Dr. Stephanie Weyrauch, a physical therapist, shares her journey into pelvic floor therapy and mobile PT services. 🩺🚗

Common Misconceptions about Pelvic Health PT ⚠️ Stephanie debunks frequent misunderstandings:

• It’s just about Kegels 🙅‍♀️
• Only for postpartum women 🤰

Keys to Effective Pelvic Health 🔑

1. Full Range of Motion ⚖️: Stephanie emphasizes the importance of pelvic floor mobility.
2. Mind-Body Connection 🧠💪: Addressing both physical and mental aspects of healing.

Holistic Approach to Physical Therapy 🌟 Stephanie advocates for a comprehensive perspective on health:

• Incorporating home routines and equipment 🏠
• Focusing on overall lifestyle changes rather than quick fixes 🔄

Innovative PT Delivery 💡 Stephanie offers mobile PT services to make healthcare more accessible! 🚗🏥

For more information on pelvic health and physical therapy services, visit Movement-X 🔗

Remember, proactive healthcare leads to better outcomes! 🏃‍♀️🥦

Follow Stephanie on socials:
@thesteph21 | @movementxinc | movement-x.com/billings-montana

Follow Granite Fitness on socials:
Facebook | Instagram | YouTube | X | granitebillings.com

Follow Ryan Jore on socials:
Instagram | jorestrengthtraining.com

#PelvicHealthPT #WomensHealth #PhysicalTherapy #MobilePT #PostpartumRecovery #PainManagement #HealthcareAccess #MovementIsLife #PelvicFloor #PatientEmpowerment

Ryan Jore 00:00
Today on podcast, we have Stephanie Weyrauch, Stephanie, welcome to the show.

Stephanie Weyrauch 00:03
Thanks, Ryan. It’s great to be here. Yeah.

Ryan Jore 00:05
So now you are a physical therapist specializing mostly in pelvic floor and like, women’s, like prenatal and postnatal. What brought you to that field?

Stephanie Weyrauch 00:15
Yeah. So I’ve been a physical therapist now for 10 years. I graduated from Washington University in St Louis with my doctorate of physical therapy and my master’s degree in clinical investigation, which is basically a fancy name for a research degree. And my husband, at the time, was finishing medical school at University of North Dakota, so we had been doing long distance marriage for five years at that point, so it’s time to time to move up with the husband and, you know, live the normal married life. So I moved up to the Grand Forks area, and the first job that I took was in a rural town called Thief River for Falls, Minnesota, and we were the only clinic within a two hour radius that was a private practice, and so we had people coming all around the region to have to see a physical therapist. And a lot of the women, or a lot of the people that would come would be women who had incontinence issues. They were postpartum, they were pregnant, they were going through menopause, they had chronic pelvic pain, and we just didn’t have anybody that specialized in that area, and there wasn’t a lot of physicians or just healthcare providers in general. And so my boss asked me if that was something that I was interested in learning about. And I said, Yeah, I love the spine, and the pelvis is attached to the spine, so it was a great next step. And yes, my I don’t know if you guys can see it here online, but I have a spine and I have a tibia on my teaching. So I ended up going through some extra training for that, and I was able to help serve those, those women, most pelvic floor physical therapists. You don’t graduate as a specialist in pelvic floor, in pelvic health from PT school. You have to go on and do postgraduate training. So I went through a pretty significant postgraduate training course. And when my husband ended up matching into residency, we ended up moving to Connecticut, because he was going to residency at Yale there. And so I left that practice and moved to another practice in Connecticut. I thought that when I moved to an urban area, there would be a lot more providers, and potentially I could go back to being a generalist. I didn’t have to continue on with this specialty practice. But then I moved there, and I found out that the same problem that was in rural Minnesota, there’s not a lot of these providers. It was the same problem in urban Connecticut, and I was in the New York City metro area, if there were providers, the wait was up to six months. And when you’re pregnant, you can’t wait six months to go see a pelvic health PT, you’re going to give birth soon. So gradually, my practice started moving towards that specialty. You know, I treat a couple women here and there, and they’d go back to their obs and they talk about how much better they felt, and they talked about how great their experience was and how empowered they were about their bodies. Because, frankly, our society doesn’t talk about the reproductive system, doesn’t talk about the vulva, doesn’t talk about the vagina, doesn’t talk about the penis. And so they felt very empowered about their bodies. And so of course, they’d go to their physician, and their physician would send me more patients. And eventually my practice became all pelvic health. And then when my husband finally finished all of his medical training, we decided to move here to Billings, because I have two daughters and I knew that I wanted to offer a certain experience, especially for women, because the healthcare system has sometimes, sometimes forgets about us. And the reason that I say that is because when I went through my birth process and had my daughter three years ago, here I was in an urban area with lots of access to health care, but I still felt so alone, like my husband was a resident. He wasn’t there to help me. I had just given birth. I’d had a C section, so I had a major abdominal surgery, and I was expected to take my newborn child to the pediatrician’s office, even though I wasn’t supposed to lift more than 10 pounds. I wasn’t cleared to drive all my family was located in North Dakota’s peak covid, so I didn’t have anybody out to help me, and it was not a great experience. And then I go to the pediatrician’s office. My daughter’s not gaining enough weight, so then my pediatrician says, Well, you need to bring your daughter in every two days. For weight checks. And I was like, Wait, can I just have a like, a scale to take home with me? So you know that, and that’s one of the reasons why people don’t pursue health care and aren’t proactive with your health because there’s so many barriers with seeing providers. There’s the weight aspect, there’s the time management, balancing your life, trying to figure out, how can I fit these appointments into my job that I have to work in order to have my health insurance. And so all these factors, my personal factors, and then dealing with the barriers that my patients faced, including with dealing with insurance, I decided I want to give people an experience that will make them want to pursue health care. They’ll want to be proactive about their health. They will feel comfortable telling me these things, and I am there to guide them. And so that’s where movement X was born. So I go into people’s homes or their offices or their outdoor space, or I see them virtually. Basically, I go where the people want me to go, and I treat them trying to remove those barriers, especially because, as a mom, you know, many of you listening are probably moms, you can relate to the fact that, like, it’s hard to plan your day around naps and feedings and mood swings and tantrums, when the

Ryan Jore 06:22
idea that you’re gonna go every other day into something like, yeah, it’s just not realistic for most people’s lives.

Stephanie Weyrauch 06:26
No, it is not. And so when we moved here to Billings, I wanted to offer that service. I, you know, had done a lot of market research, and there wasn’t a practice that was like mine. And so I figured I could fill in a little hole in the community to really give women and and people of all genders, really the opportunity to have a health care provider that would tailor to their schedules and be their physical therapist, versus just seeing a physical therapist.

Ryan Jore 07:01
So what with the mobile PT, then what does that look like for most of your clients, and are they you’re going there each time like you bring all your equipment. There’s nothing they have to do, basically, other than just

Stephanie Weyrauch 07:12
open the door, correct? Yep, yep. So I bring treatment table. I bring, you know, I bring I dry needle. So I bring all my dry needling equipment. I bring my massage equipment, my soft tissue work equipment, exercise equipment. And then, of course, the idea is, I want people to be independent in their homes. I want them to work towards living a really healthy lifestyle so we incorporate things that they have in their home into our sessions, whether that be their home gym, maybe that they have freeways that they have or even like their kids, like if your kids are around, there’s ways that we incorporate children into into our sessions as well, especially when your child wants to be held or needs to be fed. There’s ways around that we can get around your life so that you don’t feel like you have to take time out of your life for health care. I can help put health care in your life. Well, it’s

Ryan Jore 08:07
really cool too, because I know everyone else wants to believe like they don’t have enough at home for them to get started with. You know, it’s like, so you’re not going to work out period, because you don’t have enough, like you can’t find so it’s like, the idea that you can show them directly. It’s like, hey, this, you know, these three things over here. If you lift these induced squats with this, like, we’re good, like, you will see progress from that chemical way of like, reinforcing for them right away. Like, yes, you do have enough to get started. Like, yes, maybe down the road we add something. But it’s like, I don’t want you doing nothing. Like you can start here

Stephanie Weyrauch 08:34
exactly and just empowering people, helping people realize that I also sometimes won’t even use the word exercise with my clients, because sometimes that can be a scary word for people. I’ll just, I typically will use the word movement. But, you know, helping that helping people realize that you don’t need to go to the gym for an hour, two hours a day, and lift 500 pounds on the squat rack to be fit like you know, the America the American Heart Association, the American Diabetes Association, recommends 150 minutes of exercise every week. That sounds like a lot, but when you break it down, it’s 20 minutes a day, and it’s of moderate intensity exercise. What consists of moderate intensity exercise, brisk walking, really, for cardiovascular health, that’s going to help benefit you. And if you can start just doing little things every single day, even if it’s walking five minutes a day that adds up over time. Five minutes a day of walking every single day is 35 minutes that you’ve just spent moving in a week. And then you gradually add time onto that, and it makes that 150 minutes really accessible. Yeah,

Ryan Jore 09:45
it’s that’s one of the most tricky things with fitness, is people never believe, like, it’s enough, like there’s they owed Azure, do zero. I remember talking to people like sis, like, honestly, it’s like, Get up and walk in trouble for 10 minutes a day. It’s like, what’s 10 minutes? It’s like 10 minutes more than you were doing. And they. Had that always, almost always, tends to snowball. If you can be consistent with five minutes a day, 10 minutes a day, you’re gonna eventually add to it. But if you believe you can’t start at anything less than an hour, it’s like, yeah, of course you’re gonna fail, because you’re just

Stephanie Weyrauch 10:11
setting the barrier too high, right? And it’s about forming habits, right? I mean, how many of us get up in the morning and the first thing we do is like, go to the bathroom and brush our teeth, we don’t think about doing that because we literally just do it every single day. And so, you know, my clients that are wanting to exercise more, one of the pieces of advice I give them is pick a time during the day and try to make that your consistent movement time. For my clients that are avid exercisers and they aren’t able to exercise because of an injury or pain, then there’s ways that we can modify the movement or modify the exercise so that they can fulfill that need and that desire, because at that point they’ve made it a part of their day. It is a habit. So how can we make sure that that habit stays there? And how can we make exercise safe as you heal from an injury? And those are all things that we work through, that that are easy to work through in the home, or, for example, if you are going to the gym, one of the things that I do is I go to people’s gyms, and I help them with their give them, get them set up, you know, they can. And I work with personal trainers like yourself. I mean, you and I have referred people back and forth, and having somebody that I trust that is working with my clients as a personal trainer is so important because, like, I know that you understand movement, and I know you understand the physiology behind exercise, and so you know how far to push clients and when to back off. And you and I have even, you know, I’ve texted you and said, Hey, like, this is the stuff we’re working on in PT, like, here’s the things that I recommend. And then, you know, my patients come back, and when they tell me about their session with you, it’s amazing just how much better they feel because they’re still moving, but they’re doing it in a way that’s not provoking their so

Ryan Jore 11:59
it also makes them more confident. I feel going into it too, knowing that because, like no one, you know, when it’s not your field, all the words they’re saying are just Greek to them. So you might tell them, hey, I want you to do unless this more of this, and it’s like that time they get just like you gave a telephone, they don’t remember. You know, I think she said not to squat or whatever. It’s like, you’ll have that direct communication is huge. I tried to, anytime I have a client who has gone to a PT or anything like that. It’s like, give me their phone number. Make sure that you’re allowed to text me, because it’s just so much easier that way. And then we can find out right away. Quickly. It’s like, hey, more of this exercise, avoid this. Boom, done. Correct

Stephanie Weyrauch 12:31
we got to do. And you know, one of the things that I always tell people is, you know, you have a really great physical therapist when they try everything in their power to help you do the thing that you want to do, versus telling you to continually avoid things. And yes, there are times where we have to tell people like, no, like, let’s just take a break from that for now. It’s not forever, but for now, but for the most part, as physical therapists, like, one of the reasons I love being a PT is because our jobs are to empower people to move and to do the things that they thought that not they was never possible. Whereas I feel like there are other healthcare providers who are focusing more on like keeping the tissue safe and sometimes under loading. And when you under load tissue for a long period of time, it’s really difficult to overload it again. And a good example of that are people like, with plantar fasciitis. I’ve had many patients whose healthcare provider will put them in a boot and offload their plantar fascia, and I understand that, yes, you want to decrease the inflammation. But if somebody is offloaded for even two weeks in a boot, that’s like, think about how like, think about when you guys skip a week a week at the gym, and you come back the next week, it’s so much harder to lift weights, even though, hypothetically, you haven’t really spent that much time away from the gym. But our bodies are naturally lazy, and so they will always go back to kind of their lazy state, and they need constant overload or maintenance load to maintain the

Ryan Jore 14:07
people really underestimate the value of like chronic exposure. Like chronic exposure is a very good thing. So like, say, We’re you’re not losing that fitness level. So then every time we have to spike it back up, we’re seeing those huge waves and workload, like being able to just maintains something is so huge. Yes,

Stephanie Weyrauch 14:22
maintenance is a big part of it. And so you know, again, when you’re offloading a body part, like, let’s say, for plantar fasciitis, where bones not broken, it’s just an inflammatory response. There’s other ways that we can decrease that inflammation. The first question is, why does that keep happening to you like we then that’s what a physical therapist is trained to do. We’re trained to look at how you move and find those habits that are continually exposing you to having that inflammation at that body part, and in this case, we’re talking about plantar fascia. So what can we change about your movement so that you’re not. Constantly aggravating that plantar fascia, versus just putting you in a boot, saying, okay, rest for two weeks, and now you go back to regular life, and it’s hurts again, because, again, you haven’t changed anything. The

Ryan Jore 15:11
boot might be the start of the process, but it can’t be the whole correct. It’s like, people that go to a chiropractor get popped one time. It’s like, I think chiropractors are awesome, but it’s like, if you sit, you know, with crappy posture, or, you know, whatever it is that’s driving your pain. Well, getting popped one time isn’t gonna fix that, if you just go back to the same habits,

Stephanie Weyrauch 15:26
right? Yep, it’s about changing habits, changing poor quality of movement, so that you’re utilizing all the muscles of your body versus one or two muscles in your body to do all the work. I always like to compare it to how many of us have worked in a job where we have really lazy coworkers that don’t do anything, and in order to get the project done, we have to take on an extra workload to get it done. And so what happens to us? Well, we get tired, we get irritated. We’re like mad at these other people. Your body is the same way. If you have one muscle that’s doing all the work, of course, it’s gonna get mad at you. It’s gonna be inflamed, it’s gonna get sore, it’s gonna get tight, because all these other muscles are not doing their job. And so as a physical therapist, we’re trained to help get those other muscles that maybe aren’t doing what they’re supposed to do. How can we get them to work harder and get that that person that’s doing or that muscle that’s doing all the work to work less, and get them to collaborate or coordinate better together?

Ryan Jore 16:33
So on a slight switch there. So you mentioned how you worked. Excuse me, over in Connecticut, work in a more urban area, how do you feel like? PT, over there differed versus like what you see in Billings?

Stephanie Weyrauch 16:45
Oh, man, that is a that is a great wherever you Yeah, that is a really good question. One of the things that I noticed about well, so first of all, I was in New Haven, Connecticut, which is considered part of the New York City Metro Area is well known for Yale ESPN summer, yeah. ESPN is up in Bristol, which is very close, yep. So you know, a lot of the treatments in in Yale were very much medically focused. So when I was in minneso, rural, Minnesota, there was a lot more of a focus on prevention and pre pre having for like a surgery. So in our clinic, it was normal that somebody was going to go get a total knee replacement. They would come to physical therapy for two to four weeks to try to strengthen up their muscles so that they were ready for surgery. And then two days after surgery, they would come to physical therapy in in Connecticut, nobody got prehab for their knee replacement, and then they would do two weeks of home health. Which home health is different than what I do. Home Health is a little is a little is focused more on functionality, but they would get some home health physical therapy for a couple weeks, and then they would come to outpatient. And a lot of you know the typical bread and butter exercises you would give somebody for total knee replacement, many times their home health physical therapist hadn’t given them, of course, that the focus was more on function. But if you’re not working on the strength, let’s say, of the quadriceps, or you’re not working on trying to straighten the knee all the way, it’s going to cause those functional problems to to manifest as you’re moving through your recovery. So that was one difference that I noticed. So I noticed that people took longer to recover from, like a basic joint replacement surgery in Connecticut, which is surprising to me, because, again, you’re at Yale. You would think that it would be but I think again, the focus is on the physician. The focus is on the surgery, the

Ryan Jore 19:05
fix, if only if, y’all, all you have is a hammer. Everything looks like a nail. Yes,

Stephanie Weyrauch 19:09
exactly. Whereas I felt like when I was in Minnesota, people were more proactive. People here, it’s been a mix. You know, there are some people that are really proactive with their health, and they want to get ahead of things. And then there are some people that, you know physical therapy is the last thing that they want to do, because they’ve tried everything else, and you know, nothing is working, so Okay, now I’ll see a physical therapist, but we know that, based off based off research, that if you can come to see a physical therapist within two weeks of an acute injury, you’re going to save money in the health in in the health care system, and yourself, you’re going to get better faster, and the reoccurrence rate of re injury is a lot less. And so the more proactive that our community can be, the healthier our community can be. So

Ryan Jore 19:59
sushi. They said how everyone views that as like a last effort. So one of my friends is a PT out in Oregon, and he was talking about how it’s even, it’s how the doctors verbalize, like doctors almost, this is like, well, you know, try physical therapy, and if not, we’ll do a surgery. It’s like, okay, you’re already giving them the implication, then that physical physical therapy isn’t going to work. It’s almost like we just got to cross this box off for insurance. We’re going to do the surgery anyways. But it’s like, it’s almost like your job is just there to fill a quota, essentially, or something. And versus like, if you actually just tell someone, like, Hey, I’m gonna send you physical therapy, like you don’t have to add anything about the surgery afterwards, you’re probably gonna give them more positive mindset going into that physical therapy, because you’re given the impression that, I think that this can work instead of this. Well, we’re just gonna do surgery eventually anyways. And

Stephanie Weyrauch 20:39
that positive mindset is really important, because we also have a lot of data to suggest that if you go into your physical therapy session and you think it’s going to help you, the chances of it helping you increases to 80% the brain’s a powerful thing. Yeah, it really is. And so having that, you know, they say that positive mindset is really important and and, you know, I work with a lot of people who are very skeptical, or I have worked with a lot of people who are very skeptical of physical therapy. And you know, you have to meet people where they are if they don’t think physical therapy is going to help them, that is okay. We do as much as we can to try to help you see your potential, to help show you the way. And sometimes people are convinced, and sometimes they’re not, and that’s okay we and that’s that’s the beauty of being a physical therapist, is meeting people, meeting you, where you are in your recovery process, because being in pain sucks, and there are a lot of environmental, intrinsic, extrinsic factors that go with being in pain. And what I have found is that if you can help people understand why they’re in pain, they’re more likely to come around to what you’re helping them achieve. Because really the question, the reason that people think, oh, surgery is my only option is because they’ve only been told the anatomic reason that they’re in pain. But let me tell you, anatomy is not is probably only 25% of the reason you’re in pain, most of the reason are other things the body is always going to protect you, and sometimes that protection goes on overdrive. I like to use the comparison of, you know, two different cars. You have a really nice Porsche that’s brand new, just came from the Porsche dealership. And then you have your heist, your car from high school, like, if I were to go touch one of those cars, which car alarm would be more sensitive? Obviously, the really nice Porsche, because it’s a higher end car, and it’s been programmed to be more sensitive that way. It’s programmed to keep that nice exterior drive this nice way, whereas your beat up old high school car is been through a lot. It gets it. It gets that life happens. And so, like some of these things, don’t bother it. The body is kind of the same way. So what we try to do is we try to make your body more resilient, so that the alarms aren’t being sounded. When you say, sit down and watch a movie for two hours that should not be painful for you. So how can we help your body understand that that is not a threat, that is something that is normal, that’s interesting. So I used

Ryan Jore 23:30
to be in kind of the marathon. I was, like, looking into an ultra marathoning type stuff, and I remember reading how they said, like a lot of your ultra marathoners are, like, in their 50s, because by your 50s, you kind of realize that sometimes stuff hurts and you just keep going, versus, yeah, like those 20 year olds, like, Oh my God, my knee hurts, is like you just automatically catastrophize. It’s like, it probably would have been fine if you just gave it, like a day or so of rest, but you freaked out about it, and then your body just naturally starts anticipating pain. So shocker, you have pain with movement. Like it becomes like a fear avoidance thing, exactly.

Stephanie Weyrauch 23:57
And we also know that the less you move, the harder it’s to move. So you lose as you become more fearful of movement, you lose that ability to move. And so again, we gradually try to reintroduce some of these movements in a non threatening way, so that people are empowered to move and to show you that you can do this. This is something you are capable of, and sometimes it takes a lot, long, a long time, and sometimes it doesn’t take very long. But again, it goes back to that piece of how soon are you getting help? The longer you let something go, the longer it’s going to take to improve

Ryan Jore 24:40
So, similar, like, so, you know, backs an easy one to use, because everyone always has back stuff or is worried about their back. And, yeah, we’ll have a lot of times where someone has, like, a low crown or, like a little acute flare up, and it’s like, we know that there’s nothing actually physically wrong there. So it’s like, Okay, we’re gonna say deadlift. We’re probably gonna underload them significantly. Because, like, it’s not right now about actually. Be getting stronger. It’s just about like getting that, that your body being afraid of it away. So it’s like, if you could normally do the 300 pounds, but I give you 100 pounds, like you’re not afraid of that now, like, magically you can do the movement. And we just keep adding that, we keep creating the exposure. And it’s like your body’s just like, oh, this is safe. No, this is safe. No, this is safe. And it just keeps going up a little at a time, yes,

Stephanie Weyrauch 25:18
yes. That is exactly right. And you know, I always talk about, you know, going through physical therapy is not just us helping you heal physically from something, but also it’s a mental experience too, because your body and your mind have to be on the same page. And so, you know, sometimes my husband jokes that, you know I’m okay, I’m some people’s counselor sometimes, but I mean it like you have to talk through that, those hard emotions. You have to talk through that hard stuff. Because if you don’t talk through it, it’s not like you could physically get all your range of motion back and be super strong, but you could still have pain, so you have to work through some of the it’s the physical and mental aspects of healing that are important to fully recover. Tony

Ryan Jore 26:08
gentokar, who’s a personal trainer out in Boston, he has a great quote about how for a lot of and he’s using the case of, like, people being afraid of getting bulky, but I feel like it’s same thing applies to strength training, where or if, with pain, I should say so have like, women’s, like, he can give them 60 pound barbell, oh, no, I’ll get bulky from that, but he can give them a 90 pound kettlebell, and somehow that’s safe. They’ll lift that all day. It’s same, same as strength train. It’s like, if someone goes into an exercise anticipating having pain, like, if they’re just convinced barbell devils are gonna hurt their backs, like, we’re probably not gonna do barbell deadlifts, because whether or not it’s causing any physical damage, they’re anticipating pain. They’re more likely to have a pain response. It’s like, if I can get them to any other variation training the same muscles and they’re not having pain, it’s like, over time, we can start to accept, like, Oh, this is safe, and then that becomes safe, right?

Stephanie Weyrauch 26:48
Yep, yeah, it’s a very important part of healing. Overall,

Ryan Jore 26:52
we’re just, we’re kind of just underpaid psychologists who have not nearly the qualifications. So stretching now a little more over to the more pelvic health side. Since you deal with that, what are some common misconceptions that people have with pelvic floor physical therapy?

Stephanie Weyrauch 27:09
So I have had clients who have said that they’ve been through pelvic health physical therapy before, and it didn’t help them. And so pelvic health physical therapy doesn’t work because they just did Kegels and well, a lot of times they actually did not go see an actual pelvic health physical therapist. Pelvic Health is more than just kegels. Everybody kind of thinks that that’s really what pelvic health is, surface level even. But a lot of times we a lot of times, if you go to an actual pelvic health physical therapist, many times, not always, but many times, we won’t even start with Kegels, because the pelvic muscles are just like any other muscle in your body. So think about your bicep, if you’re listening to this right now, or if you’re watching this, just straighten out your elbow, okay, like your elbow can reach full extension, right? Okay. Now, shorten your elbow or like, make a muscle position, like you’re flexing your muscles. So in order for you to move your elbow right, you have to move your arm through its full range of motion, from full elbow extension to full elbow flexion, right. And if you can’t move your elbow through that range of motion, you can’t use your bicep correctly. Your pelvic floor is the same way. Your pelvic floor moves through a range of motion. It goes up and it goes down. And if you can’t move your pelvic floor through its full range of motion, a lot of things can happen. You can have pelvic pain, you can have pelvic organ prolapse. You can have incontinence issues. You can have bowel problems. You can have abdominal pain, you can have hip pain. I mean, it can present back pain. It can present in a lot of different ways. And so if this is an issue for you, if the range of motion of the muscle is not where it should be, we would never start with Kegels, because we need to help train your muscle to actually move through its full range of motion before we can get you to strengthen those muscles by doing kegels. So I would say that’s one of the main misconceptions that people have about pelvic health. I would encourage people listening to this podcast, if you’ve gone through pelvic health PT before, and it didn’t help you. You know, maybe think about who your physical therapist was. Was your physical therapist actually a pelvic health PT, did take two classes in it, right? Or did they just take a course? And now they and now they say that they do pelvic health physical therapy a lot of times, too. A pelvic health physical therapist will do an internal examination. If that is something that they see as indicated, it is not a requirement. But if that is something that your pelvic health physical therapist that you went to doesn’t offer you a lot of times, they’re probably not really a specialty trained pelvic health physical therapist that should always be an option for a patient is to have an internal exam. We can find. Out a lot about your pelvic floor, range of motion. What pelvic muscles need help? We can do a lot of manual interventions internally to try to help improve how the pelvic floor is moving. Of course, it’s not a requirement. It is something that you know. We would tell you why you would benefit from and then you as the as the client would make that decision as to that’s something you would feel comfortable with or not.

Ryan Jore 30:30
So on a similar vein, then what are some you kind of address this to a degree. What are some common things you see that, like, are attributed to other issues that are actually caused by the pelvic floor? So like, when someone is, like you said, Men and having, like, abdominal pain, and they just assume it’s their abdominals, when it’s actually stemming from the pelvic floor. Could you talk about some common things? You see where they’re we’re just going at the wrong cause, like it’s actually the pelvic floor, but they’re looking somewhere, totally elsewhere.

Stephanie Weyrauch 30:55
I would say probably one of the most common ones would be constipation, endometriosis, a lot of women who are suffering from chronic pain with endometriosis, there’s stuff that we can do pelvic floor physical therapy wise, that can really help manage pain. People who have IBS, like if you have a lot of digestive problems, there’s a lot of research that is coming out now that’s showing a connection between pelvic health issues and IBS. And sometimes people that are diagnosed with IBS actually have an underlying pelvic health issue, and when you address that pelvic health issue, it improves how it improves the IBS and and the why is that? Well, think about how closely your abdominals are to your intestines, to all that those organs inside your body, and if you’re in constant pain, the muscles that are always going to be turned on to protect that area are going to be your pelvic floor muscles. It’s going to be your abdominal muscles, and it’s going to be your diaphragm. And so those muscles are always really, really tight. It gives your body no room to really allow things to move through the body. And there’s really simple changes that people can make in their lives that doesn’t even require them to exercise. When we were talking about pelvic health, the things that you eat, the things that you drink, the way that you breathe. Those are all really important things that pelvic floor physical therapists can help you with to help decrease some of the discomfort you may experience with some of these more chronic conditions. Cool. So

Ryan Jore 32:35
last major question I had, so you mentioned how, again, initially, your plan was just to be in regular PT, or, I guess, more of a general practice. How has, what did you anticipate pelvic floor physical therapy being like, as far as, like, specializing that, versus how it’s actually been, any differences you’ve noticed? Well,

Stephanie Weyrauch 32:53
initially, I Well, I mean, I fell under that myth of like, oh, well, pelvic floor physical therapy is not that hard. All you have to do is, like, prescribe Kegels to people and that’ll fix everything. And I realized very quickly that that is not the case. And so obviously, I’ve, you know, have done a lot of work over the last 10 years to really try to understand the connection between the nervous system, the digestive system, the musculoskeletal system, and how does that influence how we how we think about our bodies, and how our bodies respond to things? I think another thing that I didn’t really expect is like our bodies can be prepared for birth and birth as women and birth is doesn’t have to be a scary thing. The reason that women, I think, fear birth in this country, is, number one, birth is very medicalized. Number two, we just don’t understand our bodies. You know, we don’t have the opportunity to talk about our bodies. I mean, how think about your mother. Your mother gave birth to you, Ryan, has she ever told you about her birth story? No, yeah. You know, it’s like how? You know, there are so many women that I see that are that I see in pregnancy that don’t even know that they’re going to have postpartum bleeding for weeks on it on end. And even though, think about how many women in this world have gone through birth, it’s because we don’t talk about it. And so I think that I gained a big appreciation for getting comfortable with talking about the body, talking about penises and vaginas and vulvas and uterus, talking about all those things, and not being afraid and talking about sex. You know, sex shouldn’t be painful. A lot of people think that it is normal to have pain when you have sex, especially women, and that’s not normal, and just not. Normalizing those conversations, helping people feel more comfortable talking about that stuff and just letting them you know, letting them know that it’s not a shameful thing to talk about how you feel in your body, even if it’s your pelvis. Because you know, people talk about their knee pain and their shoulder pain all the time, but then their incontinence and their pelvic pain goes left untreated because they don’t feel comfortable even telling their doctor that they’re that when they have penetrative intercourse, that it is very painful in their pelvis Cool. Well,

Ryan Jore 35:36
thank you for coming in today. I think we all learned a

Stephanie Weyrauch 35:38
lot. Well, thanks, Ryan. I appreciate you having me on and if anybody is interested in learning more about physical therapy, I encourage you to check out the American Physical Therapy Association. There’s lots of great information there. My you can check out my website. My website is movement, dash x.com, Billings, dash Montana. And my name is Stephanie wyrock, and I’m on Instagram. You can find me at the staff 21 or on movement X Inc on Instagram. And I hope that you know you found this conversation empowering, and I have full appreciation for you doing this, Ryan. We need more of these podcasts in our community. Awesome.

Ryan Jore 36:21
Thank you again.