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Sex with Dr. Jess


May 1, 2020

Pelvic Floor Health: Perineal Massage, Postpartum, Peeing & De-Stressing Your Vagina

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Pelvic floor physiotherapist, Kate Roddy, joins Jess to answer questions and share advice for keeping your pelvic floor as healthy as possible. They discuss:

  • How to destress your vagina
  • How to protect your pelvic floor while lifting weights and working out
  • The forms of incontinence and how to manage them
  • Why you don’t have to settle for peeing when you laugh
  • How to do a proper kegel
  • How to differentiate between pain and discomfort
  • The Power of the Kegel Release Curve
  • How to find the back end of the clitoris
  • Safe vaginal & perineal massage (especially postpartum)
  • Symptoms of an unhealthy pelvic floor
  • The 4th trimester

Follow Kate on Instagram. To learn more about the Kegel Release Curve, check out their Instagram and website.



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Rough Transcript:

This is a computer-generated rough transcript, so please excuse any typos. This podcast is an informational conversation and is not a substitute for medical, health or other professional advice, diagnosis or treatment. Always seek the services of an appropriate professional should you have individual questions or concerns.

Pelvic Floor Health: Perineal Massage, Postpartum, Peeing & De-Stressing Your Vagina

00:00:05 – 00:05:01

You’re listening to the sacs with Dr Jess podcast sacks and relationship advice you can use tonight. Hey just Morelli here and I am with Kate. Roddy of sports and Pelvic physiotherapist. You have just released a new pelvic wand called the Kegalle release curve. Wiz that mean Kegalle release so I think Kiko releases. We are trying to release. Our Kiko muscles are muscles. There’s just the pelvic floor Pelvic floor consists of a whole bunch of muscles and for probably eighty years. Now we just keep getting told to our key goals and we know so much more about those muscles and knowing that we need to release them where probably overly stressed down. There are vaginas are stressed just like any other part of our body because its muscles so most people should perhaps not be doing eagles. Most people need to check in with what their vagina needs. And even within a certain week they may need different things. So if you are very stressed your vaginas probably stressed as well because those muscles respond to stress whether it’s mental or physical and they’re going to protect and guard just like any other body parts so we will always guard our most intimate or stronger than anywhere else. So if you’re stressed good chance you’re China’s stressed and we want to release those muscles like anything so you’re probably tensing up and almost doing permanent. Kegalle as out of fair way to put it for lay people like me absolutely absolutely so tension is a contraction right. It’s it’s the muscle contracting on itself and if it doesn’t let go then it’s just holding on all the time and then you don’t really have a lot more capacity for those muscles to work when you need them so for example if I am really tense and so I’m in a state of contraction almost like I’m doing Akigal though not consciously when I laugh will I P because my muscles too tired it absolutely. If women are having experiences with these accidental leaks so sneeze laugh. They go to lift something heavy. Even the jump or running those are all forms of incontinence and we call that stress incontinence right. So there’s an external factor that acts on our body that makes us have a little bit more pressure in our intra abdominal cavity. Which just means our our stomach area and that pushes down on our pelvic floor. If we’re to tents from sort of everything else going on in our lives the pelvic floor has nothing more to give when we get that external factor. And then we got drops tablespoon or hopefully not the whole bladder but it happens now. We joke about this often. So I play ultimate Frisbee and when folks come back from having taken a break because they had a kid they come back and they say I p when I run now or I P when I laugh and we accept it as just a normal part of life should we be accepting this. No absolutely not. And that’s that’s one of the things that sort of scares me and what I’m probably most passionate about in this industry. Is that the incontinence statistic rate now in women who’ve had children and actually seen it even younger with out children because of some of the high intensity activities and sports that women are now playing. But it’s one in three and that seems tremendously too high so we have accepted it because it is common. But it’s not normal and so if we were to sprained ankle and like after a week or two. Were still limping. That would be reasonable and common. If you’re still limping. Six months or twelve months later that would that would be a little bit more unreasonable. That’s that’s not common and it means that we didn’t do enough with that rehabilitation of ankle to get it back to where we need it to. And so what are some of these more extreme activities or sports were portrayed partaking in that are leading to this? Is Stress Incontinence? I would say so. Yes that’s mostly because it’s that really heavy lifting right so our cross fit population were definitely seen more younger women getting Cases of incontinence because of the breathing patterns that they’re utilizing when they go to lift right so breath holding increasing this domino pressure. So the pressure within our core and then they go to lift something more. And like there’s the little little squeak of of urine that POPs out.

00:05:01 – 00:10:11

Okay I luckily I don’t lift anything heavy ever so the only thing I lift my my carry on. Actually it’s pretty heavy and I always pretend that it’s not because you know it’s only allowed to be twenty two pounds and is this little tiny thing and it’s all packed in and when I lifted up. I pretend it’s not heavy. So no one kind of looks at me suspiciously but that’s neither here nor there anyhow. So is there a way for example you should be lifting weights differently in order to protect your public? Well absolutely right so our diaphragm is what controls are breath right and when we breath hold we sort of like sucking in and then holding that breath is really like it. Bracing everything and so. It’s almost like some of the breathing patterns that were teaching pregnant women to utilize that sort of little exhale or some people will say blow before you go right. So does that mean so. It means that you are breathing out as you exert. Okay right so you got to lift something heavy. An axe hailing out allows that extra pressure to be released from your core. Such that muscles can really contract. And there’s nothing else pushing on them so specifically pelvic floor down at the bottom if we consider that our basement of our big core cylinder. So why are people holding their breath? Because I think about you know if you’ve ever had ushering or lift weights. They do tell you to exhale upon contraction or X. Hill at the hardest powerpoint so people who have personal trainers fantastic but a lot of the general population does not so. They think that they need to brace everything before they go to left. And it’s almost. It’s just a breathing pattern that becomes almost learned where they take the big breath and and then they forget to let it out when they go to left or do anything so some of the intensity intensity heart of a performance based pieces. And I’m not familiar with cross fit. I’m not a gym person. But is it performance base? We were trying to lift too heavy as well potentially. Yeah and sometimes there’s a little give and take in terms of we want to lift heavier and you have to get to that next weight but the first couple of times you do it. It is probably too heavy for you until you build that strength. That really is. The sort of goal of weightlifting is to keep going up a little bit at a time but if we if we don’t learn the proper breathing patterns or form along the way it’s like anything. This is where we see injuries whether it’s low back whether it’s a public Florida function whether it’s you know your knee builds up tension or something like that because we’re not doing the work that we need to do to prep for the activity or even scrape that activity off. And what I mean by. That is our stretching are rolling are self care you know we look after our cars better than we look after our own bodies sometimes right so we need oil changes. We need to put gas in the tank and we need to do that. If we put kilometers on our bodies so to speak we gotta Kinda like clean them off a little bit so that the engine runs well. So what does that look like? Fear Pelvic floor so public floor. I do think it is releasing those muscles right so a little bit of what we call pernell massage or parallel release where we get down there either manually so by our hands and you insert a thumb or a finger and you’re just basically pushing down on these muscles to get a stretch so if we think about our vaginas as a clock face right straight down six o’clock to the left five o’clock to the right seven o’clock if you push down on those areas just to get a little bit of a stretch it’s also checking. What does that feel like? Are you getting pain with that? Does it just feel like a stretch like you would maybe your calf or your quad or is there discomfort to that you know? And so if there’s a little more discomforted pain. I think a lot of women feel that. That’s alarming because this area can be a bit of a mystery box and so we want to sort of like say no. This is a stretch. These muscles are overworked and if I stretched your quad after a marathon. You’d be like Woo. This is sore and life is a marathon on your pelvic floor. It’s doing a lot of work. It’s I mean I’ve heard before that it’s kind of holding everything in absolutely. It is our support structure for our public organs are uterus are Philippian tubes are ovaries are bladder right so it. It’s doing a lot and it has a lot of function that we take for granted and then when these symptoms come up. We don’t really know a lot of women feel that it’s a lot more sinister. What’s happening to them because these are sort of unexplored areas for a lot of women? A lot of women don’t know what Akiko is. They don’t know if they’re performing Akiko well and they don’t know are they too tight or are they actually just week and I don’t like to say it but they’re sort of flapping in the wind tape sort of concept and that’s not really the case of anything.

00:10:11 – 00:15:05

Most women are too tight. Okay interesting so I wanNA start with the perennial massage. This is something everybody can try absolutely. So you’re taking your thumb and you’re reaching down and sliding into your vagina and you’re pressing downward downward toward your back or toward your Ena. So oftentimes. We’ve talked about your g spot being curling up toward the Tummy Wall. This is the interior the lower wall. Yes and so you might start at those different positions with maybe just an exploration to begin with absolutely. Yeah I think and I mean I think a lot of women say when should I start this and I tell them if you’re having sex? You should be doing this. Has Sex is a workout for your pelvic floor muscles and if you work out your beloved floor muscles well enough. They’RE GONNA be tired. That’s a workout. So what if I lend my backing never move? I just want to quickly apologize. There is some construction going on. There’s nothing we can do about it. So if you here’s some drilling it’s not us our vibrators. It’s an actual drill outside so you can use your thumb to do this perennial massage. Would you start with just kind of pressing and breathing to see how it feels absolutely so we know that even like a nice focus breathing pattern can relax any muscle in the body if you do it with a little bit of focus a little bit of concentration so if you push down with your thumb and you’re feeling a little bit of like That’s a little bit sore. Try that sort of four count breathing breathing in for four hold for four down or out for four hold for four. And then you’re GONNA see. Do you still have that same amount of sort of discomfort? Pain soreness after maybe two or three cycles of that. And then if it’s SORTA faded the move your over. What happens a little bit to the left? What happens a little bit to the right? Little more attention okay. Let’s do that breathing pattern again. So it’s exploratory a little bit of stretch you know you’re not trying to. It’s not fashionable. Stretch therapy on your vagina. But it’s it’s giving it a little bit of a breather because it’s doing a lot and you now have this pelvic won the Kiko release curves really beautiful. A medical grade stainless steel at right reminds me just a tiny bit of some of the toys. I’ve seen that are gorgeous. Them and so. What advantage does a wand like this provide versus eight? Just a thumb. Just a thumb so a lot of it is so my back story is that I’ve I’ve had two children and my first child was eleven and a half pounds so R. P. MY VAGINA and But I’ve been told to do parallel massage so payroll massages. Most often recommended to pregnant women to prepare their public floors for birth. And what they WANNA do is just get a little bit of stretch on that area because ahead needs to exit and so I had a monster and God bless eleven and a half pounds. Yeah I just met your husband. He’s very tall. Yes is it his big head? That did all this like. I don’t know it was. We didn’t know it was going to be that and I had seventeen medical people. Come into my room just to see the giant baby. ’cause I had set some records that day. Apparently so yeah. Apparently I was a circus And so I had been told to do parent massage but honest to God by the. You’re usually tell you to start around thirty five weeks so that really end phase. I was pretty large. I could barely reach to wipe in all honesty. And so then they recommend like your partner do it and I was like That’s a hard pass for me. I don’t think I would let my husband massage my shoulders. Let alone go down and sort of figure it out so I remember thinking like I just needed something with a little extra reach And so that’s the first thing is our our one makes it easier for pregnant women to just get that little bit of extra reach and have their own privacy to explore themselves. Because there’s something very important that when you do it to yourself you can anticipate that amount of pressure. When someone else does it there will always be some amount of guarding whether you like it or not because you don’t know when that person is going to apply too much pressure and if it’s too much pressure you will guard. It’ll be counterintuitive. So is exactly what we’re not trying to do. So you’re actually going to tense up now. You might teach your partner leader time if you really learn about this. I think to during pregnancy so this would be relevant to all people with China’s not just pregnant folks right but I think at the time during pregnancy you’re being poked and prodded and kind of treated like an oven and folks are coming in with no oftentimes no personalization to the procedures being performed.

00:15:05 – 00:20:07

And so this is something that you can do with and for yourself. But you’re saying that all of us if we’re having sex could benefit from this absolutely so the other thing that makes the surgical grade or medical grade. Stainless steel really important is that we can warm it up and having anything warmed is always going to feel a little bit nicer so and that can be you can change the temperature you. Maybe it’s lukewarm. Maybe you like a little bit more heat to it. You know whatever it is even inserting this and doing your focus breathing with that warmth being created on your public floor can be incredibly soothing and then after a minute or two. That’s when maybe you start to apply some of the sort of like stretch and pressure to the area Which is really really nice It’s dual ended so for pregnant women. They’re going maybe. WanNa start pushing towards that larger end but for the general population. It’s about a half inch but just under two centimeters is what they’re inserting And giving a little bit of stretch for that So it looks like a a slight curve may as almost like an s shaped right or a question mark. Oh Okay and then. There’s almost a ball yet on one. End a ball on the other. There’s two different sizes different sizes. Do People also use it for pleasure? Because I could see this being pleasure lament so I’m more in the medical wellness so you can use anything for pleasure so no what. I’m saying you absolutely. If it’s got a great sort of like curve on the one smaller and that you absolutely could still do like a g spot. Stimulation grabbed the back end of the clitoris inside. Yes But we promote it more for the stretching but actually I. Yeah so when you see the back end of the clitoris. I’m thinking of the Rod on the inside so just so folks know so at the very top of where the lips meet you. Find this little ball that is rich and nerve endings that we tend to call the clitoris. But that’s not the clitoris. That’s only the head of the clitoris over the clitoris. You have a little hood and behind that little ball is shaft or a rod comprised of erectile tissue. And so you can certainly rub that from the outside but what you’re telling me. Is that if you reach just inside the vagina like not even probably a centimeter right and press up port You can put some pressure against the internal rod so to clarify. It’s not inside the vagina right but it’s accessible through the vagina with can be. Yeah I mean we sort of think of the clitoris is really like what we know the clitoris to be is that button which is really the tip of the sort of titanic iceberg. Well and it’s the equivalent to the penis have the corporate cover. Nossa CORPORATE SPONGY AWESOME. The shaft that had the foreskin and. I always joke that. If you just press and release on the head of the clitoris and ring it like a doorbell. It’s the equivalent of taking a penis and just poking on the head. So if I were take my microphone right now. It sounds or feels like just a poke with my finger. Ding Ding Ding Ding Ding Ding. How ABSURD YEP is that? So there’s a lot more to play with. Yeah with the clitoris. So this pelvic want be used to massage down below for the paradigm you suggest people begin at sort of straight in front just a centimeter or two in. Yeah it doesn’t have to be. There’s a lot of deeper muscles that we can get to with any pelvic wand and depending on there’s even some people with a lot of hip problems if we go tomorrow. Sports Medicine SORT OF FOCUS. A lot of hip problems that you know. They’ve seen physio. They’ve done a lot. They’re getting almost like a deep pain in their buttock in their sort of cheek region and they’ve seen had it massage note a lot of the time. It’s actually this internal hip rotator muscle. That’s causing most of the the problem is the culprit and we can get in there and actually release the muscle internally. Now what I’ll say with that is you really need to see a pollock floor Physiotherapist to make sure that you are on the right stuff. There is a couple of nerves in there that we don’t really want to disrupt but with the public wand. It’s possible it’s a lot harder with your own hand to get to that. What is safe for people to do in their own? Vagina? So we’re not talking about hips. Were just talking about massaging the patio floor. Is there any risk? Like are people going to do damage am I gonNA put too much pressure. Is Intuition actually in some ways gonna be better than a therapist just for massage absolutely so there’s a one spot rate at three o’clock and nine o’clock which is where our one nerve is going to sit and we don’t really want you never really. WanNa piss off any of the nerves right so Anywhere else so yeah that one inch in and just pulling down around that six anywhere from like almost four o’clock around eight o’clock you’re good right rate up at twelve o’clock is are your e three.

00:20:07 – 00:25:02

Which is our p hall. You don’t press on that you’ll know right away that you shouldn’t press on that. Is that the case that you know if the three and the nine are the best places to press that at an there’s a nerve and nerve. I’m GonNa notice that right you should but you never know so we sort of even like as me as a therapist. I am not going to push around on three hundred nine o’clock so that I don’t irritate any nerve ending. Which would give Mr potentially pelvic pain symptoms and so just to clarify this is on the lower wall. Yes this is in the lower the bottom so that bottom clock bit from four to eight year. Good that is all muscle. Okay and so folks can try this on their own or of course. I’ve always recommended. If you can see a pelvic floor physiotherapists please do. I know not. Everyone has access whether because they’re remotely located or they don’t have benefits right now but if you do have access use those benefits and now I WANNA talk a little. Bit about symptoms okay. So you mentioned that you can be kind of one of two things will you can be right in the middle which is healthy with strong toned right pelvic floor that has the capacity to both tents like eagles And release yes and then you can be kind of two tents And then you can be a not strong Yeah to lose. I don’t love that word. I know I know it’s yes basically. There’s no tone okay. We can say that. There’s no tone to the muscle and it’s it’s giving maybe little flickers or mini contractions. That really aren’t going to hold much okay. So on each of those sides we wanNA get back to the middle. Where do we begin? So I’ll tell you. I’ve seen it before physiotherapist One of the challenges I have recently especially because I’ve been really release Under some stress with some personal stuff personal stuff. Recently Is that I actually have trouble peeing so I know I am. Tensed a What is there something I can do for that so I would recommend panel massage for you right and I would say that if those muscles aren’t being able to relax on their own and these are during circumstances where people have a lot of anxiety stress. There’s a lot going on in their lives. This is when we do typically see a lot more symptoms and I can’t treat all of the the life and external factors that are acting on you and we can. Sometimes we just can’t control those. They are what they are. So what can we do physically? And where can we take moments for ourselves to sort of even give that those muscles a little bit of a stretch and do a little bit of breathing so a little bit more in manual therapy panel massage and so I like to recommend doing perennial massage in the shower? And the reason I’m standing you can do it standing or even if you got the shampoo and your hair conditioner in your hair. You’re letting it sit for two minutes. Have a seat in the top. Oh let your legs kind of flop out okay. So the TUB side okay. Then you’re relaxed okay. And then stick them pelvic wand whatever down there thirty seconds at six o’clock thirty seconds of five thirty seconds at Seven K. K. Do that once more through two and a half minutes. Okay Right No. I don’t condition my hair right. Lucky girl God bless in our Canadian winters. Good for you know I I just don’t I don’t do it at home often So that that makes sense to me and then I was also told to do some squats so squats and what that does is is when we sink down. In the way we angle are pelvis. Sometimes in a squat is a stretch right. So that’s letting your pelvic your pelvic bones almost moving away that you’re trying to give those a stretch so that is going to help I always sort of think like stretching can be good but as a manual approach. A little bit better. I just think it’s like having a massage right right going massage for that one on one. Get all the muscles in one. Go to me. That’s a really efficient way of getting a stretch on our muscles so I could do them in kind of in tandem where I can absolutely. What would it be? Good to do the parasail massage while squatting or no difficult in the position Highly flexible like little crab true. I have seen you headstone to I can put my elbows under my knees and stand on my hands like a little crab walking around okay. I probably shouldn’t these are. These are things I shouldn’t be doing to my body move and I’m not as good as good at them as I was before. Now the other thing I run into look at me just here for the free advice is so sometimes I have trouble and I know that I just need to take a few deep breaths because it yes I need to do. The physical part which isn’t helping to relax those muscles might but also I need to do more mindful breathing.

00:25:02 – 00:30:12

I need to wake up in the morning I’m trying to start right now. With seven deep. Slow breaths where I just feel my body rather than reaching for my phone checking my messages. Which is you know. Become a bad habit while I’m on the road to wake myself up. I never do that at home because I’m not taking the phone into the bedroom but when I’m on the road I have these bad habits I find that I need to do a body scan at some point during the day so to work on the physical elements as well as the psychological elements that pressure if have a psychogenic effect. Meaning what I’m thinking and what I’m feeling marsh showing up with physical manifestation silently. And so the other thing that I run into sometimes I feel like I have to pee but I don’t have to be. Is that typical for someone with what’s the diagnosis? I had from mine. So hyper tonic. Pipertone right. So hyper being excess and tonic. Just meaning the tension hyper tonic pelvic floor. My absolutely. So you’re saying that you’re feeling that urge and sometimes that can be just our public floor muscles pushing or or squeezing our bladder such that. It’s giving a cue to our bladder that we might be full or we might have urine there and so and then you kinda go and everything relaxes and it’s like. Oh No that was. Not that was unnecessary just dribble. So is it sort of and this is again Li people term because this is not my area of expertise. Like I’m tensing up that it’s putting pressure on the butter making me feel like I have to pee. Yes exactly. Does that have an effect on my sponges. Well it can Any pressure on that area. Yes the reason I ask is sometimes when I have to pee like if I actually have a full bladder That pressure I think affects the g spot or the sponge and I think that I want sex like I feel like I might be horny and then if you go. You’re like Oh man. I just need to go be a so much easier. No right sometimes as pleasurable right and you’re at a meeting and now that’s more convenient exactly so You know we have folks like me. Who are are to ten and I know I really work on this on being more relaxed in life. It’s funny yesterday. I was feeling so relaxed. my flight was delayed. And I got a couple of extra hours with my partner and we got a bite to eat and we hung out in the bedroom and then something happened on the way to the airport With a family member and it just got so worked up and I remember I in the car I had to say. Okay I need to calm down because I don’t feel getting on a flight feeling this way. I have to go straight to an event when I land and so I had to do the psychological piece because at the airport. I’m not reaching an enduring. The perenniel massage for sure. And so. If we have hyper tonic meaning to tents yes the opposite of that so you got nice and relaxed and healthy intoned capacity to now tracked and release in the middle which were all kind of trying to get on the other side we have. Is it? Hypo HYPO HYPO tonic. Right so and that can be absolutely after birth. We see this. I think a lot of women assume that that’s just what’s going to happen after birth. The baby sort of like paves a four seven highway out of you and then you’re left with sort of like this entirely stretched out sort of hallway so the four zero seven folks is A toll road outside of Toronto or I don’t actually know where it goes but somewhere in the Toronto Arch Highway. Yeah a big highway. That doesn’t have a lot of cars on it because it’s like twenty bucks to drive on that exactly. I’ve taken it before. And then you get like I think. Got A twenty dollar bill in the mail for like you know a twenty minute drive so so yes so it it. It paves a highway out of you. And then you’re left with these muscles that don’t know how to contract or relax and almost I think we also associate that. If if they’re damaged you know so appeasing meaning they have to cut your floor to allow the baby to pass or even if women get tears that those muscles have just like stopped being used and everything sort of weak and that can happen. I think a lot of where women are getting. That is that there was a lot of pain associated with the with the birth. And then they pain will always inhibit okay. They never really dealt with any stretching because right after birth. Good chance all of that guarded and then maybe six eight months pass. It’s painful and so. The contractions aren’t happening. The body will intuitively stop contracting any muscle. If it assumes that it’s going to cause pain right so we see this a lot even with knee surgeries. We can’t get the one quadricep muscle the fire because the the brain is telling it. Don’t do anything right now. Everything’s healing and so then we get into this pattern of disuse and disuse will always create weakness and so- postpartum. Where do you even begin? And I know that everybody’s going to be a bit different but just considering it is it okay to say that childbirth is traumatic absolutely as beautiful as childbirth should be like eleven and a half pounds trauma right but it’s even if we have the best birth and it’s such a great experience.

00:30:13 – 00:35:01

It’s still an athletic event for our vaginas right and and it’s still hot to go through. Contractions we’re pushing. That is effort. It’s a vaginal Olympian. It absolutely weightlifting during Labor. Basically right we are. Those muscles are contracting. They’re pushing a baby. Is Pushing stretching them open wall? We’re trying to contract even so -absolutely it’s it’s an Olympics. So what do you do after childbirth? Wendy you start. Where do you begin so everyone should just calm down? So I’m a big believer in the fourth trimester. Might and the fourth trimester really is. It’s twelve weeks and I would say that if you had a knee surgery I would not let you run anywhere between six to twelve weeks after that knee surgery. I don’t care if you’re an Olympic athlete or Jessica on the street. I you need to wait. Because there’s a healing process and so allow that healing process to happen. I don’t even need you to be doing a whole bunch of key goals right after and I think that’s what we are told because there’s this fear and there’s this stigma that I’m loose right. There’s this huge. Because when I was diagnosed as hyper tonic. The idea was that I’m tight. But it’s actually that there’s a tension but I’m week so it’s not a good thing and we were like oh tight vaginas. Good loose vaginas are not good at. That’s not the way it is. We want our vaginas to be or is it John. Are the muscles around the vagina? Vagina is our internal? So that’s still. It’s considered okay pelvic floor so sometimes we’ll just say public floor. We want it to be toned. We want the ability to is it. Okay to say squeeze yes and release. Yeah right we don’t WanNa be too squeezed then we don’t WanNa be too released guests and the you know the stigma. It’s you know it’s rooted in Misogyny and it’s rooted in the notion that like they’re good but China’s and bad vaginas. If you have with lots of penises you’re going to be loose which is hilarious to me because the same penis can you over and over again and the notion is that it doesn’t stretch you because it’s the same penis. But if I pick like fifteen different penises in a span of fifteen days. Somehow it’s worse and again this is just you know tied to gender expectations sex and you know challenges around the notion of Promo Witty. I love that Word Right. So relax for the first twelve. Weeks is what you’re saying. I think so. I think that we need to just relax and heal right and then you sort of see your Obgyn or your birth provider. Whoever that might be at the six week mark and we get into those appointments and they say how are things going? You’re like fine I think. And then they say okay. You’re good and then women are really left a little bit. What do we do right so you can absolutely start public physio at that six week mark. Okay I tend to say goes eight to twelve weeks right. There’s a lot of swelling that is still present even at six weeks and a lot of pressure and a lot of pressure. You’re probably not sleeping. Well no you’re probably not taking the time for yourself right. You’re probably not really carving out time to connect with a partner or partners if you have them and so everything in your world is in flux absolute right there probably can’t be a big transition for most people than becoming responsible to take care of a life and make sure it makes right and so the pressure alongside the physical components. I think it can be overwhelming yet absolutely so I mean when we talk about stress being like a big effect on the pelvic floor. That is a very stressful time. So I think we can leave the pelvic physio off the table as you’re doing that. Whole transition and around eight to twelve weeks. Get yourself booked in for public video exam. Maybe you had a tear. Maybe you had an maybe you just WANNA start learning how to use that pelvic floor muscle that Kegalle again. And that’s when we’re going to start doing that. How do you do a proper eagle? So a proper key goal is probably the most misunderstood concept ever and it’s really a mix of a squeeze and a left so there are so many different analogies. I’m doing it right yet. Your eyebrows told me. Is that a thing if somebody lifts their eyebrows and they might be doing. Kegalle art that but the look of concentration that a woman has has on her face.

00:35:01 – 00:40:11

You can just tell and I have seen a lot of facial expressions as I say. Okay give me your best. Kegalle so squeeze and lift so squeezing left so a couple of analogies that get used right so one is picturing a blueberry rate at the entrance of your vagina and that you are GonNa try in just almost with a Straw. Poll that blueberry inside of you okay. Another one is the milkshake. Is You got a milkshake and a straw and you need those muscles to pull the milk shake that thick milk shake up in in A little bit more. I like that Even sometimes Picturing the other thing that women need to know is that blueberry can either be pictured at the entrance of your vagina or at your anus. It’s the same muscles I didn’t do this. Mind blow my I was supposed to isolate these muscles and not squeeze my anus at the same time so squeezing or but cheeks together is our gluts which is an external muscle but that left so sometimes thinking about like not passing wind in the elevator. Twelve other people. There you’re gonNA you’re holding. That’s not necessarily your butt cheeks. That is public floor. So it’s can I say like it’s kind of the muscles of my As opposed to the muscles of my glued Sir Makes Journal by inside so thinking about not passing. Wind is sometimes that for women. Sometimes is a big q unless nobody’s going to know who it is in the elevator. Then go ahead exactly dude. I think that’s everybody’s Mo on the plane they just fart like crazy because no one can hear them on like it’s one of you. I know you know what there’s enough different smells that. It’s all of you out of HIV exactly. So you are clenching your but but you’re squeezing your butt cheeks exactly so if you if you push your pelvis forward and that sort of that thrust that we can kind of picture with our butt cheeks like that push forward. That’s all external. That’s you’re just moving your pelvic bones. But not nothing internal right. Nothing’s lifting inside when we do that. Motion Okay so that’s really useful. Now that’s how you do the first half of what is the second half with the release with the release is so a couple of things. I don’t particularly like in my vagina to a flower. That’s just been a thing for me. I don’t it’s not a flower just the middle of the daisy. All the pedals are going right so a lot of some. Some public physios will say. Think of the flower blooming right to release that muscle and so we live in Toronto. We have Ripley’s aquarium and so I’ve picture the jellyfish right so think of that jellyfish when it lifts up polls altogether so there’s your public floor contraction and then as it sort of flattens backout. It’s that relaxation. So I might actually pushing out or am I just relax. Just relax. I can push show like I’m trying to blow it a candle. That’s not what happened to do. No that’s not it. That’s that’s actually if you’re pushing. That’s that’s tension right. That’s a contraction is to push down and a lot of that actually is just a built out pressure in our core so it’s just relaxing Okay and so I actually wanted to ask you another question from before. How do you differentiate when you’re doing the perennial massage? And I’m sorry to jump back but I think it’s important between pain and discomfort great question so I tend to always liken it to like stretching any other body part right so if I had someone maybe stretching my calf my quad I may feel a bit of a pull and that may not feel the best and so I usually call that discomfort if i WanNa tell that person to stop to me. That’s gotten into a pain. Type provocation. Right like a little bit of pull a little bit of pressure but if it feels like if it’s burning yea up for a hinchey pain or it’s causing you to move that to me is pain okay right so if you want to either stop or you shift to get that pain or that that sensation to stop to me. That’s pain. That must be difficult because so many of us don’t want to admit that we feel pain. I’ve even run into this in a massage where it may be is too much but I kinda don’t want to tell them. I haven’t practiced and developed my being assertive enough to say that doesn’t work for me so I think that if you’re moving onto your floor you might want to practice in your body. I in in an area. That doesn’t feel maybe sensitive or as intimate or as vulnerable absolutely and. Yeah that’s just something that kind of resonates with me thinking about being afraid to admit when something’s painful partly because I’ve been maybe taught to be tough right or you don’t want to admit it but I think really we have to trust our own intuition because if you can tell if you know.

00:40:12 – 00:42:28

I pinch thumb right now or I could take the tweezers and pinch to the point that it hurts. And I can of course differentiate between those two so I need to have enough confidence my body to know that I can do the same thing with my vagina and especially if you had. If you’ve had given birth year in Olympia. The giant is an Olympian. It’s the best in the world. It’s done this thing. Yeah and populated the world and of course there are plenty of people who aren’t using their vaginas as a birth canal. That is also cool. I happen to be one of those people right. So no no pressure I think. Oftentimes we feel like we must do all of these things however your insights are relevant to absolutely everyone. Yes I find I find So many takeaways here so I hope people will think about perennial massage with a thumb or with your finger with a prop with a tool. Lighten the Kiko released curve. Your pelvic want an think about what a key goal is and practice. Consider seeing a pelvic floor physiotherapist and then of course the psychological piece and the lifestyle piece about you know looking for ways to feel more relaxed in your body because we cannot just fix the muscle. We have to fix the whole body in the whole self and the whole mind and we were talking about this a couple of weeks ago with Dr Maha about if you only release the muscle but don’t deal with for example trauma right right so of course so we were talking about that genus. So we have to look at all of this holistically and Yeah I think I think we’ve got some great tools for people to begin with and I think we covered a lot. So thank you so much for talking about the fourth trimester. The Blueberry analogy the visualization of the jellyfish. How to do a proper legal different approaches to Paren- neo? Massage the difference between Hypersonic Hypo Tonic. And the Nice kind of happy space in between. That’s a lot of take away so thank you for being here. We’re GONNA share all your links so people can follow along and check out the goal release curve. We’re going to leave a link to that as well Thank you for being here. Thank you to you for listening. Thanks to desire resort and cruises makes you check them out on instagram at desire experience. And wherever you’re at have a wonderful you’re listening to the sex with Dr Jess podcast. Improve your sex life improve your life.