goal is I want to get stronger, I want to target certain muscle groups when I work out, then you need to train those muscles and learn to engage them properly. So again, back to your question, there's not really a lot of exercises that target those areas the most. Maybe easier than others, but there are all exercises that can be targeting your deep core, if that makes sense.

amelia:

Totally. I love that you're saying that because that just is a great example again of how everything is connected and it's if you're just focusing on one thing then you're really not able to address that like big full picture and complexity

Courtney:

totally. But you don't want to end there. Like starting there is great just to get that isolation, but you have to be able to take that isolated contraction and move your limbs, move your legs, move your arms, move over a greater range of motion, or you're not going to actually create change, right? Nobody can really move their arms and move their legs unless they get the isolated contraction first. That makes sense, right? That's the progression. But you really can't stay there long term. You gotta progress to bigger compound movements.

amelia:

yes. And I know you are into progressive overload and strength training. And I think that is so important. And I also just want to add that you have this amazing free resource and community. This skool and I know you have a great, like two week... it's included in that free group that goes over some really great exercises if someone's just wanting to start with some pelvic floor health. And since we're on the topic, and I chat with so many women who are either like cardio junkies or are into that just like high, high volume, but maybe lower weights, can we dive into the strength training and progressive overload a little bit and just like how powerful that is when you're increasing your weights, every week and thoughtful programming versus, high volume, just like no pain, no gain mindset.

Courtney:

Oh, absolutely. In terms of back on the topic of training versus exercising It depends on your goal and it's not my place to sit here and tell you what your goal should be, right? If you want to go burn calories, go exercise and burn calories. You can do both. You can burn calories and train but if your goal is just to go do a high intensity interval training to get a good sweat Then go do that but you can still do that and train certain muscle groups really well if you have a great mind and muscle connection. And so when your goal is to train and maybe your goal is to put on some muscle, get that toned look or get out of pain or, get rid of symptoms, then the goal needs to be training and to get stronger, your muscles need progressive overload. They can't just get by with doing five pound dumbbells and ten pound dumbbells the rest of your life. And when you feel the burn of doing five or ten pound dumbbells, that's not necessarily meaning that you're strengthening your muscles and you're getting stronger. That's literally just lactic acid buildup in your muscles and that's why you feel the burn. There's no long term carryover from that. You might get sore from it because you have a lot of lactic acid in your muscles that now have built up and that's what soreness is, it's just lactic acid in the muscles. But in order to actually see progressive change physically in your body, more of that aesthetic change. Maybe you want to burn fat, you want to build muscle, whatever your goal is, each week you have to challenge yourself in the gym. So if you're doing squats, for example and you have a 45 pound barbell on your back, like you can't do four weeks of just 45 pound dumbbell, three sets of 10, like your body needs change to adapt. If you do 45 pounds, three sets of 10 week one, Maybe the next week you do 55 pounds, 3 sets of 10. And you're really surprised on how much you can actually do more than you can. What is it, the mind will quit before the body will quit, right?

amelia:

Yeah. true.

Courtney:

A lot of Women, for example are afraid to progressively overload because they're afraid to get big, they're afraid to get bulky, they're afraid to whatever, look a certain way that they don't want to look. And that is literally the furthest from what can actually happen because you physically cannot put on the muscle mass Men can do, right? We don't have the same body compositions to be able to do that and the same hormones and I think that a lot of people have a misconstrued conception of what lifting weights can do for your body. But that really is the key to long term success in achieving maybe your desired look, but also your desired feel. How do you want to feel? Do you want to feel stronger? You're not going to feel stronger by lifting five pound dumbbells. You won't. You might look like it, but that's not going to carry over into you being able to carry 45 pound kids on your hips, you're going to feel a lot weaker doing that. So whatever your goal is, if it's not even an aesthetic look, maybe it's how you feel, right? You want to feel strong holding your kids, playing with your kids and feel strong doing that all throughout your life. Progressive overload is the answer to get there long term.

amelia:

Yeah, I love so much of what you just said, and that's such a huge part of my message is really thinking, like, when you have health and success goals, what's the why, like, how is that making you feel, because that feeling is that desire you're really after. And I think the really empowering thing with something like progressive overload is that even if you're not yet seeing the physical results. Every week, that's just such a great feeling of being like, I just lifted more weights than I did last week. It's such a great way of seeing the progress in that really empowering way.

Courtney:

Yeah, it's awesome. And the ability to feel strong and the physical aesthetics are the benefit. That's just the side effect, right? You're like, that's cool. I look better because I'm getting stronger. But more, more so it comes from the internal feelings that you get, euphoria that you get from working out, feeling strong, building competence, feeling empowered. That's really what most people are after when they're working out. And then the aesthetics are just the byproduct, right?

amelia:

Yeah. Totally agree.

I'm popping in for a moment because you may be realizing,"wow, Stress is impacting my body in ways I didn't even realize", or maybe the way that you've been working out is actually preventing you from achieving your goals. And if that's the case, you're not alone. So many of the typical messages and roles that were taught lead to health and success don't they may lead to temporary moments that feel good, but they're not sustainable. And in the long run, they can actually be detrimental. I learned that the hard way. After decades of working so hard to be good and to follow all the rules, I thought would lead to health and success, instead of feeling happy and healthy, I found myself burned out and exhausted. And that's why my coaching programs help you to start looking at things from a new holistic perspective so that you can connect the dots, seeing how your brain, body, and stress are all linked. And so you can actually start unlearning the messages and rules that have been keeping you stuck. My holistic Life Boost Changing approach helps you to uncover the root causes of what's holding you back so that you can move forward in a way that feels energizing and sustainable. Check out the details in the show notes to learn more and to chat about which program is right for you.

amelia:

So I want to shift topics a little bit because I talk to so many other women who pee a lot, it's that urgency and that was one of the things that originally brought me to see a pelvic floor therapist because I drink a lot of water and just felt like that was normal. But then the more I started to learn about pelvic floor health, and I was like, am I? Am I peeing a lot or like having urgency because I'm drinking water or is this actually related to pelvic floor health? So how do you know if you're urinating often because you're well hydrated or Because it's a pelvic floor Dysfunction issue or a mixture. Can you speak to that a little bit?

Courtney:

Totally. So urinary frequency, like the true definition of urinary frequency and having a frequent times of going to the, bathroom is normal is, three to six hours. That's probably like textbook definition. Three to five. Every book is going to be different. Maybe two to four, three to five. I say three to six. And that's normal. So if you're peeing more frequently than that being every 30 minutes, every hour, it really, shouldn't be from the water that you drink. There's two parts to having urinary frequency. One is a bad habit. You've created a habit of going. So every time you get the urge to go, you immediately give into the urge thinking that it's a true urge and that your body just needs to rid. That is the situation where that can create an urgency and a frequency problem. Because every time you get the urge, you just go, you don't even give your body a chance to make a decision of Nope, don't need to go. You just give in every time. And this is where we actually saw a rise in urinary frequency and urgency issues when COVID happened. Because everybody was at home every time they had a glass of water or they heard running water or they had to go pee because they had the urge to go, they just went because the bathroom was right there. So many problems started from COVID at home, right? And so now, anytime you have an urge so people that started that issue maybe in 2020 or whatever now have an urgency problem four years later because they're still giving into that urge just like they would, maybe they're still working from home, working from work, whatever. And so in the absence of water intake and you're still having that urge to pee frequently, that's more of a nervous system dysregulation. Like you've trained your nervous system to, Tell you to go when you need to go the bladder sense of stretch the receptors in your bladder Communicate to your brain. Hey stretched out gotta go. Your brain now just makes a decision for you Oh, all right time to go Courtney and you just go so that becomes a nervous system dysregulation Even if you barely even have a trigger or a stretch to the bladder, right? So now that's an issue. That's not even an issue in the absence of water intake. Maybe you drank a sip of water and now you have to go. But again, that can just be a trigger because you drank water and water is the trigger to cause you to set the nervous system off, right? There's so many moving parts to this and you really have to break down some of these patterns, do a bladder diary, do a bladder log to find the patterns of what's actually causing them to actually have to go. Is it a true urge or did they just drink 40 ounces of water and that's why they gotta go. So typically we say drink half of your body weight in ounces of water a day. So if you weigh 100 pounds, you would drink 50 ounces of water a day. That is sufficient for your bladder, but your bladder is a muscle that stretches. So if you fill it with more water and it can only handle two ounces of urine at a time and you drink a lot of water. Like in one, 30 minute timeframe or one hour timeframe, you might have to go because your bladder has been trained to only hold two ounces of water. So you have to retrain your bladder physically to be able to hold more volume, but also you have to retrain your nervous system to not give in to every urge. To have you be the brain of the control of the bladder because now your bladder is just in control So there's so many moving parts to this and I could go on and literally I have an entire webinar A 90 minute webinar over urgent continence and frequency. So if anyone wants that on my website And it dives deep into the nervous system dives deep into urgency and frequency and all of that, but it is crazy the amount of urinary frequency and urgency problems we see. And women just associate with, I have a small bladder. No, you don't.

amelia:

Yes.

Courtney:

No, you don't. We all have the same type of bladder. Promise. You've just trained it to be small.

amelia:

Yes. Just to share my personal experience a little because everything you shared was such a light bulb, eye-opening moment for me. And I think it's such a great example of our unconscious and our nervous system, like it knows more than us and it's aware of more than we consciously are aware of and it's doing these things, like being aware of these triggers where it thinks it's time to go to the bathroom and then we end up just being a slave to that. And

Courtney:

Yeah.

amelia:

that was really wild to me. And I think for me, it started so early on of my parents being like, Oh we're going to go for a car ride. You better go to the bathroom. And having that feeling of Oh, any opportunity there is to empty my bladder, I should. And I started realizing like, okay, it's as soon as I get home that, or if I'm about to leave, those are times when my bladder has decided that's good. And it does create this vicious cycle because then you feel that urgency and then you're worried like you, you don't want to, leave and then not have a bathroom and not be able to hold it, but at the same time, it's like you said, if you are just, Oh, getting that signal and then instantly giving in, you're never able to train. And so that was crazy to me to realize, oh, if I just constrict my pelvic floor a little and just send a message to my bladder, like actually, no, we're not going to go to the bathroom right now. Then that urge will go away, which was crazy to me.

Courtney:

yeah, it's all about the retraining, but learning too most times people don't really realize why it's happening, and once they learn why, then they're like, oh, really? I can do something about this? And that's the side of it the empowerment from knowledge of why your body's doing what it's doing. And that's the whole point of what I do on social media, what I do in my school, my free school group is in educating people to become empowered on how to heal their own body. That's really what it is. It's really not that secretive. There's not a lot of things that need to be gatekept about just learning how to control your own body. When you know, when you learn, that's when you know better, you do better.

amelia:

Yes. That knowledge really is power. I see that so much with my clients. It's just as soon as you understand how your body works and why it does the things that it does, it's such a game changer. And so nice when you are able to be working with your body instead of against it.

Courtney:

Absolutely.

amelia:

So to talk a little bit about the other, like bowel movements real quick. We mentioned that can be related to constipation, but I think gut health in general is just something that so many people don't know a lot about, like what is normal or optimal, because it's something that we're not talking about. Even the fact that you can be having bowel movements every day and still be constipated if you're not fully evacuating. Can you speak just a little bit to when it comes to the pelvic floor, what do you think is important for some people to know when it comes to bowel movements?

Courtney:

Yeah in the absence of a true bowel dysfunction or like a GI issue there's a lot of issues that can come from constipation from the pelvic floor muscles. If the pelvic floor muscles are too tight and a lot of people, don't really realize that it's from the pelvic floor, they're always like, Oh, I'm not eating enough fiber. Oh, I didn't drink enough water. Oh, I must be stressed, right? They're always blaming something else. And rightfully when you don't know, you don't know, right? But a lot of issues can come from tight pelvic floors. And so then what happens is a lot of times with constipation. A lot of people are straining on the toilet to have a bowel movement because maybe they're uncomfortable or maybe they didn't have a bowel movement that day and they're like, oh, gotta have my bowel movement today and they end up straining to get it out. And that long term can lead to more issues down the line because not only are you straining through the pelvic organs, but you're straining the pelvic floor as well. And honestly Straining is not helpful. People perceive it as helpful because you feel like you're pushing it out, but you're honestly straining the bowels. To push out something through a muscle group below it that's pushing back up, right? The pressure from below has to meet the pressure from above. The whole job of the pelvic floor is to provide support and stability and sphincteric function. And when you're bearing down, that doesn't just magically open your pelvic floor muscles. or the sphincters that are releasing the feces, right? The muscles below don't want to be pushed on, so it's going to meet that pressure back up. That's the way the body was designed. And so straining can actually just strain on those muscles, and then over time it leads to weakening. of not only the pelvic floor muscles, but also the sphincteric function and also the perineum, which the perineum is like literally everything below, right? It's like the, all of the structures and that can lead to issues like urinary, fecal, gas incontinence, pelvic organ prolapse, rectocele, which is your rectum prolapsing and all of that can create long term dysfunction. I used to strain all the time when I was younger, because, Nobody has time to sit on the toilet like all the time before I was a pelvic floor PT. And so now it's never do we strain and learning when you know better, you do better, right? So no straining on the toilet, sit there, relax, breathe, do your diaphragmatic breathing. And if nothing comes out, get up. You don't have to go, right? Go drink some hot water, go eat more fiber, and come back and try again, right? That's the issue that a lot of people don't realize oh, that's also a pelvic floor issue. Or could be, in the future, 10 years from now, a pelvic floor issue. And I see it a lot with younger kids teenagers, 20 year olds, and then they end up having a baby. Sorry, my dogs.

amelia:

We love dogs.

Courtney:

30 year olds that have a baby now have pelvic floor issues. And it's oh, I have a rectocele. It's oh, what maybe caused that? Not always are rectoceles or prolapses birth traumas. It can come from lifestyle habits as well.

amelia:

That's such a great example of how little things add up until suddenly it's just too much. And posturing can help a little, right? What about those like squatty potties do you think that those help?

Courtney:

Oh my gosh, yeah, if you don't have a squatty potty you guys all better get on amazon right now and buy a squatty potty They are

amelia:

Okay from

Courtney:

Courtney. So helpful.

amelia:

Awesome.

I'm pausing this convo just for a moment to say, if this episode is just blowing your mind and you're really interested in learning more about gut health, or maybe you're like, wait, what was that about having bowel movements every day and still potentially being constipated. You're definitely gonna want to check out episode 71. Cool things you didn't know about gut health. Just like this episode, there's probably so much that just hasn't been on your radar, that you really should know when it comes to gut health in order to feel your best.

amelia:

So I know that we're getting towards the end of our time here. One question that I like to ask everybody is when do you feel most alive? It's

Courtney:

When do I feel most alive?...

amelia:

When

Courtney:

I have control over my body, I would say Because for the longest time, I've been injured in the past I've not been able to do something that I, my, one of my biggest fears, I would say, because this kind of goes along with this, is aging and dying. Not being able to do what I want to do and that is my biggest fear ever I hate that. And so when I feel alive is when I can do whatever I want to do without any restrictions. And so when I like to exercise now, it has a lot to do with how I can strength train, how I can be flexible and go to a yoga class, how I can go for a 10 mile hike, how I can just go outside and go for a three to five mile run. I want to feel so good that if anybody says Hey, do you want to go play softball? You want to go for a run? Yes. Yes. I don't feel like I have to train for that. Because, like I said, my biggest fear is not being able to do something. My independence, but also my strength, and my mobility. And when I get injured, say, for example a couple six months ago, I hurt my hip, right? And when that happened, I was like, oh my gosh, I can't. Lift. I can't go for a run. Walking my dogs was uncomfortable. And that bothers me because I can't do something physically. I have to rest or I have to rely on somebody else to do something or I won't be able to do something, right? That's probably my answer to your question because my biggest fear is tied to that,

amelia:

I can relate. I definitely want to be that hundred year old feisty woman who's still going to the gym. And I think, that's everything, right? When you have the body and you can enjoy your life. And hopefully today is a good reminder. So I have a three life boost Cs that can help anytime you're feeling stuck or something's feeling hard that will always help you to move forward: compassion, curiosity, and connection, and keeping in mind everything today, the first is always just having compassion for yourself and your body knowing that it's always trying its best to take care of you, and then getting curious about, like, why is it understandable that Something in my body isn't working right

Courtney:

hmm.

amelia:

And connection reconnecting with yourself and looking at the big picture of how everything is connected. And hopefully today, all the things that we spoke about goes to show if you are experiencing some of these things that may be really frustrating or painful, or if you've been dealing with them for a while, seeing actually there may be a really understandable reason that your body is doing this. And if you can start tuning in and working with it, that's really the road towards healing and feeling alive.

Courtney:

Totally. Working with your body and not against it or ignoring it. That's what I would add to that. There's so many things out there that people just choose to live with not by, sometimes by choice for sure, but sometimes not by choice. And there's so much help out there. There's so much hope for healing. If you can't get through something do your due diligence to be your advocate, to be your own health advocate for as much as you can, as long as you can. Because chances are that someone else in your exact position has gone on the other side of this. They have healed, they have done something to help their body heal. Get better, improve symptoms, get stronger, right? There's a good chance that someone's already done it and there's also hope for you as well. And even if you don't get answers from your doctors, your providers don't give up. Don't assume that one opinion or those two opinions are your inevitable the rest of your life because there's always somebody out there who can help you, who has a similar story to you, who can inspire you, who can give you hope, who can give you motivation to do whatever you want to be able to do. And that is my biggest message to everybody. Our entire mission at Female Athlete is to get women who were active, previously active, currently active, continue living their best life symptom free. Because that is the goal. That is everyone's ultimate goal. That's my goal, right? That's my biggest fear. So I help women do the same because they shouldn't be held back by their symptoms. They shouldn't be told they can't ever lift again. They shouldn't be told to just stop jumping. They shouldn't be told these things. That's not true. There's always something to do.

amelia:

Yes. Thank you. That is such an important message. I think our society in general as women, we're just programmed like our body is the enemy or an inconvenience that we need to control or ignore. And that's, couldn't be farther from the truth. And so I love that, it's like maybe the traditional approaches are a little siloed, but there is always someone who, has can relate to what you're going through and can help to problem solve. So I love what you're doing and you have so many amazing resources. So if someone's interested in learning more and they want to connect with you, where can they find you? What would you like to share with us

Courtney:

Yeah. Social media is obviously the biggest outlet that I have. I would say my Instagram. I'm not super present on TikTok. I'm so biased to Instagram.

amelia:

I am too.

Courtney:

I love it. I love Instagram. It's an OG for us. So Instagram and then school. School is just like a Facebook group if anyone is, I keep talking about skool. They're like, what do you mean school? School is S K O O L. So not like a typical school, it's called skool, like cool, k.. And it's just like a Facebook group, but it's not social media. So you're only on the group to learn. It's literally like I have courses on there. It's a community. There's a ton of women in there sharing their story, sharing inspiration, and there's a ton of education in there. And so those, Instagram and school are my two biggest platforms on how you can get started. Like you said earlier, I have a 14 day challenge that you can get started with, and that's how, really, you're able to get educated and feel empowered, and ultimately take back control of your life.

amelia:

Amazing. Yeah. I can't emphasize enough. I'm so impressed with how much you have available. And as a coach, I know how much work can go into creating a space like that. So definitely encourage everyone to check it out.

Courtney:

I love it. Awesome. Thank you so much.

amelia:

Thank you, Courtney. It was so great to connect with you. Bye.

If you enjoyed today's episode, please share it with someone who you think could benefit. And if you're enjoying this podcast, it would mean so much to me If you would take the time to leave a review so that others can find me. And as I thank you if you leave a review, send me an email, letting me know, and I'll send you a free guided meditation for mental rehearsal. So that is exactly what elite athletes, executives, incredible surgeons all use at the scientifically proven way to improve performance. And the reason this works so well is because when you are mentally rehearsing, the same area of your brain is lighting up as if you were actually doing it. And so it's a safe and effective way to be preparing and practicing and improving your skills for when you're actually living it in the moment. So send me an email at amelia@lifeboost.Today if you leave a review and i can't wait to share that with you cheers your inevitable health happiness and success