Episode 134: Optimize Your Pelvic Health: Unfolding Facts with Dr. Betty DeLass

You are listening to Physical, Emotional and Health Secrets with your host, Amanda Elise Love. Whether you're dealing with autoimmune problems, sleep issues, trauma, mindset blocks, or any other health issues you are in the right place. In this show, we cover all of these topics and more. Amanda is a registered holistic nutritionist who teaches women how to cook allergy friendly, healthy meals and integrate a holistic approach into their lifestyle. She has made it her life's mission to teach others who are suffering, how to lead a more holistic life. We are so excited to welcome you to the show. Now let's get to improving our health.

Hi, everyone, welcome back to the podcast my name is Amanda Elise Love, and I'm a registered holistic nutritionist. And today's guest is Betty. So welcome to the show.

Thanks. Thanks for having me on.

I'm so glad to have you. So what is your backstory on how you got into what you're doing today?

Sure. So I am a Doctorate of physical therapy. And I specialize in pelvic health. And so I founded a company about a year ago called Reborn Pelvic Health and Wellness. I've been a PT for over 10 years. And so it's just a compilation of me growing as a person becoming a mom realizing a lack of care in our medical system for pregnant and postpartum people. And so I'm really super passionate about that. Because I think there's a lot of chronic pain that happens with pregnancy and postpartum and all sorts of things throughout that journey. And that can really spiral into other parts of their life so that people aren't really, you know, they're either embarrassed or sitting on the sidelines not participating in life. And our main mission is really to just change the world, one vagina at a time. And so that's my whole purpose for what I do and why I do it.

Kick her out to becoming a new mom.

Because I have almost four year old and almost two year old. So

That's crazy. Yeah, I have a sister and she has almost three year old and she just had her second, like almost a month ago. So

Awesome.

So with pelvic pain, what is the big thing? People are like, Oh, I'm dealing with pelvic pain. And they're new mobs. Do they think about that when they come to you?

Yeah. So I would even say I'm really trying to get more upstream even on that, because I think a lot of people think like, oh, if I have any issues, I'll go see a pelvic floor therapist after I have my baby. And really, if you're having any chronic pain before you get pregnant or anything like that, like those are prime times to come in and get seen during pregnancy, too. A lot of people think what's common is normal. And that's not necessarily the case. So common does not equal normal. So any pain that you have, or discomfort that you're having during pregnancy, like SI joint pain, low back pain, shoulder pain, hip pain, pubic symphysis, pain, all of those things can be treated with proper and great excellent care from a pelvic pt. And so just knowing that you don't have to suffer with that, and you can get help, the help you need right away is super important. And so some things that people come in to see us for is like tailbone pain, SI joint pain, sciatica, low back pain, pubic pain, just having as an overall pelvic pain in general. And we usually do a very holistic look at people through that. So we'll do a full body movement analysis on people and then we'll dive into each area of the body, we'll look at their spine, their ribcage, their breathing patterns, their abdomen, their hips, their pelvis, SI joint, all the way down to their toes. And then we'll do an internal exam as well, just like a midwife or an OB, but we're looking through the lens of a PT. So we're looking at range of motion, strength, coordination, trigger points, scar tissue, any of that stuff. So a lot of times, especially when you grow human being, that's the biggest change in your body that ever happens throughout your entire life. And so it's really important to really cater to that and help make sure that that your whole system is functioning properly. And so that you're not living in pain. And a lot of people after giving birth and stuff like that they'll have terrine or a C section scar or anything like that. And so really getting on top of that stuff ahead of the game. Or if you are having issues can really help change the trajectory of your life and what you're able to do and get back to doing so. That's really what it's all about is just making sure that that awareness is out there. I think that's our biggest hurdle is people just don't know we exist and what we do and how we can really help impact and change lives for the better. So yeah.

And I think a lot of times we don't really think about like our pelvic pain with pregnancy. Like, if we're say we're thinking about getting pregnant. Shall we start go into what?

I would recommend that even just from like a health standpoint of like the awareness of your own body and really being the expert of your body of like, is everything normal Do I have a normal pelvic floor doesn't move like it should, is there already stuff lingering there under the surface that could be addressed ahead of time so that it can set you up for success in the future. Or if you already have pelvic pain or pelvic issues going on, then 100%, you should go before you're pregnant. So you can address those things. A lot of times people will have painful intercourse or painful bowel movements or pain with urination, some of those daily functions. And it's not necessary to live with that chronic condition that we often see too is painful bladder syndrome, or interstitial cystitis. And so those things can be tremendously helped with pelvic floor PT, and really set people up for really great success going into those life events.

What about like, in general, if we're just like, maby we should just go just to

Totally we love though. Yeah, we got people like that all the time where they're just like, I don't have anything like glaringly wrong, I just want to see where I'm at, is there anything that I can do to improve on and set myself up for optimization, and we love that because those are the people are proactive about their health, they're curious about their bodies, they want to do the best that they can for themselves. And that's just really encouraging that healthcare is really shifting that way. And so we're getting more and more of that happening, instead of the sick care, wait until something's broken, really broken about it. And people are being more proactive. So we absolutely love those people, when we see them. And they come in doing that, because they're the ones who take that next step and really progress to like optimization of their health instead of just like, okay, I'm fine, like men carrying on with life.

And I think we need to be proactive about what's going on with our bodies is what are the symptoms people should be besides pain? Is there something specific that people look Alipay?

Yeah. Other things to look out for is like incontinence, whether you're really getting urine, or fecal matter or farting when you're not supposed to be 13. So all of those things are in the pelvic PT, wheelhouse. prolapse symptoms, and prolapse is like falling down of the organs into the pelvis. And so that is kind of like that heaviness, pressure falling out those things we can help with separation of your abdominal muscles. So like diastasis recti, is what that's called, we can help with that. And endometriosis, another big one to where that can have a lot of adhesions, and difficulty and pain with those types of things. So yeah, any of that stuff, you can look out for painful periods, or menstrual cycles. Also, again, not normal. But we've been told in society, it's like, oh, it's just normal to have really painful cramps, when you are menstruating and stuff like that. It's like, No, we don't have to deal with that. So I've worked with plenty of people who we can really make a huge difference. And they're like, oh, my gosh, I'm having pain free periods. And I'm 35 years old, why did I deal with us all of my life. And in a couple of sessions, it's like gone. So it's really important to just like, advocate for yourself of like, No, this isn't normal. And I don't have to just deal with that. So anything with pooping, peeing or sex, like, totally in our wheelhouse, and we can help with that?

Well, that's interesting, like you mentioned, painful periods and stuff like that. And we just think we have to deal with that.

Just a minute. Oh, you'll be fine. No, no, no, no, I like to change the world against that. So

Well, let's talk about that a little bit that I guess, what exactly do you do to help with painful periods?

Yeah, we do what's called visceral mobilization. And so that's a fancy term for you have fascia all over your body. And fascia is kind of the spiderweb material that holds you together. And so all those can get like, whether it's muscle or fascia bound down, or restricted, or adhesions, or knots or trigger points, you'll hear all that kind of terminology thrown around. And that can be a pain generator, or lack of movement generator. And so we do mobilization to the fascia around the organs. And then that can really help free up that mobility. So just like your joints move and articulate together, your organs move and articulate on top of each other. And so if there's restriction between your uterus and your bladder, or uterus, and your rectum, or your intestinal wall and something or stomach, like liver, all those things, we don't treat organs or organ pathology, but we can treat the fascia around the organs, which can impact your function and your discomfort or pain levels around that. So that's what we do from a painful period perspective. And then also doing work around the muscles of the pelvic floor that are attaching and and directly coordinating with all the organs as well, because basically, the pelvic floor holds all those organs. So yeah, there's so much.

Wow, that's, that's incredible, especially for people who are like, really, that time of the month. It's like, horrible and they keep it's too facilitator.

Yep, yep. And those are signs that I tell people if we can think more upstream, if you even have daughters or people that are menstruating, have your own, you know, children, you should get them in to see a pelvic floor therapist to help with that. So earlier on, so that they don't have to just suffer or stay home from school or take a bunch of pills and all this stuff like that, like, there's more holistic ways to address that.

Do you so what is like, do you find a lot of people come to you like that age, like, teenagers?

Not typically, most of the time we're getting people postpartum, or when there's like big issues. So we just want to make sure that like we're speaking upstream on stuff as much as possible, we kind of focus upstream as much as possible. But sometimes we still get people that are looking to, that they need more help in the upstream is allowing. And so we'll see people whenever that meets their, their needs.

So what is like something people can be doing to improve their pelvic health?

Yeah, number one, see a pelvic PT, or OT. And then number two, I would say, if they're able to really work on that breath work, like you kind of we talked about before we jumped on here of like, knowing your body, knowing how to get into that good 360 degree breath, versus just like diaphragmatic breathing. So a lot of times diaphragmatic breathing is hand on the chest and in the stomach, make the belly expand. But that's not where your diaphragm is. And so your diaphragm wraps around your ribcage 360 degrees. And so focusing the breath and that 360 degrees there can really help with the diaphragm on the top and the pelvic floor on the bottom, moving together as a unit. And so that's one thing that we always start with people's making sure that they can breathe properly, and then build off of that. So that because breathing is really your fundamental movement, as long as you're alive, you're breathing, right. And so if we can give that as a foundation set, and then build on top of that with other exercises and movements and stuff like that in coordination, then it sets them up for really great success from the start.

So you start them off with the breathing. So

Yep, yep. We start with breathing, making sure that's good. Now we do a lot of hands on stuff, where it's that mobilization and movement, and then getting them to move on things. I think that we have the probably the coolest job ever since we get to play detective with each individual person of what's truly their limiting factors. Because we could have 10 Different people come in and say they pee their pants when they sneeze. And they all be for different reasons. And so it's playing detective like what is the reasoning in your body? And what do we need to work on and optimize so that that symptom doesn't happen of peeing your pants when you sneeze? So it's individualized and really unique for each person?

I like how you said individualized because I think a lot of we think what sighs all and nobody.

Yep, it's totally not.

So like when people are having trouble and doing like pain, the pants, what are like some underlying reasons that that's happening?

Yeah, it could be a combination of things. Sometimes it's breathing. Sometimes it's pressure management through the system, sometimes it's a weak pelvic floor. Sometimes it's a really tight pelvic floor that doesn't have any mobility to give. Sometimes it's other trigger points or something that's connecting to that sometimes. It's the core pressure management and the core strength or the hip strength. And usually, it's a combination of all of the above or some of that, where it's like, okay, these things are affecting this, we're going to work on those three things, and then that clears up, they're leaking, or whatever they're coming in for. So really just depends. It's never ever just like one thing. It's always usually combination.

And I think that's the thing everybody thinks is always one thing when you're dealing with a health issue, and it's always five or six different things.

Totally. Yep. So we want to do comprehensive, individualized care with each person to make sure they're getting what they specifically need from our clinical lens and judgment of like being a PT, orthopedic, PT, and a pelvic PT, and really holistically coming around that from a whole person standpoint, because it the pelvic floor doesn't work in isolation, it works within a system of your entire body. And so really making sure that we're looking both inside the pelvis and outside the pelvis and really bridging the gap between the two of like the coordination that happens through all that entire system.

That's interesting. What's the difference? You've mentioned all the different P T's what's like the difference between all of them because I personally.

Yeah, so pelvic PT is definitely a niche and you need specialized training to do the internal work and all that stuff like that. So when you graduate PT school with a doctorate level position, you are just a PT, a regular physical therapist, but then you can specialize down and niche down so most pelvic PTS are really good orthopedic PTS which means bones, ligaments, joints, muscles, tendons, all that stuff like that, and can treat people with Just like low back pain, shoulder pain, knee pain, kind of your like standard pt. And then pelvic PT gets more specialized and goes internal and really works on diving deep into like the abdomen, the hips, the pelvis, the SI joints. And honestly, I think we're like the nerdiest nerds of nerds, because we just couldn't stop learning. We're like, we're missing something, we're missing something. There's gotta be something that's contributing. And then we arrive at the pelvic PT land, and we're like, oh, my gosh, everyone needs to be a pelvic PT. They're totally missing the biggest piece of the puzzle, and that's the pelvis. So

Oh, you know, think about the pelvis.

I know. It's like taboo, it's off the market. It's like, Nope, don't go there. Like, that's sensitive area. And it's like, no, no, no, there's tons of muscles, ligaments, joints. And honestly, it's the Grand Central Station of energy exchange, like everything up and down the chain, whether it's upper body or lower body goes through a transfer of load through the pelvis. And so we need to look at that as a cornerstone piece, in my opinion. Anyway.

Speaker 1 00:15:59

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So what do we know about pelvic health that we don't know?

Oh, so much, just like medicine in general, I think we're just scratching the surface. And what we know is really cool. And it's helpful and stuff like that. But I think we're just evolving in healthcare and in pelvic PT itself of like we're getting to be, we're starting to understand more and more. And the more we know, the more we don't know, just like anything else, like, oh, we need to learn more, we need to learn more.

That was like the definition of what is public health.

Yeah, I think that's a broad spectrum. And like, if you think about it, it's considered niche. But it shouldn't be niche, because everyone has a pelvis, just like cardiologists, you'd go to the cardiologist, if you had a cardiac thing going on. If you have anything happening, anything in your pelvis, whether it's being pooping, sex pain, orthopedic related, like you should go see a pelvic PT, but we think like, oh, that's so specialized. But it's so sad that it's not like normal mainstream. So yeah, I just hope it someday becomes that.

Why is it so specialized? Is it just because it's not mainstream, and we don't talk about it?

I think that's part of it. And I think too, because not everyone wants to do internal exams, so PTS have to want to be doing that. And then also, the patient has to be consenting to that as well. So that's a barrier to some extent, but most people who have issues with that don't have a problem consenting to an internal exam, because they want their problems fixed. And they want someone to assess what's truly going on.

And how long does it take for people to like, the dealing with pain for like, so long? How long does it usually take before they come to you?

Sometimes people are really proactive, and sometimes it's we're like 7, 8, 9, 10, providers deep before they get to us. And they're finally like, Finally, I found you, which hopefully, we're hopefully flipping that narrative. People come in earlier and sooner so that they're getting to the right provider at the right time for the right care.

So was the biggest thing that people come to you for?

So we specialize in? So pelvic health itself? I'm going to back up a little bit on that question is a specific area. And then there's all sorts of pelvic health therapists. So some of us like ourselves specialize in like preconception pregnancy postpartum. That's really what we're passionate about. We love working with those types of people. Some people specialize in pediatrics, some in men, some in oncology, some in transgender or gender reassignment surgeries. So it really just depends on like, that kind of like niche and who you like to see. So primarily us. It's that like, pregnancy, postpartum population.

And, like, what can women be doing? When they're new mothers? And they're dealing with pain? And they're just like, not sure if they need to go to a PT or not?

Yeah, great question. So there's some screening tools out there. One, and you can even find this on our website. It's called the Cozean Pelvic Floor Screening Protocol. We have a free download on our website for that, and I'm assuming you put that link in the show notes, but it's www.rebornphw.com. And it's a 10 questionnaire. And basically, if you say yes to three or more of those things on that 10 questionnaire, you belong in pelvic floor PT to really address those issues. So that's an easy thing to do is just kind of self evaluate of like, do I need help or not? Another thing I tell people is don't do kegels. That's what the mainstream thing is, is like do Oh, do your key goals, do your kegels, do your kegels and that's to like fix all in every pelvic floor dysfunction and it's just not true. Most The time kegels do more harm than good for the patient. And so it really makes me and gets me fired up when I see like articles online or other people posting things like do your kegels or like, all of a sudden I'm like, Oh my gosh, that's such a disservice to that person, because it could actually make their symptoms worse. So I often like just don't do kegels, go see someone to get the appropriate amount of thing that you're supposed to do. And then just become more self aware of your own body of the functions that it's that it has, and what it's doing and all sorts of things like that.

What is kegels if people don't know what that is?

Yeah, so kegels is a term that is defined by a guy named Kegel. And it's basically a pelvic floor contraction. And so the way to think of that is if you like to squeeze your pelvic floor and contract, it is a kegel and then to relax or bear down is a reverse kegel. And so it's just basically the contraction of the pelvic floor muscles. And a lot of times people think of that of like stopping the flow of urine, holding a third in like that kind of stuff. That's what a kegel is. It's just a contraction of those pelvic floor muscles, the muscles between your pubic bone and your tailbone.

That's interesting, is that was being push.

And I think that's the thing that people don't know what to do with their public health.

I think that's what's been pushed in the past, I think us as a profession has really shifted that narrative as pelvic health providers of like kegels are not the answer, we have to look at, at a more integrated level of a system and getting people functional and doing things because the honest answer and truth is, is when it comes down to research is you have stronger and more robust strength through that pelvic floor and endurance, when you do a lunge than you do if you were to just Kegel and do a pelvic floor contraction, so your pelvic floor is stronger, doing more functional things because it works in a whole system. And so really taking that to the next level for our patients, is really where it's at.

Yeah, they have no idea. Honestly, the biggest barrier for us as a profession is people don't know we exist. And then people don't know what we do, and what we can help with. And so just getting the word out there of like the pelvic health in pelvic PTS, and OTs, like that's where you belong, to really get to the root cause of some of these issues and become functional. A lot of times people think, oh, I'll just, I'm gonna have to have surgery, or I'll just wear pads, the rest of my life like this is the price of motherhood. And it's like, no, no, no, no, no, it doesn't have to be that way. And so that's really what I'm passionate about is just educating and getting people aware of like, pelvic health is a thing, first of all, and what do we do? And how do we help? And like, here's the answer to some of your long lasting problems that you just thought you had to deal with. Because I'm, I get on my soapbox about that of like, common is not normal, and you can totally do something about it.

And, like, it's not common for people have to be in pain or have to wear pads. And yeah, I call that

It's common, not normal. Yep.

Yeah, do a lot of people come to you with problems mostly after they have the baby,

I would say that's the majority of the time, it's starting to shift a little bit just because our culture is is shifting of people are coming in more when they're pregnant, and getting on top of things and prepping for labor and delivery, and postpartum and really trying to optimize their body ahead of time. And I think that's what we're trying to preach to is just like any other major musculoskeletal thing, so like, if you're going to have knee surgery, or shoulder surgery, or hip surgery, we know with research that if you do prehab, so you go to therapy, before you actually have that event, and then do it after with rehab, you have better outcomes than if you were to just do it afterwards. So really trying to apply that to the pregnancy population as well. Like you should get in there and prepare for this major event that's about to happen when you're growing a human being and it's the biggest change of your life and your body. And then to you go from being pregnant to not pregnant and give birth one way or another either vaginally or a C section. And that's a big change to your body drastically within you know, a couple hours. And so really prepping yourself so you can be prepared and optimized into that and then have a better recovery than postpartum as well.

And how does it help with like, after you have the baby and stuff, it's just your muscles are more better and stuff.

Yeah. So your body stretches to accommodate that growing human and so your core is weaker mom, but is a real thing too. So like as soon as you give birth your butt kind of like disappears, and you're like where's my bike go and you can't really activate it very well. So we work on also bringing ribcage down in in because the ribcage flares a little bit by accommodating baby getting ABS back online glutes back online. I'm working on some of those muscle coordination, soft tissue work. And especially after we see people anywhere from two to four weeks postpartum, we don't do any internal until after they've been cleared by their provider, and everything's healed. There's no infection, like all that stuff like that they're bleeding. So then we would start that internal, as soon as we could Once cleared, and really just like we would any other thing that we did surgery on. It's like, we would do this in a rehab setting, why are we not doing this for pregnant people? Because current standard of care is like, Oh, don't do anything for six weeks, yet six weeks and like, you're cleared to go, and it's like, wait, no one assess you for that. They just assess to make sure that your uterus has stopped, you know, back down to size and there's no bleeding and there's no infection and it's healed from like that standpoint, but you're not healed from a musculoskeletal standpoint. So we want to make sure that we're addressing that as well.

Yeah, we don't think of our musculoskeletal system. Mm hmm. Yeah. And so like, what, what should we be thinking about with that?

Any pain or dysfunction with that, so whether you're having low back pain, hip pain, SI pain, tailbone pain, perineal pain, so pelvic floor pain, pubic bone pain, decreased endurance, strength, just not feeling right down there? Those are all things to consider. That's like, Okay, how he PT would help or OT would help with this tremendously.

That sounds something like everybody should be thinking about, because we don't think about our skeletal system.

Nope. I know. That's why I'm so passionate about what I do. Like we can do so much better.

Well, we hear about like, even I did a little bit with the skeletal system, but like nutrition, but more of its like, was on the immune system, the other systems of the body, and stuff. Oh, we just don't care about the skeletal system at all.

Yeah, which is sad. I think that's our own professions fault. Like we're just not good at marketing or good at like, showing the value that we can provide to people. And hopefully, that continues to change and trend in a better way where people are starting to think about that stuff and really advocating for themselves. And I think that's truly where it comes from. It's just educating and knowledge and having that power of knowledge to know oh, maybe I can do something about this. Maybe I should look into that. Go see a professional that specializes in this area, so that I can get the help I need and be the best version of myself that I can be and not just live with it.

That's great to know. Is there anything else you'd like to share?

Um, no, I think you had some awesome amazing questions. And I hope that your listeners enjoyed this talk about all things pelvic floor.

Thank you so much. It was a great interview.

Thanks for having me.

I'll have all your information show notes.

Sounds good.