EP17 Part 2: Debunking myths and uncovering the truth about your pelvic floor health with Dr. Angela Turnow
Welcome to part 2 with Dr. Angela Turnow who specializes in helping active moms stop bladder leakage so they can run, jump, stay active and stay dry using all natural methods. On this episode we debunk common myths you may have heard when it comes to bladder leakage and pelvic floor health.
- Understand what the pelvic floor is and how it functions
- Understanding the relationship between the pelvic floor, abdominal muscles and the diaphragm and how they work together
- Looking at bladder leakage as a symptom
- Understanding that leakage does not equate to having a weak pelvic floor
- Learn about resources and where to learn more
- Why bladder leakage is not normal, and how we can address it
- Understand that you don’t have to live with bladder leakage as part of your life
Learn more here: https://achievemovement.com/about
Join Dr. Angela's free Facebook group for bladder leak solutions here: https://bladderleaksolution.com/
Join our Checkable Health Hero Moms Community: https://www.facebook.com/groups/1357609938045306
0:00:00.0 S1: Dr. Angela Turnow specializes in helping active moms stop bladder leakage so they can run, jump, stay active and stay dry using all natural methods. On this part two of a three-part series with Dr. Angela, we're gonna be debunking myths that you may have heard when it comes to bladder leakage and the pelvic floor health.
0:00:25.5 S2: Welcome to the Wellness Essentials Podcast, where we invite you to join the conversation and get inspired to be in the driver’s seat of your health and well-being. On this podcast, you'll get an all-access pass inside the minds of MDs, experts and thought leaders in the industry. No topic is off-limits, and we're asking the questions to get you the answers across the gamut of topics when it comes to optimizing your health. This is the WE Podcast.
0:01:03.8 S1: And we are back for part two with our guest, Angela, to talk more about the bladder, leakage, the pelvic floor health, and all of these great things. So thank you guys for tuning in. And thank you so much, Angela, for chatting with me today.
0:01:19 S2: Absolutely.
0:01:20 S1: Let's get the guest a little recap of what we talked about last week, you kind of explained the pelvic floor, what it is, and the importance of it. You wanna recap a little bit about that?
0:01:30 S2: Yeah. So the pelvic floor is a sling of muscles that sit inside of your pelvis, so they're the muscles you sit on. They are your pee, poop, sex, childbirth muscles. They are posture muscles, which people don't recognize typically, and also they support your pelvic organs and so bladder leakage specifically, a lot of people think that it's just the pelvic floor muscles, but it's not, it’s how all of the muscles work together, and so that is how I approach this issue when I'm working with my clients, and it's been very effective looking at it that way versus just the pelvic floor.
0:02:08.2 S1: That is again, so insightful, I love that you, that was very enlightening for me, and I'm sure a lot of our listeners or moms out there, really open their eyes to what the function is and how it works with other parts of the body, so that was super cool. Let's talk about some myths and debunk some of the things that we maybe have heard that aren't true, and get to the truth of our pelvic floor health. So what are your thoughts on bladder leakage, and does it really mean you just have a weak pelvic floor?
0:02:40.2 S2: No, no. So, let me ask you this. If you had knee pain or elbow pain, would that mean that you have a weak bicep or a weak leg?
0:02:53 S1: No, probably not.
0:02:55: S2: No, no. So, bladder leakage is just a symptom. It's just a symptom, just like knee pain or elbow pain. They are just symptoms of something not working well. Like your body is not working efficiently, it's not working well together. And so that is where a lot of people get it wrong, is that they look at bladder leakage as it's only the pelvic floor, or it's only this one set of muscles, and no. That is not the case at all, and the other thing is, it's not just having a weak pelvic floor, because if, let's say you were to flex your biceps, so that's your arm muscle, if you were to flex your bicep or just flex your arm for three hours, one, you're probably gonna feel weak after you let that muscle go because it's been working so hard.
0:03:48.5 S1: It sounds exhausting just thinking about it.
0:03:51.0 S2: Right, exactly. So then when moms think or when they have bladder leakage and they just need to tense or engage their pelvic floor muscles, and you're doing that all the time, well, those muscles are, they're not gonna work well. They're gonna feel weak. And so that is often the case too when I've had clients that they went to their midwife or they went to their practitioner, and they said, “I have a weak pelvic floor”, and typically the position that you would check that in would be like on your back, just like a women's exam type of a thing, and one, I don't really find that to be a reliable test because it could be that your muscles are just so tight or they're working so hard, and so again, if you were already flexing your muscle, if you're already flexing your bicep, you can't flex it more. Does that make sense?
0:04:46.0 S1: It does, it sounds like the muscles are, they're fatigued, they're tired, and the symptom sheds light on that.
0:04:54 S2: And then also, if you're not connected with how to use those muscles, that's not gonna be an efficient test. Right, so if I ask you to do a handstand push-up, would that be an efficient way, if you're not used to contracting those muscles in that position, how is that a reliable test?
0:05:12.7 S1: That makes sense, because I think about it as an athlete myself, it’s you have to work up to something like that, your muscles aren't prepared or trained to do that.
0:05:25 S2: They're not trained. They're not trained to do that, right. So typically, women aren't just, they're not leaking or having bladder leakage symptoms or pelvic floor issues when they're laying on their back. It's like when you're up and moving and doing things, so I'm more so, go in the realm of, what are you feeling? What are your symptoms? Let's talk about that, and let's make it very specific to your needs. So I just ask a lot of questions, and I make it very applicable to their life of really figuring out what is happening, situation by situation, which there are a lot of overlap with most people, but everybody's unique. So it's like looking at, are you having back pain? Are you having hip pain, are you having painful sex? Are you having leaking when you move too quick? Or, when are you experiencing this? Is it when you sneeze or is it like you are walking to the bathroom and it's like you're five steps away from the toilet, and that's when you leak? So just one, are you having your symptoms, is it that first step out of bed that you're like, “I can't hold it”.
0:06:31.6 S2: It's like, ah! So looking at all of these scenarios and when are you having your symptoms, and it's not just that your pelvic floor is weak, but it's how the whole system is working together.
0:06:43.4 S1: That makes so much sense. I think about it, say I'm someone who jump ropes and that's where I'm having my leakage, well you lay me on a table and you check everything out, it's not gonna be the same, 'cause it's not in that, it's not in the scenario of the lifestyle when that episode is happening. That makes so much sense.
0:07:01.5 S2: Exactly, and then the power in that is like maybe if you lay on your back, everything checks out fine, but it's not fine because you're having issues. So sometimes people are like, “Yeah, I did traditional”, I would say I'm not a traditional pelvic floor therapist. I did that round of therapy and I graduated and it was great. I met all the criteria but I still have issues and I'm like, “Alright, well, I can help you with that”. So that's the cool part.
0:07:37.0 S1: Yeah, I absolutely love that because you're getting into the nuance and you're getting into the individualized care again, and looking at the body holistically, and those are, I think where our healthcare is going, where it needs to go to get proper care because yeah, how many times do we hear people go in, they get a diagnosis or they get a clear, they're in the clear like, “Oh doctor says I'm fine”, but then you're still having the issues and then you're looked at like, you're the crazy one because you're having the issues when the reality is, it wasn't treated properly to begin. I don't know if I should say that.
0:08:12.9 S2: Well, it's just they're not trained, right, because they're trained in the bladder or the uterus or, I have no business in delivering a baby, it's a very small area, and it's just I wouldn't deliver a baby, but then at the same time, I'm the muscle person. So it's where are you getting your care from, where are you getting your answers from. You have to get it from the person that is like, I've spent years, hundreds and thousands of hours getting trained in this. So again, I have no business delivering a baby, and if it's a true bladder issue, like the organ itself, go to a urologist, but if it's a muscle thing, and there is value in knowing if it's not a bladder thing, and there is value in knowing it's not the uterus thing, but there's also, don't stop there. If you're not getting your answers there, it doesn't mean you've ended your, you've explored all the options.
0:09:08.9 S1: That's true, like it’s about finding harmony, and it's like if you're, that's the thing I think women as we need to do, is if we aren't getting the answers we need in a place that it's just, it's not that that doctor, that person doesn't care. It's just that there's, like you said, the specialty, it's like, keep trying, keep going, and again, that's why we put these resources out there on the podcast to just share. It's like maybe this is a light bulb moment for one woman, it's like her cue, “Alright, this is what I need to try. I've tried everything else. Let's give this a shot.” And I think that's why we do this, we touch people's lives and give them the resources, so...
0:09:47.1 S2: Absolutely, and to kind of stack on that a little, it's like, I like it when people have tried other things, 'cause then it's like, it gives you insight like, “Oh, I've tried this, I've tried this, I’ve tried this this”, and I often, when I'm talking to my clients and I don't work with everybody that I talk to, 'cause I wanna make sure that I can absolutely help them, and so, but a lot of the conversation too is, what have you tried, what hasn't worked? And so if you haven't tried things, sometimes it's hard to know where you're at. Does that make sense?
0:10:20.7 S1: Oh, 100%. And I'm such a huge goer of trial and error because I'm a taste tester, you bring me the whole dessert tray and I'm gonna taste everything, and that's kind of like how we can look at this as keep going, keep trying. Don't give up, don't suffer, you don't have to live in your suffering. There's so many different options out there. So I kinda wanna dive into the next question 'cause we talked a little bit about leakage, we talked about different scenarios. Now, some people think it's just part of getting older and that's normal. Is it?
0:10:52.7 S2: No, no. So I would say fix these things earlier because it's always better to be proactive and or fix things when they're not as big of an issue. But I have helped women in their 80s, I'm not saying it was easy, right? But what I am saying is, any time you can fix this to an extent, right, because there's going to be a time where it is kind of too difficult and you're past the window and you might need more invasive support with that. But again, that's what we kinda dive into, we look at where are you at with things, have you tried what's available to you as far as your body to fix it, because it's not just the pelvic floor. So how are your hips, how's your core, your shoulders, your mobility, your posture, body mechanics, looking at all of that, and you can kinda think about it like with your kids, if you were to create an, you're gonna do an art project with them, and there's glitter, let's say there's glitter involved in this art project.
0:11:57 S1: Love it, gotta have some glitter.
0:11:59 S2: Yeah, there's glitter involved in this art project. It's like, are you gonna set some ground rules upfront and know that there's gonna be clean up later. But if you set ground rules up front, there's usually less clean-up later. Or are you gonna just go at it and there's gonna be a huge mess at the end that's gonna take more time, more effort, more energy to clean up, we'll say...
0:12:22.7 S2: Right, and so in a sense of, let's say postpartum, and when you're a mom, your partum is for life. But if you are, let's say earlier postpartum like up to, let's say even three years earlier postpartum, then that would be the time that you can really, it's easier to fix things 'cause before they become more ingrained in your day-to-day, but again, I've helped women that are 15 years postpartum, 25, 60. It's not a part of normal aging. Definitely not. And think about it this way too. Bladder leakage is just a symptom, just think about it as just a symptom, and so if you had knee pain or back pain, those things are probably more common when you get older, because it's just your body, your body is like, let's say breaking down or it doesn't bounce back, it doesn't like, it's just, it's part of the aging process of, you go for the long walk and if didn't use good mechanics, things break down faster, you might have knee pain faster than you maybe would have 20 years ago. But at the same time, if you have knee pain or back pain, that's not...
0:13:31.0 S2: I mean, you can fix it. Does that make sense? You wouldn't just sit there in your misery, hopefully, and just think, “Okay, this is just my life now”, so they're just symptoms.
0:13:41.5 S1: It's like our body is talking to us and tuning into that, and if something feels out of alignment, like lean into that feeling and that's when that's a great place to start, is creating this awareness that we're doing is, this isn't normal, even though we may think, let's tune in, if something's changing in your body.
0:14:01.5 S2: And that can be the really tricky part, is that I would say a bladder leakage for moms or as you're getting older, it's just, it's become so normalized, but then it's hard to question if, is this something I can fix? And I would say some companies have taken advantage of that, there's pad commercials of just, “wear the pads” or it's like, “Oh no”. They've really capitalized on the fact of normalizing this issue, and it's not normal, it might be common, but common is not normal.
0:14:37.7 S1: I'm really glad you said that common is not normal, and that's again to we're creating this discernment in your own sense of self is a huge thing, like, it's the pads too. It's just like a big old band-aid, really.
0:14:52 S2: Absolutely.
0:14:53 S1: 'Cause it's not really solving the problem. So this is a really great way to create that spark of, “Aha, okay, I feel this is something going on, but my girlfriends, three of them have it after they had kids, and they seem to just be dealing with it, so I'm gonna deal with it”, but instead we can create this awareness and say, “You know what, I'm gonna take action, and if that action is responsive and good, I’m gonna share that with my three girlfriends and then they're gonna take action too, and then all of a sudden nobody has these issues anymore, and we've solved them because we're getting into our bodies.
0:15:25 S2: Absolutely. And there's just so much power in that. Because when you understand your body better, you are going to exude that in every area of your life. If you are gonna just imagine just being able to step out the door and go for the run and not worry, “Did I pee before I stepped out the door?” Calculating out how much water you drink before you step out the door, or like mapping out bathrooms on that run, just imagining the freedom of just, or chasing your daughter across the yard and not worrying about if you move too quick, like what's gonna happen. So it's just, in that way, that's gonna resonate into your family, into how you interact with your community and at work, and that's really what I'm about is changing the life of a mom, changes the life of a community.
0:16:16.3 S1: That is so well said, it’s so true, because if we feel good about our bodies and feel like we're not putting all this energy and thought and worry into the symptoms and the problems that those are resolved, we can get back to living. We can be better versions of ourselves and just know that we're healthy. I completely get where you're coming from with that and this is so great. Yeah, of course. We share it with our friends, we share it with our friends, and that's the best part is spreading this great awareness of being in tune with our bodies. It's pretty awesome. What would you tell a brand new mom who does have these symptoms and is maybe scared to say something, she's like, “Oh, it's just part of it, part of motherhood.”
0:17:04 S2: One. I would say, speak up, okay. So one year providers asks that everything is normal when I hate that question, because if you don't know what normal is, if you were struggling with back pain or bladder leakage or even postpartum depression, but if you're struggling with those things and you just think that that's like a, and maybe all of your friends have those things, then you might also think that that's just normal. So normal is dependent on your perception of normal. And so instead, I like to dive deeper. It's like, “Okay, what is normal for you? What do you think is normal?”, and I've had moms that, one mom was peeing 60 times a day and she was like, “Yeah, it's just normal.” And I'm like…
0:17:54.3 S2: Let's talk about that. Just only because she had lived with, if you live with something so long, and I guess you are, if you're early postpartum or a new mom, it's like you have no context of what is normal. And even if you're a third time new mom, then again, you've, you've never been a third time new mom, so it's still new for you, you might write it off as like, “Well, I've had three babies, so I guess, three babies, that's normal.”
0:18:26.2 S1: Yeah. That makes so much sense, it's almost like re-calibrating that part of our brain because it is so normalized and it is so accepted as, “Oh, this is just part of it”, when reality is, that's what I love too, about what you do, is that holistic lifestyle approach. This has become normalized in a person's mind, but then it, this helps to recalibrate. Let's resolve this. And get you doing what you love to do.
0:18:53.4 S2: That's really it, because bladder leakage is a major health problem. It is a major health problem, and I just wanna talk about that for a minute, because I think a lot of women can water it down or dilute it as like, it's just, I'll just for a pad, but it's like, again, that is a band-aid and it will likely get worse, and when it gets worse, it's like you start off by not jumping on the trampoline, maybe you're like, “Okay, I guess I'm at the point where I just can't jump on the trampoline with the kids anymore. I just have to give that up, right?” But then what is the next thing that you're willing to give up, and slowly, by slowly, you're giving things up until you don't even recognize yourself, and in the process you're getting weaker because you're not doing things. You're not going out for the run, 'cause you're like, I guess at this point in my life, I just can't run anymore because of bladder leakage, but maybe you didn't even put the two together that you weren't, because it was such a slow process to get to that point where things are just slipping away and because you maybe unconsciously feel uncomfortable or maybe it's very obvious that you're uncomfortable, but sometimes it's not, and you're just getting weaker in the process, and because of that, now you're not as active, so maybe you're gaining weight, or maybe you're having back pain or hip pain, right, and so now you're going to this specialist and that specialist, and I've had people...
0:20:22.6 S2: Because they gained weight, they had things like other health issues that come along with that, maybe you need gallbladder surgery now, or you're just having more health things come up because you're not being as active, and that is just so sad to me. You know, it's like it stemmed from feeling uncomfortable with bladder leakage and now because maybe you're farther from the event of childbirth, a lot of people don't connect the two, is that was actually when the problem started. The other thing too is if a pro athlete, like a pro football athlete, if they tore their hamstring on the field, they are going to get very specific care of how to get back to the field very quickly, very efficiently, and move well for their body, and if that did not happen, even if you're not a pro athlete, but if you tore your hamstring, which was a very, like it hurts a lot, but like childbirth, like come on, that is the biggest strain on any muscle is childbirth, and if you had a c-section, hello, that's a major abdominal surgery. If you had a shoulder surgery, you're gonna have therapy, you're gonna have very specific help with how to get those muscles working again, not just try to second guess and try to be like, “Oh, I’ll just do these ab workouts and try to figure it out, I guess”, but if you had a major injury of tearing your hamstring and you didn't do anything about it, you just rested six weeks, which is like the six weeks is like the clearance time for usually postpartum moms going back to whatever exercise they want, but if you just laid around for six weeks with a torn hamstring and just started to...
0:22:02.9 S2: Just went back and figured it out on your own, you can probably guess that you're gonna maybe have things like hip pain or back pain or knee pain in your future because you didn't learn how to use the muscles correctly. And so it wouldn't just be about doing hamstring curls, it's gonna be learning how to re-use your body, how to walk efficiently, how to move through your hips efficiently, mobility, things like that, and that is the same thing for a new mom, it's like it's not just about the pelvic floor because it impacts so much of your body.
0:22:38.5 S1: That's so true. This is like, this is so enlightening, because that is one place where I feel that we definitely are in the dark with this concept, because we go and we have our baby, we come home and we rest, there is no real, correct me if I'm wrong, I also haven't had a child myself, but is there any sort of care that women get when they leave the hospital?
0:23:07.6 S2: Typically not. Typically not, like you have all of your visits for the baby, you're told typically, don't lift, take it easy, but at the same time, then you have your baby who maybe is, if you're lucky, maybe 6 pounds or 10 pounds or any number in that, and then you have the car seat, so it's like, don't lift anything, but also carry your baby to all these appointments, which the baby carrier and the baby is probably 25 pounds or 20 pounds or something, right? So where I like to come in, it's like, okay, yes, during that six weeks, you should lay low, but at the same time, it's unrealistic to think that you are never gonna lift, so let's teach you how to use your body efficiently, right, because the other thing that I just think is kind of just so silly is that whenever you put, and this is kind of across the board, this is just my thought, and I know we're talking about the pelvic floor and bladder leakage, but if you put lifting restrictions on people, let's say you can't lift over five pounds. Okay, so five pounds, if there's a five pound weight and it's close to your body, that is gonna feel a lot lighter than if you were to take that 5 pound weight and hold it out away from your body, so, that same five pounds now feels much heavier. So at the same time, it's like, let's teach you how to lift efficiently so that five pounds doesn't feel so heavy.
0:24:40.1 S2: Right, and so then you're gonna help yourself out of back pain and hip pain, and a lot of the aches and pains that new moms can have only because there's no direction.
0:24:50.7 S1: That makes total sense. It's like, instead of saying, just don't do this, let's see how we can do this efficiently.
0:24:58 S2: Yes. And safely.
0:24:59 S1: And safely. This has been such an incredible talk, and I wanna go in a little bit to ask you, how do you feel when it comes to women, and all of this information has been incredible and sharing this, how do we get women to invest in themselves and to take action when they do feel out of alignment with something or having leakage, things like that.
0:25:26.7 S2: Yeah, I think moms need to be okay with putting themselves first. A lot of moms, a lot of women, we can put themselves on the back burner of like, “Okay, well, I have to do this for my child, I have to do this for the house or at work, or for your husband or your spouse, right, you're just putting everybody in front of you, but now you have nothing to give more, because the more you give, give, give, and the more you are becoming depleted, the less you can actually do for other people. So by helping yourself and helping yourself feel not only confident, because when you don't have issues and you don't have pain, how much more confident and happy do you feel, you have so much more energy to give.
0:26:17.7 S1: 100% agree with that. When I'm feeling good about how my body's functioning, how I'm functioning, I am so much better to those around me as well, or I bring my best foot forward for sure.
0:26:31.6 S2: Right, and that can be so positive and so powerful for your family, for your kids, because if I'm in a negative state for whatever reason, because I'm human, right, but if I'm in a negative state, I see that reflected in my kids. They might have more attitudes, they might have more whining, and then I become kind of reflective of that, so it's like this negative loop, but if I'm feeling really positive and it's not just about forcing positivity, like you have to think positive, that is not what I'm saying because just when you get to the root cause of helping your body feel good, there is a huge mind-body connection, I am such a proponent of that, and so when you can invest and fix these things from that perspective, now issues just, they don't feel as big and you can, you feel more resourceful, you can just find a solution for things, you can take on the world, at least you can think like that, or if you can be active in a way that feels good for you, if I'm having, if I feel like I'm having an issue or I just cannot think of the solution for whatever it is, say, I'm trying to come up with how to coordinate the kids with the traveling and I just...
0:27:55.9 S2: I can't think of the, how to make it work. It's just not gonna work. But then I go out for a run or I go and be active, I come back and I'm like, “Oh, this is all I have to do”, right. I'm just able to be more resourceful and figure out the solutions easier, and if you just don't feel good in your body, and because of bladder leakage or back pain or hip pain, or you just don't feel confident in yourself, that is going to impact everyone around you.
0:28:23.9 S1: That's so true. That is so well said, and that is, if we fill our cups, we will overflow and be able to help others even better, that's a great way to put it to moms, we care so much about our kids, let's invest that energy. We wanna be there for them, we wanna be able to play on that trampoline with them, we wanna be able to see them go through a lot of life and to stay healthy and happy and take care of ourselves will allow us to be more engaged with our kids.
0:28:54.5 S2: My kids, and I'm sure other women feel this way too, but my kids, they're just, they're so great. They're so great. And I've just noticed that when I am at my best and I go out and go for a run and take the time to be active and do the things that make me feel good, my daughter looked up to me the other day, and she's two. I did not prompt her to say this, I've never said this at all, but she looks up at me and she goes, “Mama, you tough”. I'm like…
0:29:23 S1: I love that.
0:29:24 S2: I was like, “Oh, thank you, Alana.” It's like they are seeing what you do, and if she sees me feeling confident and positive in myself, then she is seeing that for herself as well, and so it was so cute, so we just back, back and forth in the mirror. “Mama, you tough”, “Elena, you tough”. We just went back and forth in the mirror as I held her and it was just so precious, and I just want that for all moms, like you deserve to feel like a badass. I don't know if I can say that, but you deserve that.
0:30:01.6 S1: You can say that. 'Cause it's so true, it's so true. And that is, that is what I love about, this is like the women empowerment, we hear that term everywhere, and it means a lot of different things to a lot of people, but truly, this is empowerment, this is giving that daughter or giving all your kids that sense of self-confidence that they can do things that they can invest in themselves later, 'cause they're watching you. They're watching you as how you treat yourself, that is very, very true, how you take care of yourself is hugely part of that. So this has been an incredible conversation, by the way, again, I love it. This has been so great, we hope that you guys have gotten so much out of this, and Angela, just share again with the audience how they can find you, if they haven't been able to find you yet. How can they get in touch with you?
0:30:56.3 S2: If this has really resonated with you, and you are at the point where you want to get back running and jumping on the trampoline and never worry about peeing your pants and just feeling confident in yourself to get back, being active, chasing your daughter across the yard and not worrying about bladder leakage, we can chat about what's going on and put together your game plan. All you have to do is find a time to chat with me so you can go to bladderleaksolution.com/apply and grab a time and we can just see what that would look like for you. And then also, you can find me on Instagram, my handle is @bladderleaksolution, and then I also have a Facebook group, so, “Bladder Leak Solution for Active Moms”, but you guys, I am more than happy to see if you qualify to work with me so that you can actually fix this. You do not have to live with bladder leakage.
0:31:53.2 S1: Amen, I think this is gonna resonate with so many of our listeners, and I'm so excited to have you back. We're gonna have a part three with Angela to share about things you should consider that may slip through the cracks and the mind-body connection, so we're gonna be diving in deeper, getting you more answers to your bladder leak solutions. Thank you guys for tuning in.
0:32:23.4 S2: Thank you so much for tuning in to today's episode. We hope you got a lot out of it. If you haven't already, be sure to subscribe to our podcast so you can stay up-to-date with our latest episodes. Also, you can find us on social media by searching, Checkable Health. We look forward to seeing you again soon.