Speaker 1 00:00:02 Welcome to the Lifestyle PT Wellness Spotlight. Our goal is to connect you with local businesses and to assist you in living your best life. Now, introducing your host, Dr. Karen Chuli.
Speaker 3 00:00:16 Hi, I wanna welcome everybody to the show. Today I am talking with Jodi Withro and she's with ACEOS Physical Therapy in Gastonia, North Carolina. Jodi, welcome to the show.
Speaker 2 00:00:28 Thank you so much. I'm excited to be here.
Speaker 3 00:00:32 So, Jodi, today you're a a physical therapist and you specialize in pelvic health. We're going to be talking about, pelvic health and why it's important and who can benefit from it. Before we dive into that subject though, I'd like for you to tell the audience a little bit more about yourself.
Speaker 2 00:00:49 Yeah. Um, well, I have, uh, been a physical therapist since 2006. I went to school at Grand Valley State University in Michigan, and, have worked in a variety of settings over the last 17 years. Um, done some outpatient physical therapy, some home health, um, skilled nursing facilities. And, uh, we moved out to Lake Wiley in 2020. And, um, kind of over the course of that time within our healthcare system, just, um, saw some changes and wanted to be able to provide something a little bit different. And so when we moved out here, I decided I was going to start a Keso physical therapy and, um, and yeah, have just kind of been growing the business over the last couple years.
Speaker 3 00:01:52 So you started, you know, as a result of some changes, um, in our profession, but, you know, that's where it's great. Good things usually come from stuff like that. Um, and now you're primarily specializing in pelvic health, is that correct?
Speaker 2 00:02:08 That is correct, yeah. I also see, um, orthopedic conditions. But, um, what I realized in a lot of the folks that I see, which probably the, the bulk of my clientele are, um, folks between like the ages of 35 and 55. Um, and predominantly female, but not all female. Um, I just found that many of them had signs and symptoms of pelvic floor dysfunction and I really wanted to be able to serve them in the best way that I could. Um, so yeah, so that's when I moved forward with getting my certification in public health and really diving into that.
Speaker 3 00:02:56 So you evolved into pelvic health because it was a need that your clients, um, needed to get better, is that what you're saying?
Speaker 2 00:03:05 Yes. Yep. Yeah, I just, um, could see things, you know, they would show some improvement, um, but maybe weren't having kind of the long-term relief that I would want, um, and just felt like there was a piece that I was missing. Um, so that was where the, the pelvic health side of things came into play and it's just been amazing. I enjoy it so much. Um, so yeah,
Speaker 3 00:03:28 I love that. That's really how my business evolved as well, um, at lifestyle physical therapy because of if patients weren't getting better, then why, you know, or why are they still having that little bit of pain, you know, what's sabotaging them? So I love the fact, and that's why I love to dive deep and to figure out that puzzle and, you know, what's that, what's that piece of the puzzle that's missing? So, um, let's talk a little bit more then about pelvic health. I'm sure people don't realize, you know, this is kind of a, a new specialty, uh, within our profession that trying to get the word out to people that they can do better. Um, and you know, I personally have benefited from it. I, after having babies, it's common to have leakage when you cough and sneeze. And I put up with that for 28 years and then actually received pelvic health, physical therapy myself and, and now don't have to deal with leakage when I sneeze and cough and run. So, um, I know it can be so beneficial. So why don't you, you know, help people to understand what, what is pelvic health? What does that mean?
Speaker 2 00:04:32 Yeah, so it's really looking, um, at the pelvic floor muscles and evaluating and assessing how they're functioning, um, in relation to the rest of the body. So for those that may not be familiar with what the pelvic floor is, it's a group of muscles that lines the inside and underside of our pelvis. Um, it has really important roles in sexual function. It helps to support the organs in our abdomen. Um, it helps with circulation and lymphatic movement, um, and also helps with, you know, urinary and bowel continence. Um, so it serves a lot of really important functions in addition to supporting our low back, our hips and our pelvis so we can have dysfunction in that area. Um, and it can really affect lots of other places within our body. So if we don't address it then um, you know, we don't get, we sometimes don't get the, the best results that we could.
Speaker 3 00:05:41 So what do you say to the person? Um, again, even as a physical therapist, all they taught us back in the day was do Kegels. So I did Kegels till the cows came home. Uh, you know, I've had three kids and thought they don't work. So if somebody, you know, for those of us who are, are listening and kind of going, okay, yeah, I do Kegels, they don't work. Um, is pelvic health more than Kegels?
Speaker 2 00:06:03 It absolutely is more than Kegels. Um, and a, I have actually noticed a lot on social media that is kind of painting Kegels in a bad light, which isn't necessarily great either. There's certainly a time and a place for Kegels. Um, but really, you know, what we look at is how are those muscles functioning? So a lot of people, if they do Kegels, they may not be coordinating and activating those muscles correctly. So it's kind of like trying to strengthen the muscles in your arm by doing leg presses. Um, so you could do it every day, all day, but if you're not activating those muscles in the right way, you're not gonna reap the benefits of it. Um, so that's one of the things that we look at is how are the pelvic floor muscles actually contracting? Can they contract and uh, what other muscles might be turning on to try to help the pelvic floor, um, when they don't really need to be. So there's a really large, um, coordination piece of what I do of seeing how those muscles are working and then doing different activities that may include Kegels, but not necessarily, um, to help those muscles move in a more coordinated and efficient way.
Speaker 3 00:07:29 I know for me it was learning to turn it off 'cause I have taught Kegels for so many years that I had just so overactivated <laugh>.
Speaker 2 00:07:37 Yes, that definitely can happen too. Mm-hmm. <affirmative>.
Speaker 3 00:07:41 Um, so what are some key indicators that somebody may be dealing with pelvic floor dysfunction? Yeah,
Speaker 2 00:07:48 This is something that might really surprise people. Um, certainly any urinary or bowel leakage, um, would be a sign of pelvic floor dysfunction. And that's probably what most people kind of associate, uh, with pelvic floor issues would be just urinary incontinence. Um, but other things could be, um, a lack of pleasure during intercourse, um, that can indicate those muscles aren't functioning correctly. Uh, chronic constipation can be something that has a pelvic floor can component, um, any pelvic pain. So, um, pain with sitting, um, in the pelvic region or in the low back or hip area can sometimes be pelvic floor related. Um, and, um, bloating sometimes too. So again, that pelvic floor is, um, it's a really important piece for helping with circulation and lymphatic flow. So if that gets kind of congested or isn't functioning correctly, then that can affect the way that our intestines are functioning and contribute to, um, yeah, bloating and constipation.
Speaker 3 00:09:04 Wow, I wouldn't have thought that. So, I mean really, uh, an important and key piece, um, in our body that we probably do not address enough, um, in our society.
Speaker 2 00:09:14 Yes. Yeah, absolutely. And,
Speaker 3 00:09:17 And you can kind of see with women that, that probably all women <laugh>, you know, need some pelvic floor evaluation or something, you know, just because our pelvises are made to move umhmm <affirmative>, but so can men benefit from pelvic floor, um, or pelvic health treatment? Yeah.
Speaker 2 00:09:36 Yep. So certainly pelvic floor dysfunction is more common in women. Um, but men certainly deal with it as well. Um, so any pelvic pain could happen in men or women. Um, so, uh, if there's a man who's struggling with pain in the pelvic region, he would benefit from pelvic floor therapy. Um, also erectile dysfunction and premature ejaculation are other issues that have pelvic floor components that we can treat. Um, yeah, and also, you know, a big thing that I see commonly in the orthopedic world, which would be applicable to to men as well, is just chronic hip and low back pain that hasn't resolved with other more traditional treatments.
Speaker 3 00:10:25 Okay. Yeah, I have a feeling that probably most men do not realize that this is something that, uh, they could benefit from.
Speaker 2 00:10:32 Yeah.
Speaker 3 00:10:34 And as far as, you know, somebody might say, well, I'm just old so I'm supposed to have a little incontinence. I'm supposed to have, you know, um, you know, and not a lot of older people really get stressed out about the bowel situation and go into the restroom. Um, what do you say to that? Are you ever too old to address the pelvic floor?
Speaker 2 00:10:53 You are never too old to address the pelvic floor. It's a muscle just like any other muscle in the body. So if it's been neglected for a while and you haven't really worked on trying to improve its strength and function, um, then obviously it's not gonna do its job like it like it could do. Um, but if you're willing to put the work in and address it, then it has just as much potential to improve as any other area of the body. You just have to be willing to do the work
Speaker 3 00:11:26 Well. Great. That's good news. Yeah. Yeah. I like to tell people we don't hold your age against you <laugh>.
Speaker 2 00:11:31 Right? Yes. I love that
Speaker 3 00:11:33 We put the work in, you can still get better, never give up. Yes. So can you give us some examples of, uh, maybe some different types of, and maybe even some unique situations that somebody would've maybe have not realized that it was the pelvic floor that was causing their issue that then helped 'em to get better?
Speaker 2 00:11:52 Yeah. Um, so the, the constipation piece is probably what surprises people the most. Um, so anyone that I see when, uh, when they first come in to see me, I give them a pretty thorough questionnaire that goes over, you know, what the, what's the quality or consistency of their stool like, um, and I I ask about, you know, any incontinence or leakage that they might be having as well. But, uh, the stool question always kind of surprises people and they're like, why do you wanna know about my poop? Like, what's this about? Um, but uh, yeah, so usually, you know, when we ask about that, particularly if they've had um, either pelvic pain or like low back pain for quite some time, um, there oftentimes is a connection there. So I'll ask 'em, you know, ask 'em about that and then teach them different techniques to help manage the constipation and improve the motility within their abdomen.
Speaker 2 00:12:56 Um, and they'll notice like, you know, not having to strain as much when they're using the bathroom is really helpful and, um, yeah, really helps them with the pain that they're dealing with, but also just like having a better understanding of their body. I think when we're dealing with constipation in particular, if it's a chronic issue that can be really frustrating and lead down this path of taking, you know, certain medications to deal with that that aren't always pleasant. Um, so it really gives them more control over their bodies and understanding of their bodies to be able to deal with it. And yeah, they find that they're not as focused on it and just able to manage it, which is really cool to see.
Speaker 3 00:13:42 That's one of those nice side effects, uh, that now you're more constipated from <laugh> working on your pelvic floor <laugh>. Yeah. You, and is that, is it kind of a, you're probably gonna say all the above when I ask this question, but is it more muscle coordination and like you said, the motility of things not being pushed through the system or is it more diet, hydration, those types of things?
Speaker 2 00:14:08 It definitely can be a combination of that. Um, and that's one of the things that I talk a lot about with my clients is, you know, sleep hygiene, how much hydration they're having, what kind of foods are they eating, um, and just their bathroom habits. So for anyone listening who is dealing with constipation, sometimes just a really simple thing that can make a huge difference is using um, like a squatty potty when they use the bathroom. Um, yeah. So sometimes we have one
Speaker 3 00:14:42 Of those, they're great <laugh>.
Speaker 2 00:14:43 Yes, yes. Everyone should have one. It should come when you buy a home, like it should come standard with squatty potty <laugh>. Um, so mm-hmm. <affirmative>. Yeah. Now,
Speaker 3 00:14:56 And I know we're, we're saying, so like constipation, it is beyond, uh, incontinence, which means you know that you're losing your B bowel or your bladder. Um, and it's also beyond postpartum. But let's talk a little bit about postpartum. I mean, I personally feel like every woman who has given birth should have, um, pelvic health, physical therapy. Um, but so maybe speak to that a little bit of, of how they people who have given birth can benefit from pelvic health therapy. Yeah,
Speaker 2 00:15:24 Absolutely. I agree with you a hundred percent that it should just be part of standard care to at least have one visit with the pelvic health specialist. Um, obviously, you know, during the course of pregnancy, those pelvic floor muscles are um, taking a strain as the pelvis moves to accommodate the baby. Um, but then also during delivery it's um, you know, you could have damage to the pelvic floor. Maybe you needed to have, um, an app episiotomy to accommodate the baby and that trauma can really affect the way the pelvic floor is able to coordinate as well as its strength. So, um, just having a few sessions after baby is born can help, um, decrease any tender areas that have developed through there and just help the brain relearn how to coordinate and work those muscles. So that can have a huge preventative benefit, um, for any kind of incontinence down the road, but also, you know, weakness and pain that can result from pelvic floor dysfunction as well.
Speaker 3 00:16:38 Okay. Well, and that kinda leads me in, 'cause I'm sure in those situations you might have to do, uh, what we call some internal work. Um, I know that it doesn't always require that, um, but can maybe speak to some of the benefits of, of what internal work can bring you versus uh, not having that component. 'cause you might have a physical therapist, like at our facility we, you know, we do treat the stress incontinence and that kind of stuff, but we don't do the internal work. Um,
Speaker 2 00:17:06 Yeah, I think that, um, external pelvic floor work can be hugely helpful and is often really all that people need. Um, but for those that are continuing to have issues or just not seeing full resolution of their symptoms with the external work or the other treatments that they're doing, the benefit of the internal work is that we're able to really fully assess what the pelvic floor is doing because there's three different layers really of the pelvic floor. So when you're working on it externally, you can really only tell what the outer part of the pelvic floor is doing. So there may be some dysfunction that's happening a little bit deeper, which we just can't fully understand, um, without the internal assessment. So the first benefit is that it really allows us to assess and evaluate all layers of the pelvic floor. So it gives us a better overall picture of what's happening with the pelvic floor.
Speaker 2 00:18:14 But I think also when you are having some internal work, there's different areas of feedback that you can get that makes, it can make it easier to reconnect that like brain to body connection. Um, doing a kegel or a pelvic floor contraction can, um, it can be a really challenging kind of obscure abstract contraction to think of. Uh, and it can be really difficult for people to grasp. So when you have some of that feedback internally, um, it can help with that piece of things. It's also possible that you could have, you know, tension or pain. So kind of, you know, what you had experienced with not being able to relax the pelvic floor enough when you do internal work. It allows us to do some, um, different techniques to help those muscles that are deeper that we can't reach externally to help them relax so that they can heal and function better.
Speaker 3 00:19:18 And just to kind of help those of us who might be sitting here thinking of a typical traditional physical therapy clinic and going, okay, how do you do that? It's a big open gym. Um, you know, I actually wanna let people know you just took me on a tour of your facility, uh, right before we got started and to just let everybody know that Jodi's facility is a nice quiet, uh, environment with a private treatment room and, and, uh, you know, this would be a very, um, private session to where, you know, people also are not gonna hear your conversations, you know, and have to discuss this in a, in a big open gym. So just know that your pelvic health therapist, uh, are set up to, um, be discreet. 'cause I know this could be a difficult topic for some people. Yeah,
Speaker 2 00:20:06 Absolutely.
Speaker 3 00:20:07 Let's talk to the physical therapist for just a minute. Um, you know, 'cause again, not everybody is cut out to be a pelvic, um, health specialist like yourself. Um, and, and I know we have, we need more of those and have very few in the profession, but that physical therapists could probably be a referral partner for you. Um, at what, what are some key indicators that maybe, you know, their client could benefit from, um, either pelvic health treatment if they don't do that or getting to that internal treatment component?
Speaker 2 00:20:41 Yeah, I think certainly, um, in, in the orthopedic setting in particular, you know, if you've done the external work or you've worked on other things and um, and their symptoms are just kind of reaching a point where they're plateauing maybe that you're just, they're not getting, um, full resolution of their symptoms, um, then it could be good to, you know, have a few sessions with a pelvic floor specialist to, to do the internal exam and see if there's something that we can address. Um, that would probably be, I would say the main thing is that just in, uh, traditional PT clinic, if you're finding that your patients have any of those signs and symptoms of pelvic floor dysfunction, um, you know, which would include the leakage, pelvic pain, constipation, um, any of those things in addition to, you know, whatever orthopedic condition that you're treating them for. Um, if they're just reaching a point where you're not seeing that continued improvement, then this would just be another tool, you know, that they could utilize to help them kind of get to that next step of their rehab.
Speaker 3 00:21:57 And, you know, you bring up a good point about this being very orthopedic. Um, you know, but I was thinking as you were talking, um, uh, do you address at all like the neurogenic, uh, type bladders and, and dysfunction that may happen from some, uh, nerve damage? Uh, is that something that you address as well?
Speaker 2 00:22:16 Yeah, um, yes, it is actually. So interstitial cystitis as well, you know, sometimes people can have those bladder have some pain and after the infection clears, they just continue to have some of the same symptoms, um, of the infection even though the infection is cleared. Um, so that's something that we can address. Um, ental neuralgia is another, um, diagnosis that we can treat. Um, so yeah. Um, so that would be something that we could look at as well.
Speaker 3 00:22:53 Great. That's helpful. 'cause I know some people might be thinking, well, I've just got this weird nerve pain going on, so I'm glad to hear that that can be addressed as well. Well, Jody, this has been a great conversation. I, I just don't think we can talk about this enough to try to get the word out to people that you don't have to live with, um, sneezing and leakage or stop running because you are jumping rope or whatever, you know, because you're leaking, um, for whatever the purpose may be, uh, male or female, and know that there is help out there. I know personally, it, that part has transformed my life. Um, 28, you know, I dealt with it for 28 years and that was unnecessary. So just know that, uh, all you CrossFitters out there, you know, and you're trying to jump and you gotta go into your bladder ahead of time, know that there's help you, you know, you don't have to do that. So, um, before we go tell people where you're located, how they can get in touch with you, um, if you've got a website, maybe give your website.
Speaker 2 00:23:53 Yeah, absolutely. Um, so my clinic is, uh, in Gastonia and, um, you can kind of check that out at, uh, www.asopt.com. So that's a C E S O pt.com. Uh, I also have Facebook and Instagram accounts, which is, uh, aso.pt. Um, yeah. And I would love for anybody to, you know, message me there, or you can shoot me an email at, uh,
[email protected], which is j o d i at ace s o p t.com.
Speaker 3 00:24:38 Great. Well, Jody, thank you so much for your time today and for sharing your wisdom and your experience. And, uh, I just encourage anybody, if you're having any of these issues, um, and again, we don't know who may be listening. If you're in the Lake Wally Gastonia, North Carolina area, then uh, check Jodi out. But if you happen to be somewhere else in the country, um, you know, just start Googling pelvic health and pelvic health therapist in your area. Um, I can tell you as a specialty, so it should come up, you know, as to who treats that and do your research, you know, look at your Google reviews and, and those types of things. But, um, but don't suffer in silence 'cause uh, there is help out there for you. And, and I just love how your, your private practice has evolved, um, because it evolved because there's a need Yes. And you're meeting that need. And, and that's, uh, to me is just the heart of our profession and what we're all about. So I wish you much success with that and, uh, just excited to have you in the area so that people can get the help they need.
Speaker 2 00:25:42 Awesome. Well, thank you so much. And, um, yeah, I really enjoyed being here and sharing a little bit about public health.
Speaker 3 00:25:51 All right, everybody, thank you for joining us today and, uh, until next time, we look forward to having, uh, future conversations with you. And you can check us out on Spotify, Amazon Music, and, and also on Apple Podcasts. So thank you for joining us today.
