The Pelvic Studio : thepelvicstudio.com

Hannah:

Welcome to the Burn Pod, listeners. Now we’re really excited to get stuck into today’s episode, which I know will be an educational, informative and interesting discussion. We’re very lucky to have Jaclyn Thurley, founder and principal physiotherapist at The Pelvic Studio, which is a physio-therapy practise with expertise in pelvic floor for both women and men. So welcome, Jaclyn.

Jaclyn Thurley:

Thank you for having me, Hannah.

Hannah:

Thanks so much for your time. Now, so our listeners can get to know you a little bit more, tell us a bit about yourself. What got you started in this area and if you’ve got any passions, let us know.

Jaclyn Thurley:

Yeah, exactly. So I’m a physiotherapist that is subspecialized into the pelvic worlds, or pretty much anything below the waist and above the thighs. And how I got into this area was through personal experience. So when I was 20 or maybe 21 and I was at university, I was going for a run and there was a little divot in the ground that I didn’t realise was there. And I jarred my hip and I think I gave myself a little labral tear, which is a little ligament in the hip, and started to get hip pain. And then after getting hip pain, started to get pain with sex and it was all very connected.

            And when I went to say an amazing physio who eventually gave me a job, which was great, she fixed my hip, but she also fixed my pain with sex. And it just made me really interested in the connection between the outer muscles and the inner muscles. So that is how I got into the pelvic health world and started off as a hip pelvic girdle physiotherapist that had an interest area in that, and then went back to uni and did a few extra degrees and now I’m a pelvic health physio.

Hannah:

That’s amazing. And you never would think that if you tear something on the outside, it could affect you on the inside. That’s quite fascinating.

Jaclyn Thurley:

Yeah. It is, isn’t it. You treat one and the other gets better.

Hannah:

Yeah, that’s pretty crazy. So tell us a bit about The Pelvic Studio. So you started in the area. What got you started or what got you founding The Pelvic Studio?

Jaclyn Thurley:

So I’ve worked in Hobart, originally, but then I went interstate and worked interstate for most of my late twenties and got lots of good experience working with some really good pelvic health physios and working alongside some really good specialists and GPs. I always wanted to come back to Hobart and I always wanted to start my own practise because I had this image of this holistic service that was really comforting and welcoming and made pelvic health fun rather than a horrible, daunting experience. So I moved back to Tazzie late 2019, pretty much opened The Pelvic Studio the week before Christmas in 2019. That’s just how it worked out, stupid. And then we shut down for a couple of weeks over Christmas. So really we started 2020-

Hannah:

Which is perfect timing for COVID.

Jaclyn Thurley:

Well, then three months later, COVID, but luckily, COVID didn’t affect me much at all, which is interesting because there’s just so many pelvic floors to help, so that was good. But yeah, so The Pelvic Studio is a physiotherapy practise that has a special interest in pelvic health, so that can be pelvic girdle pain, hip pain, pelvic floors, anything to do with the pelvic floor, so bladder, bowel, sexual function. We see a lot of pregnant and postnatal women. And we also see a lot of men and it’s very important to know that men can have issues as well, not as common as women, but men do tend to have issues as well, so it’s good to help them.

Hannah:

Yeah. I mean, when you do think about pelvic floor, it always comes back to women and pregnancy, but we’ve also got three branches in our pelvic floor. Men have only got the one, don’t they?

Jaclyn Thurley:

Well, they’ve got two.

Hannah:

Yeah, two. Yeah.

Jaclyn Thurley:

Their urethra and rectum runs through, whereas with women, we’ve got urethra, rectum and vagina. But I see a lot of men pre and post prostate, but also a lot of young really, really fit men tend to get issues because I think of pelvic floor tightness. So yeah, we like to see women and men and also of all ages, so it’s a really good mix.

Hannah:

Yeah, cool. And I guess when you think about pelvic health, like I mentioned before, and pelvic floor for women, the first thing that does pop into our heads is pregnancy and post-pregnancy. So I guess it’s a bit of a running joke that we have when it comes to star jumps for the ladies to choose other options, if they don’t actually quite trust their bladder.

Jaclyn Thurley:

Yes, yes.

Hannah:

Are there ways that we can help strengthen or look after our pelvic health before we’re even considering pregnancy?

Jaclyn Thurley:

Absolutely. And what’s so exciting is I’m seeing so many more people coming in are women coming in pre-pregnancy saying, “I’m thinking about starting a family. I want to get on the front foot and I want to have an assessment and see where I’m at and what I need to do to optimise my pelvic health in preparation for pregnancy.” And that is literally the best way to go. That is the ideal way.

Hannah:

Because everyone’s pelvic floor is different, isn’t it? Everyone’s in a different position and if they do different things in their life, so we can’t say that one size fits all in of your approach to looking after your pelvic health.

Jaclyn Thurley:

Exactly. And we also know from research that queuing someone to turn on the pelvic floor is not overly helpful if they’re not sure how to do it properly. So a lot of women incorrectly contract their pelvic floor when asked to do so. So it’s important that women come in and just make sure they’re doing it right because it would be terrible to waste your time if you do start to do some pelvic floor exercises pre-pregnancy or during a pregnancy, and you’re actually wasting your time or even worse, doing more harm than good. So it’s important to know how to do the contractions correctly. And as you said, every pelvic floor is different, so it’s good to get an individualised programme.

Hannah:

Mm. Yeah, exactly. We’re lucky. Just before this podcast, we had the Women’s Health Education Network here.

Jaclyn Thurley:

Oh, yes.

Hannah:

And we were talking, pelvic floor is a big part of what they do as well. The key out of that was get yourself assessed because everyone’s pelvic floors are different.

Jaclyn Thurley:

Yeah, exactly.

Hannah:

Now, are there main issues that you see that people have before they even consider pregnancy with their pelvis and their pelvic health?

Jaclyn Thurley:

Well, we have really good guidelines to grade A recommendations that continent women, so women pre-pregnancy that have no bladder issues, should have a pelvic floor assessment to help prevent the common issues that occur in pregnancy and postnatally, especially if you do have some preexisting issues. So say for instance, you’re a young woman who hasn’t had children yet, but you tend to go to the toilet a little bit more often than your friends and family, so you might have what we call bladder frequency, where you tend to go more often. That might prompt you to definitely come in for an assessment to work on that because pregnancy is probably only going to exacerbate that problem because people that don’t have any pre-existing bladder frequency issues tend to get them in pregnancy and it can be quite annoying. If you have any urgency issues, so where rather than a gradual buildup, that you need to go to the toilet to empty your bladder, it hits you like a freight train out of nowhere and you’re busting for the loo.

            So if you have any issues with that, I would definitely get yourself to a pelvic floor physio before falling pregnant and leakage episodes. So that’s not just a thing that happens after children. You can have issues with leakage with exercise, cough and sneeze, laughing, whatnot. That might be an extra motivator to go get your pelvic floor checked. The other thing is good bowel health, so constipation and straining, because the other thing that happens in pregnancy in many of my patients is they get super constipated. And so if you have preexisting bowel issues, it’s good to get your bowels regular and soft before falling pregnant.

Hannah:

And you don’t really think about that or it’s not the sexiest thing to talk about, is it?

Jaclyn Thurley:

I talk about it all day long.

Hannah:

So how early should you, if you are thinking about having a family or starting a family, how early should you go and see someone? Is it literally as soon as you can?

Jaclyn Thurley:

Yeah, definitely. I think especially if you’ve got a couple of those issues we just described or any preexisting back-hip issues, then I would pop in to see probably physio just to see if there’s a pelvic floor contributor to your back and hip issues, but also to optimise your bladder and bowel. So that could be as soon as it’s on your radar, you might be wanting to have kids in a couple of years, but you might pop in to get an assessment to see where you’re at. When you pregnant, we tend not to do an assessment in your first trimester, but at 12 weeks we highly recommend coming in and getting an assessment, the earlier the better. It’s never too late. Sometimes I have patients coming in their third trimester for a pelvic floor assessment and that’s completely fine, but ideally at that 12 week mark would be perfect.

Hannah:

Yeah. Yeah. What are the main issues or focus areas you see during pregnancy? Is there any way that we can reduce potential issues there?

Jaclyn Thurley:

Yeah. Well, in terms of the very common issues that tend to happen in pregnancy and can be as early as the first trimester, six to eight weeks, you could start to notice some changes in your bladder, so going to the toilet more often, it being a bit more urgent, especially going more often at night time. Sometimes that can be a sign that you’re pregnant is if you normally sleep through the night and then you start getting up twice a night, you’re like, “What is going on?” That could actually be a sign that you’re pregnant. So in terms of urinary incontinence, that’s very common. One in two women experience leakage during the pregnancy. And what often gets fed back to me is patients that are pregnant that have leakage might tell people that they’ve got some leakage. They might tell health professionals that they’ve got leakage and they get told, “Oh, that’s normal in pregnancy. Don’t worry about it. It’ll go away once you’ve had the baby,” and that is not true.

Hannah:

You’re right.

Jaclyn Thurley:

Even though it’s common, it’s not normal and it is a predictor for issues postnatally. So we want to get onto it ASAP. We don’t want to leave it until after you’ve had the baby to manage it.

Hannah:

Yeah. So get in early. Is it a good idea to have regular checks throughout your pregnancy with a pelvic specialist?

Jaclyn Thurley:

Well, it depends. So sometimes I might only see someone once and give them the green light and then usually we’ll catch up again at the six-week postnatal mark to do another assessment. It would just depend that initial assessment and if there’s anything that pelvic floor physio finds that they want to follow up on. But no, sometimes it’s just the once.

Hannah:

Yep. Yep. And are there so that we can strengthen and manage pelvic floor health after pregnancy? Because I mean, your hips have to widen to get this baby out of you and your poor pelvic floor is been stretched to muckery.

Jaclyn Thurley:

Yes, yes.

Hannah:

How can we manage this and what do you generally see as the standard, I guess, recovery for people post-pregnancy?

Jaclyn Thurley:

Yeah, exactly. So usually we catch up at about six weeks after you’ve seen your antenatal team for a follow-up postnatal assessment and we check your posture and alignment. We check your abdominal wall because your abdominal wall recovery can have a huge impact on your pelvic floor health recovery. So they’re very interconnected. So we check your tummy, we check your pelvic floor and we usually get you started on some very specific exercises because it’s not… In terms of the recovery of your tummy and your pelvic floor, it’s not six weeks. It is literally more like 12 months. So we do pelvic floor. We know it usually takes about six to seven months for that muscle to strengthen back up, thicken back up, and with the abdominal wall, it can be even longer than that. So it’s a bit of a long process and it’s nice to get some guidance on how to optimise your recovery and hasten your recovery of those muscles.

Hannah:

Yeah. And it’s nice to be told by a professional, “Don’t expect to be back to how you were in six weeks or three months. It is a process, so take that pressure of yourself.”

Jaclyn Thurley:

Absolutely. And I think that expectation, so giving those kinds of timeframes and managing expectations is really important because these kinds of things can get women down and it’s important to trust your body’s process and the amazing healing process that your body can go through. But give yourself time. Don’t rush back into things too quickly. But in saying that, exercise is the best thing for your body and building up and progressing your exercise is so important for that recovery of those muscles.

Hannah:

Yeah. Are there any forms or any movements that you would suggest people will need to be really mindful of post-pregnancy like deep squatting, big weights, that kind of thing?

Jaclyn Thurley:

Yeah, exactly. So in the first six weeks, I would focus more on movement and activation and not going too deep into squats and lunges, not doing heavy core work and then gradually building up more to strength and conditioning type things, so heavier weights, heavier bands, adding in some core work and obviously doing your pelvic floors every day. And then in terms of more of that high level stuff, so your jumping, star jumps, which you mentioned before, running and things like that, even if everything’s going really well, you’ve got no symptoms, you’re really happy with your recovery, we tend to recommend waiting the 12 weeks until you start the return to running and the return to jumping. Because usually from that six week mark to that 12 week mark, you’re doing a lot of strength and conditioning work and gradually building up your body’s strength to get to the stage where you’re feeling ready to return to things like that. But to be honest, sometimes it’s a lot longer than that. It can be six to nine months. Everybody’s so different and that’s why sometimes it’s really important to get that individualised assessment.

Hannah:

Mm, exactly. And for those that are really keen to get back into their cardio, there are different forms of cardio other than running or high intensity interval training, those impact jumping stuff that you can do. I mean, you could get a stationary bike. If you’re comfortable, you could swim. I assume potentially even boxing without jumping around.

Jaclyn Thurley:

Absolutely. Boxing, I love, for the abdominal wall. That’s such a good one and you can slow it right down and focus on pre-engaging your pelvic floor and deep core. Also just to set a light dumbbells and some resistance bands and off you go and you can really get the heart rate up. So you can turn more of a Pilates style workout into a cardio workout by adding some pace and things like that. So you can definitely have some low impact options in that first 12 weeks.

Hannah:

Yeah, exactly. I guess, let’s move a little bit away from specifically pregnancy and I’m wondering if we could talk about pain associated with the pelvis and how we can identify this and what we do about it, if that’s okay.

Jaclyn Thurley:

Yeah, definitely.

Hannah:

I know one of the… When people talk about, “I’ve got pelvic pain,” I guess we could talk for forever about the options that could be occurring for pelvic pain, but are there some standard or some regular things that crop up when women talk about pelvic pain?

Jaclyn Thurley:

Yeah. So I suppose the important thing is the definition and being funny about the words. So pelvic girdle pain is different to pelvic pain. So in terms of pelvic girdle pain, we’re talking more about pain on the outside of the pelvis, so that could be at the back of the pelvis between the bottom muscles where the sacroiliac joint is, so what we call SIJ pain. So that pelvic girdle pain, very, very common in pregnancy. Tends to go away after having the baby, but you can also have it at any stage in your life. And you’ve also got pelvic girdle pain that can happen at the front of the pelvis, just below the bladder at the pubic bone or the pubic symphysis. So that’s quite common in pregnancy as well. And then pelvic pain is more talking about internal pain, so pain with sex, pain at the entrance of the vagina, pain with bladder filling, bladder emptying, pain with bowel filling, bowel emptying or pain in the lower tummy. So they’re slightly different, I suppose, umbrella terms for pain.

Hannah:

Yeah. Are there sort of key issues that create that pelvic pain, so that pain with sex or with urinating?

Jaclyn Thurley:

Yeah. So there can be issues with the pelvic floor muscles. So sometimes the pelvic floor can be too tense. So I know that it’s quite common knowledge to hear about the weak lax pelvic floor, but just like any other muscle in your body, your pelvic floor can become two tense and it can be strong and tense or it can be strong and weak. And that can contribute to both pelvic girdle pain, so pain on the outside, and also pain on the inside. And then it’s not just about the pelvic floor, it’s about the whole system. So if you’re looking at the stability of your body, so how good your core stability is, how good your glute strength and stability is, even as far down as your ankle, maybe you’ve had multiple ankle rolls and possibly your ankle is contributing to your pelvic girdle pain. So yeah, it’s quite broad.

Hannah:

Yeah. And does that associate up into the back as well and around the whole hip area?

Jaclyn Thurley:

Absolutely. It can go high and low. And what we also know is most people have a couple of things going on. So they might have back in pelvic girdle pain and also have bladder leakage. It’s very common to have both. And so, yeah, it’s very important to look at the body as a whole and assess things and get started on a management plan, which is usually a combination of strength and conditioning work and some stretching and some pelvic floor rehab.

Hannah:

Yeah. And for those that don’t have any underlying or they don’t have any issues that they notice at this time, so you’re generally feeling pretty healthy, are there ways that we can just, or things that we can do, just to keep an eye on our continued pelvic floor and pelvic health?

Jaclyn Thurley:

Yeah, exactly. So it is ideal to do some pelvic floor exercises, if you’re sure that you know how to do them properly. So that’s one thing. The other thing is to keep good mobility in your hips. So if you tend to be someone who is quite a stiff person, keeping good mobility through your hip joint is amazing, not only for your pelvic floor, but also for your back. So having a little regime of stretches is always a good idea to do a couple of times a week or ideally daily. Yep. And twice a week strength and conditioning, so just general strength, stability work. Often a little bit of single leg balance work is always good and getting your 150 to 300 minutes of cardio is a great thing to maintain your pelvic and back health.

Hannah:

Yeah. Yep. There you go. So if our listeners want to find out more about The Pelvic Studio, how do they do this?

Jaclyn Thurley:

Well, they can visit our website at www.thepelvicstudio.com. We also have some social pages, so at The Pelvic Studio. We’ve got a Facebook page and an Instagram and feel free to give us a call or send us an email, if they have any questions. We often get emails going, “These are my symptoms. Are you the right people for us to see?” And we’re often like, “Yep. You’ve found the right place.”

Hannah:

Yep. So guys, what we always suggest, and like we said at the start of this podcast, go and get your pelvic floor and your pelvis seen, so they can find a plan for you that’s specific to you. And if you do have any concerns, definitely reach out to the professionals. Jackie is fantastic and she’s got a brilliant team around her, so definitely reach out to her with any concerns.

Jaclyn Thurley:

Ah, thank you.

Hannah:

Well, thanks so much for coming on the pod, Jac. It’s been such an insightful and educational conversation and I’m sure, as always, I could talk to you forever about things. We could go deep into one topic, but I really appreciate your time.

Jaclyn Thurley:

Pleasure. Thanks for having me, Hannah.

Hannah:

Thanks very much. And for our Burn listeners, until next pod, have a fantastic day.

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