Health, Fitness & Personal Growth Tips for Women in Midlife: Asking for a Friend

Ep.180 Beyond Kegels: Functional Pelvic Floor Care for Leaks, Prolapse & Painful Sex

• Michele Henning Folan • Episode 180

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Urinary (and yes, bowel) leakage isn’t “just part of getting older”—it’s a signal from your core and pelvic floor. In this straight-talk episode, physical therapist Christina Walsh, co-founder of Tighten Your Tinkler, joins me to dismantle the shame around pelvic health and lay out a functional path forward that goes far beyond “just do more Kegels.” 

We cover what’s really driving leaks, pressure, prolapse, urgency, and painful sex in midlife; how breath, posture, fascia, and daily toileting habits influence symptoms; when conservative care is enough—and when devices, pessaries, or surgery may be appropriate. Christina also shares practical first steps you can start today (hello, decompression and diaphragmatic breathing), plus how to talk with your partner without pushing through pain.

What you’ll learn

  • Why leaking is common—but not normal—and what it’s trying to tell you
  • The limits of isolated Kegels and what a functional approach looks like
  • How breathing, posture, sitting, and constipation ramp up pelvic pressure
  • Staging prolapse (1–4), what’s realistic to “functionally heal,” and red-flags
  • Painful sex in midlife: estrogen, lubrication, tone, and boundaries that help
  • Fascia’s surprising role (yes, your bladder “talks” to your neck)

Links & resources

https://www.tightenyourtinkler.com/  (listener code Michele for $50 off)

https://www.instagram.com/tighten.your.tinkler/ 

Tighten Your Tinkler free quiz https://www.surveymonkey.com/r/tinklerquiz

If this helped, share it with a friend, rate the show, and hop on my weekly newsletter for midlife health, fitness, and no-BS motivation.

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Transcripts are created with AI and may not be perfectly accurate.

Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing, or other professional healthcare services. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your qualified healthcare provider with any questions regarding a medical condition.

Michele Folan:

Let's talk peptides. These little chains of amino acids are having a moment. And for good reason. Yes, they can support fat loss and metabolism, but that's just the beginning. Think glowing skin, thicker hair, deeper sleep, sharper focus, stronger muscles, and even better libido. Basically, all the things that start to shift in midlife, peptides help your body work like it used to. I've seen the difference myself and only recommend what I trust. If you've been curious about peptide therapy and want to learn more, check out the show notes for my preferred telehealth partner. Because midlife isn't the time to slow down, it's the time to optimize. Health, wellness, fitness, and everything in between. We're removing the taboo from what really matters in midlife. I'm your host, Michele Folan, and this is Asking for a Friend. Today we're talking about something most women don't bring up at brunch that millions are silently struggling with: urinary and bowel incontinence. Research shows that nearly one in three women over 50 deals with some level of urinary leakage, and bowel leakage is far more common than anyone admits. Yet too often we've been told it's just part of getting older or what happens after kids. Let's be clear. Leaking is not normal. It's common, yes, but it's a sign that your pelvic floor and core are crying out for help. Think about it. Maybe you crush your legs every time you sneeze. Maybe you avoid jumping in a workout class or running with your grandkids. Maybe you've said no to intimacy because of pain. Or you plan your errands around where the bathrooms are. Does any of that sound familiar? Causes can range from childbirth trauma, hysterectomy, and hormonal changes in perimenopause and menopause to chronic constipation, poor posture, or even too much time sitting. And yet too many of us have been told to just do more kegels or worse to live with it. My guest today is Christina Walsh, a physical therapist and co-founder of Tighten Your Tinker, who, along with Jenn Lormand, has made it her mission to dismantle the shame around pelvic health and give women the tools to take back control without invasive procedures or endless kegels. Christina Walsh, welcome to Asking for a Friend.

Christina Walsh:

Michele, that was the best introduction. I couldn't have written that that well myself. Like you had you checked all the boxes. And so much of what we love to do is really help women connect those dots. You know, because so many women are either they're dismissed at their doctor, they're ashamed, they're like all those things. And no one's helping women put the picture together of all these different issues that many are dealing with, and no one's saying that's all related and that shares a root cause. And so, I mean, wait, five-star, five-star nature. Yeah. You checked all the boxes. And like, I love you already brought up the idea that, you know, our the symptoms are signals. Yeah. You know, it's not the feeling is so deep with these issues because you start to feel broken at your center. As a woman, it's devastating. We carry that around like a weight. And if you've been carrying this around for a long time, you probably don't even realize how heavy it is anymore. But these symptoms often creep up slowly over time. For some women, it's sudden, but for more of us, it creeps up slowly over time. And it feels like our body has betrayed us, right? Very often. But it's really our body trying to go, hey girl, I need some help here. Yeah. You know, why don't you, why don't you give me the support I need so like we can roll on, you know, into our later decades in fine fashion.

Michele Folan:

Yeah, and it's embarrassing too. I mean, women don't really want to talk about this stuff, but it's there and there's help there that, you know, I think may go underutilized because we aren't asking the questions. But I want to start real quick though, because you have a journey as well as your co-founder of Tighten Your Tinkler, which by the way, cutest name ever. And so catchy. So it it's it's very transparent what you do. But tell me a little bit more about the genesis of how you two connected and what you have in common.

Christina Walsh:

You know, like many of us in this space, it was it's personal. You know, I we didn't just accidentally find, well, we did kind of accidentally find ourselves here. It's the kind of thing you wouldn't wish on anyone. But once you navigate this path yourself and you find a different and better way to approach these issues, you can't be, you're, you cannot be stopped anymore from getting, doing everything you can to get this message out there. And yeah, we teach on all this stuff on all of our, you know, platforms and everything. And the comments, you know, on our YouTube teachings on this very public platform are always like, you know, I thought I was the only one. You know, you're you're just hitting the nail on the head of so many issues. And they're saying, you know, because it's not the first thing you want to talk about. When you get that elusive coffee date with your mom friend, that's not the first thing you want to talk about. Maybe probably not the last thing you want to talk about. But so, yes, it's personal to us. You know, my story is a little bit winding of how I got here. I really think seeds were planted in my childhood. I'm the oldest of four kids, and I watched my mom suffer with some of this stuff, you know, and I'm a natural helper, I'm a natural healer, you know, that's just my personality. And so I wanted to help her. And I didn't know how. And I all this has come to me so clearly as I've walked this path, you know. But I was thrust into a what for many is much more of a later midlife journey uh as a primary caregiver for my mother. She suffered a 15-year, absolutely terrible decline. And I was at her bedside at 34 years old saying goodbye. I mean, I'm gonna get emotional. So, you know, I was losing her as I was becoming a mom. And so I I kind of I think I dedicate all this work to her in my heart now. Um that's not that's not how I found myself here per se, but it's a part of the story of why I do what I do now. You know, I ended up getting out of traditional PT work because of a neck injury first. And this, you know, the system didn't have what I needed to get all the way better enough because it's like an occupational hazard. When you work with, you know, ill people and sick people and injured people, you see where that can go. Oh, yeah. You know, and I was in my 20s with this injury, going, I don't want to be having a surgery at 45 just so I can keep functioning. And so I made, I went on the war path to find other treatments for that first, an orthopedic injury. And I found a manual therapy technique that I loved. And I always had this idea in the back of my head, in my heart of hearts, that I wanted to work with women and moms in a women's health space, but I didn't take that traditional path that many PTs do to end up in that women's health space. I ended up meeting Miss Jenn Lormand, who is an exercise physiologist extraordinary, recovering from traumatic birth injuries. She landed on my table for manual therapy, trying to get better. And we just had this soul connection. It was that moment where sparks fly and you're like, I we have to do something together. And she invited me to practice out of her personal training gym. She was already working on recovering from her own birth injuries. She was working with women on pelvic floor issues. Then I got pregnant and had a couple kids. So we were working under the same roof as two separate businesses. I'm doing manual therapy, she's doing personal training. And then I had a few children and I had what I thought was the foresight of working with all these other women with injuries. And I was going, I'm gonna do this differently. I'm gonna have a doula, I'm gonna have a midwife, I'm gonna have an unintervened upon birth because I know that that will lower my risk of injury. But guess what? We don't get to control all of that. Okay, so I had that birth. I had no medical intervention, but I had a sunny side-up delivery. You can't control that. And I had to push for two and a half hours, and that is a risk factor for developing prolapse, which is where those organs shift and fall and lose their home in your pelvis, and it results in lots of symptoms. It's kind of like the progression of pelvic floor dysfunction, you might say, is prolapse when the organs really shift. But so I didn't know even then that pushing for greater than two and a half hours, two hours was going to set me up to be at risk for prolapse, and I have dealt with it. Yeah. You know, and but so then Jenn and I became insanely united in our cause to find help for these issues. And Jenn had tried Kegels and they didn't work. She'd been referred to her urogynecologist who looked her straight in the face at 36 years old and said, it's not if you're gonna have surgery, it's when. You have stage two prolapse of all three of these compartments, you're gonna have surgery. And as she tells the story, she left that office sobbing, crying, and with an insane new determination that that was not gonna be her story. Because he looked at her and he was like, and the really sad thing about this is that these surgeries really have to be redone every 10 years. So if you have it done now, you know, that's that's just your path. And she was like, no. And so I'm recovering from, you know, birth injuries, you could say, from a non-traumatic birth. She's recovering from more severe injuries. And we were like, we have to find a different way. You know, what's been proposed? We either don't want to do it or we've tried it and it's not working. So we went on the war path, you could say, um, with fire in our heart to help ourselves and then every other woman dealing with these issues. And we did find a different way. We found a functional approach and we've embraced that, we've ran with it, and we did three years of university research study to validate it because we are nerds like that. And we were like, testimonials aren't gonna get this out into the world. You know, we were published in a peer-reviewed medical journal with the protocol we found and dialed in for ourselves first. And we thought that was gonna be the way we helped women was getting that research out there. But it kind of fell flat because it was too, it was too zoomed out for most of the Western medical system to accept that all these things were connected and that functional approach could get it all better. And so we here we are with Tighten Your Tinkler online now because the women in our study were like, please make us a video. I need this for my friend of Virginia. My sister-in-law needs this, she doesn't live here. And so it was at the, you know, at the urging of the women in our research that is why Tighten Tinkler exists and why we've been shouting it from the rooftops ever since and trying to teach and educate, pull back the veil of shame. Uh, just encourage women to get help now because this stuff doesn't get better on its own.

Michele Folan:

Well, no, it doesn't. And and that's the thing. And we've all been, you know, told if you've if you've been in this situation where you have any kind of prolapse that surgery is going to be your best option. But on your website, you also say please stop kegling. And I I think that's always been the default is is kegels. And I told you before we started recording, my dad was a urologist, and he always told us to do our kegels. Why would that possibly worsen or mask the underlying dysfunction?

unknown:

Yeah.

Christina Walsh:

Well, and first of all, let's not, we're not throwing anybody under the bus here for recommending that. Like, much like your a recent guest that um the dentist you spoke with recently talked about how, like, you know, everybody was doing the best that they knew at that time when they're recommending that. And the same thing applies here. Nobody gets into a healing profession because they they they get into it because they want to help people. And so Kegels were the best anybody had thought of or knew to do for a very long time. And that also applies to those devices. Anything that you insert into your body and just isolatedly squeeze around is the same thing as just doing a Kegel. And the problem is, there's lots of problems with the approach, it's not functional. So if you strengthen a muscle just in one place in one range of motion and you just squeeze and relax, you're not gonna gain strength that carries with you through the full motions of that muscle. And like we need that muscle to be able to subconsciously turn on for us when we're in a deep squat picking up a laundry hamper and we sneeze. We don't need it to work for us just when we're lying on our back in that one position. And furthermore, it shouldn't have to be a conscious thing, right? Think about before you had any of these issues. Did you have to think about squeezing the muscle before you sneezed in order to not leak? No. So it's not functional. For some women, that works. And by look, if you have done Kegels and it worked for you, girl, that is awesome. I'm not talking to you. I'm talking to the thousands of women who come to us and say, I've tried that. It didn't work for me. It made it made it better for a little while, then it made it worse. Or I've tried the devices. That also didn't work for me. I'm talking to you because that's why we're so wonderful that so many options exist now, because our bodies are not all the same and we need different approaches. So we're just honored to be able to provide one option for women looking for help for these issues.

Michele Folan:

You know, we've normalized leaking. Yeah. You know, I mean, sure, there we've seen the the pharmaceutical uh companies talking about, you know, gotta go, gotta go, gotta go right now, you know, those, you know, giving people um a pill for it or or just wearing some depends or a pad. How do we get people to finally wake up and say, okay, I know this isn't normal.

Christina Walsh:

I need to go address this. It really depends. It's up to every individual woman to decide she's had enough. And it's it's fascinating to me what that breaking point is, is very different for different women. For some women, they come to us and they're like, the very first leak, they're like, I can't live like this. I'm fixing this now. I want to get to the root cause. This is the right path for me. They have so much clarity. For so many other women, though, it's a slow progression over time of like, well, it, you know, I had some leaks every now and then, but it didn't really bother them me that much. This is a language we hear all the time. My back was tight all the time since I had my kids, but it didn't really bother me that much. For some women, it's okay, but now sex is painful. I can't have this interrupting my marriage. So now it's a problem I need to take action to fix. Or now, one woman, it was, I was walking on the beach with my family and I couldn't have a pad in because I was in a swimsuit and I sneezed and I felt the pee run down my leg. I'm done with this. I want to fix it now. So I'm not here to convince you that it's a big enough problem to fix. I'm telling you that there's a path to healing. So when you decide I've had enough, this is impacting my life so negatively that I want to fix it, there are options and there is hope.

Michele Folan:

So, for women who leak, say they cough, sneeze, exercise is a big one, let's say, even during sex, how do we help them identify whether it's like overactive bladder versus a pelvic floor dysfunction issue?

Christina Walsh:

I love that question because overactive bladder is still a pelvic floor dysfunction issue. And here's why. So the nervous system is routed into all of our body, right? And so for overactive bladder, very often a huge component of that is over tightness of the pelvic floor, where that sphincter can no longer clearly get the messaging and do its job. So a lot of times we need, so our approach is functional and holistic. So we always recommend women decompress first. I love you. You know, so go back and listen to that breathing episode. The the breathing diaphragm is the top of the core. So you've got to loosen that breathing diaphragm if you want to loosen your pelvic floor. Get our free at-home decompression technique. That is a great place to start. If you suspect that hypertonic or overtight pelvic floor, if you're dealing with urinary frequency or what you think is overactive bladder, um, start with decompressing. Start with stretching. That is where you want to begin. Make sure to get yourself a squatty potty so you're ergonomically emptying. Stop pushing out your pee. Like there's so much you can start doing now, today, to really stack things in your favor as far as taking care of your pelvic floor. You want to be making sure you're optimizing your bowel consistency. So think about how many times you pee and poop. If you're in the ergonomic position with a squatty potty, knees higher than your hips, and your bowel movement consistency is not too hard and not too soft, and you're not straining or pushing, you're breathing, you're relaxing, you're even swaying on that potty to help empty completely without pressure. That is a gift to your pelvic floor that you are giving it like multiple times a day. So, so much good you can do right now.

Michele Folan:

Christina, we're gonna take a quick break. And when we get back, I want to talk more about bowel leakage, urgency, and how that intersects with urinary leakage. I'm really curious, how many recipes have you saved over the last month? How many random workouts are sitting in your camera roll? And how many times have you said, I'll start Monday, or maybe in the new year? Here's the truth: you don't need more Pinterest boards or another motivation Monday. You need a plan that actually ties it all together: nutrition, movement, mindset, and in a way that's doable and sustainable. That's exactly what I do in my metabolism reset with Faster Way. I'll teach you how to eat, train, and recover like a woman who's done making excuses and ready to feel strong, confident, and in control again. Check the show notes to join us because this time I've got you. We are back. Before we went on break, I wanted to talk about how does bowel leakage, urgency, and even constipation intersect with urinary leakage? What's the interplay between the bladder, the bowel, and pelvic floor function?

Christina Walsh:

Perfect. I love this question. I had someone else come up with the catchphrase that you know the pelvic floor is responsible for the three P's, peeing, pooping, and penetration. Oh. So it is. Yeah. It's a the pelvic floor. It's like people think of it as like this mysterious entity, the pelvic floor. What is it? It's a sling of muscles that holds our guts in from below. So, like there's no bone holding your bladder up and in or your bowel or your uterus. It's all soft tissue compartments. So, you know, that's the piece of where it's all connected down there. And it's all con, and the pelvic floor connects to your low back. It connects to the front of the pelvis, it integrates with the deep abdominal muscles. So all of that should be working together when things are healthy and well. But pelvic floor issues can present, we say towards the front of the bowl or the back of the bowl. So you can have, depending on the births you had, depending on, you know, if you have like what you talked about earlier, if you had that history of constipation chronically over a lifespan, all of that's gonna, you know, sunny side up delivery puts you more at risk for issues on the back side of the bowl. Other things put you more at risk for issues on the front side of the bowl. So it's all pelvic floor in the end. Now, that being said, that's what I mean about, you know, start with the low-hanging fruit to take care of your pelvic floor, those things we already talked about, because you're positively impacting your whole pelvic floor function when you take those steps we already talked about. Um, and if you're dealing with bowel leakage or gas leaks or pressure, pressure and heaviness down there is a telltale sign that that things aren't happy and well down there. That feeling of like, why do I feel like I'm in my third trimester of a pregnancy and I'm not been pregnant in 20 years?

Michele Folan:

Or or you feel like you've got a tam, like you've got a tampon in and it's falling, like the tampons falling out, that kind of feeling.

Christina Walsh:

Yeah. Yes, yeah. Or the bulge. Many women just say there's a bulge. All of that are telltale symptoms of prolapse. I'm not diagnosing you over the internet, but I've I've done this long enough and I felt it in my own body to know. Um, but so yeah, the back of the bowl, the front of the bowl, it's all just different parts of the same muscular sling. And where you feel it more, what symptoms you have more of, just speaks to what tissue was overstressed most for you over your lifespan.

Michele Folan:

And then there's also painful sex. And I know that's can be taboo. People don't want to talk about that too much, but you you all address it very openly. Yes. What are the most common causes in terms of the pelvic floor related to pain during sex in midlife?

Christina Walsh:

And how do you approach that? This is fantastic. I've done literally an entire episode on just pain with sex. So I will try to summarize this, but it is nuanced and it does involve, it involves certainly the pelvic floor tone and health, but sometimes it's more than that, especially as we get to midlife, right? The estrogen's dropping, collagen's decreasing, we have less moisture being held in our tissues. So sometimes it's you need, you know, a topical estrogen cream. Sometimes you need a lubricant. But if you but there are certain types of pain with sex that are directly pelvic floor related, also. And it can be some of both. It can be some of all of it. Just like any pelvic floor symptoms that women are experiencing look a little different for each woman because where was that tissue injured? How was it overstretched or over-tightened? But it's all the same ball of wax in the end. If we address the root cause and strengthen that undercarriage and remove some of that pressure and those kind of offending issues, then we can, we can really heal a lot. But so the different types of pain with sex, one is pain with penetration. That's kind of the most clear, direct, like that's often that over tight pelvic floor. And so you're gonna want to really get into some stretching. You're gonna want to get into that decompression position at home, work on your breathing, get your diaphragm moving, and you know, maybe get some lubrication. Do not push through pain. You know, this is the most, it is, I feel like it's just a sacred connection that you have with the person you spend the most time with in the world. If you push into pain, that is not a gift to you or your partner because it's gonna lead to more pain because your body's gonna recognize that as a trauma and you're gonna be scared next time. So we have a partner guide, also. I can give you that link. We've this is something we've lived through too. So it can be a hard conversation to start. Your spouse loves you, your partner loves you. They don't want you hurting. It can be, this can be the hardest topic of all to bring up. Even women who are comfortable talking about you're in leaks with friends, this can be a doozy. So we have a guide to help you have that conversation with your partner. Don't push through pain. Um, start those things if it's pain with penetration, but there's so many other nuances of pain with sex. Like for me, what I've had more is less of that. And it has more to do with the prolapse. So when the organs are kind of shifting and falling out of place in their little soft tissue compartment homes, it creates a weird suction situation because the kind of the passage isn't fully clear and upright and propped up. And so you can end up with like a pain higher up in your abdomen, like a deep soreness, like something's being punched repeatedly. You can also end up with uh puffiness and swelling and an increase in that heaviness in kind of that external genitalia after sex. All of this is pelvic floor tone and strength related. Does that I try to kind of summarize things there?

Michele Folan:

And I'm like, I'm thinking back, you know. So I told you I I I don't have any issues now. It's Amen. Yeah, right, right at 61. But I did postpartum after my second, like bad. Yeah. Like, you know, I had I had a urethral tear, rectal tear. Yeah, it was it was really bad. And I remember the healing process, and for years feeling that pain pressure, you know, and I luckily things things calm down. But listen, that is not fun to deal with. I mean, and you and again, you you brought that up that it it can it can make you dread having sexual relations with your partner if things are not healthy in there. And and this brings up something else too, Christina. And I I am a big advocate of vaginal estrogen, and I know my listeners are like, oh, please stop, Michele. Cut it out. We don't need to hear this again. No, bring it on. Don't cut it out. But but even if you don't have pain during intercourse, there are so many great reasons to be on vaginal estrogen. It is not absorbed systemically. I will say that until I'm blue in the face. But, you know, it's like using a wonderful, luxurious face cream. You you deserve it, use it. I did have a question. So vaginal rejuvenation, I don't know if it's still hot, but I know a few years ago everybody was talking about vaginal rejuvenation and dermatologists were offering it. You know, gynecologists were offering it. What does that entail and does that really help with this?

Christina Walsh:

You know, I will I'll be straight up and honest with you. It's not something Jen or I has ever, we've ever tried personally. So I don't want to speak to things I haven't tried, but you know, we have worked with lots of women who have tried it. And I'm sure for some women it works, you know, and they're the ones who don't end up coming to us. But we've also worked with lots of women who've been there, done that, tried that, whether it's that, whether it's devices, whether it's pelvic floor therapy, whether it's Kegels, you know, and and those are the women we see most often because they've they've tried all that or or they don't want to go that route. A lot of women who end up finding us are specifically looking for something non-invasive. They don't want to disrobe and have things penetrating down there. Maybe they have a history of trauma, um, or that's just outside their comfort zone. So it's wonderful that there's all these different options, like you do you, boo, all day long. Like if you're called to that, try it. I can't speak to it personally. I'm sure it helps some women. You know, that's why it probably exists.

Michele Folan:

Well, and this brings up something else I was just thinking about. Yeah, anything.

Christina Walsh:

How much does the fascia get involved in this? So involved. My bodywork practice, the the thing I was led to from that neck injury we talked about way at the beginning, is all about fascia. So it is something I can geek out about all day too. And I like to describe it as like, you know, when you're uh cutting up a chicken breast or, you know, that all that slimy, skinny skin stuff that's like in and through and around. That's the fascia. And it's like that in our bodies too. It encases everything from the small individual fibers to the larger chunks of muscle. So it connects everything to everything else. And that is actually why I love, I love the way you're the path you're taking this conversation, because we Jen and I love to geek out on this stuff. Many women with prolapse also have neck pain. And there is a fascial, a direct fascial line from the bladder to the neck. You could say, in essence, your bladder hangs from your neck. So even if you just want to get your prolapse addressed because you don't want a neck hump, that's worth it too. And many women with prolapse have foot problems because it just, you know, when you're disrupted at your center of gravity, which the pelvis is biomechanically, um, not to mention our energetic center as women, it it has repercussions up and down that chain.

Michele Folan:

Yeah.

Christina Walsh:

So yeah, fascia all day long is important and absolute part of this picture.

Michele Folan:

Yeah, I didn't, I didn't think I was gonna ask you that. And and honestly, I ask questions and I'm not sure I like have this like genius format that I go by. I just, you know, I start thinking of things and I start pulling questions. That is your genius format. I love every single one of your interviews. Like that is your genius format. It just cracks me up. Yeah, I had a guest on and we talked nothing about nothing but fascia. And I was fascinated. Yes, I thought, oh my gosh, this could answer so many people's issues, but you have to go get a physical therapist that understands the fascia.

Christina Walsh:

But well, and if you want a jumping off point for that, the the specific techniques I was trained in that helped me so much with my neck and that I use in my bodywork practice is um it's mostly through the school of up ledger craniosacral therapy. So it is gentle, non-invasive. It is so good for your whole body, your nervous system, your tissue, everything. It just decompresses everything. So if you're looking to just start one new type of holistic treatment to ease your body into a state of healing and take the load off your tissues, try that. I mean, that's a great place to start. Okay. That's yeah.

Michele Folan:

We could go down a whole different path with that, right?

Christina Walsh:

We could go down so many wormholes. I mean, and that's exactly what that's what we do, you know, in our teachings, like on our YouTube channel. We I we always say we've gone down the rabbit hole of everything you might be afraid to Google because this can branch off into so many different nuanced discussions. Um, but I I love that you're letting your intuition lead the way.

Michele Folan:

There are women out there that have been told you've got stage three, stay stage four prolapse, and they think now they're too far gone for any of this to work. So, what kind of guidance would you give them when they do have advanced prolapse?

Christina Walsh:

This is such a compassionate question to bring up because while while we love when women find us at stage one, stage two, and by the way, you don't have to know what stage you are to get help. We have a free quiz that really is based off of all of the research data that we took. And it's it is research-validated questionnaires that we combined into an online quiz, and we can grade you and stage you into three different zones based on the data. We are not making this up or pulling it out of a hat. And we can tell you with confidence, you are a great fit to benefit from conservative treatment, like working with us in our signature program, or you're in that middle zone, you can benefit, but you need to give it a little more time before you're gonna see results, or you're gonna score in a zone, which is what a woman dealing with these more progressed issues is gonna most likely score in. If you are dealing with stage four prolapse and you've been diagnosed, that Means the organ has fully exited your body. I mean, that is something that where I'm st I still would advocate to use the square, do all the things that we already talked about. It cannot hurt you, it can only help you. However, if that organ has fully exited your body, you are a surgical candidate. I mean, there's no, there's no amount of strengthening that can put that organ back inside and hold it there if it's gotten to that degree. Stage three is a trickier case. And um, stage three, many women can still benefit from conservative care, strength-based, you know, decompression, strengthening, much like what we offer in our signature program, but you often will still need regular body work to keep things decompressed, regular chiropractic care to keep things aligned. And you will most often likely sometimes benefit from the use of a pessary, which is that it's kind of like a little scaffolding, you might could say, that you insert and that stays there to hold hold things up and in. And for what it's worth, Jen and I have never had to resort to that because of the path we've been on. But we have worked with enough women to know that the one I hear the most good about is the cube pessary, because they come in all kinds of shapes and sizes. And I hear a lot of good reports about the cube. So if you're at that point, you'll need to get fitted for that. And so stage three is really a borderline. Stage one and two, you can heal. And I'm not saying, I'm not saying reverse the prolapse. I'm saying functionally heal. I don't have data on reversing the prolapse, so I'm not going to make that claim. But functionally, you can live forgetting that you have this on most days. That's what I mean about healing. And that that's powerful.

Michele Folan:

Yeah. So even if you had stage four and you had to have surgery, would you want to follow up with that patient to do like show them more exercises and things that they need to be doing to maintain that surgery?

Christina Walsh:

That is a fantastic question because I think education at the very least, because a lot of these major pelvic reconstructive surgeries do have a 25% failure rate. So this is a big deal that you want to take care of your body well. If you've gotten to that point, you do want to get some care still after that to make sure that you're not pushing your body past the point where it what you had done is gonna undo itself, which is the most tragic comments we get under our teachings, like on YouTube, is I just wish I could scoop up these, you know, so many women find us at just the right pivotal moment where it's not too late to take action and get relief without those much more extreme measures. But there are so many women who find us where it's like, I wish I could scoop them up and plop them 20 years ago and say, hey, let's do something now so you don't end up here. And look, the data is overwhelming that taking action sooner than later is absolutely in your favor and it can make a difference because one in three women overall will develop clinically significant prolapse in their lifespan. For women who have had children, that jumps up to one in two. And the prevalence of prolapse doubles every 10 years after menopause. So the great news, if you're in midlife though, like if you're in your, you know, if you're if you're not there yet, take action now. You know, the hormone shifts are not going to do you any favors. So many women find us in their 40s, in their 50s because the issues were ignorable before. But then you have that estrogen and collagen decline and all that soft tissue down there. And then all of a sudden it's like, whoa, what was whispering is now screaming. But it's that's the time. Don't wait any longer. Take action now. Yeah.

Michele Folan:

That and that was gonna be my next question. So if you, if someone listening who's age 55 or 65, and they are experiencing some mild leakage, but hasn't crossed the line yet, what proactive steps would she take now before things get worse?

Christina Walsh:

All the things we talked about earlier, like and and and then some. So there are so many ways you can gently, compassionately care for your body when you're dealing with these issues. Avoid compressive garments. Like if you even tight jeans or tight underwear, especially if you're gonna be sitting all day, like this stuff matters because all these little things add up. We always talk about this in our team and in our private community with our members. These little things add up to the big wins of relief that you're looking for. If you're gonna be traveling all day or sitting all day at your desk and you've got something tight around your waist, it's going to add pressure to your middle. And where does that pressure go? Especially if you are already weakened or compromised down below. That's where it goes. And you will notice if you've worn something that you felt like, wait, why when I wear that or when I sit in this garment for so long, am I noticing like a little increased leakage or that pressure gets worse or my back is tighter afterwards? It's not in your head. This is one more little thing you can do and pay attention to and choose activities that don't, you know, for lack of a word, don't piss it off, that don't make it worse. You know, and this sounds so simple, but it's it's we've, like you said, there's been this layer of acceptance of these issues. I think because people are struggling to know what to do about them. So there's all these jokes about peeing on yourself. So everybody's like, well, I guess I'm just gonna keep doing what I'm doing. But if if you're doing an activity, a high impact exercise, some heavy lifting that's making it worse, that is your body like really trying to wave the white flag. Like, please stop. I can't handle this right now. I don't have the foundational strength to tolerate this without breaking down. So choose, choose activities that are kind to your body. Choose clothing that is kind to your body. Use the squatty potty, use those proper toileting techniques we talked about. Optimize your stool consistency so you're decreasing that pressure. Choose active rest for your nervous system and your hips and pelvis in that at-home decompression position daily. All these things will add up. And then if that's not enough, then you need to go and add functional strength. And that is what we are absolute experts in. If that feels like the right path for you, we are one option. And that that's what I'd recommend. Don't wait. Start listening to your body.

Michele Folan:

And I think too, that this brings up something else too. You can do the work, but you may have setbacks or flare-ups. But do you have like a like a way to sustain? So, like things that you would do to continue to make sure that the the work that you've done holds.

Christina Walsh:

Yes. And we talk about this constantly in our our members only community with our program members that this healing is not a linear journey, whether that's our mental emotional health, uh, an old injury, or the pelvic floor piece and the prolapse piece, because life keeps happening. You know, we're working on strengthening, we're doing all the things, checking all the boxes. And then guess what? Winter comes and your kid brings home a cold and you're hacking and coughing. So, what you what the formula for that for our program members is lean more into those recovery positions, those rest active rest positions where you're offloading pressure, lean more into the gentle stretching at that time. Certainly take all the supplements that help you fight that cold, you know, and then get back to your strengthening exercises. And, you know, our bodies are miraculous healing machines by design. So, like if you've already done this foundational strengthening and you have a setback, it's not going to take you the same amount of time that it took you rebuilding the first time to kind of get back on the train afterwards. And the whole emotional piece of this is huge. So before you've reset that foundational strength, when you got a cold and you you had that setback, or you, I mean, for me, it was one time we were hiking with family on a trip and my kid was like three, my littlest one, and he was just having a day. And he wanted me, only mom could carry him. Mom needs to carry me. And it was like there were all of the all the cousins and everybody was together. And I was like, I'm gonna do this right now. I'm gonna carry this kid, I'm gonna piggyback him. And I love that special moment with him, but I knew as long as we were walking, I was gonna kind of pay for that later. I was gonna feel it in my body. But here's the thing when you have that flare up and you've already done the strengthening and you have the tools you need, it no longer sets you into a spiral of fear and despair. You no longer have to go, oh my God, I'm gonna feel hopeless again. You have the tools you need to get back on top of things again in a matter of a few hours or a few days. So the emotional weight of that flare-up completely changes. Life will still happen, but it doesn't devastate you anymore.

Michele Folan:

One thing that as you were talking about this, I started thinking about just posture and how we sit so much. Yeah. Talk about that a little bit because I don't think people realize that there is a direct connection between how we sit and our posture and how we stand and you know, your pelvic floor health.

Christina Walsh:

Absolutely. Well, and we talked about how the diaphragm is the top of that system of the whole core and pelvis. And so we're taking shallow breaths because we're running on empty, we're having go, go, go lifestyle. So that's part of it. We're shallow breathing, our ribs are getting stuck tight, and then that is not helping our pelvic floor at all and adding downward pressure. And when we're sitting all day, our pelvic floor is just like, I guess I'm clocked out. You don't need me. I know, and your outer hips, your glutes, which need to work in synchrony with your pelvic floor to have everything functioning well, they kick off too. And so, yeah, we're sitting all the day and it's just like downward pressure. We're slumping, that's more heaviness and pressure. We're not breathing well into our diaphragms. That's adding more pressure and tightness. And then our glutes and our pelvic floor, when we're sitting, are just like, okay, I'm off the clock. You don't need me. And so they they become dormant, you know? And so we really need that reactivation. And that's what the functional strength approach adds that most others are skipping is that root activation of turning the muscle back on. One of my favorite things is getting messages, emails in our member community of women going, I'm two days into this. And I am I crazy. It feels like my muscle is literally turning back on again. I mean, and they're it's it's a crazy feeling when it hasn't turned on in so long. And they're like, it feels like it's alive again. Yeah, you know what?

Michele Folan:

Yeah. It's so exciting when people make the connection of, I feel better when I'm moving appropriately, right?

Christina Walsh:

It's just so and it becomes an upward spiral. And I know you see this with the women you work with that you think, how am I gonna fit this in? It's one more thing. But then when you start to feel better, it's like this, it's this instant reward that you crave. You're like, God, I want to do that again because like I really feel it in my body, and it's amazing. What a relief. What a load off my shoulders from walking around with this weight of dysfunction and feeling broken all the time. You feel that load lift and you're like, I can't wait to do this again tomorrow. I just love your energy. Your clients must love you.

Michele Folan:

I mean, I really, you're so inspiring. I mean, I I I just to give women hope when you know, with with you know, urinary leakage and and bowel incontinence, it's just you you there's just such a thing about our psyche with with all of this as well. I'd love it if you could share a client's story. Oh gosh. Well, things I have so many.

Christina Walsh:

I have so many. Okay, let me see. Okay, one, I'm thinking we have women uh not so infrequently. This this blows my mind, the courage that women share after they have healed. They come to us and say, What can I do to help other women? I want to help get this message out now because my life has been so dramatically altered. And we often invite them to give a video testimonial. And many will. I mean, it is incredibly personal, but they're so compelled to get the message out there and do whatever they can. One woman, I love her interview so much because she was mid-50s and had tried all the things. You know, she had tried the Kegels and she'd been in pelvic floor therapy for like two years. She'd been referred for like a very expensive internal device that was $1,500. She tried that, it still didn't work. She was now having to keep underwear in her work drawer because she was leaking so much and she was just debilitated by it and crushed emotionally by the burden. And so when she got better within two weeks, she was like, Wait, I just, I, I, I'm not sneezing and peeing anymore. And I just can't believe it. And then she was like, wait, and I'm sleeping through the night now. Like, I even know that was possible. She didn't join for that, but that happens too. And then she was like, in this little video interview, she was like, I just want to jump up on the rooftops and go, hello, ladies, there's help for you. Oh, that's life changing. It is life altering. And and every year we kind of go back through, you know, new testimonials that have rolled in in our private community where we support our members or in our email inbox. And I just end up in tears as we're kind of regrouping those to share them. Of course, we always ask permission, but because it is life altering when you've you've lived with this stuff. And so, like you said, so often we've kept it to ourselves. And shame, you know, truth is the antidote to shame. So, you know, that's part of our mission is to pull back the veil, you know, remove the taboo, which is your whole mission, which I love, and just shout it from the rooftops because the more we talk about this, much like um, you know, a grief journey or having somebody struggling with substance abuse in your family, when you get the courage to talk about it, you realize how not alone you are. And that is part of this healing. Absolutely.

Michele Folan:

So well said. Before we close, I would love to know what one of your own non-negotiable self-care practices is. And it doesn't have to deal with your pelvic floor. It could be, it could be anything.

Christina Walsh:

I I practice what I preach and do all the things I just advised everyone else to do, of course. But aside from that, at a really deep core level is I'm not willing to compromise my family time. And that's a value that my partner Jenn and I share to our core, and we lead through example in our business as well. That when we clock out, it's family time. You know, when we pick up the kids from school, we're not answering emails. And protecting that boundary of that time with my family helps me show up fully present for my work, fully invested here with you, with my clients, because I have that time with them. And, you know, you know, those, you don't get those years back. So that is a deep core value that luckily Jen and I share. So it allows us to lead by example uh for our team as well, that that time is sacred.

Michele Folan:

Fantastic. And then finally, for any listener who wants to connect with you and Jenn and Tighten Your Tinkler, where can they find you, your website and social media?

Christina Walsh:

It's Tighten Your Tinkler everywhere, basically. It's TightenYourTinkler.com. It's hello at Tighten Your Tinkler if you want to hop into our inbox. Um, real people, you know, it's a very small team of working moms who've all lived this path ourselves too in that inbox and supporting our members in our private community. We're on YouTube. It one of the YouTube is our most popular platform, and I think it's because it feels like a safe space for women to look up those scary things. And we've got teaching videos there on all, again, all the things you're probably scared to Google. And don't be a don't be a stranger. It's at Tighten.yor.tinkler on Instagram. Of course, we're on Facebook too. So you can find us any of those places. And if you're like, I don't even know where to start, hop onto our newsletter list. Our you know, our messages, we share personal stories of our own journey, but we share action steps too. Like if you're like, that was so much information, I don't even know where to start, grab that weekly message and it'll just pop in with holistic wellness and tips for your whole self-care and especially as it relates to pelvic health and take that quiz. If you're just wanting to just scratch the surface of learning more about what all this entails, where do you fall on the spectrum of severity? That free five-minute quiz is the best place to start. It is data backed and it will give you that answer in no uncertain terms, as well as refer you to appropriate resources based on where you fall. Yeah, I took the quiz.

Michele Folan:

Yeah, that was my prerequisite. That was my homework for this interview today.

Christina Walsh:

I took it really, you know, it really does help connect the dot. It doesn't very subconsciously like, oh, wait a minute, that's part of this too. You know? Yeah. So no, it was good.

Michele Folan:

That that actually kind of set the table for some of my questions too. So it was good. And then you also, with your courses, you have a discount code for the listeners too.

Christina Walsh:

Yes, for your listeners, $50 off if you feel called that that functional strength approach, that holistic approach, that at-home non-invasive approach, 10 minutes a day approach, I forgot to mention earlier, is right for you. If you're feeling that call, that coupon code is Michele 1L, obviously, um, as your listeners probably already know. And that'll be $50 off of our signature program, which includes lifetime access to the both the program, which we're constantly improving upon based on feedback as well as membership in our private community of support for women as they navigate all the phases of this healing journey. Wonderful. Christina Walsh, thank you so much for being on Asking for a Friend.

Michele Folan:

Thank you, Michele. Thank you for listening. Please rate and review the podcast where you listen. And if you'd like to join the Asking for a Friend community, click on the link in the show notes to sign up for my weekly newsletter where I share midlife wellness and fitness tips, insights, my favorite finds, and recipes.