Healing at Your Core with Bree Allred EP 1
Bree Allred: [00:00:00] Just because it's common does not mean it is normal. In the pelvic health world, I [00:00:05] always say TMI is my jam. It is the too much information is [00:00:10] never enough information for me. I wanna talk about your bowels. I wanna know what they look [00:00:15] like. I wanna talk about how easy it comes out of your body. I wanna talk about sex.
I wanna [00:00:20] talk about your vagina. We wanna talk about your bladder and your pee. We're talking about all of these [00:00:25] things that most people are too embarrassed to actually talk about, but if you are having dysfunction in [00:00:30] these areas, it is 100% affecting your life, and that is why I do what I [00:00:35] do.
Narrator: Millions of women are living with pain, discomfort, and [00:00:40] silence, told that it is just a part of life. It doesn't have to be. [00:00:45] This is Healing at Your Core, where pelvic floor physical therapist Bre Allred brings more [00:00:50] than 20 years of clinical expertise to the conversations women deserve to have. [00:00:55] Real answers, real healing, no shame.
And now, your host, [00:01:00] Bre Allred.
Bree Allred: Hi, I'm Bre Allred. I'm a pelvic floor physical therapist of 20 [00:01:05] years, and I am so excited to be talking with you today. I [00:01:10] started in physical therapy because I really have loved the medical field, but I did not [00:01:15] like blood. I would pass out. So this was a really good fit for me to be able to be a physical therapist [00:01:20] and have my, my feet in the medical world and not have to deal with any [00:01:25] blood.
I really have become very passionate about pelvic [00:01:30] health. I'm a pelvic rehab practitioner, certified, and have really made [00:01:35] this my life's passion over the last 18 years in, in my career. It [00:01:40] is something that we need to talk about that people don't talk about. [00:01:45] I started my career in a clinic where I did a lot of work in the spine [00:01:50] clinic, and I was the only female therapist at the time, and so I ended up [00:01:55] getting to work with all the pregnant women who were having troubles during their pregnancy with [00:02:00] back pain and pelvic pain, and that really started my journey in treatment of [00:02:05] pelvic floor issues.
I have since then really made this, it [00:02:10] is 100% what I do with my career and feel that it's been just [00:02:15] a gift of mine to be able to connect with people on these levels and make uncomfortable [00:02:20] things comfortable, and to do so in an environment that is safe for people. So I'm [00:02:25] hoping that's what we're gonna create on this podcast.
I want women to know about these things. This [00:02:30] podcast is for women ranging anywhere really from 16 to [00:02:35] 80 years old. The pelvic floor is especially pertinent to women because [00:02:40] we go through a lot of hormonal change when we very first meet our period, and [00:02:45] then as we go through a season of childbearing, our body has another big hormonal [00:02:50] change.
And then we deliver children. We go through childbirth, whether that's through a C-section or a [00:02:55] vaginal delivery. And then as we go through menopause, again, we have another season of a hormonal [00:03:00] change in our life, and the pelvic floor is especially sensitive to all of these changes [00:03:05] We're doing this podcast because we really want [00:03:10] to educate women, and this is one of the best platforms that we know to get that education out [00:03:15] there to people of all ages, and to be able to start [00:03:20] conversations that normally wouldn't be started, and hopefully help just grow [00:03:25] everyone's awareness so that we can stop treating common things as normal.
[00:03:30] Just because it's common does not mean it is normal. In the pelvic health world, I [00:03:35] always say TMI is my jam. It is the too much information is [00:03:40] never enough information for me. I wanna talk about your bowels. I wanna know what they look [00:03:45] like. I wanna talk about how easy it comes out of your body. I wanna talk about sex.
I wanna [00:03:50] talk about your vagina. We wanna talk about your bladder and your pee. We're talking about all of these [00:03:55] things that most people are too embarrassed to actually talk about, but if you are having dysfunction in [00:04:00] these areas, it is 100% affecting your life, and that is why I do what I [00:04:05] do. So let's delve into why is the pelvic floor pertinent to all of these [00:04:10] TMI questions that I just asked about So [00:04:15] this is our pelvis.
It would be sitting down lower in my body, but the striated red [00:04:20] here is all of the pelvic floor muscles. A picture's always worth a thousand words, right? But [00:04:25] as we're looking at this, you can see here at the front in the pubic bone, we've got [00:04:30] pelvic floor muscles that attach there, and they're almost like a bowl of muscles that go around and [00:04:35] attach at your tailbone in the back and in the two bones that we sit on here on our [00:04:40] sides.
There are three different layers to the pelvic floor. These layers [00:04:45] work together to help us with function. So the outside layer has a little bit more [00:04:50] circular nature. These circular muscles play a big role in the [00:04:55] sphincters, if you guys have heard of that, right? We got like the anal sphincter. We've got another one that's around the urethra [00:05:00] that's in the middle layer.
They play a big role in sexual function as well in helping us to be able to [00:05:05] orgasm or to be able to have penetrative intercourse. The deeper muscles are a little [00:05:10] bit more postural, a little more supportive, and they do lift and help close openings as [00:05:15] well. So as you can see, we're talking around, we're surrounding urethra, we're surrounding [00:05:20] vagina, we're surrounding the anus, and that in and of itself really leads to it- [00:05:25] how it interfaces with our bowel, with our bladder, and with intimacy issues [00:05:30] Now, another role of the pelvic floor, a fun one.
You can see how it's gonna be integrating with your [00:05:35] pelvis, and how it's gonna be integrating with your spine and your tailbone, and how [00:05:40] also it integrates with your hips. So if we have pain in your back that's not getting better, [00:05:45] this might be a culprit. If we have pain in your hip that is just not getting better through standard [00:05:50] methods, you've gone to physical therapy, you've seen multiple physical therapists, are they looking [00:05:55] at the pelvic floor and the contributors to that?
We're also talking tailbone pain can be a big [00:06:00] thing that did you know you can do something about it? Can also be very helpful. These [00:06:05] muscles also integrate with our deep core, and it works as a canister. So if we're thinking of a [00:06:10] canister, the pelvic floor's the bottom of the canister. If I'm coming over the top right here [00:06:15] into our ribcage, we would be looking at the diaphragm muscles, and then we've [00:06:20] got the abdominal muscles in the front and the back muscles in the back.
And that's really what we talk about when [00:06:25] we're talking about a deep core. And so deficits in the pelvic floor leaves [00:06:30] a weak area in the core canister. With our core [00:06:35] canister, I want you to think of a soda pop can. It's pretty strong, right? Especially when it's [00:06:40] unopened. Now, if you pop the top, it's much, much easier to collapse.[00:06:45]
So pelvic floor, if it has a weakness, it's the weak link. [00:06:50] It's like popping the top on the core canister, okay? And it makes it [00:06:55] much easier to collapse, and that's a lot of how it's going to be relating to your [00:07:00] spine, to your hip, and to your pelvis as well.
Narrator: Now we're looking at the pelvis
Bree Allred: [00:07:05] with the organs in it.
So we've got your bladder here in the front. We've got the uterus as it [00:07:10] comes over the top. We also have these two fallopian tubes with the ovaries at the end [00:07:15] of them, and your bowel as it's exiting the body right there at the back. [00:07:20] So when we have a lot of pelvic pain, we're gonna be looking at what all of [00:07:25] these structures in here.
We're gonna be looking at what's happening in the bladder, what's happening in the [00:07:30] uterus, what could be happening in the ovaries, what's happening in the bowel. So pelvic floor is going to [00:07:35] encompass all of these, and a pelvic floor therapist is going to also be looking and having some extra [00:07:40] knowledge with these organs here.
Males, I did not forget about you. Here you go. We have a [00:07:45] bladder here in the front. We have your bowel in the back. This is your genitalia as it [00:07:50] comes out. Okay. I'm gonna put this person on their back, and now you can [00:07:55] see the male pelvic floor. We have all of the same structures organized a [00:08:00] little bit differently in our body.
Okay? It's an interesting kind of thing that we think about. But if you're [00:08:05] looking up muscles from a male's perspective and a female perspective, do [00:08:10] you see the similarities? The same muscles exist. They're just organized a little bit [00:08:15] differently. Okay? We can also say males have a urethra, [00:08:20] females have a urethra as well.
Okay, the male's is generally external, female's [00:08:25] is more internal. Okay? We have a penile head right here. [00:08:30] We have a clitoris in the female body. So similar parts [00:08:35] organized a little differently. Males have a prostate. Females have a uterus. [00:08:40] Similar, okay, helping with reproduction, but organized a [00:08:45] little bit differently.
Are we seeing this? It's like males have a pelvic floor, too. They're just less likely [00:08:50] to have dysfunction. They're not going through as many hormonal changes within a month or within a [00:08:55] lifespan, and they're not delivering babies out of here. So their dysfunction is less often. Females, we have it [00:09:00] more often.
But if you have a husband with testicular pain, if you're struggling with [00:09:05] penile pain, if you're struggling with groin pain, hip pain, all of those things, the same could still [00:09:10] be happening from our male counterparts and could have issues as well. I will date myself just a [00:09:15] little bit, but if you've ever seen the movie Kindergarten Cop, they talk about-
YouTube: Boys have a [00:09:20] penis, girls have a
Bree Allred: vagina
right? And that's kind of how we're taught about our, our [00:09:25] anatomy. But let's actually talk a little bit more about the external female anatomy. Okay? [00:09:30] This would be sitting in my body right here is the back, and this is the front. So this person is [00:09:35] sitting or is laying down on their back. But what we're looking at here on the outside is [00:09:40] actually called the vulva on a female.
Okay? So the vulva, here we got the [00:09:45] labia, okay, on- majora on the outsides, labia minora on the [00:09:50] insides. We'd have the clitoris here up at the top, and then the actual hole [00:09:55] at the bottom is the vagina. So it's not just a big, do you know what I [00:10:00] mean, overall vagina, right? When we think of boys have a penis, girls have [00:10:05] a vagina.
But we're really talking, it's like vagina is the hole And [00:10:10] the vulva is what we're actually thinking of when we're talking about our private parts or our external [00:10:15] genitalia. Now, let's specifically talk through how the anatomy can then [00:10:20] lead into some of the symptoms or things that you might be having in your pelvic floor, and how we may go [00:10:25] about treating that.
So we can have bladder issues. Bladder issues can occur [00:10:30] with difficulties in the bladder itself, difficulties within the urethra. [00:10:35] I guess you could even say up the chain a little bit in the kidneys, where if we have a kidney stone, [00:10:40] you could get some pain in these areas as well. And then it can also have dysfunction within the pelvic floor.[00:10:45]
The pelvic floor can either be too tight, and it can cause issues with [00:10:50] being unable to empty your bladder well, or you sit down and you're like, "I can't pee. I know I [00:10:55] need to pee, but I can't pee." That can be one sign or symptom there. It can also cause urine [00:11:00] leakage if these muscles are too tight, so that can be a big issue there.
I have [00:11:05] women that feel that they have recurrent UTIs or chronic UTIs, and [00:11:10] then they go into the doctor to get their urine tested, and there is no u- [00:11:15] infection. So then why are you having these UTI symptoms? Guess what can be the culprit? [00:11:20] These pelvic floor muscles. If they're too tight, it can create some of those burning sensations, that [00:11:25] having to go to the ba- bathroom often getting that urinary frequency.
So that can be a [00:11:30] symptom there. Another thing that we will have is having to go to the bathroom often with strong [00:11:35] urgency. Pelvic floor muscles can be a part of that, whether they're too weak or too tight. That can both [00:11:40] feed into it. There are some things within the bladder, whether it be hypersensitive nerves.
[00:11:45] Sometimes there's conditions called interstitial cystitis or a painful bladder syndrome that [00:11:50] can be a factor within the bladder itself, or some nerves in the bladder itself that can be a [00:11:55] problem. We can also have the muscle that's around the bladder become a little bit overactive as [00:12:00] well. And there are some strategies that we can do with physical therapy to be able to help that as well.[00:12:05]
Now, moving on to the uterus itself. What are some problems that could [00:12:10] happen within the uterus? Really, these are gonna be things like adenomyosis or [00:12:15] endometriosis can be things that are growing here. We'll do a special episode to talk just [00:12:20] about that in it- of itself. But endometriosis can cause a lot of pelvic pain, and [00:12:25] oftentimes there's a lot of muscle tension that's associated with that as well.[00:12:30]
From a bowel perspective, we have two ends of the spectrum. We have constipation, where you're [00:12:35] really struggling with being able to empty your bowels, or we have incontinence, where it's like, "I [00:12:40] can't control my bowels," and so we may be having some accidents there. With that, [00:12:45] pelvic floor is a... We like to call it the doors.
[00:12:50] Those are the doors that are controlling when things exit and when things stay in. [00:12:55] So if you had a door that wouldn't open well, could you see how that could [00:13:00] contribute to things being unable to come out of the body? [00:13:05] AKA you're constipated. You're having to strain to have a bowel movement. It's a workout to go [00:13:10] to the bathroom, or you're feeling very bloated just not well.
Do you know what I mean? Very full in your [00:13:15] stomach. That can be from the pelvic floor. And if it's weak, if the [00:13:20] doors are open all the time, it makes it really hard for things to stay in the body, right? [00:13:25] So then we can work with that as well. We can work with bowel urgency. There's so many different [00:13:30] things that it's pelvic floor can encompass.
Are you starting to see? It's a central hub of your body. [00:13:35] This is where we talk about it's healing at the core, right? This is where we're really addressing, it [00:13:40] is a center spoke the center hub of a... Do you know what I mean? All of these wheels and [00:13:45] spokes that come in on a wheel. If you're looking, it's like we've got...
The legs are coming into this, and it's [00:13:50] transferring that force up through into your trunk. It's also transferring force from [00:13:55] your arms down to the ground. So it is a really big central hub [00:14:00] where things are absorbing forces, where they're transferring forces. It's very [00:14:05] complex, and it's very crucial to our lives Now let's talk a little [00:14:10] bit about intimacy.
Okay? We can have issues with being able to have these [00:14:15] muscles relax enough or having enough size or stretch to be able to allow [00:14:20] penetration. This can also be, like, painful tampon use. I may have clients [00:14:25] who have struggled with some traumatic experiences in their past that these muscles are [00:14:30] remembering what's happened there, and they're trying to protect your body, and that can be an [00:14:35] issue that we could have.
There's also some women, just in our culture, I'm in Utah, [00:14:40] so we have a very predominant religious culture here, and that [00:14:45] religious culture is based around a belief that we should wait to have sex until we're married. [00:14:50] Now, in a lot of individuals, all of a sudden getting married doesn't switch [00:14:55] the education that you've had before marriage, and so inside, you still have a little bit of a [00:15:00] belief that it's wrong and that it's not okay, even though you know it's okay, but you [00:15:05] don't think it's okay, right?
Because your teaching, your education, your belief up until [00:15:10] that point is that it's not okay and that it's a sin if you do it [00:15:15] beforehand. And so we may have some issues with your brain telling your body [00:15:20] that this isn't okay, even though you're actually thinking it is. I hope that's not too [00:15:25] confusing, but you're seeing the process here, right?
It's okay now because you're married, but your history [00:15:30] has been that it's not okay, and so your body is responding to the history and the belief that you have. We [00:15:35] can work with being aware of the muscle responses, and we can work with what's feeding into [00:15:40] those, which oftentimes will need some mental health counseling a little bit or some [00:15:45] coaching along those lines as well.
And then we combine that with some nervous system [00:15:50] training, right? And we can get to where this is no longer an issue for people. It's really [00:15:55] neat moving up, let's talk about childbirth. Okay? Let's go [00:16:00] before that. Let's talk about pregnancy. What happens during pregnancy? You see this little uterus?[00:16:05]
In most people, it's about the size of your fist. So I want you to just think about that. So if you're a little [00:16:10] bit bigger person, your uterus might be a little bit bigger, right? But your uterus is about the size of your [00:16:15] fist. Then during pregnancy, there are huge changes that happen in your [00:16:20] body. For the first 12 weeks, we get a huge hormonal change.
We [00:16:25] are skyrocketing several hormones in your body. Estrogen skyrockets, progesterone skyrockets. [00:16:30] There's another hormone called relaxin, and that's not all of them. But that's why we get sick for the first 12 weeks, [00:16:35] is your body's "Whoa." There's a huge uptick in what's happening. [00:16:40] Then your body is also increasing blood flow by about 40%.
Isn't that crazy? [00:16:45] So you are almost, you're one and a half times-ing the amount of blood that you have in your [00:16:50] body. Your uterus is going from the size of a fist to at least [00:16:55] the size of a watermelon, and usually a little bit bigger. Okay? Significant changes [00:17:00] there. We're stretching the abdominals.
The pelvic floor is now having to carry all of that [00:17:05] weight from the increased blood flow from a uterus, from a baby, and from the amniotic [00:17:10] fluid that's in there, and it's doing so with hormone changes that are really [00:17:15] made to make things loose in the body, okay? From a ligamentous standpoint [00:17:20] so that your pelvis can actually change, your body can grow and house a baby, and to do so [00:17:25] safely without causing any injuries.
Then we go through childbirth. [00:17:30] There's two ways that baby's coming out of your body. It's either going through the vagina [00:17:35] or it's coming out through the abdomen. Both can cause a lot of dysfunction, [00:17:40] and this is where I always say, I'm like my own mother, I remember as a, I think probably a [00:17:45] 10-year-old kid, that I'm like, "Mom, come jump on the tramp with me."
And she's "Oh, honey, I can't do that. I'll pee my pants." [00:17:50] And that was just something that she accepted, that she was never going to be able to jump on the tramp with her [00:17:55] kids, and she altered what type of exercise she did. She [00:18:00] also, I don't remember my mom ever really going running with us, right?
For same [00:18:05] reasons. Like it was that whole idea of I've had a baby now. It's just [00:18:10] normal The reality is it's not normal. It just means these [00:18:15] muscles have never been rehabbed. They stretch, they get cut, [00:18:20] they tear, and if we don't do something to help correct it, it doesn't ever come [00:18:25] back to normal.
I use the example of an ACL [00:18:30] surgery, right? You tear your ACL, you go through surgery. Where are you [00:18:35] almost immediately after? You're in rehab. Why? Because those muscles [00:18:40] don't wake up and they don't get back to the full strength without us actually working on [00:18:45] them and doing something about it. So it can be a huge thing when it's like [00:18:50] all it takes is just re-educating these muscles how they should function and [00:18:55] what sh- they should do.
Another issue that can happen is prolapse. As we go [00:19:00] through delivery of a baby, but even just carrying a baby and the pressures that are generated [00:19:05] during that timeframe of our lives, we can have something called a [00:19:10] prolapse occur. If you've grown up on a farm, you likely know what a prolapse is. It happens in [00:19:15] animals, and it can also happen in humans.
Really what it is, we've got these three [00:19:20] organs, okay? We've got the bladder, we've got the uterus, and we've got the bowel back there. [00:19:25] They are nice and suspended in this pelvis, and we've got the pelvic [00:19:30] floor muscles that can help with that, and there's some ligaments on these organs as well that help hold them [00:19:35] in place.
When there is downward pressure for a prolonged [00:19:40] period of time, whether that be for pregnancy or with pushing for a [00:19:45] delivery or sometimes if there's complications where you need to have a vacuum or forceps, this is a little more [00:19:50] likely. But these organs can fall into the vaginal canal, [00:19:55] and oftentimes women will say, "It feels like there's a bulge in my vagina," or, "I feel like I'm [00:20:00] walking around a golf ball."
Those could be some symptoms of that. A lot of it is just a lot of pressure [00:20:05] within the vagina, but the bladder could fall back, the uterus can fall down, or the bowel can [00:20:10] fall forward into the vaginal canal, and that's another condition that pelvic floor [00:20:15] therapy can help with. So that's a really fairly thorough introduction [00:20:20] of the pelvic floor, the anatomy, who I am, and what we're hoping [00:20:25] to educate a little bit more on throughout this podcast.
We have some screenings, [00:20:30] a screening questionnaire available, so if you're wanting to see if you could be a good candidate for pelvic floor [00:20:35] physical therapy we'll attach it in the show notes.
Narrator: Millions of women are still waiting for [00:20:40] someone to take their symptoms seriously. You found this show. Share it.[00:20:45]
New episodes of Healing at Your Core release every week. Evidence-based, [00:20:50] non-surgical, and built around one belief: You do not have to live with [00:20:55] [00:21:00] this.
