Is Your Pelvic Floor As Healthy As it Could Be?

Discussing pelvic health can be quite an uncomfortable topic for some, but physical therapist Tanya Goodrich wants to talk about it. Women’s pelvic health is understanding the basic functioning of the bladder, bowel, sexual health, and all the muscles down below and how they play a pivotal role in our everyday quality of life.

With a background in dance, Goodrich went to school to pursue a career in physical therapy with a focus on working with dancers. During one of her rotations in PT school, a mentor suggested she look further into a different aspect of therapy, pelvic PT. She turned to her friends to try to start an open conversation about women’s pelvic health, but they wanted nothing to do with it. In that moment, a lightbulb went off and Goodrich realized this was her calling. From then on, she has been determined to shed light on how crucial pelvic health is and to eradicate any shame associated with it.

A CONVERSATION WITH TANYA GOODRICH

Tanya, can you break down what pelvic health is? Why has discussing it been taboo?

These are some of the most intimate conversations you can have between patients, doctors, and clinicians, so it has been in the shadows and avoided. For many women, there is profound shame in discussing these common health issues. I don't think we’ve been allowed to speak loudly about these things. In my field, we say there is no such thing as TMI (too much information) on the topic. In my practice, we ask about painful sex, urinary leakage, hemorrhoids and lots of things that might seem uncomfortable but are critical to understand.

You talk about how most people don’t think about pelvic health until they start having issues. How do you know if you are having issues? What are the signs we should be paying attention to?

Issues can range from back pain and pain during sex to leaking after coughing, laughing or jumping. What women need to learn is that there are ways fix these problems with the help of a pelvic floor therapist, who will do a simple exam to check the strength of the pelvic floor muscles.

Unfortunately, most medical professionals just don’t learn a lot about the muscles and connective tissue in the pelvic floor, so they're not experts in it. They aren't necessarily aware of everything we can do for this area from a musculoskeletal perspective.  Women need to understand these issues are not inevitable. With proper care and knowledge, there is help.

You’ve seen a lot of women suffering through fixable problems, and often say women deserve better than this. Can you speak more about that?

I have a very personal connection to this because I see women ranging from age 17 to 90 who have not been seen, heard, or treated appropriately. They have been dismissed—and it is not okay. 

I am not okay with women just assuming that as you get older, sex will be more painful. I am not okay with women assuming they will inevitably end up in adult diapers. This is just not true! Women deserve better than this—better information, better care, and less shame. Your pelvic floor deserves to be treated like any other part of your body. Just like you would rehab an injured ankle or knee, you can rehab the pelvic floor. 

And like all medical issues, prevention is the best care. There are many things you can learn to do before problems arise. It is important for women to be proactive in getting the help they need.

Kegels is a term that many women have heard, but you say there are some misconceptions about this topic. Can you talk more about this

What I find is that many doctors and clinicians haven’t really studied the area, so when their patients want to know why they are leaking urinary or having painful sex, their healthcare providers throw out simple answers that attempt to be a panacea for all vaginal issues. Kegels is an example. It’s a muscle exercise that women do to tighten their pelvic floor and to help with urinary leaking and painful sex. However, pelvic floors can range in tightness, and some women clench or hold their pelvic floor muscles all the time. In this case, telling someone to do Kegels can actually make symptoms worse because their pelvic floor is already “gripped.” A pelvic floor physical therapist can quickly determine if Kegels will help or hurt your issues.

Are you hopeful about the future of pelvic health and its integration into standard healthcare?

That is my wish and I do think it’s possible!  We are learning that one in four women will have a pelvic floor issue during their lifetime—so, if it’s not you, it’s your mother or sister or aunt. And I have seen a shift. Women are demanding more, saying I have a problem, and I will be heard!

I have young women reach out and ask about checking if their floor is tight or loose. I have 70-year-old patients who are just now learning how to stop leaking. And they tell me about the improvement in their day-to-day lives. What I want all women to know is this: It’s never too late to get help. 

Tanya Goodrich, PT, DPT, founded Healthy Pelvis Physical Therapy and serves as Clinical Physical Therapy Director for Evernow, a women’s healthcare company. She holds a BFA from the California Institute of the Arts in Dance, along with a Masters and Doctorate in Physical Therapy from the University of California San Francisco.