SPEAKER_02 0:01

All right. Well, welcome back to Evolve and Wellness Initiative podcasts. We have been a little delayed in getting more out. We apologize for that.

SPEAKER_00 0:10

A little mediatist.

SPEAKER_02 0:13

Well, it's hard when working two schedules to get them to come together. It's a little complicated. Today we would like to talk to you guys about pelvic floor therapy and visceral manipulation and how well they work together. Both of us are external pelvic floor therapy certified, but I do visceral manipulation too. And it has a profound impact on the healing part of everything else connected to the pelvis, among other things as well.

SPEAKER_01 0:51

I think it has a big impact on how well you can work the pelvis and sometimes if it will pick it up. Like if I have somebody with a weak pelvis, I feel like I send them to you. Or if I have somebody with a bunch of scar tissue, I feel like I send them to you a lot because I can't get it to like sometimes I can't get it to pick up no matter what we're doing. I mean, I don't know if they're doing their stuff at home, but I can't get it to pick up, or like the other day I couldn't get a side to release, but uh and the VM helped. Yeah. Um it had to do with I guess the scar tissue, wasn't it letting it release in there? And uh I got one side to release, but not the other, but I mean seven minutes of VM and you had it released, so so it kind of goes hand in hand.

SPEAKER_02 1:36

Do you feel like most of your pelvic floor clients have abdominal scarring?

SPEAKER_01 1:41

Yeah.

SPEAKER_02 1:42

From what exactly?

SPEAKER_01 1:43

I feel like people don't really think about it until they get in pelvic floor, and then they when we do the consultation and we talk about it with them. Um I feel like people think, well, pelvic floor, well, I haven't had an epesiotomy, or I haven't had a C-section, so it doesn't and I feel like most of the time people don't even think about apesiotomies, but they're just like, Well, I haven't had a C-section. I'm like, Well, that doesn't matter. Have you had a DNC? Have you had a hysterectomy, either laparoscopic or vaginally? Have you had a appesiotomy because then you have scar tissue that kind of goes up in?

SPEAKER_02 2:20

Explain a little what appesiotomy is for those who don't know or have never been through labor and delivery.

SPEAKER_01 2:25

Apesiotomy is when you the baby drops into the canal, but they can't necessarily fit, and your pelvis makes enough room, but the musculature and like all the fashion and stuff isn't. So they do go in and cut the muscle in between. Um snip snip, right? To make more room for everything. And then they stitch you back up. Typically, they stitch internally and then externally. Um, but most people don't think about that, but that affects that bulbo spongenosis muscle that kind of goes up around everything, so it affects like bladder leakage and stuff a lot. Um, but people don't think about scar tissue, but from epesiotomies, DNCs. So if you've ever unfortunately had a miscarriage or something and had to have it, you know, cleaned um afterwards, that can cause scar tissue, hysterectomies, whether they're open, laparoscopic, or removed vaginally.

SPEAKER_02 3:21

I tend to see that people think there's no scar tissue with laparoscopic surgeries as well.

SPEAKER_01 3:27

There is. I mean, I worked in the OR. I don't know if I mentioned that in my first episode, but uh working in the OR, I mean, people think it's no big deal because the incisions are really tiny, but they're not always careful or like gentle with everything, and it's still something going in. So anytime you have something go in, it's gonna be scar tissue no matter what.

SPEAKER_02 3:49

Yeah, that's what I try to tell people too.

SPEAKER_01 3:51

And I think people don't think about for pelvic floor how the abdominal cavity scar tissue affects everything too. Like if you've had your gallbladder out or if you've had a lap band or if you've had cosmetic surgery or whatnot. Uh I feel like a lot of people don't think about how that affects it.

SPEAKER_02 4:10

Well, even my breast augmentation clients, they don't realize how that scar tissue there goes down into that abdominal cavity as well.

SPEAKER_01 4:19

I think the worst place to have scar tissue is your pelvic floor or your abdominal cavity because I feel like it's spiders more than anywhere else in the body.

SPEAKER_02 4:28

I agree. Like it's a little bit of a couple of things.

SPEAKER_01 4:30

It's just a big open cavity, so it's gonna go. It's gonna keep keep traveling out because you use it so much. I mean, it's your core, you do everything with it.

SPEAKER_02 4:36

Yeah. Well, how do you feel pelvic floor relates to the average individual?

SPEAKER_01 4:49

I think everybody could use pelvic floor because we've all everybody sleeps funny, everybody, I mean, we live in Kentucky, we get ice, so I mean everybody's falling.

SPEAKER_02 5:00

Any fall, any bike ride, right?

SPEAKER_01 5:03

Yeah. I mean, any kind of car accident, whether you've had kids or not. I feel like if you even have an abdominal surgery, you have your gallbladder out. I mean, that starts the process of scar tissue, then the scar tissue spiders out into the abdominal cavity, and then you know, you have your pelvic flora that connects through the intrinsic core that left helix in the body into your diaphragm. It all connects so much through fascia that I feel like even if you have the least little bit of surgery, it affects it over time. Because I get that a lot. People are like, I'm like, well, we need maybe need to think about some pelvic flora. Well, I haven't had kids. Well, my kid, my pregnancies were fine. Or it's a male, and he's like, Well, that's not for me. But it is.

SPEAKER_02 5:50

Yeah. I think there's a common misconception that pelvic flora has to generally be related to sexual dysfunction or urinary leakage.

SPEAKER_01 5:59

And it doesn't?

SPEAKER_02 6:00

No. It could be hip pain, it could be low back pain, chronic low back pain, the coccyx could be out. There's so many things that affect the alignment of the hips to the spine, which then affect the core, which then affect the shoulders, which then affect the neck. And that's moving upward, that's not even talking about moving downward. So the pelvis is a bowl. So if everything is not contained in that bowl, that bull bowl is tipping forward or backward or side to side, there's going to be a unilateral disadvantage.

SPEAKER_01 6:38

I mean, it's like how the psoas connects, and if you've got that psoas is depressing one side of the pelvis, it also tilts it forward, or then you're dumping all the organs out. So then you're affecting the diaphragm. So then you're people think it's it's not really related, but it is. That whole core is just one piece. Um I feel like everybody that comes through pelvic floor should at some point get visceral manipulation because I mean, like I wish we could start it that way.

SPEAKER_02 7:10

I wish they all came to me for VM first, because VM's 45 minutes.

SPEAKER_01 7:14

Yeah.

SPEAKER_02 7:15

And then transition to pelvic floor because it just makes the transition less intense for them. Like it's not as hard to get into some of the muscle groups, I think, when that happens.

SPEAKER_01 7:29

Yeah, sometimes I feel like uh, especially in that sideline pelvic floor work when I'm trying to like move the tissue to slack the pedundal nerve, like I feel like sometimes I can't get it, and I people usually feel it up in their stomach or like up deep in their pelvis. But I feel like for some people, especially if they've had a lot of surgery, when I try to slack, I feel like I'm fighting and pulling down from the bottom that abdominal cavity. Um, I mean, just like the other day. I feel like it makes it easier.

SPEAKER_02 8:01

Yeah. And you were able to get in there easier, and she didn't have to feel it as much.

SPEAKER_01 8:07

Yeah, it wasn't as painful for sure. Yeah. I feel like there's a big misconception too with pelvic floor um for men. I mean, I've been in healthcare since I was 17, so that's been, you know, when we rode dinosaurs to work, but uh I think that I think that uh there's a big common misconception with men. I mean, again, I've been at EMT, I worked in the OR, did all the things, and like I never knew that you could um work a man's pelvic floor, but they have just as many issues as we do. You know, it affects the prostate, and um, if they've had a vasectomy, that's all kinds of scar tissue. I've had guys that have had prostate cancer and testicular cancer and all that kind of stuff, all that affects the scar tissue in there too. I mean, a vasectomy, you're literally cutting the vas deferens. So, I mean, things people don't think about it because it's so small, but really it changes things in there. Um, or I told a client the other day, I mean, he's had prostate cancer and had it removed, and I'm like, well, now you've created all this negative space and you're not really using those muscles anymore, so sure, everything's weak.

SPEAKER_02 9:25

Yeah. It plays it plays a big part. I feel like it plays a big part in a lot of things. And as a therapeutic office, it would it would kind of be nice to just delve into that and go from there with that.

SPEAKER_01 9:40

I feel like VM also affects I don't know, VM, VM also affects I feel like men differently because they have they have so much external. I know it doesn't make sense an anatomically, but in my mind, it makes sense that when I'm doing pelvic floor with a male, that VM impacts them more because everything's external and everything moves. Like females, we really don't have moving parts, like everything's pretty internal. Yeah, but they've got moving parts, right? Like, so like things drop, things pick up, like all that kind of stuff. So in my mind, it makes sense that they need VM more. And I see that some in pelvic floor because stuff's restricted and it doesn't move as it should. What's the importance of VM, you think? Honestly, to in turn, not just in pelvic floor, but like total, total body.

SPEAKER_02 10:44

Honestly, VM has been a game changer for my practice.

SPEAKER_01 10:50

Um, I've seen you do some crazy stuff with VM.

SPEAKER_02 10:53

Yeah. I'm like amazed, like stuff that I'm shocked by. I'm like, let's just see if this works. Oh my god.

SPEAKER_01 10:59

Every time I'm like, hey, do you have five minutes to come in here with my client?

SPEAKER_02 11:02

I'm like, wow, a unicorn in the wild. And for me, it's the joint.

SPEAKER_01 11:09

Because I just watch you do crazy stuff with it.

SPEAKER_02 11:11

I'm just the facilitator. The body does what the body does. Um, but you know, and there's been documentation that organs hold emotions. You know, your liver is anger, your lungs are grief, I mean, just your stomach's anxiety. Um, all of all of that, whatever is going on in your life, is also affecting your organs. And usually, usually, and typically what I find is a lot of sluggish livers and stuff like that. So with just a little hug with a little support that actually starts moving their whole body to more homeostasis as opposed to recovering. So it's being proactive instead of reactive, and it's allowing healing to facilitate in the body on its own, right? So when you help, when you help the liver, the right shoulder moves better. When you help the stomach, the left shoulder moves better. I've done some crazy stuff with some stomachs and some shoulder stuff. Greater omentum in the lower abdominal that covers all the intestines and stuff. Sometimes there um there's issues with hernias or surgical procedures that happen in the abdomen, whether it's tummy tuck, whether it's C-section, and all of that tissue just sticks together. Like if you melted something in a pot, a bunch of crayons, and you let it congeal again. And that's what it feels like sometimes down there. And and when you get up from the table, you can breathe easier. You feel like things are moving, people are like, oh my gosh, I feel circulation in my legs again. Like I didn't realize um all that was going on. So with visceral manipulation being a part of a manual osteopathic modality, it also has an SER component as well.

SPEAKER_01 12:52

So does pelvic floor.

SPEAKER_02 12:53

Yeah.

SPEAKER_01 12:54

I feel like a lot of people don't realize they are might get emotional during pelvic floor until we talk about it in the consultation part, just because I mean they just think, well, it's just my pelvis, but I mean that's the first place you hold everything, and then your organs affect your pelvic floor, and then they're emotional too.

SPEAKER_02 13:12

Well, I mean, I I without knowing anatomy, right? The pelvic floor connects the upper body to the lower body. Yeah, it has to start somewhere. There has to be a core intrinsic place for it to start. And that's kind of where it starts. And then you add in the organs, you add in the small intestine, the large intestine, you add in uh, you know, the grain omentum, you add in the duodenums and the sphincters, all in the abdomen. Uh all of that is so interconnected through fascia and possible scar tissue from you know any fall or injury that you may have had, that it just makes sense from a body standpoint to do that for me.

SPEAKER_01 13:55

What do you think is the worst surgery that you can have for your abdominal cavity?

SPEAKER_02 13:59

Tummy tucks.

SPEAKER_01 14:00

Yeah.

SPEAKER_02 14:01

Tummy tucks.

SPEAKER_01 14:02

Because I think it's the worst for your lower back and pelvic floor, too. Lower back.

SPEAKER_02 14:06

Lower back because my my tummy tuck clients, they they tend to have a lot of lower back issues after that. Now it is better if you can if you can heal the scar tissue and soften it and keep the scar tissue at bay. They tend to do better that way. But the you know, the research wasn't out there that this was a problem till much to much later, till now, really. Last couple years, they're starting to see where the scar tissue affects other things.

SPEAKER_01 14:36

I think it's I think it affects um the work we do as well, because I think with tummy tuck clients, especially if it's been stretched downward quite a bit, it's very, very hard to work the psoas, which is a huge mover in the lower back for lower back pain. Um and I think that it it just makes it hard to get in there to move the organs out of the way to get to the psoas. So I don't feel like I get as good of a release in there anymore.

SPEAKER_02 15:12

Yeah, and that's that's where the VM comes in because you can kind of soften that area a little bit, which doesn't take away the tenicity of the stomach, just so we're clear. Yeah, it just softens this the stuff so that where it should be softened so that we can perform the work to get you the best quality of service that you came in here for, because obviously we offer the best quality service for quality of life, right?

SPEAKER_01 15:37

Yeah. Wow. Um I like that the I don't know how to say it, Barral, Barrel.

SPEAKER_02 15:46

Barral Institute.

SPEAKER_01 15:47

Barral Institute. That's the like governing institute of the visceral manipulation. We posted a thing back in February that uh there was a 2025 study published in the Journal of Clinical Medicine that found that five weekly sessions of VM significantly help improve quality of life in women with endometriosis and pelvic organ prolapse. Uh, it also they did another study, and it also uh brings up the quality of life and postural stability in women with endometriosis as well. Um I think it just goes hand in hand.

SPEAKER_02 16:24

Yeah, it's it's been so fascinating, and I can't wait to explore more avenues of that next year. I think we're booked out on continue ed this year.

unknown 16:34

Yeah.

SPEAKER_02 16:34

I'm thinking I'm gonna add some more visceral manipulation stuff next year because it's just been so fantastic for every client who gets it.

SPEAKER_01 16:42

We have like a we have like a 12-hour requirement, and me and you have 12 hours of continue ed by like you know, the second week of January every year.

SPEAKER_02 16:50

So Yeah. Well, I mean, if we're not learning, we can't bring it here and help people, so yeah. That that's what makes the most sense to us.

SPEAKER_01 16:58

How do you work with the lymphatic system in the in the abdominal cavity?

SPEAKER_02 17:03

I mean, just that's what happens with the visceral manipulation, so it just opens everything up, and sometimes I'll even throw in some craniosacral therapy just to help settle the CNS, the central nervous system, so that the dural tube and the cerebral spinal fluid moves more freely, which then kind of puts your body in that in that not heightened anxiety-ridden state that it was in, which then also allows your body to heal. Because if you're high anxiety all the time because of stress, because you sat in traffic, because I don't know, your kid left his underwear on the floor, whatever it is that puts you into that heightened state, this the perennocral helps rebalance that out, settle the nervous system, and then at that point you can digest food better. Visceral manipulation softens everything, so you can digest food better, right? What happens when your central nervous system is able to digest food better? You get more and better absorption, your colon works better, you're able to go to the bathroom easier, you're absorbing your nutrients easier, like there's just a whole systemic profound effect on the body when you combine the two.

SPEAKER_01 18:17

I feel like you probably impact the, like looking at it from a lymphatic standpoint, you probably impact inflammation in the abdominal cavity and the lower extremities quite a bit with VM just because of where everything is. So, I mean, deep in your abdominal cavity, you have the cisternic alley that's your largest lymph collector. So for us in lymphatics and lymphedema work, if you act if you have somebody with lower lower extremity uh lymphedema or swelling, or you have it in the abdominal cavity or the pelvic region, once you activate that cisternic alley, it's kind of like a vacuum, so it sucks it up out of there. Well, it helps too. You have to push it, but um I feel like you probably inadvertently do that when you're working everything too.

SPEAKER_02 19:06

Well, yeah, but also like it helps with so you I can help with acid reflux too. So with esophageal tube that meets the stomach right in there, like it helps it helps that part of the lymphatic system as well. So I mean you're getting overall benefits, and for most people it's pretty comfortable work for the most part.

SPEAKER_01 19:26

Yeah. Um I think the biggest, other than pelvic floor, the biggest thing with my clients that you've worked on is I mean, who doesn't know somebody who takes mirrors every day to go to the bathroom? I mean, that's not people think, oh, that's normal, or your doctor will tell you, you know, just take Murilax and it'll be fine. I mean, that's not really normal that you're not really getting a good like emptying of the intestines. Uh, and a lot of people can't go, whether they it's a pelvic floor thing and they have to get like positional and stuff, or they just can't go for whatever reason is blocked. I think that's the been the biggest thing other than pelvic floor with my clients with you is just getting people to regularly go to the bathroom without having to take mirrorac every day or take an enema or something.

SPEAKER_02 20:13

And if you do your research on Muralax, it's not safe, especially for prolonged use for the body. So, really, you know, part of my conversation is, and you've heard me say this, is changing your diet. Drink more water, eat more fiber. So those things will also create uh just the natural urge to go to the bathroom, just increasing that, which would then keep that whole lower lymphatic system working.

SPEAKER_01 20:41

I think um I think I think the osteopathic approach is pretty cool, especially with VM and craniosacral. I mean, I've seen you do crazy stuff with craniosacral. I mean, my daughter had a uh tongue tie, a cheek, no, two cheek ties and a lip tie, or was it a tongue tie? I can't remember. It's been like three years now.

SPEAKER_02 21:03

Uh no, I think it was a lip. I think it was lip.

SPEAKER_01 21:07

Lip tie and two cheek ties, I think. And they wanted me to cut it, and I took her to the I took her to the uh tongue tie specialist, pediatric tongue tie specialist, and um that doctor told us that without Christina that we would have been in PT with a helmet and had to have it cut, but you did craniocral as soon as she came out of me, as soon as she was born.

SPEAKER_02 21:32

Yeah.

SPEAKER_01 21:32

Literally, like minutes, and um we didn't have to have it cut. And she's she's fine. Her uh oh my gosh, what's the word? Her the back of the head.

SPEAKER_02 21:46

Occiput?

SPEAKER_01 21:47

Yeah. I was like, why couldn't I not think of that?

SPEAKER_02 21:50

That's okay.

SPEAKER_01 21:53

Um I mean they were worried about how the sinuses would form and how her head shape would be in the occiput. And all that stuff, and it's fine. I mean, the pediatrician said it was fine and it was good. And literally the only thing I did was I mean, you do craniosacral on her all the time.

SPEAKER_02 22:09

So uh that is what I love about babies. I want my hands on them as soon as soon as they're born, as soon as I could possibly get my hands on them, because the sooner you do that, the more changes are prominent and immediate. They're prominent and immediate, meaning that they they they already go into that. I mean, they're sleeping so much, so they're healing while that's happening, and then everything else forms correctly, right? So if there is a tongue tie or cheek tie, then that's gonna affect how they suckle. Are you gonna need a nipple shield? Are you not gonna need a nipple shield? Are they even gonna be able to breastfeed? Like it plays a big part in all of that. And I mean, I love I love the baby part of it because the results are just so immediate.

SPEAKER_01 23:02

I think, I think uh all the work you do with babies is important for later in life with pelvic floor too. I have this like, I mean, this is I don't know if there's any research out there on this, but I have this dumb theory that like how you're born affects your hips later. I feel like some people have like pelvic dysfunction from the way they come out, right? Because, you know, everybody knows somebody that their doctor waited too long and the baby got stuck, and then we're in an emergency C section. So we've been pushing, pushing, pushing, shoving, pulling, doing all this stuff. And babies are babies move a lot, you know, they're kind of rubbery, but I don't know, I feel like how they lay matters, and then how they're born matters, and how they're pulled out matters, and then if you don't if you don't really do anything, you've pulled on their body, you've done all this, and then they just grow up, and they, you know, you get a little more solid as you grow. So I feel like that just kind of sets things sets things off going forward, and then people are like, Well, I don't know why my 12-year-old has lower back pain. Well, I mean, how were they born? I mean, what's their life been like?

SPEAKER_02 24:14

Well, I mean, they it just takes one torque of that neck to get the baby out of the baby's neck for it to create a fascial strain into the shoulder, into the opposite shoulder, you know, or into the hip, and then they're not digesting their food properly, right? And then they won't turn to the right or they won't turn to the left. They maybe have torticollis. Like it just it's a because they're so little and so fresh that it takes one pull, one wrong pull of pulling that baby out to create that fascial pattern, which is why I think there should be more more pediatric cranial sacral therapists to help with that.

SPEAKER_01 24:51

Yeah, Harlan had that when my son, when he was born, he couldn't turn his head to the left. He always kept it to the right.

SPEAKER_02 25:00

Um, but I mean And he was born vaginally, where Mahela was C-section, right?

SPEAKER_01 25:04

Yep. But I was induced with him, so it was very a very long process. Oh yeah, I forgot about that. Very rough process. And then uh all the pushing and stuff like that. I mean, I pushed for quite a while and then he had the probe and all that kind of stuff in there as well, and he couldn't turn, and you fix that with I mean, immediately with the craniosacral and baby massage.

SPEAKER_02 25:29

Yeah.

SPEAKER_01 25:30

So pretty cool.

SPEAKER_02 25:32

Yeah, they all tie together. So start start taking care of them when they're young, and then they have better function of their bodies as they get older. So, you know, they compete better at sports, they grow better, um, they move better, they have less issues, wear and tear issues overall, and their immune system is typically stronger, so because it affects that as well.

SPEAKER_00 25:55

Yep.

SPEAKER_02 25:58

Well, just a reminder that we're not here to treat, diagnose, or give you medical advice. We are here for informational purposes only. So please know that going forward, we're not telling you what to do or telling you how to do it. We're just here to give you advice and share stories of what happens in our practice.

SPEAKER_00 26:20

It's alleged for legal purposes. For legal purposes, especially if your story's about us.

SPEAKER_02 26:25

Yeah, yeah, that too. But please feel free to reach out to us on email or when you're in the office if you have additional questions. We'd love to be able to answer them for you.

SPEAKER_01 26:35

So we have a Facebook page too. Evolve a wellness initiative. You message us there.

SPEAKER_02 26:40

Evolve a wellness initiative. Perfect. All right, see you soon. Bye y'all.