Episode 99- Exploring The World of Pelvic Health with Dr. Melissa Stendahl
Episode 99 Show Notes
Join Tiffany Wickes for an enlightening conversation with Physical Therapist, Dr. Melissa Stendahl, a specialist in pelvic health. Tiffany and Melissa dive into the often unspoken topics of pelvic health, including common issues like sacroiliac joint pain, pain during intimacy, and the importance of pelvic floor therapy. Dr. Stendahl shares her journey into this field and offers valuable insights for both women and men.
Key Topics:
Introduction to pelvic health and its importance
Dr. Stendahl's background and journey into pelvic health
Common pelvic health issues and their solutions
The role of pelvic floor therapy in postpartum recovery
Addressing pelvic health concerns in men
Innovative solutions from Liv Labs for pelvic floor strengthening
Herman and Wallace Provider Registry
Stay strong and informed about your pelvic health. For more insights, follow Dr. Stendahl and Liv Labs on Instagram at @LivLabsFitness and check out their latest innovations for pelvic floor fitness on their website: https://www.liv-labs.com/
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Hey friends, welcome back to the podcast. Today I have Dr. Melissa Stendhal here to talk about all things pelvic health and answer some of the questions you guys have given me regarding pelvic health and, like all the burning questions you don't actually want to ask a practitioner, but you'll put in my question box. I will ask on your behalf. without further ado, Dr. Melissa Stendhal, please tell me a little bit about yourself, what you do, and, we'll get on with the questions.
Melissa Stendahl (00:32.137)
Thank you. Yeah, I'm excited to answer things that no one will ask out loud. I love that. It's my wheelhouse these days. Yes, so I'm a doctor of physical therapy and my specialty area within physical therapy is pelvic health, which means I help people with poop, pee, sex, pelvic pain conditions, prenatal and postpartum, and post-surgical, core fitness, anything in that abdominal pelvic region.
I've been doing that for almost my entire physical therapy career. That's over a decade. Prior to that, I was in the military doing something totally different, which is how I met you, Tiffany. So that's the of the short and sweet background. I'm also the Director of Services Strategy and Clinical Expert on Liv Labs, Team Liv Labs, which is a women's health tech startup focused on pelvic floor fitness solutions.
That is my other professional endeavor.
Tiffany Wickes (01:30.54)
That's a lot of endeavors. So what got you so I know that you're sporty. Okay. My listeners may not know that, but Melissa is super sporty. we actually, like she said, we met when she was in the military and my husband was in the military and I got a dog, she had a dog and we both played soccer and she just shows up on my doorstep one day and was like, hi, I have a dog. You have a dog. Maybe we should walk our dogs together. And that's basically how our friendship started.
Melissa Stendahl (01:32.039)
Yeah, some days.
Melissa Stendahl (01:49.663)
Thanks.
Melissa Stendahl (01:59.856)
a little differently. could swear we met at a soccer game, but hey.
Tiffany Wickes (02:05.208)
But the arrival on the doorstep actually did happen. So I was like, cool. I like walking. Yeah, well, we'll walk our dogs together. So we did. walked our dogs together. Adam and I had a soccer team and Melissa was part of it. She is an awesome soccer player. and after that it was like, let's go work out together. Let's walk our dogs together. And then we found out we had a lot in common and we have been besties ever since for many, many, many years. So Melissa.
Melissa Stendahl (02:09.927)
and alert.
Tiffany Wickes (02:31.842)
What I don't know though, of all the things I do know about you, I have no idea what interested you in physical therapy outside of being sporty to begin with, and then what prompted this specialty in pelvic health.
Melissa Stendahl (02:48.687)
I always wanted to be in healthcare and I think I came across PT. I didn't have an injury that got me into it. A lot of people get into PT from their own injury rehab or in pelvic PT from like postpartum experience, for example. But for me, it was neither. I remember learning about it and just looking more into the options in healthcare and being really drawn to PT because it's used preventively too. It's such a useful.
useful profession. And then with the pelvic health part, so I remember it was my first year or two of practice. was in an orthopedic and sports setting and I had a pregnant client with really persistent SI joint pain and I really just didn't feel like I could help her very well. And I didn't know what I didn't know. You know, I guess I felt like my toolkit wasn't big enough for pregnancy.
And a lot of the other providers would not even touch a pregnant person, especially the male providers. I was like, all right, I need to know more. I can't just start labor off by like working on the SI joint. Right. So like no need to be scared, but I don't know what to do. Right. So my first pelvic health course was an intrapartum care. So like prenatal through postpartum labor delivery care. And that just opened the door. So I took
everything pelvic health after that. And then my next job was in a pelvic specialty clinic. So that's, I pretty much dove right in from there. And I don't just see postpartum or prenatal population, but that's a big, that's a major time in life for females when pelvic health or the pelvic floor first comes into focus. So, so that's what got me into that.
Tiffany Wickes (04:31.618)
So is SI joint issues a pelvic health issue?
Melissa Stendahl (04:36.347)
It is the SI joint is a pelvic joint, which I can show you right here. Yeah. So this is a pelvic model. If anyone's like looking, you may have seen this on a skeleton somewhere, but in the back, it's this joint right here. So between the end of the spine and the actual pelvic joints, which form, which forms like the bony hip or waist. So a lot of people have like dimples in the back, the low back above their buttock, like where
Tiffany Wickes (04:40.764)
nice.
Melissa Stendahl (05:04.947)
the SI joints are, but some people don't.
So yeah, technically it's a pelvic joint. It's also just commonly known as left or right sided low back pain.
Tiffany Wickes (05:15.534)
Okay, so if a pregnant mama is listening and she's like, yeah, that hurts on me a lot, like what would this suggestion be to help her?
Melissa Stendahl (05:24.829)
Yeah, well, first of all, get it properly evaluated. If you're doing activities on your own and doesn't actually target the thing you're trying to target or the source of the pain, then you're probably still gonna have pain. if it's like low back in the spine on the middle, know, the spine, that's different. So SI joint can be irritated a lot with, or I should say conversely, like you can help SI joint pain by figuring out what's going on with posture maybe.
how you're, especially if you're loading things more like running, jumping, landing on a single leg. So you've got that force going up through one leg at a time, translating through that joint there on the side. And especially if you're lifting heavy things, whether that's lifting kids or working out. you know, that can bother it more too. So, but yeah, properly diagnosing is number one. So pelvic health PT can certainly help figure that out.
Tiffany Wickes (06:23.694)
Okay, are there any muscles that can be activated prior to like fitness seeing or something that can help it?
Melissa Stendahl (06:31.411)
Yeah, again, that's kind of like a more complicated answer. It's not necessarily one thing that helps that side pain. It could be a tight muscle. There's some muscles in the low back that attach onto the top of the sacrum there, kind of pull on the area. Sometimes relieving that muscle tension can help, but muscles also don't necessarily get tense unless there's something that keeps making it tense, right? Like again, either a stagnant posture or a demand at work, manual labor, pregnant belly, like whatever it is that keeps like, you know,
increasing the tone or tension in the muscle. And then if we like look a little more expansively, most things around pelvic floor and the low back may be improved with better core support. And core muscles are really deep abdominal wall. So beneath the six pack, the back muscles, the roof of the core is the diaphragm. So under the rib cage are mainly like respiratory muscle and then the floor, which is the pelvic floor muscles. So some kind of coordination conditioning.
strengthening may help with that as well.
Tiffany Wickes (07:32.91)
Okay, awesome. So another common question was about pain during sex from our own research, meaning I like, so I've never had pain per se while having sex. However, I have had like, discomfort physiologically if I wasn't like ready, you know? I believe there is some shifting of anatomy that happens during the arousal phase of sexuality.
Melissa Stendahl (07:53.276)
and
Melissa Stendahl (07:57.247)
Mm-hmm. Good.
Tiffany Wickes (08:01.72)
So can you tell me a little bit more about that kind of discomfort? Like, hey, my body's just not yet ready to receive versus this is actually a problem and you should get this evaluated.
Melissa Stendahl (08:13.799)
Yeah. So we haven't like, I don't know if people need to know this, like what is the pelvic floor to begin with? If that would be helpful to like quickly review. Yeah. And then you're right. There's like some things that change with proper arousal and then some other indicators that like something else usually muscular is going on that's uncomfortable and like how to differentiate that. So pelvic floor again, if you're watching everything in red is the pelvic floor muscles on the model.
Tiffany Wickes (08:22.754)
Yeah, of course.
Melissa Stendahl (08:42.771)
So this is like looking directly at someone's like abdomen and front pelvis, right? Pubic symphysis here. And then we have openings, anal opening, vaginal urethra. You can see that. And then the yellow dot is indicating the clitoris. And so our circular sphincter muscles, like when we tighten or kiggle, they close and then they have to relax and open to allow things to pass, whether that's going to the bathroom, whether it's intimacy.
or having a baby. And then we have long muscles, some of which are more superficial across here. And then the deep layer forms more of that floor shape for the core. And these longer muscles run front to back, like pubic bone to tailbone. So they do attach on the end of the spine. So back to like some back conditions or back pain and then form like little walls down there. And the hip, by the way, is closely related to this too. This is kind of like
Tiffany Wickes (09:25.0)
Melissa Stendahl (09:41.609)
part of this wall is formed by deep hip muscles. So sometimes hip can be related. anyways, with intimacy, With arousal, arousal helps certainly with increasing lubrication and then also kind of like lifting the top of the vagina, almost like things feel, you know, they can be like deeper. I'm not the arousal expert, so I don't wanna, you know, say too much more than that in case I'm wrong, but.
but there's like basically a lifting of the vaginal vault and then this increased lubrication. So the tissues feel better and mentally there's part of that, you know, a play in that too. Now, if somebody, regardless of whether or not they think there's like proper arousal for them for intimacy, if there's kind of a pain with stretching that doesn't go away, if there's pain in deeper areas,
that aren't really going away. feels like kind of like a sex session, whatever you want to call it. I know it sounds like a clinical term, but like if things don't get better as you go, and it's like that every single time, or let's say you've never had a completely comfortable intimate experience, those are more indications that there may be an issue with the muscles relaxing. It's usually muscular. In rare cases, it might be something with the quality of the tissues.
Certainly, if there's been any sort of sexual trauma, there may be other work that needs to be done with mental health and trauma-informed care to change the perception of a sexual experience. And then, of course, treating any tissue damage. But the main reason is usually muscle. So the muscles remain more tight. It can be harder to stretch. It doesn't feel good. Think about a tight shoulder or something. It can hurt. It can have knots.
And that can happen in pelvic floor as well. So a lot of pain issues, intolerance to gynecology exams, like we're talking like it's never a good experience. That is something that's usually treatable.
Tiffany Wickes (11:46.606)
Okay, so if you're having some sexual dysfunction with your partner, like what's the best way to communicate like, hey, I need to go get help with a pelvic, like how do know that this is not gynecological and obstetric versus when to see a pelvic PT?
Melissa Stendahl (12:07.455)
Got it. I mean, the first step, a good first step is the gynecologist, just routine GIN, make sure that everything is normal with the anatomy. So like nine times out of 10, maybe more than that, they're gonna check and there's not gonna be sign of infection. There's not gonna be a sign of inflammation. The cervix, the end of the uterus is gonna look fine. Pap exam would be normal. There's no UTI. A lot of times people get checked for UTIs because, you know, UTIs can come with.
sensitivity at the entrance area. It's usually urethra, but it can feel like kind of everywhere there. And so there's no positive urine culture for any kind of bacteria. And you're told, I can't find anything wrong. There's nothing wrong. That's usually the case. And so the next step, this is the part people don't usually know is you can book an evaluation even without a referral or a script for that evaluation with Pelvic Health PT.
And that's where we're gonna dive down into the tissue types and like what's going on with pelvic floor muscle and the tolerance to that, you know, whatever the pain, the activity where the pain's happening.
Tiffany Wickes (13:14.222)
Okay, is there a national registry to find pelvic health PTs or do you just Google search that ish?
Melissa Stendahl (13:21.609)
I mean, you definitely could. It's more common to see them in your area, especially if you're in a bigger city. If it's a pelvic health specialty, they usually have search terms, you know, and Google that will help identify them or it might be in the name. And ideally you find one that's a specialized pelvic health clinic, not a pelvic PT somewhere else, but the whole place, that's what they do. And then there's some hospital-based systems, there's outpatient, that's pelvic providers, but there are also
Registry so APTA American Physical Therapy Association APA dot APTA com has a provider registry you can look up and drill down by specialty There's also Herman and Wallace pelvic rehab Institute and they have a prior provider directory and that's a specific It's a specific Institute for pelvic rehab. So that's gonna be all pelvic based providers. There are some more
but there's actually quite a few. So I don't know if that's something you want me to provide a resource for later, but I would start with the Herman and Wallace provider directory and then apta.com and pick the pelvic specialty.
Tiffany Wickes (14:30.862)
So just out of my own curiosity satisfying this, are there sub specialties within your specialty of public health?
Melissa Stendahl (14:41.775)
say no, but some providers also treat males and some only treat females. So if you are a man needing public health PT, you want to make sure that there someone there who treats men. Also, there are people who specialize more in certain things like maybe bowel colorectal disorders. There are also people who really specialize in just perinatal, prenatal, postpartum care.
And again, usually that's pretty well advertised. Like if that's their thing. There are also sexual health PTs who specialize in all the sexual dysfunction. while, you know, technically it's like a, I guess it's a yes on the subspecialty.
Tiffany Wickes (15:25.814)
Yeah, it's sounding like there are a lot of subspecialties within this. And you know what? I wasn't even going to go into the male side of it, but I do have a fair amount of male listeners on this podcast. Probably because I have sort of like a more masculine presence, but let's like, let's just talk to the dudes for a minute here. What does pelvic floor dysfunction look like in a man?
Melissa Stendahl (15:53.695)
Well, shocker, dudes also have pelvic floors. There are some people who don't know that part. It's almost the same as a woman, but there's different reproductive organs that it supports, right? So part of that pelvic floor function is supporting the organs in the pelvis. And so for guys, one of the more common presentations would be male pelvic pain, like chronic pain affecting the genitalia or in the, you know, just...
down there or the rectum pain that is felt like rectally, for what seems like no good reason. Again, usually it's negative for any kind of infection or bacteria, not prostatitis, right? It's not, and in fact, tronic male pelvic pain is classified as non-bacterial prostatitis. So the funny thing is prostatitis means inflammation of the prostate. And in these cases, there's no inflammation of the prostate. The prostate's normal.
And usually this is guys under age 50. So they start having pain, but also super common for that population to have erectile and ejaculatory dysfunction. So either their sexual performance isn't going as well, or it's uncomfortable to have an erection or to ejaculate. And of course you can imagine how distressing that is as a young man with like no infection, like what is happening here. So that's one of the more common ones.
Tiffany Wickes (17:19.17)
Wow. I wouldn't have even thought to seek pelvic health PT if I were a guy experiencing that. So that could be some really valuable information for my male population. And granted, I can think of, so many things that they're like, my dick hurts when I use it. You know, like where, who do you even talk to about that? Like you go to your, they're not going to want to go to their general practitioner. feel like, yeah, I mean, right. They,
Melissa Stendahl (17:32.031)
Thank
Melissa Stendahl (17:44.735)
They usually go for urology, but urology is clear and you might have urologists. This is the same with women too, like GYNs. It's very variable how much a physician knows about the pelvic rehab area. They might know a lot and have a good referral base and relationship with other providers, including PTs, and they might not. They might not. So with guys too, another common one is bowel stuff, like constipation.
Constipation is actually a pelvic floor disorder that's common to also treat in everybody. And it's something that if chronic can start leading to other issues with like pee or sex because of its effect on the muscles.
Tiffany Wickes (18:28.11)
Okay. So speaking of P, so toddlers, okay, we're to move back into the kid category. toddlers, when you have like bedwetting that exceeds a normal age range, like, you know, I think being fully potter trained, like through the night around four years old is pretty typical, like for and under. If you have bedwetting that goes beyond that and you've been cleared by your pediatrician and says, there's
nothing bacterial going on, they don't have a urinary tract infection. Could pelvic PT be something kids could benefit from?
Melissa Stendahl (19:06.207)
Yes. Yeah. I am not a pediatric pelvic PT. So my ability to talk on like the interventions for that is going to be really limited, but that is a thing. It's even harder to, it's even like, there are even less providers that do it. So it's really hard to find, to be honest. But if someone needs it worth doing it, because yes, there are interventions for pediatrics, which is basically under age 18. Okay. But yeah, if there's a really late bedwetting or some kind of like
Again, back to bowel stuff, like holding back, toileting issues in general. That may be the public PT, pediatrics may be where the solution lies for that.
Tiffany Wickes (19:46.794)
Okay, well, since I'm in the thick of it, I'm going to just go ahead and ask the question when it comes to holding back pee and stuff like potty training toddlers from a pelvic health perspective, is there a better time or not to start potty training little kids?
Melissa Stendahl (19:51.347)
Click.
Melissa Stendahl (20:03.931)
No, I would follow the normal recommendations for that. I do want to say that something you said would be important for kids and adults where when you are potty training or they've been potty trained and it's still early on is trying not to familiarize a person with going when they don't have to. A lot of people do like, I'm going to pee before I leave the house. They don't have to go at all.
then maybe they want an hour ago. But adults do this too sometimes of like, I'm just going to go before I go, you know, just to get it out of the way. But that's actually not, you know, with bladder signaling, we want it to be normal. You get the urge when you actually have a full enough bladder and you listen to the urge in a timely manner. And then conversely, if you don't have to go, you don't just like go because you can actually train the bladder to go more frequently. And certainly if you are an adult, especially again, postpartum and beyond,
we may have some leaking issues and it certainly is harder to prevent leaks when urge signaling starts happening like stronger or more frequent. So no, I wouldn't, I don't know any reason to like not follow normal recommendations or like, you know, American Academy Pediatrics on bed wet potty training. But I do want to like mention there's some, you know, we don't want to bring bad habits to kids early within reason, right? Within reason, do what you have to do for like,
Tiffany Wickes (21:27.978)
Right. Well, my gosh. I'm like, I'm like, uh-oh, because we've been setting a timer to like bring Roman to the potty. And well, actually he prefers right now to go outside like a dog. So I'm just like setting him in the front yard and I'm like, okay, do you have to go? And a few times he's been like, no. And I'm like, okay. And then we just move about our day, but I'm not like holding him to it. Like you better pee right now. So is setting a timer just to remind myself to offer pottying?
Melissa Stendahl (21:29.352)
Very good.
Tiffany Wickes (21:57.492)
Okay. Or should I just like wait until I see him look down because that's, you know, it's so fun to watch your pee come out when you're a boy. Like, am I messing this up, Melissa?
Melissa Stendahl (22:03.773)
No, there's no, no, no, with the timer, if you're helping your child get in touch with their awareness, that's different. Do what you're doing on that. Yeah, the only thing I was gonna throw out is like, probably just beyond potty training is where this becomes more relevant, is they do understand their own signal. They've been going, their pants are dry most of the time is like,
teaching habits of going when you don't have to go or holding too long. Right. Again, there's going to be an exception here and there, but yeah.
Tiffany Wickes (22:40.824)
Okay, so now I have a follow-up question to that because my eight-year-old will oftentimes wait until like she's darn near peed or pooed herself and I'm like, my gosh, you're waiting too long to go. Like surely you knew earlier and then will inevitably be at the very back of Costco and I've already offered toileting and then she'll say, no, I don't have to go. We're all the way at the back.
Melissa Stendahl (23:00.639)
nurse side.
Tiffany Wickes (23:04.386)
We've got a cart full of things. I've got lots of little kids and she's like, I have to pee right now. And I'm like, are you kidding me? I just asked you 10 minutes ago. I know 10 minutes before I got to go pee. So now I'm curious with kids is, is me saying, Hey, I want you to sit down and try is that training her to go when she, but every time she sits, she goes. But I think there's gotta be some level of urine retention for everybody. Cause Roman was doing that outside earlier. I put it in my stories, you guys.
by the time this comes out, you're not going to see it. But long story short is he was like peeing, like watching it come out dribble. was like, look, you're going pee. Great. And then he, he'd shut off the flow and then he'd walk a foot and then he'd pee again some more. He'd look at it, look up, smile. And he's like, delighted at the fact that he can start and stop the flow of his urine. And I was like, well, at least he's creating this like mind, body awareness right now is where he's making the connection. Like, I can control this.
which I think is really cool and it's a great piece of data for him to have as he's learning to transition out of peeing in a diaper and into a toilet or on the grass such as it is. But for the eight year old who does have awareness but ignores it, what do we, cause I know I am not the only parent who does this, who's like, no, you're gonna sit down and go because I'm not getting stuck in the meat section when you decide you're gonna freaking pee your pants.
Melissa Stendahl (24:11.625)
Yes, yeah.
Melissa Stendahl (24:27.507)
Yeah. I mean, there's a lot to figure out there. You know your kid better than anyone else. So if they're, you know, if they're denying it when they probably shouldn't be because they don't want to be distracted, they don't want to stop at what they're doing, they just don't like appeasing you, like, I don't know. That might be one thing, but the you're right. Like the no signal to go, poop or pee should be urgent the first time you have it. We get like a ding. It's almost like a ding. It's
You're gonna have to go soon. And of course, as adults, we might forget, right? Like we might not even be aware of that first, especially the bladder urge, right? Like, cause we know what to do. We're potty trained for many years. So, but yeah, we do get kind of an early signal and then it'll grow the longer you wait. And then there's kind of a reasonable time, like, okay, I should go now.
And then you know when if you wait longer, it's going to start being a problem. so you get, yeah, you have to give yourself enough time to get to the toilet or whatever. But kids don't necessarily do a great job of it. But they're also distracted or don't take it seriously or just trying to be defiant. Or maybe they're embarrassed about going in public. There I've heard all sorts of things about developing like losing a bladder urge signal or.
becoming constipated because of really long delays in going from everything from literally bathroom scarcity, like not being able to because there's not enough bathrooms available to those situation with a very, very large larger than your large family with like one bathroom. There's also issues with embarrassment or like insecurity, unsafe in public. And so people will avoid. So, yes, you can actually develop
changes to bladder signaling and or like losing the signal a little bit or constipation from really long delays. Keep in mind you have to do this like a lot. It doesn't happen for doing it a few times or once in a while. like, you know, again, a little bit of variability, a little bit of kid stuff, no big deal. So this would be more like routine. You're an adult and that's what you're doing maybe from work because of work or something, you know.
Tiffany Wickes (26:44.928)
Okay, so let's move into the pregnancy and postpartum category because I know this is a big one and it always bugs me when I see influencers online like laugh about crossing their legs when they sneeze and they make a joke of it. like we all do that. I'm like, no dog, actually we all don't. and I can tell you that we don't, not all of us do simply because we've had kids and I don't
urinate on myself because I have had pelvic floor PT for the last three babies. Thank you, Dr. Melissa Stendall for being the voice in my ear for that. was like, Hey, you do need to go do this. And I was like, okay. So, you know, thank God that we've got the resources available to us to get that care, because this is not typically covered under any sort of postpartum care or insurance, or is it?
Melissa Stendahl (27:40.733)
No, it's certainly not a standard program of any sort. Our country and states and even individual physicians or providers, because it could be midwives too, there's not a standard referral to pelvic floor rehab postpartum or standardized coverage of that. Some insurances, most pelvic floor PTs are going to be cash-based out of network because for reimbursement purposes. I mean, we do hour-long
Thereabouts, some people do a little longer, some a little shorter, it depends on the practice. But about hour long, private appointments, one-on-one. You will not be passed off to someone else for even the exercise portion. Like it's one-on-one, obviously it has to be private in nature if we are assessing pelvic floor. But that is a really solid evidence-based and clinically, clinically, clinically exc...
Whatever, that is the treatment model that works for pelvic stuff. So a lot of us go cash based out of network to be able to do what we need to do with people. And overall, the amount spent usually is the same or maybe even less than in network, depending on if you've met your deductible, what kind of coverage you have, all of that stuff, and also how fast you got better. Like if you were seen by someone highly skilled and had sufficient treatment time in the sessions. So anyways,
All that to say that like, no, there's no standard pathway. And then some people get like out of network coverage. Maybe you find it in network provider. There are sometimes in network public PT places. So it's not a hundred percent no on that. But most times it's not. So I think that answered that one right.
Tiffany Wickes (29:24.428)
Yeah, so let me just tell you guys my experience real quick. When she talked about like it's private, these private sessions, if you've, so I've had physical therapy twice. So one was pelvic floor physical therapy and the other one was on my shoulder after I had a rotator cuff tear, I was doing physical therapy. So you might be familiar with physical therapy offices where everybody's in a room and some people are doing the hand bike, some people are walking on the treadmill. You don't see pelvic floor PT's.
assessing people there because oftentimes like, I mean, my PT did have to access my pelvic floor and she was very gentle and it required my pants being off and she would put a hand on the inside of my leg. She's like, I'm touching your leg. Is that okay? Yes. And then she'd move up. I'm touching higher on your leg. Is that okay? Yes. And it was like multiple times she was
gaining my permission to be touching my body. And then she was assessing internally and there was like squatting going on where she was watching what my pelvic floor did when I squatted, when I grunted, I bore down, you know, like there was a lot of looking going on. So if you guys are nervous about that, you're not gonna be in the room with the hand bike people. You're going to be in a private setting where you will be properly assessed with somebody who is
Melissa Stendahl (30:17.855)
Yeah.
Melissa Stendahl (30:32.073)
Yeah.
Tiffany Wickes (30:48.118)
know if trauma, trauma, like sensitivity or education is part of your core training. can tell me that, but I know for sure my practitioner was very trauma informed and she was very, very gentle. And like I said, she gained my consent every step of the way and there was nothing that surprised me, nothing that hurt. and she gave me really valuable data on what my pelvic floor was doing and how I could optimize my own health. So.
I flew through seven pregnancies with fairly minimal SI joint pain until, you know, I did have some, and then I went back and was like, okay, what's going on here? And she did give me some exercises to help activate certain parts of my, you know, glute muscles. And that helped tremendously. At one point I did wear a support around my low hips, but nonetheless, that's my experience. It was amazing. And what I didn't know is that I should have accessed care sooner.
So from your perspective, when is the best time to access care for a woman who is either pregnant, postpartum, or thinking about being pregnant? Like, which category do we fit into?
Melissa Stendahl (31:56.863)
Well, let's just start with postpartum because that's when a lot of people think about it for the first time or maybe they have a tear from giving birth or they had a C-section so their abdomen was cut open, they're like core, they don't feel like they have good core activity anymore or they have pain down there and maybe with returning to sex, maybe the pain never went away after having a baby, maybe their core feels weak, they're leaking, whatever it is, right?
Four to six weeks postpartum is a really great time to first come in. You could actually come in sooner. We're not going to do the internal assessment too early on. We do want the initial healing to be done. Certainly if there was any skin tear, we want the superficial tissue to heal. We want the bleeding to have stopped from the recovery of the uterus. So we don't necessarily do that stuff right away, but there are activities you can do day one postpartum.
to start reconnecting with your core. A lot of it is breath work to start with. A lot of it is baby handling, posture. mean, car seats and strollers are heavy too. Like prenatal visits often include, want you to show me how you're going to squat with that car seat with good form, you know? So things like that. So four to six weeks postpartum, sooner if you're so inclined. It's just that like logistically, I don't see a lot of people getting out of the house.
or managing to come in sooner than four weeks. But yeah, and then ideally, most likely it would be recommended to come in like once a week for a few months to guide your recovery, even for someone who feels fantastic and really didn't have any issues, no injuries and feels good. A lot of times we're helping that person return safely to their highest level activity without overdoing it too early and ending up with
Pelvic prolapse symptoms or leaking when they actually weren't, know, by overdoing it, you can do that. And then prenatally, really anytime prenatally, certainly if you have symptoms, if you have pain in the low back and pelvic region, hip as well, if you start having leaking or vaginal erectile pressure symptoms, if you have really unmanageable constipation, like things like that, that's a good time. Pubic symphysis, pubic bone pain in the front.
Melissa Stendahl (34:22.857)
Those are all indications like come in and don't wait. So if you have those, try to come in right away because during pregnancy, we just get bigger and bigger until the end. So a lot of times it gets harder to manage. does not mean being pregnant doesn't mean you're just going to be uncomfortable the whole time. That's actually not like normal. It's common. It's not normal. So yes.
Tiffany Wickes (34:42.806)
Right, right. I'm glad you said that because there's a lot of things that are common but not normal. Okay.
Melissa Stendahl (34:46.951)
Yeah. So pregnancy, if you have symptoms, but if you have no symptoms during pregnancy, still come in because we can totally assess pelvic floor during pregnancy if someone's up for that. And also other things, maybe if you're still exercising, we can look at technique and safe progressions during pregnancy, but also kind of work preventively and try to make sure that you're really unlikely to develop symptoms during the rest of the pregnancy. And we can also do labor and delivery prep.
Are you pushing properly? Do you want help with pushing? Especially if you've had an issue with pelvic floor tightness or clenching, like can you actually relax and bear down properly? So there's push prep. We can go over positions for labor and delivery. If you're free to move during, you know, if you're able to move around, walk around during labor, like what positions are helpful? What reduces the risk of perineal tearing, et cetera. So there's a whole bunch of preventive stuff too that...
typically takes like maybe three to four visits to cover that can just be seen as like a labor and delivery prep situation.
Tiffany Wickes (35:52.876)
Excellent. Okay, so staying on with the postpartum person. So let's move into the gym girls. Okay. There are lots of programs for returning gym girlies to get fit again and.
Melissa Stendahl (36:01.78)
Okay.
Melissa Stendahl (36:06.472)
Okay.
Melissa Stendahl (36:10.591)
Can I mention something real quick? With the pelvic floor assessment, I also want people to know that you don't have to have one if you were really uncomfortable with that or you maybe wanna like get to know the PT a little bit. There are other ways to assess some of the pelvic floor activity externally and also look at other things like this would be a segue into some of the maybe the gym stuff. There's a lot that we can look at that affects the strength and coordination of your pelvic floor muscles.
Tiffany Wickes (36:11.936)
Yeah, of course.
Melissa Stendahl (36:39.475)
that we can start looking at if someone's really hesitant about pelvic floor exam. And also if you do have discomfort with the exam, like physical pain, it's not like maybe a physician visit where we're trying to go in, get a sample and get out. We work with where the symptom is. If someone doesn't feel good, if we can't touch certain muscles, we start working on that. We don't just blow through that.
I think that's important to know. A, you're the boss, you have consent or can decline at all times. And B, it's very much like, as you mentioned, you get a lot of information. You get performance variables about how your public floor is working. So it's highly rewarding and valuable when you do get that. It's different than any other visit.
Tiffany Wickes (37:27.298)
I mean, gosh, yeah, you're talking about, how things are working digestively, urine, sex, pushing recovery. Like there's so much going on there. It's so undervalued. okay. The gym girls. All right. Here's the problem is they go to their, so their six week postpartum visit and doctors like, you're good to go have some sex and go ahead and work out. And you're like, I don't feel good to go at six weeks.
Melissa Stendahl (37:41.283)
That's what the 10 jollies.
Melissa Stendahl (37:56.382)
No.
Tiffany Wickes (37:56.61)
And admittedly for the first, what was that, four kids, I did not do a pelvic floor program postpartum. was like, I'm good to work out. So I jumped back in the gym. did way too much, way too soon. you know, learning more and growing as such as we do, or at least I do, I was like, okay, pelvic floor PT. So that happened with babies five, six, and seven.
that I did do a postpartum pelvic floor rehab program. So that was meant specifically for getting you, not even just functional day to day, but to get me back into the gym safely. So can you talk to my gym girls? Well, really any girl who's had a baby really needs this, but I think more specifically the gym girlies, they have a different mindset when it comes to working out. They are in beast mode, which is great, but it's not great.
Melissa Stendahl (38:41.086)
Yeah, yeah.
Tiffany Wickes (38:53.26)
six weeks postpartum, like you need to chill the F out and they don't. So tell us a little bit more what some programming would look like for that.
Melissa Stendahl (38:54.975)
Yeah.
Melissa Stendahl (39:01.183)
There's so many valuable points. I don't want to miss any. I think one of the first things I want to say is if you haven't before, take the time, try to calm it down a little and think about, hey, in this window I need to be doing more low impact stuff just because I need more of a healing window. Things are still changing my body. haven't recovered full. Do you know 12 months out from birth, pelvic floor strength is still not what would.
what it was like mid pregnancy. This comes from research on preemie Paris women, meaning first child. But a year out, pelvic floor typically still isn't as strong as what it was. Now,
Tiffany Wickes (39:42.24)
No, hold on. I can tell you this. So there is a particular move I still can't do. And I am almost two years postpartum with my seventh kid. So if I'm in a bear hold and they're called sit throughs and you turn and then your like outside leg goes the opposite direction, I cannot do that. Those connection points in my pelvis, they'll be like ping and I'm like bug that hurt. So I still can't do those.
Melissa Stendahl (39:56.767)
you can. I'll you men.
ever.
Melissa Stendahl (40:08.307)
Yeah, yeah. So that's a good window of time. Maybe not how far you are, but like the earlier window of think to yourself, like now's my time to work on stuff I always put off because it's just not that big a deal. For example, for one person, it could be mobility in one of their hips. Maybe they're always tighter on one side. Well, don't let that bite you come back to haunt you like, I'm horrible with figures of speech. Don't let that come to haunt you like,
maybe because you get back to exercise too quickly and your body's more relaxed than it was. Maybe you're lactating. There's still homeroom changes going on and your core strength is not what it was yet, right? Take that time to maybe work on mobility and make things symmetrical. I love to recommend that people, if you're just self-assessing, check your symmetry. Do a bunch of single limb stuff, single leg stuff. Arm not as important for down here, but you could do upper body stuff too.
See how it feels to load on one side, single sided farmers carries and farmers walks and things like that, single sided dead lifts, like anything you think of, single leg squats, right? And assess is strength and stability and control feel equal per side and if not work on it, mobility, right? Hip mobility, spinal mobility, whatever. Now's the time, right? You can come back, maybe performance can be even better than ever, but just take that time of like when you're supposed to be doing.
more low impact stuff to maybe work on those things. So that's important, maybe a mindset shift on that. And then there is some variability with whether or not someone can kind of get back to full beast mode sooner or later. So one is if you were doing higher level of activities through pregnancy, if you were capable of doing that, you will probably be able to return to it sooner. If you had a difficult pregnancy and had to do a lot of bed rest or just lower activity,
you're going to need to gradually get back to that. The baby's not out. You're not just like good to go again. You know, you have to kind of like recondition. Another would be weight. So again, gym girlies, they're probably in fairly normal weight range, maybe on the high side because of muscle mass, but someone with more weight, there may be more issues with public like pressure management and pressure. So if there was a higher weight gain or something kind of unique with that, gestational diabetes, anything like that, again, that might be a factor.
Melissa Stendahl (42:28.831)
Mental health, that's a huge deal. That's something that's not screened very well with moms, but someone who has postpartum depression, you really want to help guide, and that's something I would do as a professional, guide them on safe return to exercise because people do all sorts of things for coping. Some people hide in a hole and they don't work out at all. Others may overdo it. The big factor being like when there is some mental health, acute mental health issues are more severe.
judgment can be clouded and it can be harder to kind of figure out, like self-assess what I'm safe to do for exercise. Reel me in. What other points do we want to talk about with the gym stuff? There are some guidelines out there on return to exercise postpartum. Again, let's say you feel really great and you just want to make sure you do the right things and don't overdo it. So there are specific windows of timeline with like during this phase you generally should be doing non-intensity strengthening activities.
And then around the three month mark is when you would return to run or other impact like jumping stuff. So weightlifting specifically is something that I'm really comfortable having with people do earlier than later. You just have to, again, start lower load and maybe more reps. Watch your fatigue level, that kind of stuff. And then start progressing to where you want to go with lifts. Impact is one of the things you want to do later. So whether that's jumping.
some kind of dancing or cardio class or power, like higher velocity lifts, snatches, things like that. That's where you would wanna be waiting till like three to four month mark. And again, gradually go into that. Maybe you add some jumping, but without the weight. Maybe you do walk-run intervals instead of just, I hit the three month mark, I'm going for a three mile jog. Like, well, hold on.
Tiffany Wickes (44:11.118)
Mm-hmm.
Tiffany Wickes (44:22.52)
Mm-hmm.
Melissa Stendahl (44:23.717)
Even if we feel good maybe in our joints and energy wise, what we have a hard time measuring on ourselves is that pelvic floor strength and endurance and coordination. So you might be fantastic, then you start jogging and right around the mile mark, you just start feeling like you're going to pee yourself and you can't figure it out. It keeps going and it goes like that for months and months. That would be a not uncommon scenario. So what we need to do there is figure out, well, something about that mile mark
the demand exceeds the capacity. For whatever reason, pelvic floor, we need some sort of like probably some individualized conditioning for whatever's going with that mom's pelvic floor. And that's where an assessment would come in handy. Like I can't tell you what the problem is. It could be your breath mechanics. It could be your posture. It could be literally weakness or endurance issue. It could be that tear that now there's like scar tissue there and it needs to be actually like mobilized.
Tiffany Wickes (45:21.198)
Brilliant. Yeah, well, I know when I started running postpartum, was like, felt so awkward. like you were spot on because like lifting, yeah, my muscles are strong. I'm ready to go. But as soon as you added the impact element, it changed the game altogether. I was like, why am I running like a brand new baby deer straight out of its mom? Like I just could not get all of my parts and bits to work together. Okay. So moving on to what you do with live labs.
I have been watching online and I've learned a little bit more about a device that you guys have come up with that helps with pelvic floor strengthening. So I want to know a little bit more about that.
Melissa Stendahl (46:05.471)
All right, thank you. Yes. So with the, with LiveLabs and startup company, our pelvic floor fitness solution innovations, we have just launched our first product this month. I'm holding the Pippa. This is two sizes and they're soft and squishy made of medical grade silicone, totally safe to wear. They've passed all their biocompatibility testing so can be worn in the body and they're designed to be worn internally similar to like a tampon or a cup, but
It's not for menstrual care. You can wear during your period though, because you can see it's open. So you can just flow right on past it. And there's an applicator that comes with it. So you insert. This helps you get it into the body in the right spot. you can wear it just during exercise. You can wear it all day if you want to do that instead. But it's designed right now. This has been tested in healthy women. So no regular pelvic floor issues.
But what we found is that this helps to, it interacts with pelvic floor muscles to increase muscle action. We've seen as much as 35%. So you can imagine if you have concerns about pelvic floor muscles, this is supposed to help boost that. So we're intending for women to wear this during exercise.
Tiffany Wickes (47:23.736)
So weight training, impact, all of it, what is the, who is the ideal client that would reach for that product? Like what is she experiencing? Why would she go to it?
Melissa Stendahl (47:27.294)
All of it.
Melissa Stendahl (47:32.873)
Every
an adult female, so not for kids, adult female who is curious or has concerns about pelvic floor muscle strength. Not necessarily, again, if you have like regular symptoms, we don't have it tested for that, although that doing like studies in the future where we check for how the PIPA may affect actual diagnoses that we are considering being able to do that.
This can be for anybody and your workout could be weight lifting, could be jogging, could be Pilates, it could be yoga, it could be vacuuming your house. You could just consider your chores and your regular maybe handling children or whatever you run around and do. That counts too. So our pelvic floor muscles contract all the time in demand. Like they're responsive, right? So if I sneeze, I'm going to need more support. So you're going to get a contraction or hopefully if you don't, you're going to leak.
Tiffany Wickes (48:31.532)
Yeah, no, that's right. Right. Because, know, sometimes even when you sneeze in just life, like people like hold their stomach or something, like they'll brace something. So that's basically what the PIPA is doing is bracing and supporting that particular set of muscles.
Melissa Stendahl (48:36.639)
you
Melissa Stendahl (48:47.007)
Actually, that's a little different. Some things you might be able heard of a pestery. That is, yes. Mostly, pestries are something you get from the doctor's office and there's like two available off over the counter, but those are designed or at least their average has that they brace and like push against the urethra. So the PIPA is not, I mean, it's definitely in there. It's gonna touch stuff, but
Tiffany Wickes (48:53.888)
I have. I couldn't define it right now, but I have heard of it.
Melissa Stendahl (49:16.607)
The action for the PIPA is a little bit different than that in that it increases the muscle action. So the mechanism is a conforming resistance spring. So it goes in, conforms in the wall there to the tissues in the vagina, by the way, if you're wondering where it goes in. Okay, just to be clear. And then there's a little bit of resistance, but it's not heavy. Like it's not a kegel weight. You're not going to feel this. They shouldn't have to work to like hold it in. But do you know like a resistance band?
Tiffany Wickes (49:31.522)
Yeah.
Tiffany Wickes (49:45.41)
Mm-hmm.
Melissa Stendahl (49:46.205)
you give it some tension, right? It demands a muscle response. It's resistance, right? So same idea here. The idea is that with a little bit of that spring action, we actually get an increased muscular contraction with an active kegel. So this, yes. Yeah. So yeah, for sure, if we take the sneeze example, you do need some muscles to kick in down there. I'm doing it like as though I'm the pelvic floor from below. Yeah, you do want muscle action.
Tiffany Wickes (49:50.072)
Right.
Tiffany Wickes (50:01.742)
okay.
Tiffany Wickes (50:13.954)
Mm-hmm.
Melissa Stendahl (50:16.295)
And so you can figure out the implications here, like if we're improving muscle action, the kinds of things that that supports.
Tiffany Wickes (50:26.03)
Okay, so where do you get this? Can you get it over the counter or do you have to get it from your PT?
Melissa Stendahl (50:31.551)
Not yet, and neither. Not yet. We are hoping this is over the counter and you can get this. So right now we're launching via Kickstarter. The campaign is already live. If you don't know what Kickstarter is, it's basically a platform for creatives to get new things out into the world. And it's a campaign. So if you want one of these, you go to our Kickstarter, which I can provide the link. You can also go to, let me make sure, hold on a sec.
Tiffany Wickes (50:34.306)
Okay.
Melissa Stendahl (50:59.529)
and I'll just say it loud because it's a super quick website, live-labs.com. L-I-V-L-A-B-S dot com and our homepage will take you there too. But you go to the Kickstarter page and you basically pledge an amount of money for a reward though. You pick your reward. So you can get this. There's a quick, like get it quick option, which is the first batch we're able to ship. We're raising money so that we can manufacture this and get this to more people and actually
like launch it, know, officially it's launched and we'll be able to be retail for people.
Tiffany Wickes (51:33.354)
Okay, awesome, so you're in the startup phase right now. Where? I love it.
Melissa Stendahl (51:36.201)
Very much a start company, yeah. But the Get Quick, I believe shipping for that is September. So like in a few months you can have, if you pick the Get Quick option and then there's some other options if you want two sizes, if you want a bulk order. So if there's like a professional clinician listing and you want to supply, I definitely recommend you get at least like one for yourself. And if you are a clinician, maybe a demo for the clinic. And you can try it yourself or not.
Tiffany Wickes (52:04.736)
Okay, so besides the website, do you guys have a social media presence where people can go there, watch videos, watch reels, and learn a little bit more about Liv Labs and the PIPA?
Melissa Stendahl (52:16.925)
Yes, Instagram is I think the one we do the most on and that's LiveLabs Fitness. So no dash in there, just LiveLabs Fitness. My personal
Tiffany Wickes (52:28.108)
And it's L-I-V, right? Not L-I-V-E.
Melissa Stendahl (52:31.589)
Live, L-I-V, correct, Live, L-I-V.
Tiffany Wickes (52:36.672)
Okay. Perfect. Because originally I put an E in there because I was like trying to actually spell it, but that's not what it is. But we will put those links in the show notes for you. And, last question before we sign off, what do you think? And you might have to think on this a second and that's totally fine. what do you think is the most important thing? Women specifically, not to exclude the dudes, but I do have a larger female base. What is the number one thing you think is most important?
for women to know or to be aware of about their pelvic health.
Melissa Stendahl (53:12.563)
yeah, there's a therapy. You just want one, just one.
Tiffany Wickes (53:17.482)
Well, okay, well, like if you really if you need to give two or whatever to make it feel well rounded, feel free. I don't want to limit you. You're so brilliant.
Melissa Stendahl (53:21.311)
No, mean, talk about it. geez. Thank you. Now, I think we covered a lot of ground. So even knowing what it is is a big deal. Let me say this. Let me say this. Hold on. I want to use it all up on the wrong thing. One is that there's help for that.
Tiffany Wickes (53:49.944)
Yeah, that's a good one!
Melissa Stendahl (53:50.655)
If you're not sure, if you're like, this is something I would never say out loud, trust me, I have heard it. There's no TMI in pelvic health. There's even memes about that in our industry. might get a coffee mug as a consolation. I call them consolation prizes. Like when you graduate from P.E., you might get a T-shirt. I mean, there's mugs and all sorts of stuff with sayings on it for pelvic health. So basically, if something's going on down there, all else fails. You've gone to physicians, you've cleared any, you know,
true medical issues. We're doctors. We're clinical doctors, a doctoral degree, and we are qualified to assess and treat stuff. if you have something going on down there, find yourself a pelvic specialty clinic or pelvic health specialist. Use those directors if you need to. Call if you need to. can call ahead. You can ask for a consultation. That might be a good tip. When it comes to pelvic health, you can ask for a consultation. They're often free or discounted from formal evaluations.
So if you are not even sure if you're in the right place, like do that. You can do that. And there is help for that. I mean, everything from abnormal clitoral sensitivity to persistent tailbone pain to all kinds of bowel and bladder control stuff. mean, you name it. Of course to ABWALT too, right? Hernia, we're really good at hernias because we're working with control of the pressure down there.
Tiffany Wickes (55:15.448)
Yeah.
Melissa Stendahl (55:20.083)
which includes the abdomen. And athletic performance, like sometimes that area is the missing link to somebody's athletic performance. They've got some little quirks, they just haven't worked out, maybe don't even know it. Love, would love to do that proactively or preventively with somebody, know.
Tiffany Wickes (55:36.71)
that is one more question that I wanted to ask is do you have a pelvic floor program that you particularly love to recommend? I did one, but I mean, it was, I don't even remember who it was now. Like it was that uneventful for me. I mean, I'm glad I did it, but it didn't make enough of an impact for me to remember who it was.
Melissa Stendahl (55:48.798)
Yeah.
Okay. Oh man. Putting me on the spot. Putting me on the spot. All right. I'm going to call out... All right. Well, A, let me say LiveLabs. Okay. We're going to... We're trying to... I can't give a time while I'm in this, but we want to offer an education program or a cert for fitness professionals. So if you're a fitness professional or a trainer of some sort or somewhere in like,
the industry, you would qualify, right? And you want to learn more about a pelvic floor approach or how to incorporate that, how to understand that in your training, that's something we want to offer. we want to build, a of us planning to build kind of more resources along those lines. But also I would have to say, goodness, there's really no,
A Palo Flore program is hard to recommend because it does need to be personalized. I think the right answer is probably like get at least an evaluation in person, maybe even a virtual consult if your area doesn't have anyone nearby because your issue or your big thing might be more of a strengthening approach. It might be more of a treating tightness approach. It might be more pain related. It just depends on what you need. I think
Tiffany Wickes (56:51.534)
Mm.
Melissa Stendahl (57:14.905)
personalized advice at least to start is really key. And then also you can get information or recommendations on tools and resources like, does this make sense for you? Is there something else that would help you to self, you know, do some self care with yourself? We can recommend lubricants and pelvic massage tools and like all sorts of stuff.
Tiffany Wickes (57:41.344)
Man, I know I've seen your guys's toy box and I'm like, what is that? And where is it going? And, yeah, that was a fun time when I watched a video on that. it was a wand you guys, and it looked like a very large finger with a hook. I was like, what the
Melissa Stendahl (57:47.135)
You
You
Melissa Stendahl (57:53.919)
Yeah, super common.
Just the end, most of the wand is handled. If you see a wand, a pelvic wand, I wasn't going to say that. You said it, not me.
Tiffany Wickes (58:01.688)
Just the tip, just the tip, just to see how it feels.
Tiffany Wickes (58:10.242)
Probably because I know you. I knew what was going on inside your head, but you're like, I'm a doctor. I won't.
Melissa Stendahl (58:11.539)
house.
It's not my podcast. But now most of it is handle. If you see a pelvic wand in the wild, most of it is handle. Okay. Have no fear. But yeah, I think, you know, trying to do a personalized approach, at least upfront, but as far as the recommendation goes, how about this? More, a little more general answer, but also accessible. Most Pilates is really complimentary to pelvic floor PT and PT in general, actually, like your shoulder stuff.
Tiffany Wickes (58:17.228)
Hey, my people know me.
Tiffany Wickes (58:24.012)
Yeah.
Tiffany Wickes (58:41.412)
I love it.
Melissa Stendahl (58:42.665)
Pilates is really complimentary because their instruction and then the equipment is really good at getting their body. It's like coordinating body and body control, including lengthening and flexibility stuff. So how about that? If I'm just gonna throw out.
Tiffany Wickes (58:59.414)
No, that's actually totally spot on. did. And I wrote an entire article about a Pilates studio and that's how she started was through physical therapy. She had an injury and the physical therapist was like, you should do Pilates. That would help. And then she became certified and that was like 30 years ago. So yeah, ma'am, Melissa, you are so incredibly brilliant. Thank you for being here. Yeah.
Melissa Stendahl (59:08.825)
yes.
Melissa Stendahl (59:17.459)
Yeah. Well, can I throw out a more tips? If you're a tight, painful person, the default, this is like unskilled, unevaluated, right? The default would be something more relaxing, like some sort of low, like not athletic yoga, but relaxing yoga where you're really working on more restrictions and mobility issues and a lot of the meditative breathing. Okay. Breathing is a big deal for pelvic floor. If you didn't catch that in any comments I made.
Tiffany Wickes (59:44.344)
Mm-hmm.
Melissa Stendahl (59:46.543)
If you're more on the weaker, super flexible, you know you're not in shape type of end, then strength training is a good bet. Again, this is like non-individualized advice, right? But for some people, their body, pelvic region, the core, and any symptoms are really going to benefit from sheer strength training, even if they don't know how to target the pelvic floor. We see this sometimes with weightlifting.
Tiffany Wickes (59:52.269)
Mm-hmm.
Melissa Stendahl (01:00:13.971)
where someone's got some symptoms, but they're stable symptoms. And as they get stronger, those actually disappear. That's not every case. Some cases, the training is actually kind of exacerbating the symptoms. It's like an aggravant. But in some cases, it's just a game of time where they need time to like grow the muscle bulk a little bit, hypertrophy and grow the strength. yeah, if you're more on the weaker and you kind of know it, maybe a very hyper flexible person, probably going to benefit from strength training.
Tiffany Wickes (01:00:17.582)
Mm-hmm.
Yeah.
Tiffany Wickes (01:00:27.566)
Mm-hmm.
Melissa Stendahl (01:00:44.543)
If you're on the tighter pain end, probably gonna benefit from something with a lot of relaxation and breath work. And then Pilates is kind of a great all around. So without recommending an individual or like a Kegel program, then that's what I would say. Well, that's a really long answer.
Tiffany Wickes (01:00:58.958)
Mm-hmm.
Tiffany Wickes (01:01:02.582)
I love it though, that's a fantastic answer. Thank you so much for being here and sharing all your knowledge. I will link all the things in the show notes and they can find you on Instagram too, right? Like just you as a person, not just LiveLabs.
Melissa Stendahl (01:01:14.579)
Yeah, well, I'm not super active on my account. So I'm to say Liv Labs Fitness. Instagram is at Liv Labs Fitness. If you are interested in trying the PIPA, I think at the time of this, like when people will hear this, there's going to be like a week left. So get on there. Kickstarter campaigns last for one month. There'll be a week left to get any available product and there is a limited amount. So if you want to be in that first wave and get your hands on it, please do that.
Otherwise, if someone asks questions, has follow-up questions for you, or you want to do this again, just let me know.
Tiffany Wickes (01:01:51.298)
I love it. Thank you so much. All right, strong mothers, stay strong, show up, talk to you soon. Bye.