Empowered from the Core: Pelvic Health for Every Stage of Life

What if pregnancy wasn’t a moment to “bounce back” from, but a nine-month tissue trauma that deserves smart, athletic rehab? That single shift changes everything. We invited Katie from Rehab 2 Perform to unpack pelvic health with clarity and zero shame—so you can move, lift, and live with confidence at every stage.

Katie’s story—surviving a traumatic brain injury, coaching CrossFit, then earning her DPT—drives a model of care that treats you like an athlete. We break down why leaks, pelvic pain, and heaviness are common but not normal, and how breath, rib position, lower abs, hips, and back mechanics all shape pressure management. You’ll hear what a pelvic assessment actually involves, when an internal exam makes sense, and how treatment differs for stress incontinence (reaction time) versus prolapse (endurance). Expect practical tactics you can use immediately: exercise snacking during floor time with your kids, core activation that fits into a busy day, and load progressions that get you back to walking, lifting, and running without fear.

Access matters, so we talk through real barriers—childcare, scheduling, stigma—and simple ways to start anyway, including bringing your baby to appointments or using virtual check-ins. If you’ve ever told yourself, “I had a baby, this is just how it is,” consider a better story: your body adapts when given clear signals and progressive load. Whether you’re pregnant, weeks postpartum, or a decade out, it’s not too early and it’s not too late.

Ready to move, lift, and live confidently? 💃💪
Connect with Dr. Katie Lupo & the Rehab 2 Perform team:

🌐 rehab2perform.com

📸 @rehab2perform

Chapters

• 0:00 Meet Katie: From TBI To PT
• 2:45 Fitness Roots And CrossFit To Rehab
• 5:10 Discovering The R2P Model
• 7:05 Why Pelvic Health Became The Focus
• 9:20 Common Postpartum Issues Demystified
• 12:30 Common vs Normal: Leaks And Pain
• 15:10 Pregnancy As Nine-Month Tissue Trauma
• 18:40 Barriers To Care And Realistic Access
• 21:20 It’s Never Too Early Or Too Late
• 24:00 What An Assessment Actually Looks Like
• 27:20 Treatment Roadmaps: Core And Hips
• 30:00 Prolapse, Incontinence, And Progression
• 33:00 Future-Proofing Your Body
• 36:00 Exercise Snacking For Busy Parents
• 38:00 How To Start With R2P

Transcript

SPEAKER_00: 0:00

Hey friends, and welcome to Mom Talk Maryland. I'm your host, Claire Duarte, founder of the Columbia Mom. And this is your spot for real conversations, local love, and a whole lot of community. Whether you're folding laundry, running errands, or hiding in your car for some peace and quiet, let's dive in. We look great. You look great. So excited to have you on. What's funny is that, I mean, obviously when I was reviewing your bio and everything like that, I was like, I know you. And we were just chatting about this. That actually I first met you, God, was it a year? Maybe it was it two years ago? Wow. That's so funny. Um so obviously, um, Katie works for Rehab to Perform. You are a physical therapist, um, and you know I love an origin story. So before we get into the meat and potatoes of what we're going to talk about, tell us more about you because what's funny, because when I was there, um you were actually, I was filming you, but I was doing some content work um at Rehab to Perform, and you were um rehabbing. I was an individual patient. You were an actual literal patient, but you were also in school. Yes. Um and now you've finished school, now you're certified, you're working, you've got two kids. Um so yeah, walk us through all of this. Tell us more about you.

SPEAKER_01: 1:24

So when people ask me why I'm a physical therapist or what's gotten me there, um I always I always say, do you want the the short? I always think about if we're doing the short, medium, or long version. And we'll do a uh an abbreviated longer version because I think it all plays into it. Yes. So um uh I was in a really bad car accident when I was 16 and um had a traumatic brain injury, had to relearn how to walk, talk, like all the things. Wow. Um and the doctor said that one, it was amazing I was still alive, and two, the reason I had made it was because I was in such good shape. I was a high school athlete. Wow. That changed after the car accident. Um so team sports were kind of off the table. Um and I sort of went into individual stuff. I just started running for fun and just to stay fit, because to me it was all about preparing my body for the unknown because you never know what's gonna happen. So, how do we do that? So, some of my friends that were surprised I didn't go into physical therapy initially. Yeah. Um, and I didn't probably because it was too hard for me to remember things. This is this is the honest truth. Right. Um, I had a lot of memory issues due to that. It was short-term memory loss. So I well, what I was really good at was math that I didn't lose. So I actually went into economics. I was in grad school for economics, finishing my PhD, and I didn't finish it because I had what I call my quarter life crisis. And I left grad school, I biked across the country, and then I ended up um I ended up after that kind of taking some pieces out, but I ended up then starting a nonprofit workforce development program in DC that was a community that is a community-use bicycle shop that provides opportunities to youth and using that that will refurbish bicycles and sell them back to the community. My goodness. At the same time as I did that, I was coaching CrossFit. Um very into both of the things, and then it just kind of worked, it worked out that I hired an executive director for the bike shop, and then I started working more at cross at CrossFit Bethesda, and then ended up buying CrossFit Bethesda from the former owner. Uh-huh. And then I owned that for I ran that for 10 years. I owned it for seven, I think. Wow. It was during that time I got more into rehab and movement therapy, call it. Yeah. Um, because I kept seeing people would come in with old injuries that they wanted to become fit again, and I wanted to help them do that. So I realized then that I was kind of going that direction more than the coaching. I love the coaching. Yeah, yeah. I love all I love all things with coaching and lifting and running and biking and swimming and so on. Um, so I I realized I like that more. I thought about going back to PT school. I ended up getting my massage license, which allowed me to take a lot of continuing education that's open to like massage, Cairo, and PT. Um, and then I thought that would be enough, but then I finally was just like, I gotta do it. So yeah. So then I also found that there's um like online hybrid programs for physical therapy for doctor through the doctorate of physical therapy, where you take your courses um online, but then you go to you go on-site for labs. So for 2021 and 22, 22 and 23, I get the years a little mixed up. Yeah, yeah, yeah. I was living here, but then I traveled to Boston often for the labs. Um that's how I completed, that's how these programs work. And so then I completed my doctorate in physical therapy in 2023. Wow. Worked a little bit uh someplace else before I ended up at R2P. I knew about R2P, and this is kind of as a segue into the R2P story. Um Josh worked out at my across with Bethesda for like a year or two. Oh uh. Um, he loved our 5 15 a.m. classes.

SPEAKER_00: 5:03

That sounds like Josh, yes.

SPEAKER_01: 5:05

Um and that's how I met Josh, and that's how I was exposed to R2P, and I was like, wow, like this model, like this makes sense. Like this is this is actually one of the reasons I didn't initially go into PT is because it wasn't something that this model didn't exist, or I hadn't found it. No, no, right, exactly. Um and so finding that, seeing what Josh was doing with it, because this was 2021, I think. So it's grown a ton since. It won't stop growing. That's a good thing. Exactly, exactly. Is what uh is what got me into where I am. And then the pelvic part, there's yeah, that's the other piece. Yes, how'd you end up with pelvic? Um and that was at the gym I saw for years um just mothers that would come back, get fit, but they would often have issues which started postpartum. Whether it was incontinence issues, whether it was hip issues, whether it was core issues, um I there's room for that. I wasn't really ready to go pelvic right away until I had two kids. Ain't that the truth, right? And then it was kind of like I understood it, and I also see it as an opportunity to do things now. Um, and it's like, is it rehab, is it corrective exercises, is it a little bit of both together? But whatever you're doing, you're setting somebody up for success in the future with whatever that might bring, and that's kind of what started that is what I'm all about in the first place.

SPEAKER_00: 6:31

Yes. Oh my gosh. Well, thank you so much for like literally sharing that whole story. And I know there's so more, so many even more nuggets in between that, but real quick segue. Your bike across uh the US, which one was that? Uh which route did I take? Or which organization were you with?

SPEAKER_01: 6:49

So I did part of it I did alone, part of it was with um Adventure Cycling America, I think. It's the ACA routes, and so there's they have these, they provide these awesome maps of like so you're you're on back roads that are relatively bike friendly and bike and safe. Um so it's self-supported, you sleep in tents, like you you you haul a trailer behind you. Yeah. Um I did some other touring before that, but that was something I knew I always wanted to do. So I think I was 26 and I was like, I'm gonna do it now because who knows what the future brings, and this is definitely something I want to have done in my life.

SPEAKER_00: 7:22

Yeah, yeah. Well, I asked because my brother did um that shortly after he graduated. Or wait, no, sorry, was he still in college? Was it a summer? Um, I'm forgetting now. He's my brother's six six years younger than me, but I believe it was um like the 4K for a mirror.

SPEAKER_01: 7:39

Yeah, I know exactly what you're talking about. And I'm not gonna remember the name, but it's uh is it 4K for cancer? Yes, yes, yes, exactly.

SPEAKER_00: 7:46

Yeah, so they like dedicate all of that. It's really, you know, it's really nice in what they do. Um and um, so that's why I was like, I have to know that's really cool.

SPEAKER_01: 7:54

I met a lot of people doing that, actually when I was when I was riding.

SPEAKER_00: 7:57

Oh, I'm sure, I'm sure, right, because they're kind of doing the same thing. Yeah. Um, well, so cool. Um, well, uh, yeah, I mean, uh your story is is so awesome and the connections of meeting Josh, um, and I and I fully agree about um, you know, the his his business, these kinds of things um that he's been doing, like did not exist. And frankly, even my personal story with PT, um, I had two emergency C sections. Sorry, my first was emergency, the second one um ended up being scheduled. But um, and I'm one of five kids, and I'm saying that to like my mom, she like she always totes like she's like, I, you know, I had all of you guys naturally, like no medication. So my brain was like, okay, well she did it, I can do it, you know what I mean? Again, going in with no training, no doulas, no coaching, whatever, because again, like my naiveness, and then ended up with an emergency C second that was really no one's fault, you know what I mean? Just kind of like how it shakes out. Um, and again, not that that, not that you know, we're here to say that C-sections equal, like, you know, that you have to get PT or and even you know, if you have a vaginal birth and things like that, but that's what we want to talk about today. It's just like incredible importance of this because um after I had my son, my kids, I had my kids um back to back, which I know you did too, about 20 months. So didn't have much rehab time in between that. Um they did tell me, I don't know if they said this to you, but they were like because I had a C-section, they were like, please wait like seven to eight months before trying. And that we did that, but um uh just to kind of like guess give the the belly a break. But yes um, you know, so I I I I sought it out, um, not because I was having extreme issues or anything like that, but um, you know, being like in my young 30s and stuff like that, I was like, you know, just trying to get back in shape and having a whole nother host of hormonal issues, which is just another whole thing that I've been working on now. But um I was struggling to lose weight and I wasn't because I had two C sections and I knew my core was complete trash, I was very active prior to having kids. Not on your level, but I was active and like I loved working out, I loved exercising, and um it's funny, I kind of went in not I wouldn't say I went into PT for vanity reasons, like not to like lose weight, but I was just like struggling with my core and um I'd never had my core evaluated, and I was like, I should probably have this evaluated because I was like, I don't know if like you know, if I'm ha if I have diaspora or anything like that. So I kind of went in there seeking that out, and after a quick evaluation, you know, she was able to quickly rule that out, which was good, but my um uh my hips, my pelvic floor, my core were all so so so weak, and I had really had because I was like, well, I'm strong, you know what I mean? Not even working out at that point. My son was close to a year old, I think. Um granted, I you know, I'm trying to the years are blurring now. I think this might have been 21, and I forget if it if his Columbia location had was even open yet at that time. And even if it was, I didn't know about it. And it wasn't like you know what I mean? Right, yep. So um, but I remember being really thankful for just again, I I sought that out. It wasn't like my providers were suggesting that I do that or that it was being told. And that's kind of what I want to use this is kind of the segue to ta that you're here to tell us that you're not only a PT, but you and and to have the pelvic floor um specialty is an additional certification, correct?

SPEAKER_01: 11:35

Uh or classes. So there are certifications which you don't necessarily need to have, but there there is additional training that training, right. Is yes, you do need to have.

SPEAKER_00: 11:44

Um so because one thing, you know, is we're both moms that, you know, one thing I feel like I've realized over the last few years, and then I kind of I didn't feel feel like I realized it while I was pregnant or anything like that, but you know, just the lack of I don't know, um, information, knowledge, um, education on women's health in general, especially around um pelvic health, you know, especially in, you know, I understand that OBs have a specific job, but in nowhere in any of those conversations were they ever like, hey, you know, um, whether you have a vaginal birth or a csexual birth, like you might want to consider, you know, it's you know, obviously it's not like quote unquote required, but you know, considering our bodies go through probably one of the hardest things in, you know, in the world, you know, that yeah, you could imagine that that body would need a little bit of rehab after that, even if you're not like I don't like to say like injured, but you know, you go through you're especially for me with C-sections, I knew my core was stressed. And because I could feel it, not because I was feeling like I was limited in activity. But anyways, let me pass this back to you about so tell us more about um what it what lens it is that you focus on with pelvic floor, um pelvic health in PT.

SPEAKER_01: 13:01

That's a good question. So, um, first of all, in terms of what the knowledge is of pelvic health across disciplines is really interesting. Everybody seems to kind of have their their area, yeah, and then and that's it. And the problem is if that doesn't solve somebody's problems, yeah, they don't know what to do. Sometimes it does. Sometimes just doing Kegels is all you need, right? But sometimes it's not. And when it's not, that's where like this this chain starts of where to you go. And I feel like that is partly because of a I don't want to say a lack of knowledge, but like just not as much cross-communication between disciplines so that we don't really know what each other does. And that's like between the the O B G Y N's, the urology, the PTs, primary care, and so on. Yeah. And even orthopedics. It can can fit into there because a lot of times like low back pain and hip pain stuff can be coming from public floor things. So that was kind of a side comment to what you were just saying. Right, exactly. Um, but then you asked, what is what what's our focus? So our focus, R2P is very much fitness focused, movement focused. So I want to treat what's going on, but I want to get you to move in a way that supports your lifestyle and prepares you for whatever you want to do. Um so with that said, um pelvic floor, like people think about just like the pelvic floor, like the area between their legs, I guess. But it's much more than that. Yeah. Um it's core, it's hips, it's back, and what's going on with all of those things. Um, and how do we improve, improve mechanics so that it gets you wherever you want to be going?

SPEAKER_00: 14:47

Right.

SPEAKER_01: 14:47

That's what I'll say about that. Yeah.

SPEAKER_00: 14:49

Well, and I think the point that I kind of want to make too is that, you know, I feel like as a culture and a society, I think, you know, pelvic floor, I wouldn't say that it's sexualized, but I think we have this kind of fear in discussing it because that's one of things like we, you know, we don't talk about. We don't talk about sex. And that's not what we are specifically talking about today, but there's nothing to fear around this area of our um of our body, and uh because you know, it needs it needs support. Men and women need um to be focusing on this area of health. It's not it's not something that we should be shunned, and I feel like the lot of the older I get, the more things that I'm reading on, or you know, you we should not just be adopting the oh, my body is just older now and this is what it does. Like, you know, we can actually do so much better than that.

SPEAKER_01: 15:37

So you hit on like there's so many things that you've talked about that I want to come back to. Um so first of all, um on that note, like you're talking about it's we are getting older and this is just what my body is. Um that is what I hear a lot, and but it doesn't have to be. So like a lot of the these issues are common, but they're not normal. Right. So that's what we have to understand. Like um urinary incontinence issues, which is something that we see a lot of. Um, and I think those are a lot more pronounced in society, a lot more people struggle with that.

SPEAKER_00: 16:09

And that's a little bit more vocal about it. Well, I I think like, well, to some degree, right? With like women and being printed, like, oh, like you know, that side I feel like is the more talked about, more commonly heard. And I think the point that we want to make today is that there's a difference between common and normal. Yes. Yes. It's a common occurrence, but I think because it's so common and for that is so often talked about, we just I feel like there's a normal blanket on it. When the reality is that's an actual medical issue.

SPEAKER_01: 16:39

It's a medical issue that there's there's e easy quote unquote things that can be done about it. There are things that you can do about it to to to make it not an issue. And a lot of people just don't know who to talk to and don't know where to start with.

SPEAKER_00: 16:51

Or do you think that that you even can or should or like I said that you can fix it or that you should fix it. They just think like, oh well, I've had a kid and then this is my this is what happens.

SPEAKER_01: 17:03

Like it doesn't have to be. Right. That's that's one of the big messages that I want to say. Right. Um on other things in terms of pain, pelvic pain is something that is even less talked about. Yes. Um, and that is definitely something that doesn't have to be that way either. I mean in like people think the pelvic floor is something that's taboo, we don't talk about it, we don't touch it, we don't do anything with it. Right, right. It's it's just tissue. It's muscles, it's tissue. Um that for anybody that's experienced in a pregnancy has gone through trauma. And so this literally is. Kind of comes back to something else I was thinking about is like when you you said something that brought this up in my mind, but um you have to like in terms of treatment, so bring me back with a same kind of a tangent. In terms of treatment with PT in the PT world, like we think about an acute injury like I uh I fell off my bike and I broke my wrist, right? And now I need to rehab it. Right. There's that kind of injury, right? And then there's things that have been like chronic injuries that have just been progressions of different things. Pregnancy is really so and we treat those differently because these chronic things, then you're gonna be having muscle compensation patterns and movement compensation patterns that we need to break down versus an acute injury or an ACL tear, whereas something that tissue is torn, bones are broken, and we just have to rehab that and get it back. Um so those are the kind of the two different camps to some extent. There's a lot of crossover. But so what is pregnancy?

SPEAKER_00: 18:32

Where does that like fall in?

SPEAKER_01: 18:34

That's that's the question. So how do you treat it? And what are we thinking about when we treat it? And if you think about pregnancy, it's a nine-month trauma to your tissue. So girl.

SPEAKER_00: 18:44

I I think that needs to be that is the language that should be around it more.

SPEAKER_01: 18:49

Yeah. Because you think about like an acute injury, I broke my bone, I tore my ACL. Well, you just took ten months stretching all everything in your core, and then you either had a C-section or you had a deli a vaginal delivery. So then we add on a major abdominal surgery or the the trauma to the pelvis, which kind of goes hand in hand. Right. Um, to it. So how do I rehab that? Am I looking at some chronic condition? Yeah. Not really. It's really more like the way the tissue's gonna respond is more an acute injury. Right. It just wasn't a split second, it was ten months in the making. So we need to work on how do we set up the set up the environment for healing in the belly, in the pelvic floor, so that the tissue can just transmit force just like anything else. If that makes sense.

SPEAKER_00: 19:37

No, absolutely. And um and I think like when we can start to kind of position it that way, that can really help. And granted, I mean, the next thing I was thinking is, well, okay, well then why isn't it like quote unquote mandated or part of our m maternal and women's health, you know what I mean? Um granted, there's obviously there's and well we know in the US there's multiple, multiple barriers to why that's the case. But I mean the reality is too, is like when you have a newborn infant, it's like harder than, you know, how do you even have the time to I mean that's a massive barrier just aside from the healthcare system. But um, you know, so how how would you be able to um you know get into a medical facility and be able to and you know, assuming that you can't bring your child, you know what I mean? There's a lot of barriers with that. So it kind of like so on one hand I'm like, why isn't it mandated so that we women are getting the health and tension that they need? So let's just say, you know, you you know, if you didn't have as acute of an injury as someone else, you could be medically cleared earlier than somebody else that might need a little bit more rehab with that. But that's just I'm kind of in dreamland world at the moment, but um which doesn't exist for us unfortunately, but yeah.

SPEAKER_01: 20:49

Yeah, how do you how do you start? And and like you start you you start somewhere is is what I say. Yeah um and you try to figure it out. Um one thing is like uh like calling clinics and asking if you can bring your child. So if you can't figure out the care, you don't have daycare, a spouse, partner, friend, parents, whatever can't help you out, um, is it possible to bring your child? Like uh I know that we do allow that, as far as I understand. Yeah.

SPEAKER_00: 21:16

And the then it's there is one time I brought my son. I'm not saying that that's a blanket statement for R2P. Um, but yes.

SPEAKER_01: 21:23

You know, like if you have to bring your child with you, is your care gonna be necessarily as good as if you didn't have your child? I mean, yes, the care is gonna be excellent still. But like understanding that there's distractions. And so if your child's crying, you have to do something about it. So there are distractions. So maybe it's not quite as perfect and ideal of a situation as you'd have otherwise, but it doesn't matter. Like the other option is not to do anything. So like we make it work. I know. And I think that that's what we have to just like I I hope that other people can also be doing that is just trying to make it work. The other thing that's that's a blessing in our age is is technology. Yeah. Um, so there's so much so many things that you can do, whether it's virtual, whether it's online, like starting somewhere to figure out what's going on with your body, so then it also helps direct um uh treatment better when you are in the clinic. So it's not like, okay, where do we even start? Um which is okay too, that's totally fine. But if you've been doing stuff and you're like, hey, uh this core stuff, like uh this is a problem, help me out. Right. Um you can also kind of figure out your own body better, which is always I always encourage people to try figure out what's going on, see see what you can find yourself, um, so then you can make better time of the expert opinion than expert physical therapy.

SPEAKER_00: 22:38

Right. And before we I I know that I'm jumping all over the place, but before we kind of I want to dive more into uh the actual services that R2P offers um for the women in in the Howard County area and beyond. But one thing point that I wanted to make before I forget is that I mean, fortunately the PT that I saw like made me feel really good because you know, and I and I want to ask you the same question of like, you know, let's just whether well I'm trying to phrase my question right. I mean, for instance, I saw out treatment like, I don't know, a year postpartum for my son, but I you know, and I already had my daughter at that point. And I remember feeling like, oh god, I wonder if I'm like too late.

SPEAKER_01: 23:17

No.

SPEAKER_00: 23:18

And and I think that's the point we want to make. Like, you know, if you're hearing this, if you're pregnant, thinking, okay, like, you know, well, I mean, of course I want to motivate and encourage moms if you are pregnant, like, to seek this out, of course. You know, the sooner sooner is always better in every case, you know what I mean? But you know, even if you even if you're like you're a 50 or 60-year-old woman that you know already had kids and you're like, I've been experiencing this, you're it's still not too late.

SPEAKER_01: 23:41

No, no, and it's all so it's not too it's not too early, and it's not too late. Um so people and that's the other thing is that people don't often know that if you are pregnant, you can start physical therapy. Yeah, just being pregnant. Like that's that's a reason to come, actually. Yeah. Um so and also postpartum, you don't have to have a thing that you are feeling. You're not like, oh, I have stress incontinence or I have abdominal diastasis, whatever. Like you don't necessarily have to come in with that. Um, you can just come. So oftentimes what I will see, I see um with pregnancy, a lot of people will come in with something that motivates them to come in because their back hurts, their hip hurts, they can't move well. Um, usually within a couple visits, we've cleared that up pretty, pretty well. Yeah. Um, and then I always say, like, okay, you can be done, or we can just keep doing this like once a week, once every other week, uh, every couple weeks just to make sure like nothing comes up so we can preemptively make sure the muscles that we I kind of already know what's gonna happen as your as your body changes and your your center of gravity changes, we can preemptively treat those things so that it never becomes a problem. Right. Um so I'll have people that come for something and then stay for for for the rest. Um I also have people that will just be pregnant and they just come. And so I support that. Like if you are just like, hey, I just want to be doing this and understand how I can cope with the changes that are gonna be coming over the next whatever, five to eight months whenever you come in, um, that's that's a great thing to do too. Um and the same with postpartum. So people sometimes will come and they'll have pain, back pain, tailbone pain, pelvic pain, um, and then that gets them there, but you don't necessarily have to have that. Yeah. Um, it still warrants physical therapy, will get you back to doing the things that you want to do so that you can return to the gym, return to your walking, return to your house tours, whatever it is, um, with confidence. Yeah.

SPEAKER_00: 25:37

So talk us through um some of the actual services.

SPEAKER_01: 25:41

I will. One more thing, too, is that it's never too late. Yeah, that's the other thing. Is it's it's never too late. So you can be five years postpartum, you can be ten years postpartum. Like, um, and you may come in for something else, or you might come in for that. Um, and that's that's okay. So never think that, well, I had my kid ten years ago. This can't be from that. Well, yeah. Right. It might be.

SPEAKER_00: 26:03

Yeah, and and that there's also no shame in like, oh, I, you know, I never sought out services or or anything like that, you know. And that you're again, that's that's the whole point of like it's not too late, and you know, you can still get the help and support that that your body needs. And frankly, like you should be. I mean, that's kind of why I've fallen in love with the R2P model of, you know, like, yes, it's about be you know, literally being better than you were yesterday, but I feel like as I've gotten older, I've finally kind of adopted. Like, I'm not just training to look good or feel good or be strong, like I'm training for life. Like, I want to be that 70-year-old. When I slip, I'm able to catch myself and I'm not falling and having an injury. Same thing goes for this area of our health. Yes, you know what I mean? And it needs attention. Yes, yes. Um, a hundred percent. I know. So sorry, um, I cut you off and then you cut me off, which was perfect. So, um, welcome to how I run podcasts. I'm literally all over the place. Um, yes, talk us through the services um and offerings that R2P has within pelvic health, and um and and then what like a an initial assessment looks like and kind of going down that road.

SPEAKER_01: 27:13

So, first of all, what do we see? Uh pregnancy, postpartum, what anything that's related to that, whether it's hip pain, back pain, uh pelvic pain, tailbone, pubic synthesis is common things that I would say I see. Um and then core weakness is kind of le in there too. Yeah. Um postpartum and stress UI, like incontinence issues sometimes will happen during pregnancy as well. Postpartum incontinence issues, core strengthening, hip hip pain, back pain, same kinds of things. Um vaginismus is also something that I'll see a lot of. It's often that can be from anything. That doesn't necessarily relate to pregnancy. Yeah. Um, dyspernia is the same. Um, and those are things that we can definitely work to work on. Right. Um the other things then are like middle-aged to older women. I'll see for um like the stress incontinence and your and urge incontinence are big in that population. Um chronic constipation is also something that fits into this, or any issues on that side. Um and oh, and then any like complex pelvic pain. So that's that can be young, that can be older, that can be kind of anybody. Um pudendal neuralgia, so if you get any like nerve pain, that's that's kind of the other thing that we haven't talked about that is definitely in this in this pelvic area.

SPEAKER_00: 28:42

Pelvic area for sure. So um, so if someone's if if a woman's coming to you, what does an initial assessment and possible roadmap of treatment look like? Obviously it's personalized, but yeah.

SPEAKER_01: 28:57

So it all depends. But um initial assessments, uh there's we we have an hour um and we'll talk through the history. So what's going on, when did it start, um events that may have contributed to what's going on, even things that people are like, well, that can't be related. Like it might be. Right. So let's let's talk about it. Yeah. Um then we'll do an uh a movement screen. So I want to watch you move. I want to see what your body's doing um in in all kinds of planes of motion. Because that can give me a really good idea of what's going on muscularly and what kind of compensation patterns might be there. Um if it's warranted and if the the patient is interested, willing, um, we'll do an internal exam.

SPEAKER_00: 29:38

Yeah, just gonna ask if you guys can do that. Yeah.

SPEAKER_01: 29:40

Yeah, we'll do an internal exam, and again, that's all gonna be with as long as the patient's comfortable. So um, what does that consist of is you do get undressed, waist down, we we cover everything, so you're always under a blanket, and then we'll just do an inspection and we'll do some muscle palpation um in the vaginal area.

SPEAKER_00: 29:57

Yeah, yeah.

SPEAKER_01: 29:58

Um checking for For different different things. Right, right. Absolutely. And then generally we'll talk about like there's a lot of education going on. So a lot of talking about like a lot of anatomy. Yeah. Like, here's what's happening, here's what I here's what's not happening. That if it were happening, I don't think you would have this problem. Um and and then we talk about um some home exercises in a roadmap. So what does that look like? Usually it's between eight and twelve visits, six to twelve visits is what I what I kind of go for with people. Um and then um it it depends on where you're at. Like I'll take like two things that are common are stress urinary incontinence and pelvic organ prolapse. Those are probably like two, I see a lot of those things. Yeah. Um so what is what's going on in my mind? Is it comp when I treat that? It it depends on how the patient presents. Um but oftentimes, and then what does a treatment plan look like? Um there's stuff going on with the hips. Yeah, there's stuff going on with the hips, and then the other big one which I didn't talk about yet, is core pressure management. So what's going on in your belly area? So if there is pressure that's being exerted on your bladder that is not controlled because we don't have the abdominal tone, the lower abdominal tone that we once had due to a 10-month acute trauma. Yep. Um, it's really hard to manage the pressure there so that anytime you sneeze, cough, laugh, jump, run, there's too much pressure going down, and that's gonna cause, that can cause some of the stress UI, or it can cause the prolapse symptoms. So then it's gonna depend kind of on what the person is experiencing as to where things go. So in my mind, I'm thinking clean up movement patterns, teach pressure management, work on the core strengthening and activation. So sometimes like it's strong, it's just not active in the right times, and we gotta fix that. Then from there, if it's a stress you incontinence thing, I'm thinking of reaction time. So why isn't your pelvic floor, your core reacting quick enough? It's a good way to do that. And how do I how do I get that going? So then we we'll work on once we've kind of cleaned up some movement patterns and we've got the basics down, then we'll go into the the the quick stuff, the quick reactionary stuff with different fun exercises.

SPEAKER_00: 32:11

Right, right, right, right.

SPEAKER_01: 32:12

Yeah. Um and then if it's a prolapse situation, I'm thinking endurance. So what's happening? Because you wake up in the morning and you're not really experiencing the prolapse issue so much. Um you go and stand and teach for six hours, it's terrible. You go on a five-mile run, it's not good. So we need to work on enduring load over time so that we can build up that core that muscle coordination. That's like completely.

SPEAKER_00: 32:37

I know. We just simplify already scrap out of that. I know, I I kind of wasn't fair at asking you that question, but I want to.

SPEAKER_01: 32:45

Because there's a there's sometimes it's a fear of coming. People are like, that's exactly what it is.

SPEAKER_00: 32:48

Like, I've a for anybody that's listening or watching, that's what I kind of want to paint the picture. If you've ever wondered like about these things about yourself, or if you've been the person that's kind of like over-normalized it for yourself. Again, we're not we're not here to put any more fear in you. We want to normalize coming, yes, normalizing treatment. Normalizing treatment and that you can and should. You know, and the other thing that like Josh will really appreciate me saying something like this, but I'm like, you know, in thinking of like I'm I'm kind of constantly doing or constantly, I'm kind of like working on some things internally with like my within my business about like future-proofing my business. Well, the same thing we should be future-proofing our bodies, right? You know, and because the point that I kind of want to make too, along these same lines of like, you know, if you've been living with X, Y, and Z, and I'm like, it's not all that problematic, like might not be painful, whatever. I can live with it, it's not too much of an issue. But if your core is weak or, you know, your pelvic floor is weak, you know, again, the I'm I am not a doctor, so please don't take whatever I say, but it's just you know, strengthening those areas can and can and should really help you now so that you don't have have actual issues down the road.

SPEAKER_01: 34:01

100%. And so that's where like movement compensation patterns will happen over time. Yes. And so if you take care of it now uh and you know how to manage it, um, some of these things like I'm I'm not gonna say we can cure everything and all of it's gonna go away. Like that's not realistic. But what it does is people understand what's going on, they understand their anatomy, they understand things that they can do to maintain where they are, or even improve it over time instead of it going the other way. And now that what was once just some incontinence is now terrible back pain, terri terrible hip pain. You can't do the things, the activities of daily living that you want to do. So taking that little bit of time for yourself, trying to find it, which we all know with children and a busy schedule can be difficult. But it's worth it. And and I'll say one other thing to that is that that's another thing that I will try to do with people is work with their schedules and teach them how to incorporate things into it. So sometimes I you've probably heard like the bits about exercise, snacking. Yeah. Yes. But I think that for public floor stuff, especially when you're like playing with children on the floor, like that's so applicable because how many times are we laying on our backs or sitting on the floor or in a tabletop when it's like, hey, what if I just did 10 reps of this right now? And it brings your attention to what's going on with your body, and sometimes that's enough, and sometimes that's all it takes just to maintain, and then you can get back to and continue to do all the things you want to do.

SPEAKER_00: 35:21

Right. And well, and I feel like actually, I mean, granted, well, I don't know entirely how the PT world views the kind of exercise snacking, but I actually think that it parallels really nicely because you think about it, like we should be incorporating movement and um and activity. I'm not talking like doing ultra marathon throughout, you know, every single day of your life, right? But just this idea of consistent movement, right? Which I think is obviously so aligned with what R2P stands for. I mean, kind of in a complete like side thing, like with my son, like he's in a program right now that is focused around movement. It's not it's not a PT program, but these are things that he's caught you know doing to help his cognition, his sensory and um academic things, you know what I mean? So I'm making that parallel to talk about like if our if we're focusing on the on that for our children and um and acute injuries, like women and and men, you know, we need to need to be applying that same thing to ourselves, you know, and to make sure that we are taking care of ourselves because we are f we do need a future-proof our bodies.

SPEAKER_01: 36:26

Yes, exactly. Um you never know what's coming. So how can we be be prepared and keep ourselves prepared for it? Exactly.

SPEAKER_00: 36:34

So I mean, thank you so much for your time today, Katie. I feel like we were both able to nerd out in a really good way. And I mean, my hope is that um we were able to hopefully demystify possible myths, fears that can kind of surround pelvic health, women's health, and to keep educating and sharing as much information as we can. Absolutely. Um tell us real quickly before we kind of wrap up here, what's the best way for someone to reach out and kind of schedule and kind of get started with R2P?

SPEAKER_01: 37:03

Uh call the clinic and they'll get you on our schedule. Call them and tell them that you're you're interested in pelvic health. Um they may ask you a few questions and then and then you'll get on our schedule and we'll see you then. Perfect.

SPEAKER_00: 37:14

Yeah, and I'm sure, like I said, I'm sure that will start with the assessment and then you kind of go walk your path from there. But um, yeah, you can either go to their website um or call um the Columbia location directly. Um obviously there they have plenty other locations if you are not in the Columbia area. Um, Katie, I know you're based out of the Columbia area. So if you were looking to get with her, you can absolutely do that. Um but they surely have other providers at many other Maryland and DMV locations. So um thank you again so much for your time today. Um you uh in our show notes, you'll also be able to kind of um we will be linking our dupe's um and your information specifically, so you'll be able to catch more of that information there. And um please reach out if you have any other further questions.

SPEAKER_01: 37:55

Thank you.

SPEAKER_00: 37:56

Thanks for having me. Of course. Thanks for tuning in to this episode of Mom Talk Maryland. If you loved it, leave a review, share it with a friend, or tag me at the dot ColumbiaMom on Instagram. I'd love to hear what you think. And don't forget to follow the show so you never miss an episode. Until next time, keep showing up, keep supporting local, and keep being the incredible mom, the woman, and human that you are.