Where health and relationships meet
Hello friends,
I imagine most of us have had a rough week. There is a lot of hate, bullying, and the discrediting of groups of people and of science everywhere I look. That is the antithesis of The Relationship Space and The Connection Section, which is my way of sharing my passions for public health and relationships in the hopes of supporting people to love better and feel less alone in the world. One way I feel more supported and connected is by being part of this wonderful group called the Pelvic Collective. It’s a group of varied professionals who learn, share, and collaborate on all things related to pelvic health.
I recently interviewed two smart and inspiring pelvic floor physical therapists, doctors Kana Arreguin co-owner of Wildwood Physical Therapy and Mariah Frank at Sound Body PT. Dr. Arreguin specializes in complex pelvic pain, breast cancer rehab and lymphedema. Dr. Frank treats all pelvic floor and orthopedic conditions with a focus on LGBTQ+ and pregnant people. They embody the mission of advocating for the well-being of all people through relationships and science. I think it’s worth knowing what they do and how it connects to our well being and relationships, since:
Many sexual issues involve the function and comfort of the pelvic region.
A good pelvic PT can help with numerous issues that can have a direct impact on one’s mental, physical, and relational health.
Physical changes due to injury, aging, giving birth, or cancer will impact everyone at some point.
Here are some gems from those discussions.
Q. What does the pelvic floor do in our bodies?
Dr. Frank explained that the pelvic floor is actually bowl-shaped and has five main functions, known as the Five S’s:
Support: It is like a hammock holding organs such as the bladder, rectum, and uterus.
Stability: Strong pelvic muscles and bones are part of a stable core that allows the transfer of force throughout the body.
Sexual function: The pelvis is involved in sexual arousal and orgasm.
Sump pump: Along with the diaphragm it pumps lymphatic system, so fluid doesn’t pool in pelvis.
Sphincters: It includes the anal sphincter and helps urethra close off.
Q. What issues can a pelvic PT treat?
Painful sex
Constipation
Leaking, urgent or frequent urination
Postpartum
Pre-, peri- and post-menopause
Pain in the tailbone, lower abdomen, lower back, groin, buttock, hip, genitals
Symptoms associated with endometriosis, polycystic ovarian syndrome
Erectile dysfunction
Transgender pelvic health
Post surgical (Prostate, hysterectomy, fibroid removal)
Q. What do you wish people knew about pelvic PT?
“That we exist. I think it's really sad that people are surprised that somebody can help them with this and they've been living with it for years” shared Dr. Arreguin. When people come in for sex pain they can be surprised when she recommends a mental health provider. Arreguin subscribes to a teamwork approach when addressing complex issues such as sex pain.
Q. What should someone expect at a pelvic PT session?
Both doctors emphasized that all patients should expect thoughtful trauma-informed care in which the provider continually asks for consent to touch the client. The physical therapist has ways to assess the issue both internally and externally. If a client is not comfortable with an internal exam, the PT should always respect that and have plenty of other ways to assess and treat the symptoms.
Q. What can people do to help maintain a healthy pelvic floor?
Dr. Frank offered the following suggestions.
Work on having regular bowel movements. If you’re constipated focus on improving that first.
Develop a core and glute strength routine, in particular focus on the gluteus medius.
Practice deep belly breathing with 360 degree expansion, in which you relax on the inhale and contract on the exhale.
No power peeing, no pushing.
Use good lube, no glycerin.
When going to a provider, stand up for yourself. Take up space. Any time you can speak up for yourself to prevent retraumatization is good preventative care.
Not everyone has access to a pelvic floor PT, either because of where they live, whether their insurance covers it, or whether they can afford it. Some PTs may be able to do virtual appointment. As a public health educator, I hesitate to refer people to get their health information on the internet but there are some good resources out there. If you’re on Instagram check out Dr. Frank’s content @queerly.pt. I hope this short introduction to the world of pelvic PT can serve as a tool for your toolbox, if you or someone you care about needs that support.
With loving support,
Mallory