Ruth Macy, PT, DPT she/her

A concentric/isometric exercise in isolation, like a kegel, will not meet that demand, bc a kegel hits the brakes, not the gas.

Running is a single-leg ballistic activity that requires good balance and stability in the entire leg, at every joint. You need the ability to absorb impact and turn it into momentum for the next step.

Peek into the Pelvis:

Leaking while running has a lot of contributors. Rarely do I see a "kegels-only" approach, help.

Let's talk about it:

You might be Very Good at kegels and Very Bad at letdown, while your friend Jessica cannot kegel to save her life. What we give you and what we give her should not look the same, even if you both have incontinence.

Peek into the Pelvis:

So much of pelvic floor work is figuring out what you're bad at and making you practice it.

That's why we always say "get evaluated."

Without estrogen: things thin out, lose softness, lose their stretch, and can be dry, kind of like an Oreo cookie.

Talk to your gyn!

Peek into the Pelvis:

Estrogen used v@ginally is one of the best protections for bladder and pelvic floor health in a low E body.

With estrogen, you are like a whoopie pie: thick, soft, cushiony, moist.

Anyone with adhesions in the abdomen might find the daily recommended fiber intake feels bad, and makes symptoms worse.

Visceral mobilization, a meeting with a dietician, and gastro work-up can help.

Peek into the Pelvis:

We say 25 grams of fiber per day for most women and People AFAB, but when doesn't this work?

It doesn't work with endometriosis patients, bc a large stool can be mechanically hard to pass if there are implants on the colon/sigmoid/rectum.

Peek into the Pelvis:

Letdown strategies to reduce pelvic floor tension can be both active, and passive.

Do both.

The more you train, or rather downtrain, the better you get.

When your toes touch, that's internal rotation.
When your toes are pointed away, that's external rotation.

Peek into the Pelvis:

Hip internal rotation is associated with pelvic floor opening or lengthening. If you have a tight pelvic floor, this is a great thing to work on.

The most low-energy way to achieve that: rolling your legs in and out while lying down or in a recliner.

Peek into the Pelvis:

Walk with swagger.

Swing your arms.

Swing your hips.

Be a silly goose.

It's good for your pelvic floor and will make you happy (endorphins).

(If you can't walk, wiggle and swing as able)

Peek into the Pelvis:

Lengthening your pelvic floor can happen in a few ways. My favs?
Inhaling into the perineum in sidelying or sitting on a ball.
You *allow* the pelvic floor to move in the same way you allow your belly to move when you breathe.

Try it and tell me what you notice.

Peek into the Pelvis:

Kegels shorten (tighten) the pelvic floor.

They help about 30% of pelvic health problems.

If they don't work for you, you might also need lengthening and coordination of the pelvic floor.

The Work Around: Set a reminder every 90 minutes to 2 hours during the day to remind you to toilet. That way your body doesn’t have to scream to be heard.

Peek into the Pelvis:

Capital-T Trauma and little-t trauma can leave you so disconnected from your body that you miss regular signals, like the urge to pee or poop

...until it’s an Emergency.

"Listen to your body" doesn't work when you've been ignoring it to feel safe.

Popular choices:
Coconut oil
Medicine Mama V*lva Balm
Desert Harvest Aloe Geleé
Hyaluronic acid suppository

Today's Peek into the Pelvis:
Ladies and People AFAB:
Hormonal changes can cause dryness. It can feel like irritation, sandpaper, chafe, rubbing. Applying a moisturizer right before bed soaks into the tissues over night.
⤵️

Pelvic Health Tip of the Day:

Feeling pelvic floor heaviness after activity? During periods of high stress? But then it goes away after rest and recovery?

You might have Low Energy Availability.

Bottom line?
You need to eat. You need to sleep.

Pelvic floor is a TATTLE TALE

Ruth Macy on Substack Mothers are very special beings. May you rest your burdens today.

substack.com/@drbbayruthi...

Not to brag but, while this cough from the Flu A is coming from the bottom of my soul, it hasn't made me pee my pants!

It's the little things.

Overhead at my gyn office:
"Doing kegels isn't enough, you have to work on the brain body connection so that urge doesn't take over."

She then proceeds to teach them the "stop, think, breathe, Kegel!"

Yes, gyn friend. I've taught you so well. Making me proud 🥲

Just spitballing here, but if corporations don't pay taxes to the US, they shouldn't be able to spend money related to the govt, eg lobbying, payments to candidates, and PACs.

Only tax payers should have that right.

They can be "people," but shouldn't be given rights only afforded to taxpayers.

Sometimes resistance is the stuff you do everyday.

How to use a pelvic wand to reduce tension
How to reduce exercises that are causing pain
About the pudendal nerve and why pushing on something until it hurts is a bad idea
How to train the rectum to be more sensitive

Things I taught people as a pelvic floor PT today:
How to use breathing to help a BM
How to use breathing to expand and the improve rib ROM
How to Kegel targeting the posterior part only
How to Kegel targeting tje anterior part only
How to Kegel to reduce prolapse

Thank goodness! I was hoping I didn't miss something nefarious. Seems to be going around.

"The hike itself was rigorous, even for one trained in advanced walking."

From Ricken Hale's long anticipated new book, The You You Are, actually perfectly describes hiking Katahdin!

Thoreau inspired, indeed.

#severance

Colin Farrell is all green flags, still, right?

Cause every time I go to watch a movie, there's so many red flag actors that I just cannot enjoy the movie.

Someone please confirm that Colin is still a green flag, please?