[0:00] Welcome to Artful aging with your host Amy are you a senior or caregiver of a
looking for support and Direction best-selling author educator and expert in Senior Living Amy Friesen is here with the help you need while providing you with an important and valuable support,
so now please welcome the host of Artful aging Amy Friesen.
[0:33] Good morning everyone I'm Amy Friesen and this is Artful aging with Amy thanks so much for joining us today we are live from Bold Brave TV and Today's Show is all about flushing the stigma on incontinence.
Yes you heard me correctly there is a lot of stigma around having incontinence issues however it's discussed on a rather hush-hush basis people tend to get embarrassed.
[0:59] As you may or may not know about me I don't get embarrassed very easily and my guest today you know is the same as well so we're just going to talk about it at all.
I've also noticed with my client.
When they get they get more significant cognitive decline they tend to hide personal support items and clothing items,
and which they might have had an accident in so there's different things to look for surrounding this issue.
Many of our caregivers watching have most likely had incontinence issues if they've gone through pregnancy I definitely had it myself.
And it's you know I try not to be as hush-hush because I feel like talking about this stuff creates extra questions for people to ask and find resources so,
it's not always cut and dry however and it's not always incontinence versus not incontinence you're not always in continent and there's different levels so.
For these reasons Our Guest today is going to help us discuss incontinence what it is as well as what we can do to improve the continents,
Lisa Flanders is a physiotherapist as well as a co-owner of Bloom Integrative Health and Movement Center Lisa began practicing an orthopedic physiotherapy but had a keen interest in pelvic floor Physiotherapy
she realized many individuals have common concerns related to pelvic health.
[2:16] But are often too embarrassed to seek advice or a nun or are unaware of it treatment is available which was where I was at when I met Lisa well not what I met her but when I started going to see her so welcome Lisa thanks so much for joining me today,
thank you so much for having me a me I'm really excited to be here.
I'm super interested in discussing this and you know what's interesting as my team at tea and toast we often share our podcast around because,
legitimately almost every week we're dealing with the same stuff we're dealing with them podcast so I'm always happy to have extra information to share So Lisa maybe we can start today's conversation
with explaining to our viewers what incontinence actually is and what the different types are yeah absolutely,
incontinence is defined as any involuntary loss of urine or loss of bladder control and that can be as little as.
Finished urinating you stand up from the toilet and you have a few drops to you know you are walking around and leaking all day long.
[3:20] And there are a couple different types of incontinence that we're going to talk about today so the first one probably the most common one probably the one that most people have experienced if they've experienced incontinence is stress urinary incontinence stress meaning that.
Any stress or pressure.
Place throughout the body that then kind of creates pressure in the pelvic floor causing us to have lots of urine and this is most common seeing when we do things like cough.
Sneeze laughs physical activity that includes things like jumping or running so definitely the most common type.
There's a couple other types of incontinence as well so urge incontinence and this is one that I actually experienced in this is one that.
Kind of cause my interest in public health so urging continents is when you kind of get that.
You're fine and then you get that quick need urgent need to go to the washroom.
[4:13] And then you leak either before you actually get onto the toilet or while you're walking to the washroom.
We can also have urgency which is sort of similar where you get that urgent need to go and you have to go to the washroom right in that moment but there is no loss of urine and so I should as a young child I had both.
Forms I would get home from school I you know get to the house,
I put my key in the door and I'd suddenly have that urgent need to urinate and I'd be like waddling up the stairs because we are bathrooms on the second floor and I would be,
leaking at like 16 years old the entire way up to the washroom and have to change my pants once I got home and then we also have something called functional incontinence and functional incontinence is one that.
[4:54] I don't think people are really aware of and functional incontinence means there's some sort of physical or mental impairment that actually.
Causes that person not to be able to make it to the washroom on time and.
Things that we can think of our you know someone that maybe has arthritis in their fingers and is unable to undo their button on their.
Or maybe the washrooms on the second floor and that person is on the first floor and it takes him a long time to get up to the second floor or.
You know it's night time and it's dark and that person is afraid to walk down the hall because they have to walk past,
flight of stairs to make it to the washroom so that's functional incontinence and then finally we can have a mixed bag so we call it mixed incontinence where you know someone might have stress urinary incontinence but they also have.
Urge incontinence or someone has stress incontinence as well as functional incontinence so there is definitely that combination of the the two together or the multiple types together.
[5:50] Yeah for sure I've definitely had stress incontinence written when I was after I was pregnant right and it's just yeah there was a long time where I did not jump
I try not to sneeze because you just couldn't control it and also that one of the reasons I went to see Lisa as well because I wanted to fix things up so so for today we're going to kind of concentrate on seniors and Lisa what are the most
common issues that you see and seniors let's see with our senior population sorry.
With our senior population the most common concerns and I mean it buries people come in for a variety of different reasons but some of the more common reasons that people come in are a mix of stress and urge incontinence.
So those two we just spoke about I also have a lot of people that come in with overactive bladder type symptoms so that's any sort of frequency of urination so maybe feeling like you have to go to the washroom every
half hour or every hour you know and I'm sure a lot of your viewers are going to be able to to.
[6:56] I sympathize with this like you go to the movies and you want to sit on the end row or the end of the row so that if you have to go to the washroom,
it's very easy for you to sneak out to do so I just know that I sympathize with that myself so absolutely need to me as well and I'm the type of person when I fly I like to sit on the aisle because I like to I don't like to bother people if I have to go to the washroom,
nine times out of 10 I don't have to go to the washroom but it's like the second I'm in a middle or the window seat,
that's what I have to go because I'm going to have to bother people and I don't like that yeah so so overactive bladder can be defined as frequency increased frequency of urination or just more urgency to go to the washroom.
[7:38] We also see a lot of people for pelvic organ prolapse and that's something that's not often talked about either so pelvic organ prolapse is any.
Anytime there's a weakness a typically in female and women so when there's a weakness in the vaginal wall and the bladder is no longer being supported well so it kind of falls into the vagina it kind of pitch changes,
change it changes shape part of me the rectum can fall a little bit into the vagina or even the uterus itself can start to fall down so a lot of my clients will then,
talk about concerns related to pressure so they feel like there's pressure there's heaviness,
I often Define it or when I'm talking to clients about this and they're not really sure what I'm meaning I'll say you know it's sort of that feeling of like a tampon is been inserted incorrectly and it's a little bit uncomfortable like there's a feeling there,
constipation is another really common one that we see people for so.
Can be treated with pelvic floor physiotherapy along with pelvic pain and then the pre-op and post-op surgery so whether it's a hysterectomy a prostatectomy or any other bladder repair or any other pelvic floor type surgeries,
other things we see well We're Off to the Races Lisa Lisa so we're going to take a break,
after the break Lisa and I are going to continue this conversation you're watching Artful aging with Amy live on Bold Brave TV and we'll be right back.
[9:03] Artful aging with Amy is currently looking for gas and show ideas for our next season drop us a line at hello at Artful aging with a me.com and let us know what you would like to learn about in our upcoming season.
[9:17] Welcome back to Artful aging with Amy my guest today is physiotherapist is a physiotherapist specializing in pelvic floor physio Lisa how about we jump back into our conversation about incontinence.
Before the break we were discussing some of the common issues that seniors have.
Lisa I've got to ask many as many people are probably thinking this is pelvic floor weakness and incontinence just a part of the aging process.
[9:44] I would say that it's definitely more common as we age and that's due to things like muscle atrophy as we get older you know you hear that
concept of you if you don't use it you lose it the other thing that we
that can contribute to more incontinence with aging is just laxity in the tissues over all our tissues start to lose laxity all of our tissues start to lose laxity as we get older however if.
Something that bothers you it absolutely is something that can be treated and you know.
When people say oh this is a normal part of aging I also say well yes but like osteoporosis is definitely more common as we age but doesn't mean that we're just like low you're getting older.
Too bad we actually have treatment protocols in place that are.
Specifically around osteoporosis and so we can absolutely use similar concepts for treating strengthening the pelvic floor for the same reasons and like I said if it bothers you then you can seek treatment if it doesn't bother you,
then you don't need to seek treatment so it just depends on how much is affecting your life I should also ask,
for folks that are having more advanced incontinence issues because we again work with people all the time can that be relieved a little bit or is there like a point of no return.
[10:58] I wouldn't say that there's a point of no return there's probably going to be a point where we can't one.
From a physiotherapy perspective alone we can't 100% reverse it but that's where we would start to work with Physicians your gynecologist.
[11:14] You're ologist to also discuss some other ways that we can help support that person whether it be surgery maybe medication along with physiotherapy or other,
you know occupational therapy other other therapies so I don't I wouldn't say that there's a point of no return but there might be a point that like one modality so physiotherapy alone can take you.
[11:37] Fair enough Point yeah fair enough are there any certain warning signs that seniors can look for either in themselves or perhaps their partners.
I would say the biggest thing to look for is change to your normal urination patterns or your normal toileting patterns so if you're noticing
that you or your partner or someone that you're caring for is for example going more frequently or getting up more often throughout the night anything that's just outside of,
that person's Norm is after you know many many years of having one pattern looking at what those that changes.
Fair enough fair enough yeah there's a lot of people that have concerns at night we see that a lot when we're working with our clients which are new usually new also is there anything that a caregiver could look for in their senior loved one,
yeah there's a lot of things that can that can be looked at so I would
first start with the things like communication so having a communication between the caregiver and the person that they're caring for to see if there are any changes that have been noticed we can
[12:45] Look at things like access to the toilet so where if someone is noticing oh this person's having more incontinence where's that toilet located within the house when does incontinence occur does it occur at night time,
does it occur you know it when they're wearing a specific outfit that has maybe more buttons or more challenging to take off and then also.
Making sure that there is like timing of your voids that there's again looking at any changes to those normal patterns I would say.
[13:18] One of the things that we look forward to when we have clients with tea and toast is that when they're dealing with incontinence issues sometimes actually a lot of the time like you said it's a routine a toileting routine so.
They may need some extra stuff which we'll talk about in just a second they may need some extra support but,
often it's just you know it can be taken care of with a routine and it's and not you know as a comparison for routine with my you know my four-year-old for instance
we just say okay it's time to go right it's time to go before we leave the house it's time to go after this or whatever,
and sometimes we'll say oh I don't feel like it but you know she goes right so it's just getting in the routine of doing that and sometimes that's what helps
when we're helping folks make a move to retirement living that have incontinence we asked to get into a routine so if someone is experiencing incontinence what are some of the ways that they could manage it then
yeah so again it depends on what the the reason for the incontinence is so if we're talking about more like the functional incontinence which I do notice a little bit more in seniors it's looking to manage though,
what that concern is so for example it might be at night time that person is going to be in looser pants that have an elastic waist that are going to be a little bit easier to remove,
it might be that they need a commode in their room so there's easier access to the toilet whether the toilet being on a different floor and that makes it challenging or.
[14:46] That they don't want to walk at night time past.
[14:50] You know the staircase and that actually that happened to a client of mine and I wasn't treating her for incontinence eyes treating her for a fall and then it turned out that she started having incontinence after the fall and this was
for I was even a pelvic floor physiotherapist and I was chatting with the the daughter and when we actually got into a bit more discussion about it it's because the mother was,
afraid at night time to walk past the open staircase to get to the washroom so they managed it with a commode they managed it with a baby gate at the top of the stairs and that really made a significant difference in that person's life.
We can use like pad so the person can wear powder overnight or.
Certain petting that's a little bit easier to clean night lights in the hallway making sure that you're removing throw rugs throw rugs are can be very very.
[15:37] Not dangerous but they can be a very big cause of Falls in seniors and so that can be very scary for a person so we can remove those barriers that make.
Accessing the toilet a little bit more concerning that,
what we want to try to accomplish moving the person closer to the washroom so if the only washroom is on the main floor than perhaps moving that person
down to a downstairs bedroom and there are a lot of homes and only have one wash room on the main floor or on the second floor and so just making sure that person has access.
To that washroom I actually when I was looking for houses many years ago one of the houses I looked at how to had a toilet in the laundry room like just in the middle of the laundry room with like no think except for the laundry sink and it made me think like does this person just have a hard time,
getting up the stairs when they're doing laundry and maybe the laundry is there trigger and having to walk up to the second floor from the basement is challenging so.
As silly as the toilet placement was I understood it because of the work that I do.
I definitely understand that as well and I've seen that a lot of times as well and with your comment on Flow rugs throw rugs or the bane of my existence and what I do so I've been even known to take throw rugs with me when I visit people may I have your throw rug.
Yeah oh dear so well let's take a break again Lisa when we return we'll be discussing all things pelvic floor physio what is it how it can help prevent incontinence you don't want to miss it we'll see you in a few minutes.
[17:02] Are you watching us on YouTube but would rather listen to us in the car or on a walk no problem artfully aging with Amy is also available as a podcast.
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[17:18] Welcome back thanks so much for joining Lisa and I today and our conversation about incontinence we have looked at what incontinence is as well as possible causes and warning signs let's chat about Solutions now,
as mentioned at the top of the show Lee says a physiotherapist as well as a pelvic floor exercises.
[17:38] Now Lisa many people are unfamiliar with pelvic floor Physio and its benefits I know I wasn't familiar with it until I needed to find a solution so can you tell us exactly what pelvic floor physio is and
how it helps and what it does absolutely,
Pella for physiotherapy is a branch of Orthopedic physiotherapy so Orthopedic physiotherapy is the you know you hurt your back you go see a physio you hurt your ankle you go see a physio.
Public for physiotherapy is just a specialized branch of that all it means is that,
as a public for physiotherapist I have the ability to assess a little bit more than a general physiotherapist I'm able to assess the muscles the ligaments the tissues that are found inside the vagina and inside the rectum
and then what it helps with I mean we talked about it quite a few things that we can help with with seniors we also work a lot with prenatal patients with post natal patients we work with.
Children that are having concerns with bedwetting and constipation and then you know incontinence prolapse and then pelvic pain that's a really big one that we that we work with people that I have pain in the in and around the pelvis.
[18:51] Is there I'm guessing I know the answer but is there a different type of training that a physiotherapist who does pelvic floor
I would have to get to kind of qualify I guess yeah so I'm going to like speak from an Ontario Canada perspectives I know that you have viewers that are kind of all over but in Ontario Canada,
what we what happens is we graduate from physiotherapy school we do like a general physiotherapy exam that all physiotherapist in Ontario have to take and then from there we can sort of go off and we can,
do more training in areas that interest us so.
From a pelvic floor perspective there is an additional training that we have to be able to do the original the additional training minimum is 40 hours.
And we have to also write an exam following that as well then we get.
[19:42] What's called a rostering from our college so if you are to go to the College website you will see that I am roster to be able to perform internal vaginal and rectal exams
and then from there they're like that's sort of that 40 hours worth of training that's a very basic amount of training that gives you a little bit of information to treat things like incontinence but then if you want to go,
further and treat things like pregnant like help women during pregnancy or people's constipation or people have colic pain there's like many more levels of courses that you take after that so it's definitely not something that you like take a course you'll learn what you need to and continue on it,
like a lifelong learning process so I was even in a course even after 10 years in this field I was in a course last weekend are sorry.
In November I was in a weekend course just to continue to grow and learn my skills and learn new research that's coming out because research always changes.
[20:34] That's really beneficial to like any other profession or a little bit.
You know to keep at the top of your profession you know you have to keep learning and keep expanding like you said research does change all the time and one of the reasons I asked that is because I don't see a lot of pelvic floor physios is not
something that's like all over the place so that's why I was curious when when should someone see a pelvic floor physiotherapist.
[21:01] So my thought is that especially with women at some stage in their life I feel all women should see a pelvic floor physiotherapist.
But I'm also going to say that if you feel like you have a problem then it's a good time to see someone so if we use incontinence as an example if you have.
Incontinence once a year and it doesn't really bother you and you can manage it by wearing a pad while you're doing you know whatever exercise it is that causes that and you don't feel like it's a problem then I'm not going to say like no you 100% had to come see a pallet for Physiotherapy.
But I do if you do feel like there is a problem with any of the things that we previously discussed then I would say yes that's a good time to come and see a pelvic floor physical therapist,
okay and I have to know is virtual pelvic physio a thing.
Yes it is and I think this pandemic has really sort of.
[22:00] Created like a like a jumping block to do more virtual physiotherapy just in general virtual care for healthcare so
before the pandemic started,
my business partner and I had discussed some ways that we were going to potentially bring in some virtual care and virtual care has been in place for a very long time in
like Northern Canada where there isn't really Access to Health Care the same way that there is in more of a southern areas of Canada
so we thought you know let's do some let's maybe look at doing some virtual care maybe in a couple years from now and we'll be able to reach some people in in Ontario I,
I'm only able to work with people who live in Ontario's so you know maybe reaching some people in some Northern Ontario communities that might not have access to care otherwise and then.
[22:46] Covid covid hit and we like a one-week decision that we're okay we're going to start virtual care now.
Um so we really quickly had to learn to learn how to do virtual care for public for physiotherapy so it's obviously a little bit different than if you come in to see someone in person,
in person you know we do a very much a Hands-On exam we typically do we will do an internal pelvic floor examination.
With virtual care no we don't do an internal evaluation you're not on screen showing us your your pelvic floor but we can actually help you or the.
Patient to self assess so.
During the pandemic we actually I feel like I got quite good at assessing and treating people virtually and it was a lot of.
You know moving that person through where we're at I want you to stand where do I want you to put your hand so that I could then evaluate what was going on within their body and it was actually it was.
[23:42] As much as covid-19 great because we were closed it was also great because we were still able to help so many people and I did I did have a couple patients that I never even met in person,
I only met them virtually they came in for their appointment are they had their virtual appointment we had our follow-ups and then they were doing so well that I was able to discharge them without,
without actually ever meeting them in person so that was really cool so it's definitely a thing it's definitely something that I think we're going to continue on with.
Going forward and it's great in a day and age where we have access to people to healthcare providers that we might not have had access to in the past so whether you live.
Far away or if there's a snowstorm or if you have if you're sick or your kids are home it's a really great way to continue with your care.
[24:29] Without having to come into the clinic,
and even just the whole medical system being able to go virtual has been super helpful you know talking to my doctor on the phone they have you know a lot of people also have a bit more time because it's virtual and it's not.
You know going back and forth like the doctor you know what how many problems do you have let's solve them all right and like you know what I mean which is not what was happening pre covid so I'm always careful to say covid did this excellent but you know even in my own field.
There's things that have happened that you know that have advanced the industry which is pretty cool
so let's go for a break after the break leaves and I will be discussing prevention and so get up stretch grab a cup of coffee and we'll see you back here in a few minutes you'll be watching a full aging with Amy live on Bold braid TV we'll see you in a few.
[25:23] Hello again and thanks for joining us today let's discuss prevention I find that many of our clients we work with at t-- and toes.
Have some sort of incontinence however there is never any discussion on how to improve it or to alleviate the incontinence it just doesn't seem to be on the radar that you know and it's just accepted that incontinence is just the thing and this is what we're dealing with but there.
It's a little bit surprising especially with the information that Lisa's giving us today because you know just the same if someone heard a muscle,
in their leg or broke their arm or something you know Physiotherapy and different things would come in to fix it but incontinence seems to be one of those things that is just like well I have it that's it so Lisa what are some tips that we can give our audience to help,
[26:08] The first thing that I get most of my clients to do when they come into the office if they're having concerns related to incontinence or overactive bladder is I have them complete a bladder diary now a bladder diary is really simple you don't need an actual
like I give people a hand out but you don't actually need that hand out to be able to do one essentially you're going to start at.
6 a.m. and you're going to write down till 5 a.m. so sort of a 24-hour period and all you're going to do is write down.
When you had a void.
How long it took you so you know did your voice last 15 seconds did it last three seconds we also want to know if you've had a bowel movement in that time,
and then what you've had to drink and when and that's a great tool to start with I usually get my clients to do it for two days and.
Clients of mine that are working I'll get them to do it like on a weekday and weekend so that we have sort of the comparison between the two.
And that what that first does is it starts to give us some patterns we can look at patterns like okay that this person always gets up at 6 a.m. and they avoid for.
15 seconds but then they go back to the washroom at 7 a.m. and they void for 3 seconds well what's causing that three-second void that might be one that we want to,
working on may be delaying it a little bit working on some timing so bladder diary can be a really great place to start for either,
just someone in general or if you're a caregiver and you want to start to look at those patterns as well from there we want to look at things like.
[27:38] Having the person especially with things like urgent urgent continents so having that urgent need to urinate and then not being able to make it to the washroom often times what happens is like panic.
It's like I had to go to washroom I have to go all the way up the stairs and take these pants off to do it so I always tell my patients to stop.
Don't Panic so stop and breathe.
And then just take a moment to and we'll talk a little bit more about some exercises that we can do and I think in our next segment but just stop breathe maybe do a few pelvic floor exercises and then it becomes a mind over bladder,
conversation with yourself so you know I talked earlier about how when I was a kid or teenager and I would come home from work and I put our my story I'd come home from school
the teenager I didn't have a job you're working young man I'd put my key in the door and then as soon as I put my key in the door I get this like urgent need to urinate.
And it's like well what was that key in the door trigger and often it's something as simple as you've said to yourself I'm going to go when I get home.
[28:38] So you get home you put your key in the door your brain goes your home.
And your body's like okay time to go the bathroom so if we can just change that conversation a little bit and say instead of I'm going to go when I get home,
I now use I'm going to go when I'm sitting on the toilet and my pants were pulled down so I'm being very specific about when I'm actually going to.
To void my bladder and it's actually it sounds silly but it's pretty amazing how quickly you can start to change your mindset and make it to the washroom without concern so now I can.
Have to go to washroom I can maybe run an errand I can get home I can put you know my groceries away or whatever errand I was doing I can go into the kitchen for a moment and then I make my way to the washroom and there's no longer that like Panic set moment.
[29:31] So that's called we call that Mind Over bladder then we always want to talk about are you always want to work on our breathing and then,
some connection to the pelvic floor so breathing becomes very important when we think of public for function our breath is very closely related to the pelvic floor.
When we breathe in our diaphragm descends downwards our diaphragm sits lower rib cage and when we breathe in our diaphragm descends downwards it pulls down on the lungs it creates a negative pressure in our thorax and then air rushes into our lungs.
But what happens below the diaphragm is we create a positive pressure so the diaphragm contracts it lowers and increases positive pressure in the belly and that positive pressure gets distributed and we want that distribution to happen,
front and back side to side and then down so it's almost like when we inflate a balloon,
we breathe in and there is an increase in length in the muscles of the pelvic floor and the abdomen in the low back.
[30:29] If we then try to like engage the pelvic floor against that breath it becomes very challenging because it's a struggle between your diaphragm which is under involvement mostly under involuntary control versus the pelvic floor and then trying to like engage below and we create this sort of.
Mismatch struggle between the top and the bottom so breathing is very important connecting with your breath and then putting it together with pelvic floor strength so,
in our next segment segment when we talk a little bit more about strengthening we want to make sure that we're pairing that as best we can with our breath and I mean it's not like you must do it this way it just makes it a little bit easier for us to pair our breath with our.
other ways that we can manage so we want to look at like we talked about the bladder diary so then we can start looking at timing avoid so if that person always goes at 10 a.m. and you're going to go in the car at 9:45.
Maybe that's a great reminder that they might need to avoid before getting into the car also timing of fluids so we know things like caffeine and alcohol this can start to stimulate the bladder,
Cutting those out completely or reducing the amount that can be a great way to control continents I do find when I go down south to visit my mom in California that.
[31:44] I think it's because it's a lot drier I drink a lot more water and I have to urinate so much more frequently I find like one cup of coffee just goes like rate through my system as quick as possible whereas when I'm in the cold great white North it's much different,
so yeah looking at things in your diet that might be stimulating along with medication too and we know that there's a lot of medication that,
can change you know lots of medications act as DirectX or stimulants so looking at the medications that,
you have in your life as well so you know I've some patients that say well I need to drink water right before I go to bed because I take these medications and it's like okay well can you.
Can we look at maybe moving the.
Timing of those medications up by an hour so you're not drinking so much fluid before you go to bed so those are my big ways that I get people to start with management.
That's a lot of a lot of money
no it's a lot of good information though it's funny that you say that you have to go the more when you go to the drier climate because I find that when I'm freezing maybe I'm shivering and I have to go more always cold and I have to be oh dear so we're going to go for another break after the break
Lisa and I are going to teach you how to strengthen your pelvic floor
stay tuned you won't want to miss it we'll see you in a few this is Artful aging with Amy we're live on Bold Brave TV.
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[33:32] Welcome back now is the moment you've all been waiting for I know it Lisa is going to lead us through how to exercise your pelvic floor what to look for how often should we do it.
And from my own knowledge Lisa I believe the pelvic floor muscles just like any other muscle in the body and with that it begs the question we should be working them out to is that correct.
Yeah that's absolutely correct very much like any other muscle in the body we want to at least have some sort of connection to it,
whether it's consciously or subconsciously and often as we get older we lose that little bit of connection to that part of our body because it's not something we think about on a daily basis like picking up a coffee cup.
Yep for sure so can you tell us are there exercises for the pelvic floor are they different depending on whether you're a man or a woman and can you tell us what they might include.
Absolutely so the exercises themselves are not going to differ that much just perhaps the cues that we use for.
Male versus a female or a someone with a penis versus someone with a vulva are going to differ a little bit because we have to make sure that we're queuing for the appropriate Anatomy but I mean overall the muscles of the pelvic floor the same whether you,
are a man or a woman so.
I do have my little pelvis model this is a female pelvis as you can see we have the Volta on the outside but if I take this off really everything else is.
[34:58] So we have our internal pelvic floor muscles that we can see here,
so as I mentioned the public floor is work together well with our breath along with a few other structures we don't have a ton of time so I'm going to just kind of talk about how the pelvic floor itself works with our breath,
so our diaphragm sits on top,
so like I said when we breathe in the diaphragm contracts and it lowers it creates this pressure in the abdomen and what we want is that pelvic floor to start to lengthen and accept that pressure and then as we breathe out,
and the diaphragm returns to rusting that's when the pelvic floor will then start to reflexively lift and then that's a great time for us to start thinking about engaging some of the spots within the.
So to start with very simple exercises I typically will get my clients if they're this is actually great for virtual this is how I would start someone virtual I would get you to put one hand on the side of your ribs.
[35:53] And one hand on our abdomen and I don't know if you can actually see what I'm doing here but one hand on the side of the roads one hand on the side of the abdomen and just list like start by touching base with your breath we would take a long breath in.
[36:07] And then out and a long breath in.
[36:14] And out so the first key there is that you want to make sure that you are feeling both of your hands moving.
So as we breathe in the hand should move out and then as we breathe out the hands kind of move back in.
[36:30] And then we can start queuing some different spots within the pelvic floor so.
[36:36] We're going to start with two different cues whether you are a man or a woman two different keys to start working on the very front part of the.
So as you take your long breath in.
[36:49] Everything is relaxing as we breathe out we're going to either think about lifting our testicles up so that would be a great Q for a male.
Exhaling licking the testicles up and for female we're going to think about nodding the clitoris downward so let's just do a couple breaths in and out where we think about those two cute so long breath in.
[37:10] Exhale with the clitoris long breath in.
[37:19] Exhale think about lifting the testicles.
[37:25] And then I get that person to think about where they feel that in their body and what I'm hoping that there that you know your viewers are feeling is the front part of the pelvis.
Engage in a little bit from there the queues actually become very generic.
So our second queue that we're going to use this is going to get a little bit more of the middle of the pelvic floor so we're going to think of our sits bones so our sits bones if you put your hand underneath your bum and that's exactly where we sit.
That's a bone that you'll feel when you sit when someone you know says they have a bony bum that's what you're going to feel so on are.
Next exhale we're going to think about bringing the sitz bones together but just by about 1 mm we're just doing very small movements here so we're going to take a long breath in.
[38:07] Exhale think about bringing the sitz bones together.
By one millimeter long breath in as we breathe and we always want to think about relaxing so lengthening.
[38:18] And then we're going to breathe out think about bringing the sitz bones together.
And then the third part is where we're going to think of the very back of the pelvic floor and we're going to use this again the same queue and depending no matter what body parts you have.
We're going to think about stopping the passage of gas so we take our long breath in breathe out gently think about stopping the passage of gas.
[38:44] And you should feel that one a little bit more within the bum and then we can put those three together.
So we can think about taking our long breath in.
[38:55] Exhale thing about winking the clitoris or lifting the testicles bringing the sits bones together and then gently stopping the passage of gas.
[39:06] Always stopping always end in your exercise with an inhale we always want to end the exercise with lengthening of that public floor again so we're going to just finish with our long breath in.
[39:16] Let the muscles relax now at home you can you know play around with those different cues and see what feels best for you you can you know what,
best for your body does doing one of them did you eat all three of them just combining two them together.
That's a basis of a Kegel so a key goal is a shortening and a lengthening of the pelvic.
[39:37] And then from there we can add some movement and I love adding movement because it's very rare.
People feel incontinent when they're just sitting still you know you always hear people oh I'm in the car,
and I did all my kegels and it's like great but did you actually have incontinence in the car or did you have incontinence when you were walking up the stairs so then we just want to add a little bit of movement to get the brain in the pelvic floor talking to one another with movement and I do have some different examples of things you can do so I have a little five-pound weight.
You can use a soup can at home or I have a stretchy band and you could use like a pair of pantyhose or like stretchy pants at home so then we start putting it together with some movements so I'm going to do a simple shoulder press here we're going to take a long breath in.
[40:19] We're going to Exhale you're going to engage whatever part you want to engage the pelvic floor I'm going to choose to think about winking the clitoris.
[40:26] And then all I'm going to do is lift there you go lift the arm up overhead breathe in let everything relax exhale engage.
Lift the arm up.
And you can do this with any movement so I could use my exercise band and I could do a abandoned home.
[40:47] I could in seated lift a leg up,
um you know in standing I could stand on one foot there's lots of different ways you can incorporate this I think the key is just incorporating the exercise itself with a little bit of movement.
That's awesome thanks so much Lisa I really appreciate that I hope that our viewers have been able to locate their pelvic floor and being able to start doing this,
I want to thank you so much Lisa we've come to the end of our time already together thanks so much for joining us today thank you so much I appreciate being here.
After the break I will break down our top tips from today keep strengthening your pelvic floor during the break and we'll see you in a few.
[41:29] Welcome back this is artfully aging with Amy we're live on Bold Brave TV I hope that you've learned a lot about how to exercise your pelvic floor and maybe I'll pass this episode along to some of your friends and loved ones help get the word out
there's definitely some improvements folks can do who have incontinence so let's help spread that a little bit for more information about Lisa
and Bloom you could always head over to Artful aging with a me.com there's a link there for four at Lisa as well as on Lisa site
there are a lot of videos that are called not TMI which is are my favorite so I think that they're pretty awesome so if you want to head over there there's definitely a lot of more information that you can get.
[42:11] If you've enjoyed today's episode please hit the like button and subscribe so you'll be notified when we put new episodes out
also you'll be helping other families find us because of the algorithms of YouTube and all of our podcasts and they'll come up more often so if you could help us out to reach some more families and help them okay so my top list from today,
overall health is really my number one it's important to make sure that although we didn't cover the specifically with Lisa it's something her and I spoke about previously you want to make sure that you're eating properly
you're exercising regularly you're working out the muscles to make sure everything,
is still in working order and that includes your pelvic floor muscles so make sure that you're trying on top of your General Health and well-being I think,
kind of a good tip for anything we do in life remember to have a look at your medications and see if there may be causing you some incontinence.
You can always have them reviewed by your doctor or a pharmacist some folks are taking muscle relaxant.
That may have interfered some other folks are dealing with stimulants,
that also may be interfering with their pelvic floor and causing incontinence so,
It's always important to have a good look at what's happening like Lisa said to with the bladder diary it's always a good thing to have a look at what's currently going on with before you change anything so you know how you can tweak anything else that comes up.
[43:38] Number three remember that incontinence doesn't need to be accepted as a normal part of aging there are ways to help
such as the way that we spoke about today so you don't have to just accept that you're incontinent and then you know obviously we're pads or whatever that you're going to do you
can always look into alternative things to do such as pelvic Physio and and replay the exercises today and hopefully they can give you a little bit of a leg up
that does it for us today on next week's show we will be discussing caregiving with a parent who is also caregiving
for her parents and in-laws as well as obviously her kids her name is Sarah I'm a Q and I think that it's going to be a great conversation she's also a life coach so make sure you let your friends know about the upcoming episode I think not only will it be an eye-opener for a lot of folks but it's going to be super informative
for more information on today's guests as well as upcoming guests join me over at Artful aging with a me.com there you'll also find links for extra
downloads links to all of our guests website so that if you want some more information on them it's available there and you can also head around the site
as well to look at the free downloads of tea and toast has as well so if you're looking for retirement living then you can always do that there's a fuzz in my face.
[45:01] So thank you so much for joining us on our play aging with Amy we're on Bold Brave TV from me to all of you I hope that you have a wonderful one.
[45:12] You've been listening to Artful aging with host femi many folks just like you feel they're alone in their journey and helping a loved one or.
So tune in each week and let a me show you that help is around the corner and it's just one conversation away here on Artful Aging with Amy.