Navigating Pelvic Floor Health with The Down There Doc

You blow my mind I don't know if you know.

Hi everybody, I'm Amy and welcome to the Be where youe Are Today podcast where I connect with fitness and nutrition professionals so we can help you wherever you are in your journey. Today I am talking to Dr. Marcie Crouch. Marcy is a doctor of physical therapy. She's a mom of two and she is the down there doc on social media. She is dedicated to serving, empowering and equipping women and the birthing community. From birth preparation through postpartum recovery, providing elevated care and setting a new standard for women. Dr. Marcy Arms Mamas and their partners with confidence, valuable tips and science backed information that will help decrease the risk of injury and accelerate their recovery. So Marcy and I have known each other a long time. We connected many years ago, I think, right maybe right after I had my daughter. And you can find some old videos on my YouTube channel with Marcy called Ask a Pelvic Floor Physical Therapist where we are answering a lot of the questions we'll talk about today. But so I have loved your work and have always appreciated all of your expertise and I'm really excited to be talking to you today.

Well, likewise. Like, I know I feel like it was a different time and world. I think my. This was one maybe I don't even know.

Yeah, yeah, I think, yeah, I had a baby and like a two year old and you had like a one and a three year old. So we were in it.

We made it. We made it.

We're on the other side. We could talk about that all day of like, it's okay mamas, you'll get there. They're all at school right now.

So it gets finally. Yeah, I know. School, once school happens, it's like a whole nother part of your life.

Yes, very different. Very different. Well, as I said, Marcy is a pelvic floor physical therapist. So you know, we serve a lot of the same communities. I do a lot in prenatal and postnatal fitness. But I am constantly referring people out to you and advising them to also see a pelvic floor PT in person when they can because they're very different. We need both. So we're going to start with a few little intro questions and then we'll get into things a little bit more in depth. But first things first. What are the most common questions you get? You're all over social media. You have a lot of great information out there. But what, what do you think you're asked about the most?

Yeah, it's a great question. I think lately, and I would say probably in the past three or four years, I think the most common question that people ask on social to me, to myself and my team, are more specific to reducing the risk of vaginal tearing during their delivery, whether it's like their first delivery or second delivery or kind of whatever the case may be. So that's a big one. Like, oh, my gosh, how am I going to this baby out of my vagina? And how am I going to not, like, have a horror story that everybody tells me about? Right. Nobody says the good stuff. They always are like, oh, my gosh, this thing happened to me. It was awful. Yeah, yeah. So there's that and then another one. A lot has to do with pain. So, like, any sort of vaginal pain, whether it's during pregnancy or afterwards, pain with sex, leaking urine is a big one. Um, and then also something that you and I treat together. I mean, we treat a lot of it together, but diastasis, abdominal separation, how do I get back to shape after the gym? I've had the separation in my tummy muscles. I don't know what it means. And is it always going to be like this and kind of these topics that a lot of people, I think now different than when we talked, you know, years and years ago, can kind of stumble upon a little bit more easily with social media and they have questions about them and rightfully so. So kind of all the things that I guess aren't really talked about, maybe. Yeah. Yeah.

Although I will say just having you start with the base, basically, birth preparation, being that your more common question now, to me, that feels like progress. Right? Like, it feels like for many years it was the postpartum women saying, this happened to me. How do I fix this? Is there something wrong with me? Am I broken? And the fact now that there's enough awareness from people like you and others on social media and good providers out there to say, like, there's a lot that we can do to prevent pelvic floor dysfunction and, you know, or at least reduce the risk, I guess, is the. The way we would say it. There's. There's a lot that happens in pregnancy, but there certainly is a lot that we can do to prepare. So when women work with you or you have. You have courses, you have a community, what would you say surprises them the most?

Oh, my gosh. I think that they actually. So let's like, break it down into two groups, I would say. So I think the pregnant ladies that I work with and the women that come into our online community, I think, are always surprised that our program actually works and that they have and that they actually can do something and see results from it during a time in their life when usually the messages is like, oh, well, you're pregnant. You know, there's nothing you can do, and, oh, this is just how it is. Right, Exactly. So I think they're always like, oh, my gosh, that was so awesome. I had. I had a great birth. Same with, like, second moms, second or third moms. They come in, maybe had not such a great first or second experience, and then they're surprised that they enjoyed their delivery and that they enjoyed. They didn't feel like they were, you know, walking around like a zombie afterwards because they had all this information. And I would say it's the same in clinic, too. And then the other thing that surprises them, I think, is just the amount of knowledge about their bodies and their pelvic floor and what their bodies do that they really had no idea about. I mean, no clue what anything does or what really happens during labor or how to actually push a bit. They're just so surprised, like, oh, my gosh, there's all these things that happen. I thought I just, like, don't have to do anything. And it's like, right. There's so many things. Yeah, that's always a good shock. You know, kind of an amazing, like, oh, my gosh, my body is amazing kind of deal.

Yes.

Yeah.

I mean, that's the thing. The pelvic floor muscles, we should think of them as. I mean, aside from the fact that we both think they're amazing and, like, the most important muscles, but they're like any other muscle. Like, they're strong. We need to work them. We need to make sure that they're functioning well. And there's a lot that we can do when it comes to pregnancy and postpartum with that. What would you say surprises you the most at the women you work with?

Oh, my gosh. I mean, I've been doing this. Let's see, what year is it right now? 20, 25. I'm like, how old am I, Amy? I don't even want. I started doing this work in 2010, so I've been doing this for about 15 years now. And I am just always surprised, even though it's not new. I'm just always surprised at how much the women that I treat, like, feel so empowered afterwards. And I don't know if, like, surprise is the right word, but it's always, like, so Refreshing. Like I'll never get tired of it. You know when like my clients will text me or they'll post in the community and be like, oh my God, I pushed my baby out. And I didn't. I only had like a tiny little tear with no stitches. And I feel amazing. And, and everything that you said I did. And all the nurses and doctors were like, oh my gosh. It's like I, I am just always like fills my cup so much. So I don't know if like, surprise is really the right word.

Yeah, but I love that. I feel the same way. And I think also just arming women with information. So when a lot of the things that are common happen, you know, they, they know, they know. Like, oh, it's not, you know, this does not mean that I'm going to feel this way the rest of my life. There are options. It doesn't mean that I'm always going to be leaking pee, you know, forever and ever. Because that's just how it is as a woman. We, you know, they're going into this knowing, like, things can happen and there's a certain amount that we can do and there's always options before, after, during. So I think that's really, really special with what you do. Here's a good question. What do your kids think that you do? Like if their friends say, what is, what is your mom's job? What, what do they say?

I actually have a really, a really cute reel that's posted on my Instagram. It's pig end. I'm in my jammies, having my coffee and I think my 9 year old, maybe he's 8 at the time, you know, I asked him, I was like, what do you think? I like, what do you think mommy does for work? And he's like, I don't know, you know, being a man, like a little boy, right? And then my 7 year old in the background, he's like, you help women get babies out of their vaginas, like screaming in the background. And I think I do like that. I'm like, well, kind of, I'm not in there with them, but I had to help them get ready and I help them, you know, with any injuries afterwards. And then my 9 year old is like, on the real. He's like, yeah, but boys don't have vaginas. And I was like, no, they don't. And he's like, but they have penises. I was like, totally. And we have this open conversation. So they know, they know kind of what I do. And you know Me, Amy. I mean, I'm just like an open book. And I am. Right? Yeah. I, like, walk around my kids naked, and they're like, oh, my God, I have a fur penis, Mommy. And I'm like, like, oh, I haven't been to the. We, like, I'm totally open about all that stuff. We talk about babies coming out of vaginas. We talk about how babies are like. I'm just. I just talk about it. So they don't, like, think anything of it ever, really. You know, I don't think. But I'm sure that will change once. Start. Once they get older and their friends are like, wait, your mom does what? Right? Yeah, they're open about it, too. You know, they're like, oh, holding, like, my vaginal weights that are in my office. And you're like, what are these for? Like, slinging them around. Of course. Yeah. I'm like, oh, those. Those are for mommy's patients. It helps us get strong. You put it in your vagina and they're like, oh, you put it in your vagina. And I was like, yeah, okay. And then I'll just, like, put it down and walk away, you know? It's like, totally.

I. I love it. And I think, especially for our boys, I think it's so important, but for my daughter as well. Just talking about those things. Mine, you know, we have. We've had the conversation about, as you know, I had. My first was a C section, my second was vaginal, and they just think it's so funny that one came out the top, one came out the bottom, and they just can't fathom why. Why I did it differently.

So. Right.

Because I'm like, one is not better than the other, but this is so. It's. I love that we're having those conversations with, like, the littles. Littles. I think it's gonna serve them well later.

Yeah, for sure. For sure.

Along those same lines, what are the most. I feel like I know this, but what are the most common words you use on social media or in your post? Obviously vagina. Right.

You know, unfortunately. And it makes me very sad is that we're having to kind of censor it a bit because they're. I know. Because meta is not. And TikTok, too. They're. They're not approving some of our reels. They're taking it. They're taking down. They're not approving our ads because we just say vagina birth, vaginal tearing, you know, that sort of thing. So. So I know it's so dumb. I mean, that's Amy, that's a whole nother podcast.

Yeah, that's a different podcast.

But we, I mean, I use the anatomically correct words. We talk about perineal massage a lot. We talk about vulva. We say vaginal tearing. Sometimes we have to put like an, A sign inside of it. Yeah, sometimes we'll kind of do like a little variation to add a little bit of humor to it. You know, instead of like anal opening, I'll say booty hole or something like that. You know, that's what I call it. That's what my kids call it. But I, I do feel that it's very important as we start to disseminate the information to be accurate and for lots of reasons. And like, I don't, you know, I live in the south and hear, you know, that like saying vulva like to a five year old is, you know, a little out of norm. You know, it's like a TT and you know, tutu and, you know, all things. And I, you know, to each his own. But I also feel in order to destigmatize and really empower girls and boys and adults to seek the help that they need, like you have to see and hear those words about your body without shame, without stigma. Like, why do we, like it's so bad that we have to call it a tt? Like, I don't. Yeah, yeah, yep.

You know, and I'll also say from an exercise perspective, we know that when you use the correct terminology, people engage their muscles differently. You know, when you say, especially when we talk about pelvic floor activation and, you know, connecting with the deep core, the things that you and I talk about a lot of. If I just say contract your pelvic floor, that's hard for people. They often squeeze their glutes because those are those strong muscles or they suck in. But if I say if you want to lift with your vagina and then we're also thinking about the lift from the anus and those terms that we don't want to say, but it helps people really visualize in that mind muscle connection which is so important, especially in this type of work. So that type of just being like, let's really think about all the different parts, it's not just do this, it's. Let's think about how we're engaging, how we're contracting, how we're connecting.

Yeah, exactly. How we're training our brains and how we're helping other people learn about their bodies. I mean, I've had adults come to me on social media and be like, I've never heard the word vulva before. And I was like, okay, what do you want to know? And they're like, what is it? I was like, what do you think it is? And then, like, we just talk about it, you know? And they're like, oh, my gosh, we've never. I've never heard that before. And I'm like, great. Yeah, Yeah. I could help, you know, get to know your body a little bit better.

If you learned anything from me today, it is the basic anatomy that we all need. Awesome. Okay, so moving on. We've kind of talked about this, but I think this is probably another common question you get. I get this a lot because sometimes people will be doing my workouts or joining my community, and it's very clear that they need more than just sort of basic postpartum recovery. And I will say, you should see a pelvic floor physical therapist. So a lot of times people say, well, what is that? I've never heard of that. Or maybe it's not available in their area. So if you want to give a short definition of exactly what it is you do, I think that's helpful, because we think physical therapists, we think knee rehab or shoulder surgery and pelvic floor is different, although in a lot of ways, it shouldn't be. So.

Yeah, yeah. So. And it's interesting, too, I find, and you might have found this, too, in the last couple of years, that, like, pelvic floor is, like, getting a little trendy, a little bit more. I mean, I'm loving that.

Me too.

But I still think there's a lot of. Oh, I don't know what that means. So basically, as a physical therapist, I'm trained. Trained like any other physical therapist. I have my doctorate in physical therapy. PTs really are the best people to be around. Bodies that need help with injury prevention, functional activity, pain, whether it's acute or chronic, recovery from surgery, return to function, that sort of thing. Like, we are really good with biomechanics, with anatomy, with safe exercise, with helping whatever the person needs to do, get the resources that they need from their body to do the things that they want to and need to do for their life. Okay. So from a physical therapy, from a pelvic floor standpoint, I just happen to specialize in a different group of muscles. So I work. I mean, we do whole body, right?

Sure.

Head bone connected to the. Like, don't ask me to rehab your torn Achilles, because I have not put my hands on an ankle in 15 years. But I will say, I mean, there does have an effect. Like, so all the PTs out there that are, like, freaking out, they're like, oh, it's not connected. Yes, I know it does, but I'm just saying, from like, a physical, from like a pelvic floor standpoint.

Yes.

My specialty really is, I say, like, breastbone down and knees up. So I'm looking at pelvic floor muscles, which are the floor of your core. They contribute to sexual function, bowel and bladder dysfunction and function. They support us and our organs against gravity. They basically are holding us up there. That they are. The floor of the core. Top is the diaphragm. Pelvic floor is the bottom. So because they have such a big role in everyday life, they can have lots of different dysfunctions that cause other sort of systemic issues, like frequent UTIs, constipation, pain with orgasm. Like, things that you wouldn't really expect to hear when you're talking about, like, muscle injury. There are a lot of different types of pelvic floor pts. There are pediatric pelvic floor pts that help with, like, constipation and bedwetting. There's, like, post prostatectomy for older men that have prostate removal. There's, you know, you're okay in cancer, all sorts of stuff. I. My passion and my love is the pregnancy and the postpartum population. And I like to apply all of the principles that we know work in physical therapy to pregnancy and birth. And so we are really good at prevention of injuries and figuring out and testing and doing studies and understanding how the body works. So we reduce the risk of any type of injury, like horny females and female college soccer players. So my role is to apply that clinical reasoning and that evidence, in my experience, to. To the pelvic floor to help reduce the risk of significant pelvic floor injury during delivery, which then affects a woman's life all the way through menopause. And not just, like, with leaking pee or pain with sex. Like, her ability to work, her mental health, her intimate relationships. Is she having surgery down the road? Is she able to return to exercise? People don't realize that, like, a preventable injury in the pelvic floor that happens during delivery will be, like, wreak havoc on all of these aspects of a woman. I mean, it's not just like, oh, it's like a sprain and it goes away in six weeks. No, it is something that will be with a woman all the way through menopause into her elderly years. And oftentimes when women are admitted to nursing homes when they're much older. It's because of incontinence. And that incontinence started after they had babies like 60 years ago prior. But it just got worse and worse and worse and worse and worse. Never treated, said it was normal. Went from pads to diapers and now they're in a nursing home and it's like, okay, well could we have prevented that or at least made it less dysfunctional to where she wasn't falling when she was going to the bathroom and that sort of thing? I mean, that's a little bit of a tangent, but yeah, that's kind of my breastbone down, knees up is like my area. Tailbones, good. Tailbone earth prep, early recovery scars, C section scars, perineal scars, prolapse, all the things. Yeah.

Oh, I love it. Yeah. And that is, I mean, something, you know, that I always talk about when it comes to postpartum exercise too, is that, you know, when you have a knee injury, you're usually sent home to rest. You know, you certainly get referred to physical therapy, to rehab. Like it is so prescriptive for anything else, but generally we get a six week appointment and that's it. You're cleared for everything. And I, one of my projects in grad school, I was doing research on that six week appointment. And you'd be amazed how many women don't make that appointment actually, like they're not able or they don't show up. And it's not because they're being lazy or they're, you know, they're busy there with children. And so I think that's the difference is that a lot of women go through this during birth and postpartum and we have to go home, we're handed a human to take care of. So, you know, to be able to provide women with information of, okay, how can we manage that? We can't just go home and rest. We don't have that luxury, like, you know, a professional baseball player or somebody like that. We have to still be taking care of a baby, often taking care of other kids, often returning to work at that six week mark. So what can we be doing during that time? You know, first of all, the preparation for that, the prevention. And then if there is, and then.

Early recovery, that acute recovery period. I mean, that is. So that is such an important time. Yes. Physical and emotional recovery from like birth to six weeks. Same for somebody with a torn acl. I mean, they're in rehab the next day, right? I mean, yeah, like, I mean, I Remember seeing, when I was in residency, female. My female soccer players, I would see them the day before their ACL reconstruction and then the day after. I mean, we're like up and moving immediately.

And I mean, when you have a hip replacement, you. You walk the same day, you know?

Yeah, yeah. It's just like the disconnect of that mindset is so wild to me. Even though it's like this same type of injury. And this is my, this is what my entire TED talk was on. Like. Yes, this whole ted talk, like 18 minutes or whatever it was. I mean, I could have gone, but it was like that's what it was. It's like, why is there such a disconnect? And what can we do when we have this evidence to show that it's safe, effective, and has out better outcomes? I mean, it's just like absolutely mind boggling to me that there's nothing. Yeah, I guess that's what I could say. Like, I'm still surprised about. Is that like 15 years of doing that, there's still like, oh, well, I don't know. Yeah, I guess just go home.

Because it certainly seems like in healthcare and I've worked on several different projects on the fitness side over the last couple years. One was a prehab for surgery and it was very focused on, you know, cancer surgery, mastectomies, joint replacement, things like that. And also a prehab and a rehab for cancer patients. We're learning in health care that preventative care or anything we can do to support better outcomes, surgical outcomes, but also recovery really. I mean, at the heart of it, I hate to say this, but this is what it's about. Saves people money, saves hospitals money, saves insurance companies money. Aside from the fact that it's just better for people, the people involved, I don't know why we're not there yet with, with pelvic floor pt, why that is not standard. And because you and I both have like global communities of women through social media. We know that in a lot of countries it is.

Maddening. Yeah, I know it is. And it's also just like how we're preparing our nurses too, our labor and delivery nurses, providers coming in. And I've had totally. I have had a ton of labor and delivery nurses come through as clients of mine and then. Yeah, yeah. Pregnant. Yeah. And they were like, oh my God, I had no idea. I hadn't. I've been telling this, I've been telling this to my patients for 10 years. I'm not doing that anymore. And I'm like, right so it's like. I feel like we are preaching to the choir when it's. When it's like our colleagues, but it's like, need to. I think part of the change is that we need to get more forward facing, not just direct to moms, but also to med schools and nursing schools and on ed for hospitals and all of those things. Because, like, it has to start from the beginning. I mean, like. I mean, not from the beginning. It has to start from, like, the first touch. Right. Of your provider, and oftentimes that's in the delivery room is you're a nurse, right? Yeah.

Yeah. And there's. I mean, we women are getting better, and we're, you know, learning to advocate for ourselves in healthcare, frankly, because we have to. But it. It shouldn't have to be that way that we're having to push, we're having to ask. I mean, that's something I always tell postpartum women, like, ask for pelvic floor pt, like, before you even have the baby. Just, you know, and. And most providers will say, yeah, that's great, but they may not offer it. They may not. They may still have. That this is just what happens. Or this is just.

Or that I've had patients with some physicians here that have been like, oh, they told me, oh, that doesn't work. Like, why are you gonna waste your money? Like, don't do that. And I'm like, why would you say that? Like, even if it doesn't work, a hundred percent, even if we get 60 improvement, that's huge. Yes. But now I am very fortunate. I feel so luck lucky. I. I mean, it's just really wild that this happened. But there's two physicians that are about my age who came into one of the big OB practices here a couple years ago, and they. One of them came in as a partner, is now a part. One of the partners. And there's some practitioners retiring, stop doing ob, Just kind of guy and stuff. And he. This new practitioner and the other one that came in, they send me all their patients. I mean, they're like, go see Dr. Marcy. They're. Even if it's like, symptoms, they're like, birth prep, postpartum. And one of the. Was like, is she. I told her, I was like, I really want to come with you when you're delivering. She's like, yeah, I'd love to learn what you teach patients with positions and breathing. And I was like, okay, let's do it. Let's go. Right? I'm like, can I want to smell like hold a baby, like coming out of a vagina. She was like, absolutely. So it's like, I do feel that the kind of this next generation. Yes. Of physicians and nurses, like, they're getting more exposure to people like you and I earlier and it's not so much like a fight, you know?

Yes, yes. And I, you know, for all of the things I don't love about social media, I think the awareness that we're bringing to things like this that are not, you know, are not mainstream or, you know, I think we're seeing the same in the menopause world that people are, you know, finally talking about things because they're hearing about it on social media and then they're asking their providers and then those people are the 20 year olds who then are in the med school. And then, you know, like, it's, it's that trickle down effect. So anytime I get really frustrated with, you know, Instagram or all of it, I'm like, but we are doing good in the world. Well, let's, let's tackle this Kegel question because I know you get this and I get this that a lot of women who are like, well, I was told to just do Kegels or I know I'm supposed to just do Kegels. Let's talk about that and why that's not, not right for everybody.

I know I always kind of joke and say that Kegels are like my frenemy, you know, I like, yes. Yeah. I think the old way was any time somebody would mention that they have any sort of problem down there, whether it was pain, constipation, leaking urine, urgency, frequency, leaking pee after having a baby, it was like, oh, just do Kegels. The doctors would say, you know, in their, in their op, post op appointment. Right. You know, do you know, like 10 sets of 10 and hold for, you know, 20 seconds and do them when you're sitting at a red light and when you're at the elevator, you know, just do them all the time. And lo and behold, that didn't work. Like, people shock people still had symptoms and then Kegels kind of got like a bad rap and they're like, oh, well, I've been doing Kegels for years and it doesn't do anything. It's on my pelvic floor, you know, blah, blah. But when you think about that, a Kegel is a shortening contraction of your pelvic floor muscles. Just like you would do a bicep curl. Right. It's just happens to be in your Pelvic floor. When you squeeze those muscles correctly, they squeeze in towards your vagina and up towards your head. Okay. So they're like lifting up. They are important. 100%. They are important. However, they are not the end all say all for every single dysfunction for every single person at every single stage of their life. And I think that's where people get really confused. And for my population and what we do specifically for birth prep, I think a lot of women are confused about what the role of the pelvic floor and Kegels have. Have. For delivery specifically. Yes. And for delivery specifically, like, as the baby is coming out of your vagina, those muscles get out of the way. They don't.

They're not pushing.

Yeah, no, they are not contracting. They are not pushing a baby out. They have to go away. So there's space in the vaginal canal. Because, remember, contraction, as, you know, comes in and up. Right. It's like squeezing. Vaginal birth is different. And so sometimes people think that strong, strong, strong, strong, strong all the time is going to help them push a baby out, but really, you have to have the opposite for labor specifically. And the other thing about Kegels, too, is that when we just sit in the car at a red light and do, like, 30 kegels, maybe you're getting some good contractions, maybe. But that's not a functional application of that of your muscles. Because we don't just sit all day, and we're usually not leaking or not symptomatic. When we're sitting in a red light, we're leaking and we're symptomatic when we're trying to put a baby into a car seat, or when we're coughing or laughing or exercising or having sex or lifting something heavy. So we can do Kegels. Like, I don't, you know, hate them. I don't think, you know, they're the devil reincarnated, but they have to be appropriate, and they have to be prescribed appropriately based on the individual's body, what their needs are, what, where their symptoms are, all those things. Because, like, if your muscles are too tight, and you and I talk about this a lot, especially kind of in the pain syndromes. Pain syndromes. And then, like, after a tear and scar tissue is laid down, sometimes those muscles can be super tight and doing centric shortening contractions will just exacerbate the problem. And I think there's. There's something too. That a lot of people don't quite understand, but short and tight, or short or tight and strong Is not the same. Like, you want a muscle that is strong but not tight. Right. You need it to be long and going through its entire range of motion. And if you just have a muscle that's like, contracted up here, like, doing those Kegels is not going to do anything. It's like, no.

And if we were to do that, if I were to tell, as a trainer, a client to do that many bicep curls and not also work on the lengthening and the extension, and you would not have a functional bicep, you might be able to pick something up because you're heavy, but you wouldn't be able to reach for something. You, again, you would be overly so. Again, like, tight can often mean weak. And I was one of those people too, because I, as you know, I went to pelvic floor pt, I had diastasis, I had ab separation. I felt like I was doing all the right things. As a trainer who felt like I knew what to do. But that's why an internal exam, if you have the option, if you're still having the symptoms. Working with a pelvic. Pelvic floor PT in person is life changing. I always say this because I'm like, you need somebody to internally examine you and say, oh, actually, for me, it was. I was over recruiting my obliques. You know, something that I can't tell you as a trainer, just looking at you, do you know, any sort of exercise? So that I think is really important for people to remember that, like, you know, you may be doing all the right things. Right things. And if it's not getting better, there's. There's something else to be thinking about. So I was certainly overdoing it on my Kegels and I had to work on the pelvic floor relaxation. And this is postpartum. But I always, you know, we always get that advice for pregnancy is like, we got to learn to relax. And most of us have that tension.

Yeah. And I would say, too, like, most people, not all, but most people going into their first delivery, first pregnancy are strong. Like, their pelvic floor is probably fine. Like, we're not needing, like a bunch of strengthening and like, really isolated, you know, pelvic floor exercises, like, we probably need to start to add it in as the pregnancy progresses. Right. To support the growing demand. But like most cases, unless there's a history of issues, we need to be working more on balancing both strengthening, relaxation, lengthening, shortening, all those things again, just.

Like we would say with every other muscle, right?

Yep. Every other skeletal Muscle, every other muscle.

We need to contract and release. Okay. So I do want to ask you. And then really quick get to this ending part, but I feel like we have enough and we can come to prolapse like on another time. But I would love to hear about your upcoming free webinar, push prep 101. And we're going to make sure that we include a link in the description because I think a lot of people can benefit from from this. So tell us a little bit about that.

Yeah, yeah. Push prep 101. So this is kind of one of our most popular webinars. It's what we're running right now. We have a postpartum one in the works. Just needs to get refilmed and kind of zhuzhed up a bit, you know, as you know. But birth prep 101 is awesome. Awesome. It's free. We run it, I think, pretty much every day, a couple times a day. And it tells you basically everything that you need to know pelvic floor wise, going into your delivery. So we talk about medicated versus dominant medicated delivery functions of the pelvic floor, what you can start to do now to reduce your risk of vaginal tearing and trauma, what your partner can start to help you with both from like a pain support and recovery support role. My favorite products to start to use during pregnancy, all the way from like compression to what type of pelvic ones to help you with your perineal massage. You know, myths about perineal massage, what it actually looks like, how to do it right. All the things. All the things. It's an hour. There's Q and A at the end. And then we link after the webinar, we'll link you over to our courses page. And we have all of our online courses there. The bundle is called down there Done. Right. And it's everything basically from positive pregnancy, positive pregnancy test, all the way through postpartum. And then we have individual courses as well. So this is really kind of meeting that need that we want that you and I both share to educate and disseminate as much information as possible to reach as many women as possible on their own time because they don't have access to people like you, Amy, unfortunately. And pelvic floor PT is not standard. So. Yeah, how can we like meet in the middle here?

Yeah, and I think it's so important too, because I get this question a lot because prenatal, postnatal fitness, it's my specialty. I love it. But we are not pelvic floor pts. I can be giving you a lot of the same cues, a lot of the same information, but it's very, very different. And that's why I recommend your courses a lot. I have a client who, she's six months postpartum. I think she's moving into the. She did your push prep before, but yeah, lots of them do. And I think it's because it's very different. It's very specialized pelvic floor core. Again, there will be a lot of crossover in the strength training, the endurance training, the things that you're working on in your pre postnatal fitness, but it's very different. And the stuff I always tell people, you do not have to wait six weeks to start doing things to recover after you go through delivery. That's the standard for exercise, which again is not always the case, depending on when you get get cleared. But there are so many things you can be doing with breath, work with alignment, all of the things that you talk about in your courses. So, you know, go to Marcy and then come to me like we'll work together.

And I actually reference you and your programs all the time throughout my programs too. After you're done with postpartum power, then you go see, yes, she's going to get you back to doing what you want to be doing and I'm going to get you ready. Ready for that. So it's.

And you're gonna be prepared for that?

Yes. Yeah.

I mean you do not want to jump back into doing a kettlebell swing six weeks after having a baby. You want to be. Have done the prep work to be supported for that and ready for that.

So. Hundred percent.

Okay, last question. Something that I do with all of my podcast guests. We obviously this podcast is called Be where youe Are Today, which is something I say all the time. So I would love to hear where you are today. And selfishly, because I feel like we're in a little bit of the same mom phase. My kids are six and eight years, are seven and nine, sort of that mid mom phase. We're out of the baby and postpartum phase. We're not quite in the menopausal phase. What are things that you do to support your pelvic floor, deep core strength, endurance, all of that. Where are you today in that journey?

Yeah, yeah. I love that. My boys are seven and nine and I am in the clinic a couple days a week. So I have. I always loved incorporating some Pilates based exercise into my treatment regimen. So I added a reformer into my clinic so when I'm in. Yep. I do some reformer work, and I love kettlebells. Funny that you should say that. So when my doing their Pilates work, I'll do kettlebells, and then we'll switch. I think it's important to kind of model that. And, you know, as busy moms, we gotta, like, do as much as we.

Can get it when we can.

So I do that a couple times a week with my clients. And then I ride horses. So I have. I have a horse here, and I get out a couple times a week, ride him. And that's all core or.

Yes. And that's where you really feel where those, like, inner thighs, pelvic floor, it's all connected.

Yeah. Like all my. Because it's, like, past. You know, for dressage, you go, like, past midline. So it's like all my lower abs, and I'm just like, oh, my God, so strong. And then the rest of the time, I'm taxiing my kids around pretty much.

Which we know is a workout in itself in many different ways.

That is true. Awesome.

Well, thank you so, so much, Marcy. I really appreciate you taking the time and I would love to have you back. I get a lot of questions about prolapse, which I think is maybe talked about a little less in the fitness world. We talk a lot about ab separation and other pelvic floor dysfunction. But so maybe. Maybe we'll have you back and we can talk more specifically.

Yeah, we could do. Yeah, for sure. Prolapse, bladder stuff. Whatever you want. You know, I'm yours for the taking, Amy. You just tell me when.

Thank you. And please check out. We have all the links for Marcy down in the description, and we will see her again. So thank you so much, Marcy.

Thanks, Amy. Bye.

Thank you so much for joining me today for the be where you are today podcast. You can check out our other episodes as well as extras on my YouTube channel, Body Fit by Amy, or wherever you get your podcast. Until next time, show up, keep moving and be where you are today.