Speaker A: 00:00:03

Welcome to the Connected Pleasure Podcast with me, Kayla Moore, Certified sex therapist and coach, Healer Weaver, Dreamer, Sacred Disruptor of the Patriarchy and guide for the Women Warriors Rising. This is a space to return to your pleasure, your power and your body, while remembering your deep connection to the earth and to each other.

Each week we explore what it means to lead with soft power, power and to weave a world rooted in embodiment, love and connection.

Together, we are holding the frequency of what we want this world to look and feel like as we collectively weave together a new paradigm shift called the Great Turning. Because pleasure is not frivolous, it is foundational and it's time to come home. This podcast is for education and inspiration only.

If you're wanting to explore pleasure more fully for yourself, I invite you to go deeper with me through the offerings linked in the show notes or through.

Speaker B: 00:01:07

The offerings of my guests.

Speaker A: 00:01:09

If you're unsure whether one of these containers or a therapeutic approach would best support you, you're welcome to schedule a free 45 minute consultation with me. Together we can explore what path is in your best interest and if I am not the right fit, I'll be glad to connect you with the resources you need.

Speaker A: 00:01:29

Welcome my lovelies, back to the Connect to Pleasure Podcast. Today I am with my first ever interview on this podcast with Angela. Do you want to go by Angie?

Speaker B: 00:01:44

I. Yeah, I do. Yep.

Speaker A: 00:01:46

Okay.

Speaker B: 00:01:46

So yeah, Angie Maxwell. And I'm going to have Angie jump in and tell us a little bit about who she is and why you should know her.

Speaker C: 00:02:02

Yeah, so my name's Dr. Angie Maxwell. I'm a pelvic floor physical therapist by trade. I like to call myself an orthopelvic pt.

I've done orthopedic physical therapy and pelvic floor therapy my whole career. I'm board certified in women's health physical therapy, which is a specialty within physical therapy, which is funny to me.

But anyway, that specialty includes pelvic floor therapy for all genders, but also some of those physical therapy concerns that are more related to female at birth. So breast cancer type therapy, osteoporosis, osteopenia, musculoskeletal, things that happen with the female at birth pelvis.

So I have a board certification in that. It's one of my big passions. About four years ago I decided to start a clinic that is specifically focused on female at birth individuals.

So we are my clinic is Madrona Physical Therapy in Tacoma, Washington.

And that is our passion and love is working with a lot of pregnancy, postpartum pelvic dysfunction and musculoskeletal things that affect female birth bodies and big things like osteoporosis, osteopenia. So we're kind of unique in that way. Not many clinics choose to just specialize in one area, but that's our passion, what we love.

And then the other unique thing about us is we are an out of network practice. So meaning patients will cash pay for our services. And made that decision to change.

Started out commercial insurance and then went to cash pay a little over a year ago. And it was because I felt like insurance companies were dictating care and I just, I couldn't put up with that anymore.

I've done that for 11 years of my career. And especially those sexual health issues.

You know, any whiff of that in your notes as a provider and insurance companies would deny it, nothing infuriates me more. So we decided to take our practice out of network. Patients are still, you know, it's still physical therapy services.

Patients just submit a super bill receipt, which is like a fancy receipt to get reimbursed and all of that. So it's been working pretty well and we're still finding, you know, need and desire for our services and it's been pretty great.

So we have a special clinic. We do wellness classes as well. We have a perinatal fitness class. We do. And then a bone health class.

We encourage parents to bring their babies baby friendly and include babies in session. And you know, our thing is just building community and supporting our patients throughout their lifetime.

Speaker B: 00:05:02

So yeah, beautiful.

Well, I'm so glad that you are still thriving in that transition to being out of pocket as well because I also, as the history of me being a therapist, I have not taken insurance for that same reason. Anything around sexual health insurance is and don't like and won't reimburse for.

And so most of the sexual community or sex practitioners that would be affiliated with insurance tend to not take insurance because of those specific reasons. You know, insurance is just a whole beast in its own and they don't like to pay providers very well anyway.

But especially when it comes to sex and sexual wellness. So yeah, I'm glad that things are still going well.

And I will say I started going to moderna physical therapy, not quite postpartum, but I was having some like hip pain I think from just like back and probably core issues related to like later postpartum. It was probably like a year or so postpartum. So that's how I met Dr. Angie and I came and did a. What was It. It was for the moms and babies.

We did a conversation postpartum sexual health. Yeah, postpartum sexual health with the moms and babies that came to the. What is that called?

Speaker C: 00:06:44

Baby lounge.

Speaker B: 00:06:45

There we go. Baby lounge, which I also did a baby lounge after I had my son, just not at Madrona Physical therapy. So I have known Angie for a while.

She is an amazing practitioner in the local, you know, Tacoma and surrounding areas area.

And this is something that is really important for me to talk about on this podcast because as a sex therapist and coach, it's so important to have other practitioners that are focusing on some of the more, like, physical aspects that I would not be focusing on. And really, it's about, like, having your dream team that is going to be working holistically with you throughout your entire, like, healing journey.

And where I am focusing a lot on the mental, emotional, spiritual, and, like, narratives that we are creating and how we interact with ourselves and our partners.

The physical therapist is going to come in and really help you do some of that body work that your body needs to do to find safety in itself and can also help with kind of the. Creating a more healthy and safe relationship to your body.

So I want to first ask you, Angie, it's been interesting getting some guests signed up for my podcast and asking about pleasure. And I think lot of different people have different understandings of what pleasure is.

I know you are also in the sex realm, so I feel like pleasure is not as weird of a thing to talk about. But I just want to ask you, when you think of pleasure, what does that mean for you?

And how would you kind of describe what it means to bring pleasure back into the forefront of what we're talking about in our lives and in our culture?

Speaker C: 00:08:47

You don't ask easy questions there, Kayla. I mean, it's. I. I think of pleasure.

I mean, not, I guess, not just sexual pleasure, but like, you know, you can be petting your dog and, you know, have a lot of pleasure with that or going on a walk and smelling some beautiful, I guess, fragrances, you know, or, you know, you could be having an amazing workout and really feeling your body, you know.

So to me, pleasure is just more, I guess, about engaging all those senses and that you have a feeling of, I don't know, not euphoria, but maybe sometimes euphoria, but just happiness.

Speaker E: 00:09:25

Right.

Speaker C: 00:09:26

And it's something that really gets you going and. And that you enjoy. So that's how I define pleasure. And, you know, I think pleasure is hard to access if you're if you're stressed, right.

Or you're feeling like, you know, you've got too many things going on and. Or even if you don't have enough things going on.

Speaker E: 00:09:51

Right.

Speaker C: 00:09:51

And you're depressed. So I think you're right. Like, that mental health side of it with the physical is. Is so important. Pleasure kind of sexual pleasure wise.

I. I mean, I feel like that is a necessary and wonderful element that we should all experience as humans, personally and professionally. Very passionate about helping women, and not just in my career, but also, you know, men as well, all genders with sexual dysfunction and. And issues.

And, I think, you know, as providers, it's hard because you're right. You can't just do it yourself. You have to pull in other members to be on that team. But to me, it's.

It's such an important thing for people to have and experience. Experience and be able to access. You know, it's. It's a. It's a complex concept.

So I guess I. I feel like this clinic, we are more focused on, you know, women, female at birth, bodies their pleasure, helping them to kind of work through issues of pain and issues of insecurity sometimes in their bodies, helping their bodies feel strong and capable again. You know, some women have birth trauma that really affects their ability to access sexual pleasure.

Speaker D: 00:11:12

Yeah.

Speaker C: 00:11:14

So to me, like, our clinic is. It's a safe space, right. Where we're kind of talking about that. And, you know, I'll go out and talk to groups about arousal and pleasure and how the.

That process is in our body, because to me, it's important and it's. It's important to be open about it. And I mean, I always joke, but it's like I want to bring vaginas into the light. You know, there.

You know, there's so much, I don't know, like people have, you know, patients all go to do an internal, you know, pelvic floor muscle assessment, and they'll apologize for their odor or, you know, their pubic hair or, you know, something like that. It's like, no, you know, this is a part of your body. This. I was. Nothing wrong with it. There's no judgment here.

And so I just think for us being that place in the community where women can go if they're having difficulties with sexual pleasure, and then just being an advocate out in the world as well for that and my new thing, because I have a teenage daughter, I want to do, like, a little community activity that is just, you know, for teens, like young women, to help them understand number One their bodies, the processes. You know, there's a lot myths and issues around sex and sexual pleasure, and, you know, helping women to access that is. I don't know.

I feel like it's my mission in life. It's part of what I do. So I don't know. That was a big rambling response, but it's, you know, complex.

Speaker B: 00:12:45

I love it. I couldn't have said it better myself. I love that you are bringing pleasure not just in the sexual realm, but into all the senses that we have.

Because that's definitely my mission on this podcast, too, is I am also a sex professional. So I want to talk about sexual pleasure. But pleasure of all kind, I think, is so needed in our world right now.

There's so much hatred and just anxiety and stress, like you said.

And I think the more we can set our sights on how do we infuse more pleasure into our day and into all the different aspects of our world, that we could be a lot better society. So that's kind of the overarching mission of this podcast. And as sex professionals, we definitely know pleasure on the sex and intimacy level.

Speaker D: 00:13:46

Mm.

Speaker B: 00:13:46

And I love that you're wanting to talk to teens as well. Cause I think, you know, there are obviously the different stages that we all go through as human beings, but especially women.

And I'm kind of in the sacred feminine space of that, like, maiden, mother, crone, those three archetypes that the maiden definitely goes through now, getting her first period and being in this space where maybe she starts to be sexual. And that's so something that's kind of like, you know, the birth into adulthood a little bit.

And then you treat a lot of mothers that are becoming mothers and their bodies are changing into that. And then, you know, the crone piece is probably more in, like, the menopausal space or perimenopausal space.

Speaker C: 00:14:37

You can definitely serve those women as well. You know, I. I have women who come into the clinic who, you know, we're cash pay, and so we don't have those same.

I mean, we're still using physical therapy. We're still using diagnosis codes, but they want to have better orgasms.

Speaker E: 00:14:52

Right.

Speaker C: 00:14:53

Like, they are menopausal. And it's like, wow, I used to have a lot more, like, kind of sensation and pleasure. So they're. And that's why they're here. Improve that.

That kind of physiologic part of themselves. And so it's like, great, let's do it. You know?

Speaker D: 00:15:09

Yeah.

Speaker C: 00:15:10

So, yeah, we. I mean, That's a great way of putting it. I like the, like the archetypes.

Speaker D: 00:15:15

Yeah, yeah.

Speaker B: 00:15:16

Can you talk a little bit about why you got into this? Like why is working with female sexual health and just female identified bodies in general a passion of yours?

Speaker C: 00:15:32

I mean, I just think the experience of being feminine in our society is, is challenging. I think we have neglected that side, you know, the healthcare side for women for a long time.

You know, we all know there's limited research, there's sort of like this, you know, medical gaslighting that goes on a lot where they don't take women's pain seriously or they don't take women's body complaints seriously.

And I just, I guess personally and professionally got very tired of, of hearing that and so wanted to create the space for women, I think women supporting women and helping women. There's side of that that is, it's special, you know, it's unique where we're kind of have that deep understanding of each other. I don't know, it's.

For me, I mean, I think I've been, you know, definitely more, I call myself a femaleist, but just interested in that side of things. Even from the time I was in high school, just seeing the disparities, you know, between like boys and girls and how we're treated differently.

And I don't know, I, I think we don't celebrate or value the things that femininity or those female roles bring to society. Not like we do other things as well.

So again, it's just, it's passion of mine to, to help women and kind of ease their way and really listen and I don't know, the way our healthcare system is set up, it's very, to me, you know, it's financially driven, it, I don't know, it's, it's set up in more of a, you know, volume unit. It's not about quality.

Speaker D: 00:17:22

Right.

Speaker C: 00:17:22

It's about quantity. And so I don't know, I want to change that. Like I, I'm driven to change that.

And it may sound funny coming from someone who does cash pay services, but to me it's a very one to one thing.

Speaker E: 00:17:35

Right.

Speaker C: 00:17:36

You pay me for a service, I provide it. And it's between the two of us, there's not some intermediate in the middle.

Speaker D: 00:17:41

Right.

Speaker C: 00:17:42

And, and that's the part that I, I don't know, I think is missing as well. So. Did I answer the question?

Speaker D: 00:17:50

Yeah.

Speaker C: 00:17:52

Yes.

I mean my, my other side of this is like I, I went to a women's college right out of high school for two years called Cuddy College, really small school in Missouri. And that college is supported by organization of women called peo. I'm a peo, and it just kind of encompasses that whole women supporting women idea.

And then PEO is the education educational organization that raises money for scholarships for women in addition to supporting the college. And then, you know, my own personal kind of pelvic health journey. I didn't even know I was a pelvic health patient, you know, at that time.

When I was young, you know, played sports, would have urine leakage sometimes, like, oh, why is that? You know, and then my first penetrative, you know, penis and vagina experience. I had a lot of pain, and, like, I.

It wouldn't, you know, we could not insert it fully of some vaginismus.

And it's funny, I was just telling a patient this story, but, you know, went to our family doctor who was like, you know, this country doctor, totally. And he, you know, he gave me my first pelvic exam and kind of was discovering, like, you know, tight muscles.

And then hot ring told me all this stuff and actually talked to me about using dilators and stretching and so working on that boyfriend at the time. Yeah, I mean, it was very like. I mean, he did call the dilator a dildo, but I think that's what they had back then.

You know, this is a long time ago, but I opted to just be like, well, I'll work on it with my boyfriend.

Speaker B: 00:19:30

Right.

Speaker C: 00:19:31

But then, like, connecting the dots, back When I was 8 or 9 years old, I felt. Fell on the ice and hit my tailbone, and it hurt so bad that I saw stars. And I remember it hurting for a long time.

And I think at that point I, like, hurt my tailbone, which created, like, these pelvic floor issues that kind of came up later, you know, And I still sometimes have tailbone pain and issues with bowel movement. So I. I kind of, like, practice what I preach and what I do.

Speaker D: 00:20:01

Yeah.

Speaker C: 00:20:03

And then now I'm in the. The perimenopause phase of life, which is a whole other thing.

It's very interesting and, like, learning about estrogen and how, like, your body actually needs and craves that, especially in the vagina, urethra, rectum, that area that really keeps that area healthy. And when it's not there, you start to have weird things happen, like overnight urgency, frequency of urine. It's like, what is going on here? So.

And then as soon as I got on vaginal estrogen, I was like, wow, that totally went away. So, you know, it's. To me, it's. I don't know, passion of mine to empower women Right.

About their pelvic health and with that, empowering them in other aspects of their life, too.

Speaker E: 00:20:50

Right.

Speaker C: 00:20:51

One thing we talk about probably daily here is helping women put themselves first. And that's so hard, right. When you have a new baby, this little tiny human that's so dependent on you.

But at the same time, you have to give yourself space, too. And so we. We try to be part of that team that helps them, you know, have that. So I'm a blabber. Kayla.

Speaker B: 00:21:14

Keep going. I'm a blabber, too. Don't worry about it.

Speaker D: 00:21:18

Yeah.

Speaker B: 00:21:19

So it's interesting for you that you had this injury when you were very young that led to some of these pelvic floor issues and that, you know, showed up when you were trying to have penetrative sex for the first time. And kudos to that, you know, family doctor. That is not the experience that most people have, especially from male doctors.

So that doctor was doing something right back then.

Speaker C: 00:21:51

Yeah. And I think, like, he was also a doctor that lived in the community. Like, you know, this was rural Idaho. And, you know, he knew people.

I mean, he would treat the whole spectrum of life.

Speaker E: 00:22:02

Right.

Speaker C: 00:22:03

Like, so.

Speaker D: 00:22:04

Yeah.

Speaker C: 00:22:05

Or he made it up on the spot. I don't know.

Speaker B: 00:22:08

Well, I mean, it sounds pretty close to what we hope for. Maybe not quite the dildo part, but it was in the ballpark.

Speaker C: 00:22:14

Well, I mean, just as context, too. I went with my mom.

Speaker D: 00:22:17

Yeah.

Speaker C: 00:22:17

I was, like, 18, but I still had to have my mommy there. And when he said that, she just started cracking up. So then I was completely mortified.

Speaker B: 00:22:26

So there was some shame.

Speaker C: 00:22:27

Yeah.

Speaker E: 00:22:27

So.

Speaker C: 00:22:28

And I. I. I mean, I thought I knew what it was, but then I didn't exactly know. And then my mom had to explain to me later why she left.

Speaker B: 00:22:36

Right.

And of course, like, you know, for people that don't know, like, well, you can talk more about dilators, but dilators are a tool that is used in pelvic PT to help, like, one, get comfortable with something being inserted into the vagina and help with, like, decreasing the. What am I trying to say? Decreasing the amount of stress and tension that are in the muscles around the vagina. Am I saying that right?

But they do kind of look like dildos. And so it would make sense that it's a little cringy to think about something that we think of as a sex toy. Using it for a medical Purpose.

Speaker E: 00:23:22

Right.

Speaker B: 00:23:22

Especially back in the day when, you know, dilators were probably not quite a thing on the market yet. Yeah. So. But still, kudos to that doctor.

What I was trying to get at though is, you know, a lot of women also experience some of the same issues that you were having with tightness in their muscles due to a lot of like narratives and shame around sex that we get as young people. But it sounds like, you know, it can also be because of an injury or, you know, a both and situation.

So I think that's interesting of how that happened for you. I do wonder, did you have any like shame based belief systems that were also happening at the same time that created some of that for you?

Speaker C: 00:24:18

Oh, Kayla, we could just keep going. I, so I was raised by, I mean, I don't know if people know what hippies are, but my mom was a true, you know, baby boomer hippie.

And she, I mean back then, like the ladies had vagina parties and like would look at each other's vaginas and empower themselves over, you know what I mean? So that was the mom I had.

So I mean she probably talked to me about sex and since time I was four or five years old, she tells a funny story where I was 4 or 5 and I just had a baby brother born and I was like, why don't I have a penis down there? You know. And she'd love to tell that story because she's like, yep, that's what we've started talking about.

Speaker D: 00:24:57

Yeah.

Speaker C: 00:24:58

And I'm, of course it was in context for a four or five year old, but I mean, yeah, my mom did not really when she was a sexual person, kind of expected that. And you know, we discussed along the way, I mean, when I, I, I mean I told her I'm gonna start having sex with my boyfriend. You know what I mean?

Like we said it very open. She knew about the difficulties, asked how it went the first time, you know, just that also is not the normal experience. I know.

Speaker D: 00:25:26

Right.

Speaker C: 00:25:27

But when your mom's crazy hippie, you know, she also like gathered herbs in the forest and things like that. So. Yeah.

So, but I, I do know what you're saying with the shame and to me that, you know, it's, there's, there's belief systems, there's kind of physical manifestations of that trauma especially. I mean you can have body shaming or body dysmorphia to the point Right. Where that is a trauma.

Speaker E: 00:25:57

Right.

Speaker C: 00:26:00

So yeah, I, I definitely have seen that and treated that as well. And that's where someone like, you know, having you involved with patients and referring. When we treat together.

Speaker E: 00:26:11

Right.

Speaker C: 00:26:11

Like it's part of.

Speaker D: 00:26:13

Yeah, yeah.

Speaker B: 00:26:17

So let's talk a little bit about what people can expect when they come to see you. I feel like this is kind of the thing where people are like, well, okay, what actually happens when I go to see a pelvic floor pt? What can I expect?

And just putting some people's minds at ease of how you create a safe space base and make sure that you're not doing anything that is not with consent.

Speaker E: 00:26:47

Right.

Speaker C: 00:26:47

Yeah. So, I mean, it is. It is kind of scary, Right. And to me, some people could be a big step to come to pelvic floor physical therapy.

You know, the role the. Of the pelvic floor is there's a lot going on. You know, I always say the pelvis is a very busy place.

Speaker E: 00:27:05

Right.

Speaker C: 00:27:06

Because those pelvic floor muscles are involved in, you know, maintaining stool and urine.

Speaker E: 00:27:12

Right.

Speaker C: 00:27:13

In place. They're involved, obviously, in sexual function childbirth, but they're also involved when we move.

Speaker E: 00:27:19

Right.

Speaker C: 00:27:19

And how our foot hits the ground and how our angle of our pelvis is and how our diaphragm's moving with respiration. So, like, when someone comes to me with the pelvic floor problem, it's sort of like, well, why is this pelvic floor having a problem?

Because it should be kind of postural and a little bit automatic in some ways. So it's usually telling us of problems, like, within a system. So.

So when people come to therapy and they're like, I have this problem, I. I think of myself as a detective, but I'm like a detective you've hired, and you've got to also tell me the details of this problem. And we're going to figure this out together as. As joint detectives.

But the first part is always, always sitting down, getting to know each other and doing that very intensive history. I mean, our intake forms, I mean, you fill them out online, but it could take you an hour. I mean. Yeah, just because there's a lot of detail, right.

That we're getting into a lot of intimate information we want to know, and that gives us a baseline. So we sort of know, are going through that intake paperwork together, you know, getting to know each other, talking about your comfort level.

You know, I'm thoroughly describing the exam before I do it. It's, to me, it's a conversation. Right. That first visit. And.

And then if I'm explaining, like, the reasoning, like, why I believe we should do an internal muscle assessment because it's not a pelvic exam. Like, sometimes we'll use that misnomer. But a pelvic exam to me is like, go to the gyno. You've got the stirrups and the speculum and the.

Speaker D: 00:28:59

Right.

Speaker C: 00:29:00

That's what we do here. Because your pelvic floor is dynamic. I. I do need to access it by, you know, placing my fingers in the vagina, but that isn't.

I mean, that may be our gold standard, but it's. It's like, I may do that with you laying down, I may do that with you standing up. We're kind of like having to look at the.

All the pelvic floors operating in different ways. And so it's. It's more what you can tolerate. Now if a patient comes in, they're having horrible pelvic pain.

The last thing I would do is do an internal muscle assessment with them.

Speaker E: 00:29:35

Right.

Speaker C: 00:29:35

So we have other tools like ultrasound, where we can visualize pelvic floor. That all happens just kind of above the bladder. You roll down the top of your pants for that one.

Speaker D: 00:29:50

Yeah.

Speaker C: 00:29:51

And we're assessing, like, what's happening with the pelvic floor just from a basic level. The other side is biofeedback, which those electrodes can be internal or placed around the anus. But again, it's.

It's to help us collect information, right. To like, what is the problem and then what are the things contributing to the problem?

So, so here, like I said, it's that conversation, the intake proceeding with what's comfortable to you. If you're comfortable, you know, with internal exam, we may do that. If not try other things.

And then I'm also assessing musculoskeletally, what's happening.

Speaker E: 00:30:28

Right.

Speaker C: 00:30:28

So I have to look at your foot, your hips, your breathing, even how you hold your jaw. All of that is. It will affect the pelvic floor. So it's. It's like physical therapy, but on steroids. No, you go to. Because I.

Because the pelvic floor is involved in so many functions of the body. I mean, the knee is like the knee and it's a simple hinge joint. You know what I mean?

Like, I can examine the knee all day long and treat the knee, but, you know, I mean, it's. Whereas. But pelvic floor is different.

Speaker D: 00:31:02

Yeah.

Speaker C: 00:31:02

So did the answer.

Speaker D: 00:31:04

Yes.

Speaker C: 00:31:05

I mean, that's how I do it. I.

Speaker D: 00:31:07

Yes.

Speaker C: 00:31:08

And how we do it here, because it's, to me, the most effective. And there are sometimes when I I never do an internal pelvic assessment with anyone. You know, like, they. Because it's not indicated for them.

Speaker E: 00:31:20

Right. They.

Speaker C: 00:31:21

Yes, they have stress incontinence, meaning leakage of hip, sneeze, laugh, jump. But we, you know, they're not comfortable with that.

So we're going to look at other things, maybe assess things on the outside, but then watch how they move and get that pelvic floor. You know, coordination improves strength, whatever it is, and then the symptoms go away. So.

Speaker D: 00:31:42

Yeah. Yeah.

Speaker C: 00:31:44

It is a specialty within physical therapy because not every physical therapist wants to work in that intimate space. You know, I. I used to be the weird kid, you know, go, like, you're the weird kid in the office.

Speaker B: 00:31:59

Like, aren't we all?

Speaker C: 00:32:01

Yeah. And now it's kind of cool to become a pt.

Speaker D: 00:32:04

Yeah.

Speaker C: 00:32:08

Oh, how can you just want to deal with people's vaginas and anuses all day? Like, that's weird, you know?

Speaker D: 00:32:14

Yeah.

Speaker C: 00:32:14

But it's not. It's not all what we do, so.

Speaker D: 00:32:17

Right, right.

Speaker B: 00:32:19

So how would somebody know that they need a pelvic floor pt?

What are some of the symptoms or things that people could be experiencing that's like, oh, this is a pelvic PT issue or thing that they could treat and it would be helpful to go see one.

Speaker C: 00:32:36

Yeah. I mean, any. Any pelvic pain.

Speaker E: 00:32:40

Right.

Speaker C: 00:32:40

Whatsoever. Like, it could be pain on your clitoris, it could be pain on your labia, it could be pain or, you know, anywhere in the vicinity of the vagina.

It could be pain around the anus, pain on the tailbone, pain, kind of. We kind of think between, like, your. Your hip bones, your sit bones.

Speaker E: 00:32:57

Right.

Speaker C: 00:32:57

It's like that lower pain. That would be it. I think you need a pelvic PT because other PTs are going to be like, nope, I don't know anything about that.

Speaker D: 00:33:06

Yeah.

Speaker C: 00:33:07

One of my favorite stories is a young guy I treated that had testicle pain. I mean, this not a good example, but he. They sent him to the urologist, they did all these estimates. Yes. Blah, blah, blah, blah, all these things.

Finally. And he's like, I'm not sexually active. I haven't had a partner in, like, a year. Like, I. Yeah.

And nobody would believe him, but it was truly like he had hurt his hip flexor and that, you know, that is something that can happen for men. And. But it's just like, you know, he didn't know he needed power pt, and then it took the, like, three other providers before he got to me. Right.

So even don't Know, but yeah, I mean, any pain kind of in that. That private realm or area, and then any loss of urine or stool that is beyond your control.

Speaker E: 00:33:57

Right.

Speaker C: 00:33:57

Like you cough, sneeze, you jump, or even if you have, like, fecal smearing or something like that happening, that can tell us pelvic floor muscles could be involved. You know, pain with urination, pain with bowel movements, those types of things. Any pain with penetrative activities, you know, that can be a sign.

Speaker D: 00:34:24

Yeah.

Speaker C: 00:34:25

The main ones. But it's just sort of like things are not working in that area as they. As they should.

Speaker D: 00:34:31

Yeah, yeah.

Speaker C: 00:34:32

And sometimes abdominal pain, too. Some people have weird abdominal pains, and nobody is like, I had all the CTs and.

And nobody knows what to do with this, you know, and that something like pelvic pts were more trained to deal with, like, the. Any abdominal issues or organs like that.

Speaker D: 00:34:49

Yeah.

Speaker C: 00:34:50

So if your doctor's like, I don't know what's wrong with you. I don't know why your belly hurts all the time.

You come to pelvic PT and then, you know, bowel dysfunctions that we treat, that may not be, like, pain, but it. It's like, you know, you're really constipated all the time. Or some people will have ibs right.

Where they're constipated, then loose and all these things.

So we do treat that side of it with pelvic PT as well, because there's things we can do to affect, you know, lifestyle changes, nervous system, things like that. So.

Speaker D: 00:35:23

Yeah, yeah, yeah.

Speaker B: 00:35:25

And I just wanted to add that with pain, with penetration, it doesn't even have to be, like, with a penis. It could be like with a tampon or, you know, going to the gynecologist and doing.

Doing an exam with a speculum is, like, unbearable or just even, like, more than. More than just not something that is fun to do that. There's pain involved with that.

Speaker C: 00:35:52

Yeah. And some people, like, you know, will say, I can't put a tampon in. Can't even get it in.

Speaker D: 00:35:57

Yeah.

Speaker C: 00:35:58

There's no pain, but I can't get it in. Or even a speculant like that. That, to me would be another.

Speaker D: 00:36:06

Yeah.

Speaker C: 00:36:06

Thank you.

Speaker D: 00:36:07

Yeah. Yeah.

Speaker B: 00:36:09

And for people that have, like, a lot of shame with their body and don't even like to touch their own bodies, how. How would you deal with something like that? Is that something that you would then refer out to me or somebody like me or.

Speaker C: 00:36:26

Yeah, I mean, I would definitely want to co. Treat a person like that.

Speaker D: 00:36:31

Yeah.

Speaker C: 00:36:33

But we do we do work with patients like that?

So we have kind of a process of mindfulness and just kind of self exploration that starts with just viewing the area, you know, taking a tour of the anatomy. I mean, it starts that basic. It can go even more basic than that, like visualizing.

Speaker E: 00:36:57

Right.

Speaker C: 00:36:58

The area and the kind of body scanning, things like that. So. So we do. We do work with that. I mean, we have a lot of patients that will say, I've never looked down there. Is that. Is everything okay down there?

Speaker D: 00:37:14

Yeah.

Speaker C: 00:37:14

I don't mean to laugh, but it's.

Speaker B: 00:37:16

Like, no, I. Yeah, I.

Speaker C: 00:37:19

Or they have the baby and then they're like, I. I'm too scared to look down there.

Speaker D: 00:37:23

Yeah.

Speaker C: 00:37:24

I'm just scared. I don't look down at.

Speaker B: 00:37:26

Right.

Speaker C: 00:37:26

I had my husband look. I'm like, okay.

Speaker D: 00:37:28

Yeah.

Speaker C: 00:37:29

So, I mean.

Speaker D: 00:37:30

Yeah.

Speaker B: 00:37:30

Well, I mean, I've had clients that don't even know their own anatomy. That I had a client one time that I had them.

Actually, I think I was having them read Come as you are, which is an amazing book that I recommend to everyone by Emily Nagowski. And then something that comes up in that book pretty early on is being able to look.

Speaker D: 00:37:51

Yeah.

Speaker B: 00:37:52

At your own genitalia. And they didn't know that their clitoris and urethra were different. They thought it was like the same thing for the longest time.

And it was like this huge revelation. So there are people that don't even know their own anatomy because they've never looked at it before.

Speaker C: 00:38:11

Yeah, that's true. Yeah.

Speaker B: 00:38:12

I'll.

Speaker C: 00:38:13

I'll tell an embarrassing story on my husband's part, but no, so. So, I mean, grown man. I. My husband and I got together later in life. He had children, you know, and a prior wife, and I had to talk to him about that.

Where the clitoris was and the urethra and that they were separate.

Speaker D: 00:38:37

Yeah.

Speaker C: 00:38:38

Like a grown man who has had children, watched childbirth, you know, had sex with women besides me, you know, and it's like, you know, helping him, and he was just like, wow. So, I mean, you know, it's. I think just.

Speaker D: 00:38:55

Yeah, yeah.

Speaker C: 00:38:56

As a culture, like what. We need to demystify and embrace some of this, you know, and.

Speaker D: 00:39:04

Yeah, yeah, I agree.

Speaker B: 00:39:07

And I think it goes both ways. I think I could get on a soapbox about this, but I do think it's good to teach young kids about their own bodies.

But that whole, you know, and I think for me, it was about fifth grade when they separate the girls and the boys, and then girls get talked about about periods and usually not really anything about sex. And then boys get talked about, you know, their own bodies, but there's never a talk about the other person's body.

And I had a conversation with my husband.

Speaker C: 00:39:39

They don't flip it. Like, they don't.

Speaker B: 00:39:41

At least not at my school. And I went to a private Catholic school. So.

Speaker D: 00:39:46

Weird.

Speaker E: 00:39:46

Yeah.

Speaker B: 00:39:47

But, yeah, I think I talked to my own husband about that too. Of like, I didn't. It's like, I know generally what happens to boys when they go through puberty, but I didn't know, like, the full extent.

And we both kind of talked to each other of like, yeah, what happened for you? What was that experience?

Speaker C: 00:40:06

Like, it's your partner. It's like the first one that you may talk to about that, you know, and my husband and I are going through the. The other side of the spectrum.

Like, you know, my husband the other night, he's like, you know, they.

They do tell men more about, like, periods and pregnancy and all that, but they don't tell me about perimenopause and menopause, like, what happens to women's bodies during that time.

Speaker B: 00:40:29

And they don't tell us that either.

Speaker D: 00:40:30

So.

Speaker C: 00:40:31

Yeah, and. Right, right, exactly. But I mean, but it's, you know, it's. It's so interesting. And then we are coming together to create humans.

Like, yeah, we can't talk about our genitalia.

Speaker D: 00:40:47

I. Yeah, it's funny.

Speaker C: 00:40:49

It's funny. Not funny. It's sad.

Speaker B: 00:40:51

It is sad.

Speaker C: 00:40:52

And I mean, it's appropriate laugher. But, yeah, that's okay.

Speaker B: 00:40:57

And again, like, we've been trained to be very comfortable to talk about these things, but for a lot of people, it's really hard. It's been taught to them to be very shameful to talk about their bodies, to even use, like, anatomical names for body parts.

So I think that's something that coming to any type of sex professional, we really try to make sure that it's a space where we are going to use language that maybe you're uncomfortable with, but in a way that hopefully, you know, it's like we're comfortable saying it.

And so just being in a space where people are saying it with just a matter of fact and it's not a big deal, can really normalize that and help people to release some of that shame around it.

Speaker C: 00:41:44

Yeah. Yeah, I agree.

Speaker D: 00:41:47

Yeah.

Speaker B: 00:41:48

So a few more questions. Yeah, when would you.

I kind of asked this in the last question, but when would you try to get somebody else on board with your patients that you're working with. So somebody comes to see you and you decide, oh, maybe I need to bring in, like, a urogynecologist or I need, like, a sex therapist or coach.

When does that happen for you? Or what is the situation that you would pull in other people?

Speaker C: 00:42:19

Yeah, I mean, it's. It's variable for everyone, but, I mean, I guess I do it right away, like, if I feel like. Because I'm looking at their.

Their pelvic health and entirety and how it affects their function.

Speaker E: 00:42:33

Right.

Speaker C: 00:42:34

In their life. So, you know, if you're. If you have fecal incontinence, you know, like loss of stool beyond your control, I mean, that's really affecting your life.

Right? I mean, that's. That's huge. And so, you know, there's.

There's shame and there's embarrassment and there's odor, and, you know, it's like, we want to, you know, handle these things. So I would, you know, get a GI involved, you know, with that sort of thing pretty immediately.

I might also want to have a mental health therapist involved. You know, I would probably get. Get the team together, you know, early on, then be coordinating that side of it. But, I mean, it's. It's.

It's very unique to the person. But, like, let's say a case of vaginismus, right? Like, someone who. Their muscles. Like, there's not. There's nothing is allowed to enter the vagina.

You know, it. It depends. Like, is there trauma there? Is there, you know, something else going on?

I may still bring in, you know, a sex therapist early on for that, just as this extra support person.

Speaker E: 00:43:38

Right.

Speaker C: 00:43:39

But I would have a medical doctor as well. I mean, there's.

Sometimes I'll bring in an acupuncturist or massage therapist for kind of a more passive modality to focus on the nervous system or things like that. We'll do system things, too, but it's just. It's, I guess, based on my assessment, the patient's function, the patient's comfort level, but it.

I think it's hard to treat pelvic floor just in the vacuum, like. Yeah, like, agree. You know, I mean, and. And there's times when, like, I'm like, go see Kayla, please. We need her involved. And.

But then they don't, you know what I mean? Like, so I force them to. I can just recommend. And, you know, the ones that do, to me do better.

Speaker E: 00:44:22

Right.

Speaker C: 00:44:22

Because they're getting it from all, you know, getting resources from all sides.

Speaker D: 00:44:28

So.

Speaker C: 00:44:28

Really? Yeah, it depends on the person, you know, what their goals are, their, their function, that sort of thing.

There's definitely times when, you know, because Washington state is public access or direct access for pts. And so I'll have someone who is maybe an older woman who's.

Hasn't had an exam in a long time, like doing a different type of exam, but I'm still assessing like the tissue and you know, what's happening, is there something. And then I may refer her to a medical doctor, you know what I mean? Just based on things I'm finding.

So, you know, when we have medical residents here that visit us, they're always like, you guys are like gynecologists, GI doctors, PTs, all in one, you know, because we are dealing with the, all these different systems that have to be working well together. So. Yeah, I mean, it's a great question, cuz screening is huge. And knowing what to do, it's just, it's specialized training really that helps us.

Speaker B: 00:45:29

Yes.

Speaker D: 00:45:30

Yeah.

Speaker B: 00:45:31

And you do have to know a lot and I think it's great to know that there's somebody that can do what you do. Cuz I think a lot of people still don't even know that. Pelvic floor PTS existing.

Speaker C: 00:45:46

Yeah, yeah.

I mean I, I do kind of a community thing a couple times a year for like this Latina group, you know, and, and we've had things translated and then I have a translator there and I mean it's, it's like two to three hours long. I mean it's intensive because these ladies don't know. They want to know. They're mad. They don't know. I'm the first person to tell them.

They're, you know, they want more information and that, I mean, that's what I, I love. I want to empower women, you know, to be in their bodies fully. You know, I mean, we're the life givers.

Speaker E: 00:46:24

We're right.

Speaker C: 00:46:25

I mean we're the ones that are, to me, like, I don't know, powerful and you know, to just endure so much and create and, and yet we're disempowered, you know, by society. It's, it's like this bizarre scam. I, I don't know, but I'm onto it now.

Speaker B: 00:46:48

No, we are onto it. That's why this podcast exists, because we are onto it and we're changing it.

Speaker C: 00:46:56

Yeah, yeah. And I, I mean, you know, I'm a Gen X lady. I, I'm, I'm just not willing to put up with it.

I don't know, it's just the, you know, my mom's generation is different. Um, but I don't know, Gen X I guess, cuz we're the original rebels and all that. But I don't know, you just start to see the problems. Right.

You just can't stand by.

Speaker D: 00:47:18

Yeah. Yeah, for sure.

Speaker C: 00:47:20

Well.

Speaker B: 00:47:21

And I think you already started to paint the picture, but I really wanted to end on just like what have you seen women be able to do once they go through PT and heal this problem that for probably a lot of them felt like was never going to be something that they could treat or maybe for a long time didn't even know, kind of like you that there was a problem and that it was something that could be treated or maybe they knew there. There was a problem, but there probably wasn't something that they could do about it.

So what have you seen kind of be the end result for a lot of these women and how does it.

Speaker D: 00:48:02

Yeah.

Speaker B: 00:48:03

Put pleasure back into their lives in a positive way.

Speaker C: 00:48:07

Yeah. Keep those questions coming. They're so easy. I mean, I think the, the big thing is, I guess is, is confidence.

Speaker E: 00:48:22

Right.

Speaker C: 00:48:23

And freedom.

Speaker E: 00:48:24

Right.

Speaker C: 00:48:25

That you have.

Speaker E: 00:48:26

Right.

Speaker C: 00:48:27

That you understand your body. You feel empowered in how it's working. It's supporting you doing all the things you're doing you need to do and you feel strong.

You know, I mean, I think that's what I want for all my patients to leave and, and feel hopeful. And also advocates to other women, you know, like, hey, don't put up with this.

Like it's common to leak after you have a baby, but it's not, it shouldn't be accepted.

Speaker E: 00:48:55

Right, right.

Speaker C: 00:48:55

And it's like I'm living proof that this can get better and it's gone away. It's never coming back. You know, there was a statistic that struck me. It was a World Health Organization article and about a study they did.

And this is globally. Right. Women. And it was almost like a third of women after having had a child feel they have a functional impairment that affects their life.

And, and to me that's just, that's not acceptable. And that it points to like our issues with healthcare, our issues with women's health. And, and I just don't think that's right.

You know, I, I want women to have a child and be stronger for it.

Speaker E: 00:49:35

Right.

Speaker C: 00:49:35

And not less for it. And I just, I feel so passionately about that. And you know, we deserve it.

Speaker E: 00:49:45

Right.

Speaker C: 00:49:45

It's, it's part of who we are and that freedom and confidence is needed and there shouldn't be shame, you know, in having a problem in this area or, you know, it's like, it's a problem. We identify it, we work through it. You know what I mean? It isn't a problem. And then on the other side of it, we feel empowered and strong, you know?

Yeah, that's. And we see that every day here. I mean, it's, you know.

Speaker D: 00:50:14

Yeah.

Speaker C: 00:50:15

Come in. Like, I'm afraid to lift the baby. Every time I do, I feel like my vagina is going to fall out, you know?

Speaker D: 00:50:20

Yeah.

Speaker C: 00:50:20

And it's.

By the end, it's like, I lift that baby, no problem, you know, and it's things like that, or, you know, I. I love having sex with my husband, but I can't, you know, it's painful, you know, and then, gosh, when you get people's sex life back, you're like, oh, yes, Dr. Angie is the best. Yes. I mean, it just. It makes a huge, huge difference in their lives. And, I mean, that's why we all, I think, do therapy.

I. I think because you get that close time with people, you can make this enormous impact, you know, and you are influencing the world and. And carrying that with you and. And changing. You know, I had a great instructor in school when I was pt, and.

And he would always say, you know, influence the space you're in.

Speaker E: 00:51:07

Right.

Speaker C: 00:51:07

It could be a treatment room, it could be a doctor's office. It could be, you know, the nurses station in the hospital. But you take your energy and influence the space you're in, and I've.

I carry that with me, you know, and that's what I want for my patients, too.

Speaker E: 00:51:23

Right.

Speaker C: 00:51:23

Like, I want to influence them in this positive way, and then they go out in the world and influence more and more. Yeah, it's just a chain. Chain of greatness. Yes, for sure.

Speaker B: 00:51:36

Well, I love that you have that passion for influencing not just your patients, even though that is enough, but also, like, changing the culture, which will then change the world. So, yeah, it's right in line with what I'm trying to do, too.

Speaker C: 00:51:54

So I'm here together.

Speaker D: 00:51:56

Yeah.

Speaker B: 00:51:57

Yes, for sure.

Speaker C: 00:51:58

By the way, I need you to come visit again and talk to my new therapist and give us a little training or something.

Speaker B: 00:52:05

Sure, I would be happy to. And on that note, how can people find you and what things are going on at your clinic that you want people to know about?

Speaker C: 00:52:16

Yeah, so, yeah, we're. We're in central Tacoma, but we do tell else. You know, we can do telehealth in Washington State, you know, wherever you are in the state.

And it may seem weird to do public health via telehealth, but I was the number one telehealth user during COVID And I mean, it's possible. Cause there's just, there's a lot of education, talking awareness, lifestyle changes, things that happen with, with pelvic health.

I mean, I taught patients how to do their own muscle assessment. You know, so it's like telehealth can be. Was still a powerful tool.

So you can reach us, you know, at the clinic in Tacoma, you know, our website and all that number will be below. And then. And like I said, telehealth as well. We, we do a weekly kind of perinatal fitness class that's Wednesdays at 1. Yeah, 1:15 Wednesday.

And your first one's free, so you can come try it out and you get to bring the babies. So that was really important to us that. And so we got, you know, mama's working out in there, babies screaming, we don't care. It's just chaos.

nd so I have a class Mondays,: 11:15

And that's a lot of strength training, balance and impact training for helping build strong bones and, and muscles. So those are kind of weekly things we have going on. Like last month we had a C section screens.

We have different free screenings we do in the, the community. I don't, I don't think we have any coming up right now, but those are, yeah. Main ways to find us.

Speaker B: 00:53:55

And yeah, I think you said in the questions that I had for you to fill out that you do something for women that have had C sections that you do.

Speaker C: 00:54:05

Yeah, oh yeah, we do, we do free screenings for that. Like you can come in. It's just like a half hour free screen.

Another big passion of mine is I just think the postpartum care with C section birth is not where it needs to be. So I like people to come in, have a screen and just, you know, let you know how that scar has healed.

You know, what's going on with the fascia, the abdominal muscle layers are doing what they need to do that you have your core canister back. Just checking through all that. And then, you know, if we're seeing a need to see you on the PT side, let you know of that.

I think, you know, other major abdominal surgeries get physical therapy after, but they don't do that with C section birth, which is a complete mystery to me. They don't even see him in the hospital. P.T. doesn't see him.

Speaker D: 00:54:54

Yeah.

Speaker C: 00:54:55

And it's a testament to women's bodies how strong they are that they can heal from that and have hardly any therapy.

Speaker D: 00:55:01

Right.

Speaker C: 00:55:01

Yeah, it's. Which shows how strong we are.

Speaker D: 00:55:04

Yeah.

Speaker B: 00:55:04

Anyway, but they should. They should get.

Speaker C: 00:55:10

Yeah. And I'm actually trying to work with some local OB GYNs to get a C section rehab going that happens more immediately.

Not waiting six weeks for rehab to get going.

Speaker D: 00:55:21

Yeah.

Speaker C: 00:55:21

So anyway, that's another side project. But yeah. And you can just call the clinic to book that for a screening, and then you can also do a bone health screening.

If you are concerned about kind of strength and balance and those you just call the clinic and we schedule and get you on the books. So.

Speaker D: 00:55:39

Great. Great.

Speaker B: 00:55:41

Well, thank you so much for being here and having this conversation with me.

I will link all of what you mentioned down in the show notes so that people have access to that, you know, anyone that is in the area and feels like they need some pelvic floor pt. I definitely recommend Madrona and Angie and her, you know, wonderful other practitioners that are in her clinic.

And if you are not in our general area, I encourage you to go find a pelvic floor PT in your area because.

Speaker C: 00:56:15

And I can maybe help with that too.

Speaker B: 00:56:17

Like, I.

Speaker C: 00:56:18

We have, you know, networks definitely on the pelvic PT side, so depending on where you are in the country, can. Can connect you.

Speaker D: 00:56:26

Great.

Speaker B: 00:56:27

So great. Well, thank you again, Angie, for being here.

Speaker C: 00:56:31

See you.

Speaker B: 00:56:32

Yeah, we got to see you. Yes, absolutely.

Speaker C: 00:56:35

Have you into the office and be good.

Speaker B: 00:56:38

Sounds good. All right.

Speaker C: 00:56:41

All right. Take care.

Speaker B: 00:56:42

Take care.

Speaker C: 00:56:43

Okay, bye.

Speaker B: 00:56:44

Bye.

Speaker A: 00:56:47

Thank you for joining me for this episode of the Connected Pleasure podcast. If you'd like to stay connected beyond the podcast, I invite you into my newsletter community.

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Speaker B: 00:57:40

Way to this space.

Speaker A: 00:57:41

Until next time, may you walk with softness with love and with pleasure.

Speaker D: 00:57:47

Sa.