Joe: 00:00

Welcome back to another podcast episode of Freedom Talks, everybody. This is your host, Joe Ogden, and we're sitting down again with doctor Anna Grassman, who is one of our women's pelvic health specialists here at Freedom that I believe we have pelvic floor at all locations, I believe.

Anna: 00:20

Except for Brookfield.

Joe: 00:21

Except for Brookfield currently, but that is gonna We

Anna: 00:23

are working on that.

Joe: 00:25

Anna, tell us give us a little background. Let's let's jump right into it. Give us just a little background on what exactly pelvic health is.

Anna: 00:35

Pelvic health

Joe: 00:36

From a physical therapy standpoint, I should say.

Anna: 00:38

I mean, so you have a group of muscles, your pelvic floor muscles. Just like any other part of the body, they have multiple functions. There is a function for sexual health, for urinary and fecal control, and then there's also just a pressure management function as well. So, you can have a dysfunction of any of those muscles. You can also have, you know, some pain or imbalance in those muscles as well.

Anna: 01:06

Then you can have a problem with either of those three, functions mentioned before.

Joe: 01:12

How did you become interested in treating this type of population?

Anna: 01:16

I'm gonna be really honest in that I'm just stubborn. Really?

Joe: 01:21

Yeah. That's very interesting. I would have never guessed that.

Anna: 01:23

I just felt like I had seen a lot of patients, specifically females because I only treat female, and they had some pelvic floor problems or, like, some some hip problems or low back problems or, like, sciatica problems that I felt maybe were stemming from the pelvic floor, or they had incontinence problems. And or, you know, they became pregnant, they were like, I want to do some postpartum care. And then I would have to send them off to someone else, and I was sick of doing that. So here I am.

Joe: 01:56

I think, and I'll I know this is just women's health, but I think this applies to men's pelvic health too. I think what's crazy now that I've taken the men's pelvic health portion is how much overlap there is between someone who's just coming in for back pain.

Anna: 02:12

Oh, yeah. Like,

Joe: 02:13

oh, what I mean, the it's coming from the pelvic floor or even Mhmm. The jaw pain, same thing. Like, just everything's so tight. Yeah. Either starts from there or goes back to there.

Anna: 02:26

Mhmm.

Joe: 02:27

That's crazy to me.

Anna: 02:28

Yeah. And it's another thing that, like, just having this background, it's nice to be able to just check or rule out if, you know, you have someone coming in for a hip problem and you just can't figure out. None of your, like, typical treatment, you know, is seeming to follow it, or, you know, your test and measures are coming out kind of funky. Yeah. You know, it's a good thing to be able to just be like, hey, you know what?

Anna: 02:48

Like, let's check to make sure this isn't a problem, or this isn't contributing, just to make sure that I'm not missing something here. Yeah. So yeah.

Joe: 02:54

And I think the important part of this podcast too, because when this podcast is posted in May, it's women's pelvic health, you know, kind of awareness month for freedom, so to speak. Can I talk about a little bit about essentially how it's not normal to have these symptoms and it's okay to talk about it and it's important to go and get help for this? Because I feel like that's a lot of pelvic health is like it is not normal to have these types of symptoms. It is normal to go and get treatment. Yeah.

Joe: 03:22

I think from the female side that's becoming, you know, progressively better. The men, I think, still struggle with that.

Anna: 03:29

But yeah, I mean, yeah, it definitely is getting better. But things like pain with intercourse should is not a normal problem. Leaking with cough, sneeze, laugh, leaking with lifting typical things around your home is not normal. You know, having the diastasis recti, which most people can't necessarily perfectly pick that out on themselves, but, you know, having some abnormal, either, like, you know, folding or pressure leakage when you do something like a sit up or a crunch, those are all things that, like, are atypical, and I think people are getting better about talking about it.

Joe: 04:13

But Yeah.

Anna: 04:14

It's good to know.

Joe: 04:15

How do you let's let's start from the first thing you said.

Anna: 04:18

Okay.

Joe: 04:19

When you when you're talking about pain with intercourse, is there specific things that we're looking for? Like, if you're someone who may potentially have this, or is there a sign or symptom that, oh, I should go see a physical therapist, or is it just general pain with intercourse?

Anna: 04:34

I mean, it's general pain with intercourse, and it can be just pain with insertion, or, you know, you feel like insertion is, like, really tight and difficult. Okay. Or if you feel like it takes you a long time to get comfortable with insertion. Or it can be, like, you know, pain with the actual and that can be in your hips, like, deep in your hips, or that can be, you know, closer to your vaginal opening. Any of that would be, like, a reason to come in to see a PT.

Joe: 05:02

And then the leakage. Yeah. Are we looking for, like like, I just saw a video the other day of a female deadlifting and just completely lost all control. Is it like that, or is it even just like a little drop? Like, what's

Anna: 05:14

I mean, any of that. I I'm I I don't think that that's something to advertise, you know, that, like, you're urinating with, like, a heavy lift. No. That's obviously a problem.

Joe: 05:25

I think that was extreme case. Right?

Anna: 05:26

Yeah. Right. It's an extreme case. But, you know, if you are picking up, I don't know, a grocery bag and you're leaking, if you're leaking when you're cough, sneeze, laughing, if you're leaking with standing, or, you know, with long distance walking, any of that, you know, that should not be happening at all. You know, or even, you know, six months postpartum, if you're still having some of those problems, like, you should definitely go see a pub floor PT.

Joe: 05:51

That's something a topic that I think is really important to normalize is the postpartum stuff. Mhmm. I I think is nuts. And maybe I feel this way because I'm biased because we just my wife and I are just having kids. Mhmm.

Joe: 06:04

And I I treat male pelvic floor, so I see it from a different level. But, like

Anna: 06:07

Yeah.

Joe: 06:07

You have a baby and there's nothing. Mhmm. Like, there's unless you ask for it, there's nothing. It's like, oh, good job. Mhmm.

Joe: 06:13

That's what you're supposed to do. I think it's nuts that it's not like you've already paid for this hospital bill. Mhmm. We're gonna give you some physical therapy on top of this just to kind of recover because that's a major

Anna: 06:24

Yeah.

Joe: 06:25

Ordeal. What are some of the things that physical therapy can help with in that postpartum stage or even pre pre baby? Are you pregnant?

Anna: 06:31

Yeah. Well, so I will say I've I've been hearing more from ladies who have had babies that their OB or their gynecologist or even sometimes their primary care physician will be handing out a prescription for pelvic floor PT postpartum, whether or not they have a problem. They're like, here it is. Use it if you feel like you need to. And if you don't, that's fine, which is great.

Anna: 06:58

I really think that those should be handed out, like, after you have or after you give birth. Period. So that's awesome. During pregnancy, the most common things that postpartum mom or the pregnant moms will say is that they're having, a lot of low back pain, which is typical because you're changing your body mechanics, because you're changing where your center of mass is. That's going to come forward.

Anna: 07:22

A lot of times you have an extra like arch in your back. So ladies a lot of times will complain of low back pain, sometimes hip pain. As the baby grows, you have to have like, you know, more space in the front. So a lot of people will externally rotate, then their hips start to get tight and sore. Sciatica is another common thing that pregnant moms will complain of, and, SI joint pain too.

Joe: 07:46

As the body's starting to prepare for

Anna: 07:48

Yeah. Expulsion. Yeah. Especially if That's

Joe: 07:50

a bad way to say it.

Anna: 07:51

You know, with when your ligaments start to become, you know, more lax, you you know, you have some more of that shifting and sometimes, moms will complain of, SI joint pain.

Joe: 08:02

Now baby's already here. Mhmm. How as a mom, how do I know, one, whether, you know, this is something I can just push through or when to just come see a physical therapist? Mhmm. Because even like like my experience, our first our first baby, nothing.

Joe: 08:20

The second baby, the physical therapist essentially kinda had to beg the nurse to come into the room to kinda give some tips on just transfers, how to roll Oh,

Anna: 08:33

yeah.

Joe: 08:33

The compression belt just to kinda hold things more snug. And a lot of education pieces, I think was fantastic, and it's always nice not coming from your spouse too, think, sometimes, right? Yeah, yeah, yeah. But as a new mom, how do I know when it's time to come see a therapist?

Anna: 08:54

Typically, for an outpatient physical therapist and this is a typical case we get the most information as a pelvic floor physical therapist from an internal exam. Usually most doctors are fine with an internal exam six weeks postpartum, because that's usually when you're cleared for intercourse. So what we do is much gentler than that. But we always want a doctor's note with that to be able to do an internal exam. However, if you are postpartum and you're having a lot of problems with just, like, transfers, if you're having a ton of pelvic pain, like, there's plenty we can do that is not an internal exam.

Anna: 09:34

But just typically for mom, like, there's a lot going on in the first couple

Joe: 09:38

of weeks. A lot of

Anna: 09:38

times they don't even want to come see anybody. Right. But our typical suggestion is six weeks postpartum with a doctor's note. Just to make sure that there's nothing else we need to be concerned about. But that's the usual, so we can get all that information from an internal exam unless you're having, you know, a lot of problems right away.

Anna: 09:56

Then there's plenty we can do that's not an internal exam.

Joe: 09:59

So is it if someone who has never had a physical therapy appointment with a pelvic floor specialist, is there always an internal exam?

Anna: 10:10

Doesn't have to be, no. Again, that's where we glean the most information. Well, it'll be the most effective at telling, like, if you have tension, are you performing contraction the right way? Are you coordinating those muscles the right way? Are you tight?

Anna: 10:25

Are you not, you know, are you weak? Do you have any scarring or tearing? That's the best way to get that information, but we don't always have to do that. You know, there are some ladies who are not comfortable with that. That's totally fine.

Anna: 10:38

There's other ways that we can get that information as well.

Joe: 10:41

So now we've done so I've come in. We've done an internal exam. Now what?

Anna: 10:47

A lot of times it will be Or

Joe: 10:49

how to Oh. Even like how how does a how does a typical session look?

Anna: 10:52

Oh, okay.

Joe: 10:53

From there.

Anna: 10:54

Yeah. I mean, it's similar to a typical physical therapy appointment. Like I said, they're muscles just like anywhere else in the body. We'll talk about what problems you're having. We'll do a physical exam.

Anna: 11:06

A lot of times it starts externally with looking at posture, hip and low back range of motion. And then, you know, sometimes we'll do an internal exam, so that'll be looking at, you know, tension, sensitivity, you know, again, if you have any, you know, scarring or tearing that had happened. Are you contracting well at all three layers? Do you have tension at all three layers? Because there's three layers of the pelvic floor.

Anna: 11:32

Sexual function, urinary function, and then just like pressure management. Sometimes we will look at diastasis, if you have any separation of your abdominals, if you are coordinating your breathing well, if you are recruiting any other muscles with your pelvic floor contraction that you shouldn't be. Yeah, it's a lot that we look at.

Joe: 11:54

Yeah. So let's go to another patient example. Urinary.

Anna: 12:01

Yeah.

Joe: 12:02

Urgency or incontinence.

Anna: 12:03

K.

Joe: 12:04

How do how does that typically look? From an evaluation standpoint, kind of some of the things we're looking at, maybe even some of the tips and tricks on people that may have that now, like a a quick fix if you feel like you have it now. Mhmm. Or education components, too.

Anna: 12:21

Yeah. So there's two different kinds of incontinence, urge incontinence and stress incontinence. Urge is, you know, if you feel like, oh my gosh, I have to go to the bathroom right now, and sometimes I can't make it. Oftentimes, this is not always, oftentimes that is a lot of education on how to

Joe: 12:41

Relax a bit.

Anna: 12:43

And how to, like, rewire that alert that you're getting in your head, and how to, you know, prolong that from when you actually physically need to go to the bathroom.

Joe: 12:55

Like the keys on a locked door.

Anna: 12:57

Yeah. Sometimes that'll be more education on, like, urge deferment strategies, which just means, like, how can I make this a more normal physical response to that alarm going off in my head? Yeah. Sometimes there are actual physical things that go along with that too, but sometimes that's just that education piece. And then stress incontinence means that you have some leakage with increased abdominal pressure.

Anna: 13:23

So that's the cough, sneeze, laugh, standing up, picking something up, something like that. And then a lot of times with that, we'll look at, are you performing a pelvic contraction well? And that both means, are you contracting well? And then are you relaxing well? Yeah.

Anna: 13:37

Some people can perform a really strong contraction, but they don't relax well. And they're really tight. And, you know, think about like a bicep. If your bicep is always contracted and you're always in a flexed position, you're not going to be able to get a good contraction because you don't have much, you know

Joe: 13:51

There's nothing left in the tank.

Anna: 13:52

Yeah. So you need to both be able contract and relax. And that's where, you know, a lot of the things that you can find online, everyone's like, everyone needs a Kegel if you're leaking. Everyone needs Kegel if you're weak. And that's not always true for everyone.

Anna: 14:05

Sometimes you need relaxation piece to be able to get that full contraction to be able to hold your urine with that increased abdominal pressure.

Joe: 14:12

I think that's been kind of crazy. The link with male pelvic health too is I thought that everyone was weak going in there before the class. And there's a lot of people that it it's not a weakness problem. It's a total just everything is so constricted and so tight that all it wants to do is just expel, expel, expel, expel, expel.

Anna: 14:32

Yeah. Yeah.

Joe: 14:32

Once you relax, things are much better.

Anna: 14:34

Yeah. Yeah.

Joe: 14:36

Now for women, is this the same? I remember in my male course, like, once you feel the sensation that you have to urinate, that your bladder's about halfway full. Do they talk about that at all? I don't know. I believe so.

Joe: 14:49

Just because a lot of people that have the urge incontinence Mhmm. I'm sure females are the same as men. The second they get that urge, it's like, I gotta go now.

Anna: 14:56

Yeah. Mhmm.

Joe: 14:57

So a lot of the education component is, like, learning how to just hold that in, making sure you have the right fluids.

Anna: 15:02

Yes. Yeah.

Joe: 15:03

Which what are some, bladder irritants?

Anna: 15:07

Like like food wise, is that what you're talking about?

Joe: 15:11

Yeah. Like drinks and food.

Anna: 15:12

Yeah. And that that sometimes is another, important piece too, sometimes that urgency can come from more of an irritant. Yeah. So that could be, caffeine, that could be certain foods. I know you know some of these too.

Joe: 15:28

I don't know if I know I guess any foods off the top of my head. Yeah. I don't even know what I would guess. Like spicy foods?

Anna: 15:35

Well, sometimes it's it's too we'll we'll do a bladder diary.

Joe: 15:38

Yeah. Of course. Yeah.

Anna: 15:39

Have you write down this is how many times I went to the bathroom. Yep. You know, this is the level of urge that I felt. And we can kind of look at like what you were eating, what you were drinking a few hours beforehand.

Joe: 15:52

Yeah, any carbonated drink. Yeah. Tea, coffee.

Anna: 15:55

Yep. And Energy drinks. And again, it's a little bit different for different people. Sometimes it's easier that way to visually look at, okay, this is maybe what's my problem.

Joe: 16:04

Yeah. So we've got bladder urgency, sexual pain, postpartum. Is there anything else that would fit into the female pelvic health category?

Anna: 16:17

I mean, the diastasis, I mean, that kind of goes into postpartum, but that doesn't always have to be. I mean, you see that in male. I see that in some females who it's not necessarily tied to pregnancy. But that's a separation of your abdominals. And that really plays into, you know, some low back pain that can play into, you know, really poor pressure management when you're making transfers.

Anna: 16:47

And that usually can be fixed conservatively with just some, like, really simple exercises. Yeah. And there's easy ways where we can, like, mark, you know, how, you know, both the depth, the width, you know, how far above or below your navel is that. And again, usually we can fix that with some exercises.

Joe: 17:05

Yeah. So Is rectal pain in there as well?

Anna: 17:09

It is. I will

Joe: 17:10

Or is that a different level for

Anna: 17:12

It's a different level of a course. So I just haven't taken that, but both Nina and Heather have taken that. But it's definitely a big player. Yeah. It's just not something I've gotten into that in-depth.

Joe: 17:24

Yeah. If you because I you've been doing it now, what, two years? Three?

Anna: 17:30

A year. Not quite a year. A year. A Yeah.

Joe: 17:35

Based on the patients that you've seen, is there like an overarching theme? Like, you were gonna give a couple tips on or even answer the most common questions that you've gotten from patients. Like, what what would you say is, like, the most common thing that you see?

Anna: 17:48

I mean, I I think there's still a lot of people out there being, okay. Is this normal? Is, you know, this amount of leaking normal? Yeah. A lot of people, like, wonder how often, like, what is the most common, like, or how often am I supposed to be urinating per day?

Anna: 18:04

Yeah. That's typically five to seven times per day. So if you're doing more than that or less than that, you know, that might be a time to go see a pelvic floor PT. Honestly, I really love when, like, postpartum moms come in, and they're like, I don't even know if I have a problem. Can you just give me a check?

Anna: 18:26

And they're like, I'm sorry to bother you. I'm like, no, that's no bother. I I really don't mind. And sometimes they come in and I'm like, you know what? Everything looks good.

Anna: 18:34

Here's a couple things you can work on. Yeah. Come back to see me if you have a problem, but you probably won't need to. And that's great. I think that's just good

Joe: 18:40

So healthy.

Anna: 18:41

Self care. Yeah. It's it's and it's it it makes a lot of them feel better to just know that, like, okay, that Yeah. You know, I've cleared that. Someone's looked at that.

Anna: 18:49

They've given me a green light. I I think what's hard to give, like, perfect tips and tricks is pelvic floor, there's not as like good of like awareness about it. It's not typically taught in an anatomy class. Yeah. So like things like this is great.

Anna: 19:08

People can have better awareness of like, do I have a problem, do I not? What things should I be looking for? But it's harder for people to have a good health literacy about it because it's just not taught as well. Even in PT school we didn't talk about it a lot. We maybe had a couple lectures.

Anna: 19:25

I personally wish that we had more, and not that I think everyone needs to come out being a pelvic floor PT, but it's such an important part of the human body. And I think we as PTs need to be better about even being able to flag it as, oh, I think this might be a problem. You need to go see a pelvic floor PT. Or can I at least have a couple of strengthening and a couple of relaxation, like exercises in my toolbox? Yeah.

Anna: 19:52

So that if I think that's a problem that's contributing, I can at least do that.

Joe: 19:56

Yeah. I mean, I've thought about this a lot. Think it's I was actually just having a conversation with a friend of mine who's a PT last night where I feel like I struggle, and I don't know how you feel. I think it's really hard to let's let's say we're seeing someone with low back pain. Mhmm.

Joe: 20:12

And we're doing everything and and I'm like, you know, I think this is coming from something else.

Anna: 20:17

Yeah.

Joe: 20:17

I find it really hard to transition to going to pelvic floor when someone doesn't come in for that. Oh, yeah. Because I mean, that's a little different, you know, type of treatment. And it's not that we're not doing our job. I mean, it's a part of our job, right?

Joe: 20:36

But it's such an intimate area that we don't Yeah. You know, it's not an open conversation of, like, oh, we're gonna talk about all this stuff. Mhmm. I don't know how you feel with females at all if it's if it's different at all. That's where I feel like I struggle sometimes with it, and I shouldn't.

Anna: 20:51

And that maybe is a difference between male and females. It shouldn't be. Yeah. But I feel like in general

Joe: 20:59

And females are ahead of

Anna: 21:00

Yes.

Joe: 21:00

Males in the pelvic floor world.

Anna: 21:02

Just Yes.

Joe: 21:02

Kinda preface that a little better too.

Anna: 21:07

I I think most females have been fairly open, especially if they have had children. A lot of females are like, you know, I've there's there's a lot of exposure with childbirth, so I think a lot of them are like, yeah, if you think that's a problem. Or even if they're not open about doing treatment for it, they're open with talking about it. Maybe not in an open gym, but it seems like a lot of them are fairly open about talking about, I do think this is a problem. Or like, no.

Anna: 21:36

I think don't

Joe: 21:36

know, don't females in general, every year when you see the is it every year females see a gynecologist?

Anna: 21:41

I mean, it depends. Yeah.

Joe: 21:43

But you should? Yes. Like a general physical? I mean, that's pretty open

Anna: 21:46

and Yeah. Mhmm.

Joe: 21:47

Where males don't have that.

Anna: 21:48

That's true. And that's probably because I

Joe: 21:50

just thought of that off the top of my head.

Anna: 21:51

More versed or well versed in talking about that because I have someone checking in on that. Yeah. Yeah. Maybe that's a good point. And maybe that's also a thing that, like, men haven't always thought about about themselves.

Joe: 22:04

They don't.

Anna: 22:06

Whereas females again, because they have someone asking them questions about that on a regular basis, they're a little bit more well versed.

Joe: 22:12

Yeah. I don't know what you had in PT school, but I remember we it was one or two things. We either had an online lecture of just like going over what pelvic health is, but nothing specific. You and I have talked about taking the class and I would love to take an honest poll of people. It's a little overwhelming to do the palpation stuff the first time.

Joe: 22:38

Right?

Anna: 22:38

Oh, sure.

Joe: 22:39

Yeah. Like, it's it's just a just a different thing

Anna: 22:44

Mhmm.

Joe: 22:44

Where I remember the lecture in PT school. It just kinda glanced over that, like, you don't have to do internal work. Yeah. Which is, like, yeah, you kinda do. Mhmm.

Joe: 22:54

I I don't know how you teach that better in PT school besides going all in. Because a lot of people aren't gonna be all in, and that's really tricky because that could be a

Anna: 23:03

turnoff. I mean, I think there should be a better overview. Again,

Joe: 23:05

just I don't know what you guys said, but

Anna: 23:06

Better about, like, the the different levels, the what what's the common red flag or,

Joe: 23:13

like Yeah.

Anna: 23:13

If you see this, this is what you should be aware of, and like, knowing better about how to

Joe: 23:17

We just learned the layers of the pelvic floor. I think that was it.

Anna: 23:20

Know better about how to talk about it, and how to, you know, know when to send someone, or like have a couple of ideas of things to work And the the palpation piece, I will say, like, when we the first day of the course, because it was a

Joe: 23:39

It's like jumping in cold water.

Anna: 23:40

Two or three day course. I think the our instructor did a really good job of she's like, you know, before our first lab, was like, alright. If you are not nervous about this, you are lying. And I was like, okay. Yeah.

Anna: 23:53

Because I definitely, you know, was nervous about it. And then you get really because you really do it's just it's another, like, body part.

Joe: 24:01

Yep.

Anna: 24:01

I tell my patients a lot, whether, you know, I'm dry needling a glute or we're doing pelvic floor work that I'm like, you know, butts are like thumbs to me at this point. Or, you know, vulvas are like thumbs to me at this point. Like, they're just another part of the body, and like, you are not special. Like, really it's it's just science, it's something we see. I think that's the biggest thing too that I learned from the class.

Anna: 24:27

How important it is to tell someone like, this looks good, this is normal. Like everyone is I think a little worried that their genitalia is like different or Yeah. It's there's there's a lot of variety there, but it's it's not you know for us it's it's just another body It truly is. Yeah. And if there's something that's going on that we think you should be concerned about, we're a really good person to tell you.

Anna: 24:56

So yeah.

Joe: 24:57

That's what I think is crazy too. If you look at any anatomy model or go to a beach, for instance.

Anna: 25:04

Mhmm.

Joe: 25:06

Male and female both. There is not that much covering this little private area. Mhmm. Right? But when we dive deep into it to figure out what's going on, it's this big daunting task.

Joe: 25:16

Yeah. Mhmm. For both the patient being like, my god, you know, I think something's wrong.

Anna: 25:19

Yeah.

Joe: 25:20

And some therapists are like, oh, boy. Mhmm. And it's a very small area. Yeah. We we see everything else and we're like, oh, whatever.

Joe: 25:27

I'll just go in and get it. Yeah. I'll I'll do whatever. This little area is like, oh, this is a little different. Now that I've doing it for a while, like,

Anna: 25:34

oh, whatever.

Joe: 25:34

Like anything else. But I I I also think it's important

Anna: 25:37

to say, like, we as therapists are not dismissive of the fact that it is different and uncomfortable for Correct.

Joe: 25:44

Yes.

Anna: 25:45

Like, we are just saying it's not it's not uncomfortable for us because it's very common for us. Yeah. And we are not gonna see anything that is like shocking or new or different. Right. But we fully understand

Joe: 25:57

It's a very sensitive area.

Anna: 25:59

That it's sensitive, it's uncomfortable, there may be some trauma for certain people surrounding it. And we, so we're not dismissive of the fact that it is like

Joe: 26:07

It's an intimate area, uncomfortable.

Anna: 26:09

Yeah, I tell people all the time, was like, it's different, it's weird, and that's okay. Like if there's something you're not comfortable with, like you let me know. It's typically a lot more comfortable than like a typical, like, gynecologist or gynecological visit. Like, there's no stirrups. There's no speculum.

Anna: 26:24

God, hate that thing. Like, most ladies do. So it's a gloved finger. Yeah. You know, you are you are

Joe: 26:30

Private room. Sheet. It's intimate.

Anna: 26:33

Quiet. But I also, like, I don't dismiss the fact.

Joe: 26:36

Memory foam beds?

Anna: 26:37

Yeah. And sometimes they're they're heated. There's one that's heated.

Joe: 26:39

Oh, wow. Didn't know that luxury here at Freedom Physical Therapy.

Anna: 26:42

Yeah. But, yeah, we don't dismiss that it's uncomfortable. And that is shown by the fact that, like, the fact that we took the class and both of us were, like, really nervous before. Because it's uncomfortable. Yeah.

Anna: 26:53

But this it it's really important for us to be able to get the most information from that internal exam if that's something you're comfortable with.

Joe: 27:00

Yeah. Yeah. And I I think the overall point of this podcast and I talked about this in our male pelvic health too is one, and I think you would agree. One, it's not normal to have these symptoms. No.

Joe: 27:12

Do not live with them. Two, we understand that it's uncomfortable and understand that it's it's uneasy to come and get treatment for it. Mhmm. But we feel comfortable making you feel comfortable in a setting like this.

Anna: 27:27

Absolutely.

Joe: 27:28

Do not wait. Seek out one of us. When I say one of us, not me, because I just do male, but some of our female pelvic health specialists, because these symptoms can improve. They can probably sometimes improve quicker than you think.

Anna: 27:40

Yeah. Yeah. And sometimes it's only a couple of visits. I mean, sometimes it's a longer journey, but sometimes it's a couple visits. I will also say, if it's someone that I have been seeing for a long time for something else, say it's someone I've been seeing for like shoulder pain, something like that, and they mention some pelvic floor issues.

Anna: 27:59

I always tell them like, I have no problem seeing you for that. I'm very comfortable. However, if you would feel more comfortable seeing someone else for that, because we have three other therapists at our location who do female pelvic floor, a couple who also do male pelvic floor.

Joe: 28:16

Yeah.

Anna: 28:16

I tell them, I was like, I have no problem with you seeing a different therapist if that's something that you want to keep separate. And some people really like doing that. Now it's different for you. I know we have had both Heather and Nina treat male pelvic floor too.

Joe: 28:27

Heather's about to. Nina does it. Nina does it. Heather's about to.

Anna: 28:31

So we have a couple other people. You're the only male, which I know makes a lot of males probably feel more comfortable. Yeah. But for me, I always give that as an option. If that's something you would feel more comfortable keeping separate and talking to someone else about and having someone else treat you for, totally fine.

Joe: 28:46

And some people have taken

Anna: 28:47

me up on that. So

Joe: 28:48

Yeah. That's very smart. For the the men, I think it's tough just because, one, Nina's super bugged Mhmm. Which is good. But so it's sometimes hard to flip people back and forth where I'm just like, we just gotta do this.

Anna: 29:01

Yeah. Mhmm.

Joe: 29:02

And and I always I always tell people, like, I'm I it's my goal not to be internal for forty five minutes. I want to get in and get out just like you want me to get in and get out. Mhmm. I need to get my information as fast as humanly possible and as effectively as possible. Yep.

Joe: 29:16

I would assume you probably feel the same. Mhmm. You know, it's not our not our goal to do that the whole time. Our goal is just to get the information we need and get a treatment plan put together.

Anna: 29:24

Absolutely.

Joe: 29:25

Anna, is there anything else you wanna add for Women's Health Month? Give me something. Give me something. Give me something positive. Give me some positive motivation.

Anna: 29:37

I mean, a lot of the symptoms we talked about are not normal. I think at least in the female realm, we're going in the right direction. It's better talked about. It's very rare that we hear physicians saying, like, you just need to have a glass of wine. You just need to relax, which is

Joe: 29:52

Thank God.

Anna: 29:52

Thank God in the right direction. A lot more doctors are being more aware of pelvic floor PT as an option. Yeah. We're getting a lot more referrals. And we're getting a lot more people just walking in, like ladies who are coming in and being like, you know, I think I have a problem with this.

Anna: 30:09

Or even if it's patients once they become comfortable with you being like, can someone check this out? So we are moving in the right direction, which is great. And if you think you have a problem, come see one of us.

Joe: 30:22

Yeah. Come see us. We've got four Four of you, Erin, Heather, Nina. Mhmm. Four in Fox Point, I believe two up in Grafton.

Anna: 30:37

Yep. Anne and Rachel?

Joe: 30:39

Yeah. Believe so. Yep. We're currently working on adding in Brookfield.

Anna: 30:43

Yes.

Joe: 30:43

And then there is Abigail, I believe out in Mukwonago treats it as well. Correct?

Anna: 30:49

Yes.

Joe: 30:50

Yeah. So we have availability, I believe, at all of our clinics, but if we don't, we will make sure you see the right person. Again, it's not normal to have any pelvic symptoms. We are here to help. Mhmm.

Joe: 31:00

Thank you, Anna. You're welcome. Thanks for listening everybody for another episode of the Freedom Talks podcast, and we'll see everybody in the next couple weeks.