Enhance Your Pelvic Health: Essential Tips

Jana Danielson

Dr. Heather, thanks for having me. If I had like one wish, if there was a genie and this genie said, you get one wish, not three, just one. My wish is that we could be more connected to our body because it is brilliant. sometimes we buy into societal stories and norms and narratives, and the one that I am like a champion for is pelvic floor health. It’s time that we bust some of the myths around, just because I’m in perimenopause or menopause, or just because I have another birthday candle on my cake while I should be dealing with incessant night waking, which leaves me exhausted during the day, or of course, I have to plan my day around bathroom breaks, or of course, I’m not going to be as connected and sensual with my partner because that’s what happens when you age. I’m excited for our conversation so that we can educate and inspire, and maybe just leave our audience with one or two pragmatic tools that they can start to implement into their lives starting today.

Heather Sandison, ND

Let’s dive right into it. If you had to give someone, let’s say a woman who is in her sixties or seventies and maybe experiencing some incontinence, starting to have to wear different underwear and plan her day around bathroom breaks? This can lead to social isolation, one of the risk factors associated with dementia. Our worlds get smaller and smaller when you have to be close to a bathroom all the time or you’re worried about having an accent. What would you tell her? Where would you have her start?

Jana Danielson

All right, so the first thing that I would say to her is that even though you might feel like you are alone in this situation, you’re not. and the statistics have gone from one in three women dealing with some form of incontinence to one in two women. If you think about ten of us sitting around visiting and having tea, Five women and that alone, I feel like it shifts the mindset a little bit when you’re not alone. The research also shows that in 90% of pelvic floor dysfunction, whether it is incontinence or whether it is bloating, constipation, cold, tingly feet, low back pain, or chronic tight hips, some of these things don’t even connect with the pelvic floor. 90% of that is reversible because the body—how we sit, stand, and breathe—is so important to pelvic floor health. If there was one tool that I could give that woman that we’re talking about, it’s how to properly breathe. I would love to be able to dissect that a little bit and talk about how the pelvic floor and our diaphragm work. Would we have time for that?

Heather Sandison, ND

Let’s do that. Let’s explain why and then. I have to leave without showing us how to properly breathe.

Jana Danielson

Let’s do that. first of all, the pelvic floor for some people just doesn’t know.  If you put your hands on your head, that’s your pelvis, essentially. There are three bones there that make the pelvic girdle. The pelvic floor is the group of muscles that are like the hammock inside. Everybody has men and women. Everybody has a pelvic floor. Because we live on a planet with gravity over time, if those muscles are not functional, which means they can work and they can rest, a lot of people think I have a kegel. Kegel keyed all my way to pelvic floor health. 70% of women already have a tight pelvic floor. There’s too much tension. Kegeling will just make that tension more and more pronounced, which means when you sneeze a little bit, there’s some leaking, which means when you laugh out loud a little bit because a tight muscle is not a strong muscle. We have this beautiful hammock sitting inside our pelvis. Geographically, right above that hammock is our diaphragm, which is like an open umbrella or a mushroom cap. It lives right in the rib cage. Like the crust of the ribs, when we watch a newborn baby breathe, that baby’s belly rises and falls with every breath. It’s beautiful. Then we become teenagers and young women. We buy into those societal beliefs. We are sucked in. We suck in our belly. We wear clothes that are tied around our waistbands. Guess what happens? There’s all this intra-abdominal pressure. We release about two liters of gas a day through all the orifices in our body. That pressure, when it’s taken away from the center, has to go either up or down. So a lot of women experience pelvic floor issues even without having had a baby, even without being in their 50s or 60s. It just encompasses all of us once we realize that the pelvic floor looks for leadership from the diaphragm. If we are not breathing with our diaphragm, the body is so smart that it transfers the breathwork to these little muscles in our neck. They’re called the scalene in the Sternocleidomastoid. They’re like little strips of beef jerky. This big mushroom-cap umbrella has been replaced with these skinny little muscles that already have a job. They hold our heads up on our spines. Now our diaphragm, the main muscle of respiration, is not moving. The pelvic floor notices it, and it also just goes on a little bit of a vacation. We’re going to show you how to do it simply by breathing with your diaphragm. Not only do you take in 600% more oxygen by breathing diaphragmatically, but you also give your person a pathetic nervous system, which is the rest, and digest that yummy, juicy part that teaches us to chill out. You give that a big hug. You’re also giving CPR to your pelvic floor. If you could find 30 seconds three times a day to breathe, like I’m going to show you, it could start the healing process and the functional improvement process of your pelvic floor. Everyone is worth that. We deserve to have a body that is oxygenated. We don’t live in that brain fog. We don’t live with that chronic exhaustion, or I had a good sleep, but it’s ten in the morning and I’m dragging my butt. Why is that? That’s an oxygen issue. Can we learn how to breathe?

Heather Sandison, ND

Yes. But first, what I want you to do is coach people. How do you have them? Remember, are they? Where are we setting a timer on our phone three times? Yes, 30 seconds. Some of us go; that’s just 30 seconds. I’ll get around to it, or I’ll do it, and then the day is done and we haven’t done it. How exactly do we connect it to the brush in our teeth? Do we set a timer before we do it?

Jana Danielson

Great question. stack it or attach it to something else. For me, when I open my eyes in the morning, usually it’s my body that’s waking me up to go to the bathroom. I’ll go to the bathroom. then the next thing that I do is do my breath work, and sometimes I’ll go downstairs and get my feet on the grass, do some grounding hands on my body, and do my gratitude like I’m in those 30 seconds. I’m not just breathing; I’m doing my gratitude. I might be looking at the sound or the fact that I’m welcoming my day. Then I do it as a midday habit. I’ll do it midday. My favorite lunch right now goes through these phases, but I love making acai bowls right now. That’s just my thing. As I’m making my bowl, I will do my breathing, and then I like to do it in the evening. I don’t drive much right now. I’m in Mexico, so I ride my bike to a lot of places. But another great place to stack it is if you are driving when you’re at a red light; it’s a perfect time to practice some breathing. Or if you’re more of that, I’m going to set a timer, or I like to be more spontaneous. then just set three random timers during your day. It helps when you can connect it to something because then you’ll be accountable. I always say to my clients, If you were to brush your teeth once a month, would you have good dental hygiene? No.  this is something gift this to yourself. You will notice, within seven days, a change in your body. You’ll notice something, and your brain will thank you because it is often in this state of oxygen deprivation, unbeknownst to you. That’s how I would create the strategy. That is just so you have accountability during your day.

Heather Sandison, ND

There’s a way to make it practically work. I’m ready. How do we do it?

Jana Danielson

How do we get ready? I’m going to sit, just so you can see. Here is that mushroom cap on my shirt, by the way. I like putting one hand on the belly and one hand on this flat bone here called your sternum. I want you without much coaching. I just want you to breathe in through your nose and out through your mouth. Let’s do that two times, and then I’m going to layer on some information. Inhale through your nose and exhale out of your mouth. Now, on this second breath, notice which of your two hands moves more. Inhale through your nose and exhale out of your mouth. So, Dr. Heather, which hand of yours moves more?

Heather Sandison, ND

My stomach.

Jana Danielson

That’s exactly what we want. We want this lower hand—the hand on your belly button—to be moving more. What that tells me is that you’re utilizing this diaphragm muscle as part of the breathing process. I know some of you would be like, my top hand was moving more. Here’s the thing. I love to call you my little goldfish because you’re using your gills or those little muscles in your neck to breathe—not the end of the world. We just need to remind this big muscle here what his or her job is. Now with that information, what I want you to do is feel the waistband of your pants around your body because our core is 360 degrees. I want you to breathe into the entirety of your core. On the inhale, breathe into the waistband of your pants, and on the exhale, try and melt away at 360 degrees. Try and pull the body. Melt the body away from the waistband of your pants. Do it again. Inhale. Filling that body, filling that bottom hand, and on the exhale. Think of drawing the bottom of the belly button away from that bottom hand. All right, it is three more times. Inhale out of the mouth and exhale. It’s like a little bit of an H sound with the exhale. Do it again. Inhale and exhale. If you’re doing this and have the luxury of being in front of a mirror, I want you to watch that. The shoulders are not moving at all on this one. Inhale and exhale. That is as simple as it is if you can do that for 30 to 60 seconds. First of all, this is new to you. You might be a little bit lightheaded right now. You are taking in large doses of oxygen, and your brain may not be used to it. It might be thinking like you might feel like maybe you had a glass of wine. That’s just a physiological response to the breath. I want you to be humbled by your body. Don’t be disappointed. Like, how could I let this happen? How can I get dizzy after four breaths? It’s humbling. The body is beautiful. This is now a new communication system that you have with your body because it’s going to learn that when you’re breathing in this diaphragmatic way, it is like this yummy, juicy, nurturing time you might call on this breath before a crucial conversation with a family member or someone you work with, the moments you feel like your life is spinning out of control, that you just can’t even think about the next minute, never mind the next day or the next week. Connect to the breath. It is a beautiful way to give your entire heart and soul a big hug.

Heather Sandison, ND

I hear that sometimes I feel like I’m dizzy; maybe I shouldn’t be doing this, but this is empowering. We can take this simple, free, very quick thing, and we can change our physiology and notice a difference. We can use that as we start to direct the difference. and become a little more acclimated to it and use this for our benefit. This helps our pelvic floor a little bit indirectly, though. Are there any things that you specifically do? What do you layer on to our lady who’s struggling with incontinence? What else do you tell her to do if she’s like, I ran, I got the breathing down? What’s next?

Jana Danielson

I will also usually tell her I’ll ask her a question: How much water are you drinking? Normally, she’ll say, I have a little bit of water; I’ll have my cup of tea. But at 5:00, I don’t take in any more fluids because I don’t want to be up all night going to the bathroom. Here’s what’s happening with that strategy. When you are not hydrated, your urine becomes extremely concentrated. The urine ends up in the bladder, and the tissues of the bladder get inflamed. They’re like, I got to get this liquid out of me because it’s not comfortable. It’s so concentrated. It’s like I said; it’s burning; it’s inflammatory. When a woman thinks she’s doing herself a favor by dialing back on her hydration, she’s creating a new yet different issue in her body, which is going to be the urge because the bladder doesn’t want to hold that urine. You’re going to find yourself going to the bathroom more often. Now, this feels and sounds counterintuitive. I drink less water, but I have to go to the bathroom more. It’s simply because, like I said, of the concentration. Here’s my strategy for that. You don’t need to go from zero to 60 with your hydration. This means that you’re going to play with your body a little bit. You’re going to have some fun. It might mean yes, for the first couple of weeks, getting up to go to the bathroom, maybe an extra time. But when you can reach for your water like we both are doing.

Heather Sandison, ND

You’re talking about it; I’ve got to. I know it makes me thirsty just thinking about it. 

Jana Danielson

There are a couple of strategies around drinking water, right there is the sip versus chug, first of all. When we sip, it gives us that hydration. If we were to add a little bit of Himalayan pink Himalayan sea salt, that’s going to help us cellular absorption even more. We want this water to get into our tissues. The tissues of our body are organ tissues, and our muscles are joints. Our body uses water as a priority. It first goes to hydrate the brain, then our vital organs, and then the tissues of our joints, muscles, and fascia. If we’re like there’s the hydration strategy from a pelvic floor perspective, but then there’s the hydration strategy from just an overall wellness perspective. If we’re not taking enough water and our brain is dehydrated then for sure our vital organs are not properly hydrated, and for sure chronic plantar fasciitis, chronic bursitis, or chronic sciatica, the healing for those pieces of our puzzle is going to be much more. The healing isn’t going to happen in a beautiful, systematic way. It just can’t. It can’t; we can’t heal in a desert. We need a beautiful jungle oasis. That’s an easy way of saying it with the palm trees behind me, so that’s the hydration piece. Is that sipping versus chugging room temperature versus cold, a little bit of Himalayan sea salt? Those simple little tools can go a long way. Maybe today you take a couple extra sips after 5:00, just a couple, and then next week, maybe you wait till after six and take a few more. We wanted to just very slowly stretch out at that time and listen to our bodies.  To make sure that when we are going to the bathroom, it’s not just a few little dribbles, because, again, that’s just coaching your brain to be like, that’s what a full bladder feels like. It’s good to know. Next time, it’s only 10% full. I’m going to send her the message. She better go to the bathroom. we’re learning. We’re reteaching our bodies, some of those. Do I have to go? Let me see. Maybe I can extend it by five minutes. 

Heather Sandison, ND

Like adult potty training.

Jana Danielson

It’s all just remembering.

Heather Sandison, ND

So then, is there another layer?

Jana Danielson

There’s another layer. We have the breathwork. We have the hydration. These things seem so simple. That’s why we discount them because they’re not complicated. What do you mean by Breathing in water and posture? As a Pilates instructor, I found Pilates because of my pain journey. I was on a two-year pain journey on 11 different medications a day. I was in my early twenties just to be told by my medical team that they believed the pain was in my head and I was seeking attention, and that’s when I felt like my lifeline was cut. I was like, This is my life. Will I ever be a mom? Will I ever have the desire to run my own business and marry my high school sweetheart? So what I learned through Pilates is that after I took Pilates, after my first class, sixteen weeks after I was off all of my medications, I didn’t understand why, but I was intrigued and curious enough to find out. Here we are, so many years later, and I have become a master instructor. I opened my studio and clinic and have since helped tens of thousands of people. So it is a reminder that movement and posture are medicine. Our body is on this planet with gravity. What it’s like when you see a house that’s lost its integrity. You see, the walls have shifted. I read this research about six months ago, and it shocked me.

Dr. Heather said that 80% of our lives happen within 20 inches of our noses. I was like, what? Think about everything that’s happening in our world, and 80% of our time is spent within 20 inches of our nose. No wonder we have all of this technique of posture that cuts off oxygen to our body eliminates blood flow, gives us headaches, and makes us feel exhausted all the time.  and I don’t want to go back to, like, your grade three teacher who would tell you to sit up straight all the time, but she was not wrong. If you’re sitting here listening, driving your car, and sitting and watching us, those bony bones in your butt—their fancy name is they’re the ischial tuberosity or sit bones. When we’re sitting, our bones essentially become like our feet. We want to sit upon them. We want to root them, like the roots of a tree, downward so that our body and our spine can be lifted upward. We can leave space for all of our organs, our circulation, our digestion, and our elimination. We want our limbs to move freely when we are hunched over, small, and frozen forward. None of that can happen. When we have those sick bones rooted down, the body always wants movement and wants to be in opposition. If something is connected down, there’s something that wants to go this way. That’s our spine. When we’re standing, the magic number for everyone is 60% of our weight in our heels, 40% across the widest part of our foot, and zero under the pads of the toes. When we live with about 80% of our weight forward, it ages us more rapidly because our entire body is shifting. I’m going to sound like a broken record of circulation, digestion, and lymphatics like all of those things slow down and we age quicker than we should. The breathwork, hydration, posture, and even posture play into pelvic floor health. When we’re standing with our 60-40, that beautiful hammock is in its optimal position. When we have too much weight forward or we’re schlumpy when we’re sitting, it puts this unnecessary force downward, and over time, that becomes pelvic floor dysfunction.

Heather Sandison, ND

You’ve mentioned Pilates and my own experience with Pilates after having my baby. That was how I got back into exercise. I was surprised by how much less pain I experienced day to day, how I was able to tolerate sitting more, and how much more energized I felt. But the thing that surprised me most was that the community was going to these classes. I felt lucky. There was a studio down the street from my house; it was about three minutes from my house to being on the reformer. I saw the same woman a couple of times—two, three, or four times a week. We got to know each other, and we supported each other. There was encouragement. People wondered where you were when you weren’t there, and there was this wonderful sense of community.  That was a side effect—an unexpected and positive side effect of going to Pilates. I’m wondering if you’ve seen something similar.

Jana Danielson

I can’t wait. I started my studio out of my basement, and I have clients that are still coming to my brick-and-mortar studio, like ten years later, still talking about the basement Pilates days there is this beauty when you are working on your own body when you are reconnecting to yourself through this form of movement, there is just this openness about those others who are around you. It’s almost immediate. You alluded to it earlier in our chat that social isolation and loneliness have so many impacts and outcomes on our bodies. When you can find that community as a bonus on top of the breathing, the blood flow, the beautiful movement, and getting your joints well-oiled, it’s like it’s the perfect storm when it comes to movement as medicine.

Heather Sandison, ND

We were talking about elephants in the room and pelvic floor health incontinence. This can be one of those elephants in the room—something that people don’t want to talk about because of shame, anxiety, and all—just the dignity that you lose as you become incontinent. Another elephant in the room is, of course, cognitive decline and not wanting to talk about that, the fear around that, and the shame around that. So I appreciate you making this accessible, supporting women, and finding solutions. The other piece of aging that we fear, of course, is incontinence and cognitive decline, but we also fear falling, and Pilates and movement can be some of the best things that we can do to avoid falls. Can you talk about how Pilates supports balance and fall prevention?

Jana Danielson

You are just speaking to my soul here with all these questions. Dr. Heather, I love it. Pilates truly is about a line bent. Joseph Pilates, who created this form of movement, said that the health of the spine dictates the health of the body. You might think, Well, how does my spine help me with fall prevention? The spine has these beautiful natural curves to it. Pilates focuses on the alignment of not just the spine but of our arms, our legs, and the neutrality of a neutral pelvis. All play into this. I want to challenge you if you’re here listening to this conversation. The next time you are out and about, I want you to watch just peoplewatch for a minute. If you can be in a location where you are watching people standing in line at the grocery store or maybe in line at the ATM, I want you to look at their feet. Most of us stand if these are my feet; most of us stand like ducks. Poppins just habitually over time, anatomically correct, are about 10% to turn out. Yes, we need a little bit of turnout. But here is what happens over time: We start to get too much turnout in our legs. When our bones start to rotate outward, the soft tissue is going to follow our muscle tissue and our fascial tissue. We end up with this migration of this twist. when you wear a long sleeve, kind of a tighter shirt, or you put on a pair of leggings and the seams aren’t quite lined up and it just feels weird, when you have like a little bit of a twist in your clothing and you’re like, I got to line up my seams. That’s what your fascial tissue is doing. It is wrapping around, following your bones. When we are out of alignment, our structure becomes compromised. Our core isn’t able to support us. Our pelvic floor is unable to support us. Our head posture changes. Everything changes. Ladies and gentlemen, our feet are like the stage of our performance. No one has a life. I want your stage to be as strong, stable, and supple as it can be. Our feet have 26 bones in each foot. They need to move. We should be just as dexterous with our toes as we are with our fingers. When we notice it, we notice ourselves, like walking around your house and just stopping to see where your feet stop. I guarantee you’re going to have to dial them in. That’s what Pilates teaches you. It teaches you where that alignment should be. It’s going to feel weird at first. Like, I don’t like living there. I like living here. This is what I’m used to. When it comes to fall prevention, strength, and pelvic floor strength are critical. When our lower body is out of position, what’s going on above it simply can’t support you like it wants to.

Heather Sandison, ND

So if someone listening is like I get it, I want to get on board, but I don’t have a Pilates studio down the street, I don’t know if anybody I’ve never heard of is a reformer. These Pilates machines—do I need them or can I get the benefit from home? With Zoom and online courses, is there a way to make this more accessible?

Jana Danielson

The answer is yes. In this world, live Zoom has become more accessible, and sometimes Pilates can get confused with yoga because there are mat Pilates and some of them might look like yoga. The biggest difference I feel is that I know there are different kinds of yoga, and I’m not a yoga aficionado with all the different names, but in places, we don’t hold poses. In places, we move through the ranges of motion, which is what life is like. We pick up our bags of groceries and put them down. We open a door, and we close a door. We stand up, and we sit down. There’s a range of motion. so you can get the benefit of doing movement on Zoom. If there was any way at all that you could do it, get to a studio or have someone come into your home just a couple of times to watch you because sometimes we don’t know what we don’t know. Making that investment just to have someone with their eyes on you, be like, see? See that foot, or see that shoulder, or that and that. That can also be done over Zoom. That is, that part is critical because if you can get a good base in Pilates and movement and breath, then you’re well on your way.

Heather Sandison, ND

That’s so helpful to kind of hear that there are ways to get that individualized attention because I also noticed that I would go to group Pilates classes and I would get what level of soreness, and then I would have a one-on-one session occasionally, and I would notice that different muscles would be activated just because of her level of expertise. You said that you don’t know what you don’t know. But we also get so used to the way we move. We almost don’t even notice when our flashes are twisted up. The way you were describing it, we don’t even feel it anymore because it’s our normal. So then bringing that awareness and having a professional who can work with you helps us to prevent injury, but it also helps us to get even more out of our activity, not just day to day, but out of that Pilates class or that yoga class potentially, or whatever it is that you have access to. So how about working with you? How do people find out more about what you have to offer?

Jana Danielson

The best place to connect with me is either [email protected]. Or head over to coochball.com. That is my main website. You might be thinking, like, what? What are you talking about? What are you talking about? What is cooch ball? Just quickly, when I was teaching Pilates and when I would talk about pelvic floor health because it’s such an innate part of Pilates and the core, Dr. Heather and I were talking before we hit the record, and I said there would be this weird energy all of a sudden in my studio like no one would make eye contact with me. It just got awkward.  I was like, What is happening? Why can’t we? You trust me with your body. You’ve been here for years. Why can’t we talk about the pelvic floor? and I learned a few things. First of all, so many women think they’re going through this on their own, and that’s not true. We talked about that already. The second cool thing that I learned about a year and a half ago is the prudendal nerve, which is the main nerve that runs from the brain to the pelvic floor. It’s a motor nerve. It sends communication to and from, and it’s a sensory nerve. It’s all the senses. Pleasure through pain; the Latin root of the word prudendal means ashamed. I was like, for me, that was like our jaws on the floor, like, that explains everything.

Like it’s built exactly into the language—the nerve that is the communicator. The feeler is rooted in this frequency of shame.  So what I did with that was I thought, I need to find a fun way and make something I can use in my Pilates classes that my pelvic star physical therapists that were working in my clinic could also, we could this could be a bridge between therapy and Pilates. I created the cooch ball. If you’re watching, you’re going to see the cooch ball. Is this little? It’s a five-inch ball. What you don’t see is what’s inside. The magic is inside. There’s this beautiful nylon thread that we found that’s kind of stretchy that we wrapped around the bladder of the ball, and the ball was kind of squishy. When you sit on it, the nylon thread inside gives the ball a little more substance and a little more support. When you sit on this ball, first of all, if it were rock hard, your nervous system would be like, Hell no, get me off of this thing. If it were too soft, it wouldn’t impact me the way I wanted to. This is like the Goldilocks and the Three Bears. This is just the right porridge. When you sit on it, the weight of your body sits on the ball for three minutes, and adding that breath we talked about earlier in our conversation creates this melting of the facial tissue, which is connective tissue, which eliminates blood flow from muscle. It kind of hugs faster, like a ball-constrictor snake. then the life force of the muscle, which is the oxygen and nutrients that our blood flow carries, is inaccessible by that muscle. When we sit on the cooch, do our breathing, and melt through those fascial restrictions, we bring blood flow to the area, and then we can start to improve it through our breathwork. That’s where you can find me going info@coochball, on all the socials @thecoochball, please reach out simply because, again, you’ve heard me say this before: you’re not on your own. sometimes a little bit of information. I have been saying this a lot lately: a little bit of information that becomes actionable becomes education. Information you don’t act on is just information, like, that was nice to know. But when you take information and act on it, it becomes education. Now it’s learnable. There’s more value to it. The cherry on top is that if you can take what you learned and share it with someone else, it becomes wisdom. Connecting us back to that divine feminine wisdom is one of my passions because we do have such beautiful, innate bodies; this body is just beautiful. when we remember how to work with her or him, and it’s amazing how it can support the healing that we crave.

Heather Sandison, ND

I am so inspired. Thank you so much for making this conversation a little bit more normal because, as you just mentioned, it becomes wisdom when we share it with someone else. When we model and have these conversations that are more matter-of-fact and not dressed up in shame, then we can start to have these conversations with other people. I’ve seen this happen in the menopause, right around menopause. Women, we’re so ashamed to talk about their sleep, their mood, or their hot flashes. As we’ve kind of normalized that conversation, more and more people can have it. then more and more people get access to the help that they need to find solutions and not suffer. So please, I hope all of you listening will maybe be open to starting a conversation. Or if you notice a friend rushing off to the bathroom or saying that she can’t join you for lunch because she’s having health issues or something, maybe broaching the subject and letting her know, or especially if you’ve had the privilege and the relief yourself, have you gone through this and gotten some relief? Share that with other people, because there are too many women suffering unnecessarily. please.  Jana, thank you so much for being here, for sharing your wisdom, and for making it fun, easy, and accessible. We appreciate it.

Jana Danielson

My pleasure. Thank you.