Tend and Befriend
Tend & Befriend – The Podcast for Pregnancy, Birth & Beyond
Hosted by Deborah the Doula, a birth professional with over 20 years of experience, Tend & Befriend is your go-to source for evidence-based insights, real birth stories, and expert advice. After two decades in the birth world, I’ve learned a thing or two—and I want to make sure you have access to that knowledge.
Join me as we dive into the topics that matter most during pregnancy, birth, and postpartum. Whether you're preparing for labor, navigating new motherhood, or reflecting on your own birth journey, you'll find support, wisdom, and connection in every episode.
Let’s learn, laugh, and grow—together. 💛 Listen now!
Tend and Befriend
Pelvic floor health with corey ireland
"Let us know what you think about this episode"
Pelvic health physiotherapist Corey Ireland shares her expertise on the myths, misconceptions, and transformative potential of pelvic floor therapy for women, men, and children of all ages. Through her compassionate approach of meeting people where they are and "nudging" rather than pushing, Corey explains how pelvic health impacts everything from pregnancy comfort to postpartum recovery and even cardiovascular wellness.
• Pelvic floor physiotherapy doesn't always require internal examination—treatment plans are individual and based on comfort levels
• Pregnancy should not be painful—discomfort signals imbalance that can often be addressed with proper support
• Leaking after childbirth or with aging is not normal and should be addressed, not accepted
• Pessaries aren't just for older women but can be used like "knee braces" for activities and to help with tissue remodeling
• Men's morning erections serve as vital signs for cardiovascular health, with changes appearing approximately nine months before other cardiovascular changes
• Lactating mothers experience "genitourinary syndrome of lactation" similar to menopausal symptoms due to reduced estrogen
• Being proactive with physical activity before pregnancy creates a foundation for better pregnancy, birth, and postpartum experiences
• Booking a pelvic health assessment before your six-week postpartum checkup can help identify issues to discuss with your OB/GYN
Contact Ireland Physiotherapy in Kingsville at 519-733-1010 or visit www.irelandmpt.com for more information about their services.
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Hey Mamas, you're listening to Tend and Befriend, a podcast about women's mental and physical health. This is Debra. I'm a mom of two, a labor and birth coach and birth advocate, a health professional, and today I'm your host. Let's dive into today's episode. Any information you hear or that is suggested or recommended on these episodes is not medical advice. Welcome back everyone Today on the show. I am so excited to welcome someone that I have wanted to have a conversation with for a very long time. I like to refer to her office often and I trust her fully with my patients and clients. Corey is a pelvic health physiotherapist working right here in our community at Ireland Physiotherapy, and she's the founder and if you've ever heard me talk about the importance of pelvic floor support, chances are I've mentioned her before. Her clinic has been such an incredible resource, not only for my clients, but for me as a fellow practitioner who values collaborative care. Corey, thank you so much for making time for me today. I know that your schedule is incredibly busy. Welcome to my podcast.
Speaker 2:Hi Deb. Thank you so much for that lovely introduction, and I'm so happy to be here chatting about all things pelvic health. It's something that I'm so passionate about, and I think that women, as young as even girls and teenagers, through their family planning journey and even through menopause, deserve to have optimal pelvic health. So thank you so much for giving me this opportunity to chat with you.
Speaker 1:I was reading about the children and I had forgotten that I've referred a child to you before. But that very important part that I don't talk about a lot because I work with women, in a certain stage I had remembered that you work with children and even young kids, right yeah?
Speaker 2:Typically kids around like age five, six about the youngest that we would see but kids have pelvic health too. So as a mom of two young kiddos, I can appreciate the frustration in trying to get support for our kids and I am very grateful to support families in helping their kids have good pelvic health too.
Speaker 1:I want to backtrack a little bit and talk about your credentials, because as I was reading some stuff about you years ago, I remember reading all this stuff but not fully understanding one of the special credentials that you have. So can you tell me about some of your credentials and that one that makes you a little bit more special here in Windsor and Essex County?
Speaker 2:Yeah, I didn't realize it.
Speaker 2:At the time, I had a great experience at the University of Western Ontario getting my master's in physical therapy. However, physiotherapy school makes you safe. It doesn't necessarily make you a good physio. So upon graduating, I wanted more skills. I wanted more structure to get more skills, and an avenue to do that was to get a diploma in manual manipulative therapy. So there's two avenues to do that. It's through kind of part-time over a number of years, through a diploma, or you can also do it through a second master's. So I did the diploma program and in 2015, I became a fellow of the Canadian Academy of Manipulative Physiotherapists. There's only a handful of us in Essex County. I wish there were more. I'm happy to support physios coming up and wanting to get that designation because I do really believe it supports quality physiotherapy care. I'm a very proud F camp and a guest step. I do believe it helps me support my pelvic health population in a very special way.
Speaker 1:So thank you for bringing that up, yeah that's really cool and I think my daughter's heading into that path of kinesiology, not really sure what she wants to do with it yet. She has different avenues thought out. But I guarantee you that's not something that is thought about is that once you're done as a physiotherapist, you can think about specializing. But what makes you not necessarily unique? It does make you unique, but that wasn't really the goal. It was about learning more skills to support.
Speaker 2:Thousand percent and just stronger clinical reasoning skills and being able to identify different functional or clinical problems in your patients and being more efficient and achieving their goals for them.
Speaker 1:Yeah, changing the way that you look at the body and the way that you assess a dysfunction. That's right, all right. So tell me a little bit why do you do mostly pelvic floor physiotherapy in your clinical practice?
Speaker 2:I am stuttering because that is what the community has dictated. So I love my ortho skills. I'm happy to continue to use them in exclusive ortho kind of practice. But the community has spoken and, yes, I am primarily pelvic health right now.
Speaker 1:Yeah, it's interesting because, as you know a little bit about me as well, that kind of happened to me too, and then my pregnancy and postpartum clinic got so busy that I wasn't able to take on regular care clients. I can't put a treatment plan into place because the clinic is very busy, so I got pushed into that a little bit, which is fine. I still get to do my deep tissue once in a while and get my hands on an athlete once in a while, but very rarely. So the community has spoken, and now you work mostly in pelvic health.
Speaker 1:Yes, that's correct, all right. So what was it when you were studying, or did you do that specialty of pelvic health after?
Speaker 2:Yeah. So again, this was never my path. I had a very good friend, or have a very good friend from physio school and she was going to leave physio. She was getting frustrated with certain things and she found pelvic health and she spoke so highly of what she was doing and she just felt so fulfilled. There was a local OB who has some UK training, so anyone in the pelvic health world knows that the UK and Australia are leaders in pelvic health, so he was an advocate for pelvic health.
Speaker 2:Admittedly and I shared this with some of my clients that feel more vulnerable when they come to see me I was mortified by the training process and I was not ready. But, fast forward, I had a baby and I was ready to rip the band-aid off and do it. So it was just a combination of Erica just speaking so highly of what she was doing and then again having this OB locally saying we need this, take this beyond the superficial level and let's get deeper into it. And the ball got rolling and here we are, level and let's get deeper into it.
Speaker 1:And the ball got rolling and here we are. That's amazing. I actually love that. Some of the encouragement came from an OB, like how important is that to know? That's right, right. The majority of us birth workers or postpartum workers or body care workers that work on women during pregnancy and postpartum we don't really see a lot of a collaboration with OBGYNs, and so to hear that they're supporting this is really important to know. Yes, and it's exciting, yeah, exciting. It gives us hope and makes us look towards the future. So what is the one thing that you love about working in this field? Obviously, you're in body care, you're in health care, you're in a clinical practice. What is it that really feeds you, that helps you continue? Because we all have our whys and my why is big, but there's always something that gets me hooked back in, even when I'm struggling with my schedule playing Tetris, as you said earlier this morning, you know there's something that always feeds me in this part of my business. So what is that for you?
Speaker 2:It's connection. So when I'm speaking to the women that I see the ability to connect with them. They're coming to me for help, but it's a mutual relationship. It is so fulfilling to be able to meet them where they're at and take them where they want to go, and to develop that relationship. These women aren't just my clients. They do leave a piece of them with me after we are all done, and that that keeps that engine revving for me.
Speaker 1:Yeah, that's beautiful. I love that, Thank you. You talked a little bit about you weren't ready for the training and I'll be honest with you, I do refer to pelvic floor physiotherapy every single day and I do find that I either get this like blank look or this, this, what do you mean? And I get it. I totally get it. The first time I heard about it, my sister was having it done. I was still in school studying massage therapy and I said to her that's not allowed. But when my sister told me years ago, I was like no, that's not allowed. And then that kind of put me on that path. That's when I first started learning about it and that's 22 years ago. So I'm trying to ask what does your typical day look like? Because I'm sure there's a little bit of hand-holding through the beginning of it or when you meet people? What does the typical appointment look like, I should ask.
Speaker 2:It depends. So it is really important that I'm meeting people where they're at. I constantly use the word nudge all day long, right? So I'm meeting people where they're at and nudging them. We're meeting tissue where it's at and nudging it. So an internal exam is always an option. Okay, my clients always get to tell me, no, yeah, and I do have other skills and we do have other ways to address their concerns, their skills, and we do have other ways to address their concerns. I often, then, will throw an asterisk on that comment and say, as our relationship develops and we have more trust, if we're not seeing the change that we want to see, at that point I may ask again if we can do an internal, if we can do an internal so that I think that letting that relationship organically develop is really important. If somebody is going to be really guarded that's going to mask and bias and influence our findings in an unhelpful way, yeah, so pushing something that someone's not ready for don't find is helpful.
Speaker 1:Yeah, and that's not how you practice. I love that. This comes back to something that I'm really struggling with teaching right now and that is informed consent and really what that embodies. That's right. Yeah, I love the word nudge. I think that in massage therapy we use release a lot and it gets like overused for sure, but I definitely love the word nudge. Can you tell me a little bit about, like common myths and misunderstandings and the reason that I'm bringing that up is because I feel like that is a common misunderstanding is that if you're going for pelvic health physiotherapy, it automatically involves an internal exam or work.
Speaker 2:That's right. There are many myths, yeah, so your pelvic health assessment can be whatever it is that you're comfortable with. There isn't a cookie cutter way to go about this, because there are so many things that influence incontinence, there are so many things that influence prolapse, there's so many things that influence painful intercourse so we can't follow a framework. So most of my clients are understanding in the 1000 questions that are on that very painfully long intake farm, and we do that because the story part behind why they're coming here influences where we start and how we start. Really understanding those lifestyle factors and the precipitating factors gives me that bit of an idea of, okay, like we're diving right into an internal, or an internal is completely off the table. I think that allowing that person to show me who they are does help me figure out the kind of that first day a little bit better. So internal is one of those myths that we don't have to do. I do have some really neat fascial skills that I do like to use vaginally, but again, only if that person is ready.
Speaker 2:And then there's so many other myths that I think that the younger generation coming up is doing an excellent job at blowing out of the water in terms of settling for pelvic dysfunction, we're talking so much about leaking. Leaking just because you have a baby like absolutely not normal. Leaking just because you're aging absolutely not normal. So having to be quiet about not enjoying intercourse or having painful intercourse is one that needs some help to blow out of the water. Prolapse is another one, in terms of feeling that heaviness or that sensation that something is there vaginally, one that needs a little bit more conversation around. But at any age we can optimize our pelvic health. Pesteries that's another big one. Pesteries are not for blue haired women that have no other options to support their pelvic health. That's that one I get cranky about. Yeah.
Speaker 1:It's interesting that you say that, because so obviously I'm in my early fifties and moving through menopause and I had some pelvic floor dysfunction after my second daughter, or my first daughter actually and I went to see the King of Kings in Obies in my opinion, only here in the city and he said, let's talk about empecery. And I'm like, okay, sure, and he did all the things to fit me. And I'm like, okay, sure, and he did all the things to fit me. And I'm like I don't know, I don't know what size to guess at. And anyway, as the appointment went, typically you pick a size that you think you are, then you place it and they come back in the room and check and see if it's fitted or not.
Speaker 1:And of course this OB knows me well. He comes back into the room and I'm standing and he's you have to get on the table so I can check. I went, I'm not going to lay down and wear a pessary, and he said blood red. He's like what am I supposed to do? I'm like you're going to check me right here. I'm going to jump and run because that's when I'm going to wear the pessary and you're going to check me here. And he was so embarrassed. Needless to say, that pessary did absolutely nothing for me and sat in a drawer for its entire life, but I am I'm a little confused about the pessary. It is the first option, though, that women get told. Do you agree that's typical here in our community, or do you see it being prescribed still?
Speaker 2:I'm seeing the opposite. I'm seeing a lot of women struggle with prolapse symptoms. Pessaries aren't being offered to them. I look at pessaries as a knee brace If you have a tweaky knee and you want to go play volleyball and that knee brace is going to allow you to go play. You throw the knee brace on. So, a pessary, I have some questions about your fitting experience. That's not how I fit a pessary.
Speaker 1:That's why it didn't work. I have since had a better experience.
Speaker 2:But there's some literature out there that in the postpartum it doesn't even matter the postpartum population or not when you use a pessary consistently over about a nine-month, six to nine-month period, we actually reduce the size of the genital hiatus or the width of the opening of the vaginal, of the introitus of the vaginal opening, which is incredible. It allows tissue remodeling to occur that allows shortening of that connective tissue where otherwise we're just trying to use muscles to augment, support, decrease pressure from above, do all the things. But in that postpartum population there's real opportunity here to get some earlier symptom management for some stubborn prolapses.
Speaker 1:Oh, my gosh, my mind is blown. So because of not being able to have this conversation with someone who can help me understand it. I have not been a fan of pessaries.
Speaker 2:And some of it aren't.
Speaker 1:No, but I think it's from my experience and my education, which obviously I don't know everything, but I am getting schooled and I love it. I love it. How do I get access to that information, like it's just common research, where it can really help with? Basically, what you're saying is the size of your vaginal opening, right? So incontinence.
Speaker 2:That was all the conversation five years ago and prolapse is starting to get some of that conversation and there are some neat companies that are even doing custom pessaries and so, as these companies are coming up and they're doing some really neat things, they need research to support what they're doing. So that is really providing some momentum for some new research Because, again, women aren't researched right. This is new, that we're doing health research on us. Evidence that is coming out is yes, like pesteries can support tissue remodeling, and pesteries aren't a leave it in and forget it, and it has to be for the rest of your life, like some women who are CrossFitters or marathon runners. It's a long run or a heavy workout. Throw your pester in for the workout and then take it out after it can really be used. I feel we need to have this mentality around it. It's an e-brace.
Speaker 1:Yeah, I love that analogy. I love that so much, I'm so excited. I definitely need a pessary. I definitely need a pessary, like you said, my long runs. I can feel like when I do a run that I need to do my pelvic floor work, and sometimes it's a little bit urgent after, but I feel like maybe if I had a well-fitted pessary, that I might be able to go a little bit faster and a little bit longer for sure. So pessaries are a myth. That is, or knowledge about pessaries is one of the myths that I'm seeing, and obviously, now that you've educated me, I'm really excited about that. What is another common myth? So? First one was that there's always internal work, the second one being that you know pessaries are only for a certain time and how to view them differently. What about men? What about pelvic floor for men? Because we already talked about pelvic floor for children. I know that this is common with me and my population. People are not aware that men need pelvic floor help too.
Speaker 2:So men are in terms of medical research. They are eons ahead of us when it comes to pelvic health. They are decades behind and they are silent sufferers. So there is this wave of men right now in their 60s that are on cusp of that younger generation who's talking more. And these men who are going through treatment and intervention for prostate cancer and, as a result, are dealing with things like erectile dysfunction and urinary incontinence, are very motivated to optimize their pelvic health and they're starting this trend of talking about it. But there is this whole other population of men with urinary urgency, with reduced stream strength, with the sensation that they're sitting on something that they there's a lot of stigma around them talking about pelvic health or even knowing what it is.
Speaker 2:Yeah. So it is exciting to see this generation of men right now that have have gone through prostate cancer treatment, that are going to start to improve the pelvic health of the generations to come. And then the other big thing for men that I'm going to monopolize this opportunity to just throw out, there is heart health and that erectile activity, that spontaneous erectile activity for men is an indicator of their cardiovascular wellness. There is a statistic out there that nine months before there is a change in cardiovascular status, there will be a change in that morning erection and all men, all wives, they need to know this to keep their husbands well and keep men well. That is a vital sign that they should be paying attention to.
Speaker 1:I love the twist that you just took. Okay, so you're saying that basically your husband or partner's erection and a change in it is what you're saying right. Noticing a change in it, that's right and indicate that something is off cardiovascularly 1,000%.
Speaker 2:Oh wow, it is a vital sign, just like women's cycles are a vital sign.
Speaker 1:Yeah.
Speaker 2:Men's erectile activity is a vital sign.
Speaker 1:Oh, my goodness, that is so important to know because I have done workshops with a hormone replacement doctor here in the city, dr Kristen Kapan, who I love picking her brain about all these things Japan, who I love picking her brain about all these things and I feel that I'm able to have an intelligent conversation about men's hormones and how that changes and can affect their stamina in life, not just their stamina with sexual activity, but also that decline and how it affects them emotionally and physically. Not in a scientific way, but I'm able to have a conversation and I find that a lot of people will bring that up to me, men and women about struggles that they're having with lack of testosterone or whatever. But to fully understand that this issue can be indicative of a cardio mishap is, like, extremely important. I love that.
Speaker 2:Yes, absolutely Should be in the partner handbook.
Speaker 1:Yes, yes, there is no handbook. Is there, though? All right, I want to move on to my community and who I spend most of my time with, and that's pregnant and postpartum women. And I do get the odd patient who will come to see me and tell me that they're doing pelvic floor physiotherapy as well during their pregnancy, but I want to talk about that a little bit. Obviously, we can't say when is the best time to come, because it's about meeting, like you said, meeting people where they are. But how can pelvic floor physiotherapy help with pregnancy and birth? And then maybe I don't. I feel like talking about it. Postpartum is a whole conversation in itself, but just helping people like fully understand how even going for one or two sessions during pregnancy can be beneficial and what it can help with.
Speaker 2:That question makes me go back to a previous question. So I think a really big myth out there is that as a woman, you are expected to know what your pelvic floor muscles are and what they do. So nobody tells us, right Like we're still trying to figuring out what's the difference between a vulva and a vagina. How do we even figure out what the levator ini muscles do? How do they turn on, how do they relax? So having an appointment during your pregnancy, if you're someone that is not connected to your pelvic floor and understand how those muscles work, can be very empowering to connecting to your body.
Speaker 2:The perineum literally means to shame when we translate it, and there is a lot of subconscious unwiring that we need to do. That serves as a bit of a barrier to connecting to our pelvic floor, to our pelvic floor. So an appointment during pregnancy helps me help that mom-to-be tune in. How do these muscles turn on? How do they lengthen? We need to lengthen, we need to soften those muscles to allow that babe to come out. Being able to help a mom connect and map with that is extremely helpful and empowering, just on a pelvic floor level. Another myth is that pregnancy has to be painful, so some aches and pains, yes, sure, debilitating pain? Absolutely not so. Moms that are starting with discomfort really anywhere in their body right, they can be supported with exercise or with hands-on tools or with bracing to make that pregnancy less tiring on them. And a mom that is stronger through her pregnancy, she's going to have a better birth, right. So having a strong, empowered birth is so important, then, to the postpartum recovery.
Speaker 1:I love that so much. There's so much in that, though, that I could go off on another tangent about, because it is. I feel like I'm I'm somewhat of an expert in pregnancy and postpartum with the physical body, and then obviously I'm a doula, so I know quite a bit about birth as well. But I think these conversations that I have with other experts, I think these are so important because it teaches you so many things, and one of the things like one of the problems with pregnancy that I really struggle with helping like. Typically, I want 70 to 80% of pain relief in the person's first one to three treatments. That's usually my goal, and if I don't have somewhere in that ratio, I'm typically referring out, because I do know that I need other practitioners to help me do my job as well, and whether that's physiotherapy or chiropractic or whatever that is, and whether that's physiotherapy or chiropractic or whatever that is and one of the biggest things that I have problems with helping is pubic symphysis dysfunction, and one of the highest recommended things that I see the biggest results with is pelvic floor health or physiotherapy, and I think that's really important.
Speaker 1:I've also in my mind sometimes when the person comes in and they have pubic symphysis dysfunction. Fully assessing that weight, I'm not going to be able to help this person unless I'm able to nudge them towards a pelvic floor physiotherapist. So I love that that you were talking about that. How in my mind sometimes I know that I can't fix a pubic symphysis dysfunction and then it becomes accepted I'm not going to get them out of pain, which is wrong, a wrong mindset or a myth in this community, which I'm also thinking, and it's really important that you talk about that. There's no reason to be in a painful pregnancy. That's right. Pain during pregnancy is a sign that something is not balanced.
Speaker 2:I agree with that fully and we think about that statement sometimes from a musculoskeletal level. But we do have to look bigger. With respect to sleep, restorative sleep, adequate hydration, nutrition with respect to whole foods enough protein, healthy fats and support, emotional support, social support, and what stressors were in the background. We don't give enough weight to how much that noise does impact our tissues.
Speaker 1:Yeah, yeah, and it's interesting. I don't think that we were taught this in massage therapy school and I definitely know I was not taught it as a doula, but my experience in myofascial release really talks about that and I think that changes the way that I look at the whole person, that your body and your tissue can hold emotions and feelings and stress besides physical stress. Yeah, I love that you are talking about that. I feel like that is a part of a holistic approach to the body.
Speaker 2:Yeah, as my practice evolves and I've become more confident in my skills, it's only then that I have been more open to seeing how impactful those bigger factors are.
Speaker 1:Yeah, all right, we talked about the pregnancy and how important it is. How important it is. What would you recommend for women who don't see you during pregnancy and are on the postpartum journey? What are some of the first signs that they need help? Even before I'm automatically telling people they should go to pelvic floor physiotherapy even if they're not having any issues, but what are some issues that might show up that indicate to a new mom that she might need some pelvic health care?
Speaker 2:There's a laundry list of things. So even bowel issues, especially constipation, is going to potentially contribute to prolapse. So even if there's bowel concerns, so women without babies have prolapse that's another myth. So getting on top of your bowel health and are there mechanical things that pelvic health can or pelvic health physio can assist with that would be something that is also quite impactful. And then there's the heavy hitters right Leaking, heaviness, pain, discomfort, symptoms that feel like a UTI that aren't a UTI. There's a little bit of burning around the urethra.
Speaker 2:Something that's starting to catch on is in the I'm going to jump to menopause per second is this idea of genitourinary syndrome of menopause. So we're starting to talk about this and essentially what that is. There's reduced estrogen in the vaginal tissues that create thinning of the tissues, drying of the tissues, and that there's touch, discomfort, there's pain with intercourse, there's these pseudo UTIs, the urinary frequency leaking, burning, all the things. What we're not talking about is that there's this genitourinary syndrome of lactation. So while we're lactating, we have reduced estrogen. So those same symptoms that occur with this genitourinary syndrome of menopause are occurring in this postpartum population. When you're also dealing with all of these other things and I think even just being all of these other things, and I think even just being aware of that is helpful. So if you're noticing any of those things, making sure that you are taking care of your vaginal tissue and vaginal mucosa can be particularly helpful while you are lactating, so we can also help with that.
Speaker 2:Going back to pregnancy being proactive is one of the best things that I think a woman can do. If you're thinking about family planning, get active, and activity is relative right. Walking is a really undervalued physical activity. Walk. It's really good for our hormones to strength train right. So two to three times a week, 20 to 30 minutes of strength training it is enough to have positive impact on our body and then to be able to carry that through pregnancy. You're going to have a stronger pregnancy, you will feel better and that again leads to a stronger birth. So that is my number one recommendation is to be as proactive as possible to support all of the changes. Your body changes so quickly it's hard to keep up with it. So if we have a foundation of cardiovascular fitness and strength that allows your body to adapt to those changes a little bit more efficiently, I love all of that so much.
Speaker 1:I'm really interested in the lactation's connection to the vaginal mucosa and just the vaginal health and being aware of that for your first attempt at sexual intercourse, or yeah, I think that's really important to talk about. Would you say that after the six-week checkup with your OB or your midwife? You know, because I tell my patients that book your postpartum visit with me long before your due date so that you can you can shift it if you need to, but is that something that you would recommend as a part of being proactive? Get your new mama wellness physiotherapy check on your on your books as well physiotherapy.
Speaker 2:check on your books as well. Yeah, the trend that I'm seeing is guidees aren't doing an internal exam at the six-week discharge appointment. Yes, so I do recommend to my mamas that I see you right before that appointment so that if we do find anything, then we can flag that and we can share that with their gyne before they're discharged. And then again there's an asterisk to that right. If we find things at right before that six-week appointment, I'm not super alarmed. Yeah, healing has only just begun.
Speaker 1:But I love that because we do live in a healthcare system that we need access to certain people to get the needs met that we have, yes, medically. And it's interesting because I have also noticed this trend about the OBs just doing a superficial check-in with you. That is verbal, saying how's everything healing down there? And one of the things that we include in your last visit is a six-week checkup plan. So questions to ask if you feel like anything is changed down there that didn't feel the same, which the majority of the population that doesn't feel the same five to six weeks postpartum as it did before you got pregnant that you ask for an internal exam and some of the things to ask for are and we give them a list. I love that. But I love that. I love that you do that so I can change my postpartum check plan to softly nudge a pelvic floor physiotherapy check so that when you go back for your six week checkup, if there is anything that's happening that you need the OBGYNs care for, you don't fall off of their care because you need another referral after that. That's right. Yes, I love that so much. That is such a great thing to know for your own care.
Speaker 1:So when you said that, I love that you said that you know that even if you did find something, there's no reason to be alarmed. It is, unless it's something to be alarmed about at that stage of postpartum. Really, things are just getting started, and that comes back to one of my questions about, like when to get help versus when to wait, versus when to wait. You're really talking about using this appointment to facilitate the need for an OBGYN to direct you into a medical appointment if necessary, like not falling out of their care. That's correct. Yes, yeah, so it's don't panic, this is something that is not urgent versus we can wait on this. Is that what you're saying?
Speaker 2:Yeah, so I'm using the fact that these women typically have that six-week appointment so we're trying to maximize that gyne appointment for them. But when it comes to I'm concerned versus let's just wait, it varies for everyone concerned versus let's just wait. It varies for everyone. So I say to my pregnant mamas that are leaving here before they're having their baby I'll see you right before your six-week appointment or when you have bandwidth. So there is always going to be a way to support these women. There is always going to be a way to support these women. Everyone's postpartum journey is very individual. Some are all rainbows and sunshine and some are not. If you, if a woman, is really concerned at 10 days postpartum about their pelvic floor and they are stressed and anxious and losing sleep over it, I'm going to see you at 10 days. If, at six months, you're still in the thick of it and you are still struggling to get out of your house and you just don't have bandwidth, well, we wait until you have bandwidth. Meeting everyone where they're at is the most important piece.
Speaker 1:Yes, I agree. Yeah, because sometimes you don't want to leave your house, sometimes you don't want to leave your baby, sometimes you just can't wait to get out and you can't wait to get five minutes to yourself. That's right. Yeah, any and all of that is okay, and we have to work around that. It's just supporting mamas means supporting mamas fully. Yeah, any and all of that is okay.
Speaker 2:And we have to work around that. It's just supporting mamas means supporting mamas fully.
Speaker 2:Yeah, and that makes me think of a couple of other things too being as active as possible throughout your as reasonably possible throughout your pregnancy, but to have a better, most optimal birth, like at 36 weeks, doing some perineal massage, it can be really helpful in reducing the need for an episiotomy and there is literature to support that. Six states a day, starting in about 36 weeks, helps to shorten the second stage of labor. So when we're talking about these concerns that women have with their pelvic floor, postpartum, again, what we're doing in pregnancy in those last four weeks to support birth makes all the difference. And that's where our rock star with all these women to have that birth support really does change, can change the trajectory of that postpartum journey. Yeah.
Speaker 1:I love everything that we're talking about, but as we're talking, I'm like, oh my God, I need to do another recording with her. I need to do another recording with her. I feel like so many of these things can be talked about on a whole different level, like the perineal massage, and there's research to indicate that it is very beneficial, but most of the women that are doing it are not. They're not really doing the right research and it's really hard to take on. Like, how do you teach a class like that? It's really hard to teach a class, but it's to get more access to more women, and I'm fully owning the fact that I want to have access to more women. I want more women to know, but also accepting the fact that changing one mother's journey at a time is important as well. Create more points. Yeah, exactly as well. Yeah, exactly. But I do really wish that the perineal massage was discussed more. It is sad how it's not used in our birthing world as much as it should be.
Speaker 2:Yeah, I'm going to break it down real quick. Okay, good Perineal massage, it doesn't need to be fancy. There's lots of different techniques. Essentially, what we're trying to do is induce. I'm going to use the some strain on the vaginal tissue, but not to an intensity of pain, so stretch intensity of about 3 out of 10. Essentially, if you think about your vaginal opening as a clock, so pubic bone is at 12 o'clock and towards your rectum is 6. And towards your rectum is six, creating some strain between three and nine o'clock, anywhere between three and 10 minutes, two to three times a week, is enough. You don't need to get fancy. If you're doing it yourself, you're going to need a tool. You can't reach over that pregnant belly. Ideally to have your partner help you with. That makes it easier. But using just one or two fingers and providing some radial outward pressure around three to nine o'clock is good enough. It doesn't need to be fancy.
Speaker 1:I love that. I love that short and brief description and it is very precise and perfect. Speaking of tools, what are some of the tools that you personally use, not necessarily for pelvic floor health, but just in general to take care of your body? What are your main tools?
Speaker 2:To take care of my body. Well, I know that physical activity is good for my body. I'm a wannabe runner, so that happens when it happens. I do like strength training and I would like to do more yoga and I think Pilates is also excellent. Figuring out how to do all the things all the time I haven't mastered yet. So if anyone's got tips like, I'll take them. Haven't mastered yet. So if anyone's got tips like, I'll take them. But I live very close to the Greenway and like that. To get out there and go for a run is one of my very happy things to keep me sane.
Speaker 1:It's interesting that whenever I hear someone talk about running, the way that you're talking about running, it gives me chills. I have been a runner most of my life, since about 12 and a little bit competitive. I'm not saying I'm taking part in races or anything at this age, but I do sign up for a half marathon here and there and that language that you're using it's really good for your sanity is exactly why I run. The first time I heard about meditation during movement Joe Dispenza talks about that a little bit. I really do meditate when I'm running. I don't know where I am. I've gone for a run in airports and gotten lost. I've ran and not remembered how far I've ran and then look at my Garmin and realize that it was twice as long as I intended.
Speaker 1:But I love when I hear somebody else say that there is just something that some of us get with running and some of us who still continue to do it but don't love it like that or don't feel the same way about it as were talking about, and that I resonate with fully. You're talking about running and doing things for yourself and you talked about all those fitness things, which I fully agree. Finding time for all of those is hard, and some days our best looks different than other days. What are some other things that finds you joy outside of work? I know that you have children.
Speaker 2:Yes, yes, I do. I have four and almost, and she'll be eight on Saturday.
Speaker 1:Oh, yay, happy early birthday. And are you originally from Windsor and Essex County? I am. I'm a Maidstone girl. You're a Maidstone girl. I love that. You're a Maidstone girl, I love that. So when you went to high school, did you have to get buzzed, or was there a school right? Was there a high school in Maidstone?
Speaker 2:No, I went to Essex High School. No there's a high school in Essex but that's technically the one that all the Maidstone residents go to. I think there was like Villanova, because Maidstone's in between, so my neighbors they would have went to Villanova or Essex, I think. Okay, yeah.
Speaker 1:So you get bussed anywhere. I do know that as well. We were bussers, yes, yeah, yeah, I think my kids went to Lesore, and no matter where we were, they had to take the bus too, until they could drive, of course. All right, what else, corey, do you like to travel?
Speaker 2:I am a homebody, but my daughter. She is going to be a traveler, so I just have to suck it up and get on board. Last May she told me that she wanted to go to the Philippines. We're lucky to have some country property and some peace and quiet, and that is my happy place.
Speaker 1:That is amazing and I love that. Your daughter is a traveler and understanding fully that whatever they're going to do and want to do, we are going to jump on board. That's right. Jump on board, all right. I am so grateful that you took the time to talk with me today. We have covered so many topics and I know that my audience is absolutely going to love this. I would love if you would finish off our conversation today with how people can get in touch with you and learn more about you.
Speaker 2:Yeah, absolutely so. Our clinic is in Kingsville, in the center of town, and we have a website, wwwirelandmptcom. We are on Instagram and Facebook at Ireland Physio, I do believe, is our handle. We're not too active on there, but there are some good tidbits if you scroll back on there. Good tidbits if you scroll back on there. And 519-733-1010 is the number to chat with my lovely Edmund Tiffany. And we don't just do pelvic health. I'm very fortunate to have Stephanie Rhea and Stephen George at our clinic as well, and I'm the least experienced one here. So we do really pride ourselves on the advanced level care that we are able to provide for all of the orthopedic and kind of chronic finicky pain things Amazing.
Speaker 1:Yeah, thank you so much, kori. It's always so great to connect with someone in the community who's doing such impactful work in our community. I love that you talked about your colleagues and coworkers and if anyone's listening that is curious about Corey's services and her clinic and her colleagues, there is going to be a link to her website in the show notes. Corey, thank you so very much.
Speaker 2:Thank you, deb, and thank you for everything that you do in terms of advocating and empowering women and their pelvic health as well. I am so happy and honored to be chatting with you today. Thank you.
Speaker 1:Talk to you soon. Okay, let's talk soon.
