The Power of the Pelvic Floor: Why It Deserves Your Attention with Dr. Kaleigh Mulpeter PT, DPT

As part of our Expert Spotlight Series, our founder Lauren chatted with Dr. Kaleigh Mulpeter PT, DPT. Dr. Kaleigh is a physical therapist, educator, and community builder. She is the owner of Renewal Physical Therapy, co-founder of Richmond Wellness, a perinatal wellness center, and has been teaching yoga and movement classes for over 12 years. Dr. Kaleigh specializes in pelvic and perinatal physical therapy, supporting people in all stages of their pregnancy and pelvic health journey. She utilizes traditional physical therapy interventions such as strength training and manual therapy along with mindfulness, breathing practices, and pain neuroscience education.

In their chat, Lauren and Dr. Kaleigh dive into the often-overlooked world of pelvic health, breaking down common misconceptions and highlighting the importance of understanding your pelvic floor—regardless of gender. Dr. Kaleigh explains why issues like incontinence or pain with intimacy aren’t something you just have to “deal with” and shares simple tips for supporting your pelvic health every day. If you've ever wondered whether pelvic health affects you or how to take better care of your body, you don’t want to miss Dr. Kaleigh’s tips!

Check out 5 of our highlights of their conversation below, or catch the full chat on YouTube!

1. Why Everyone Should Care About Their Pelvic Health—No Matter Their Gender

Lauren:

How would you explain the importance of pelvic health to somebody who's either never heard about it before or maybe has a very basic understanding?

Dr. Kaleigh:

Yeah, I think I would start with the statement that everyone has a pelvic floor. So just like any other part of your body, sometimes the pelvic floor can be involved in an issue or an injury. Even people with back or hip pain, sometimes the source or a contributing factor to that pain is coming from the pelvic floor. So you want to work with someone who is well-versed in assessing and then treating that. And then I think another way to get through to folks how important the pelvic floor is is to remind them that your pelvic floor helps keep private things private, like your ability to empty your bladder and your bowels to control gas, to support sexual function. All those things involve your pelvic floor.

Lauren:

I like that you started off with everyone has one because it's been interesting since I will tell people about creating the garment and what it is for, and the women who I talk to, most people in that space are like, 'Okay, yeah, I know exactly what you're talking about." Or they have a general idea. And I feel like when I talk to men, it is more like, "Well, who does this apply to?" And I don't feel like they feel like they have a pelvic floor and I'm like, "Everybody does this." It's been interesting with me being newer to this space, having those conversations and starting to see what people's perceptions are for sure.

Dr. Kaleigh:

Yeah, definitely. I think that's something that's lacking in the pelvic health sphere actually is more education for men and children and intersex folks. Everybody has a pelvic floor despite your gender or your sex. So, I know! I think we need to do a better job on educating people who don't have vulvas, that they have a pelvic floor too. And actually a lot of common pelvic floor issues like erectile dysfunction or other intimacy issues or urinary issues, I mean it's stemming from your pelvic floor and folks just don't know enough about it to identify, "Oh, maybe that's a pelvic floor issue. Maybe I should go see a pelvic floor professional."

2. “We’re More Than Just Pelvic Floors”: Why a Whole-Body Approach to Pelvic Health is Important 

Lauren:

So along those lines, I know also that there can kind of be the one-liners that can get out there and then that's what's pervasive, and I think a lot of times it can be a misconception. What are some of the top misconceptions that you see or that you have to actively work to combat in the community?

Dr. Kaleigh:

Yeah, I think the biggest one is that a pelvic floor issue, like urinary leakage for instance, or incontinence, is due to a weak pelvic floor. And the answer is always to do pelvic floor contractions--AKA Kegels. Luckily we're getting more and more info now with social media being so robust, but I think in the past the message was always, "Oh, you have an issue with your pelvic floor? Squeeze it over and over." But if we recommended that for any other part of the body, you would be like, "Do you really know what you're talking about?" If someone had hip pain, you wouldn't tell them, "Just sit down and just squeeze your butt over and over and that should take care of the issue."

So yeah, I think that dialing it back, again, issues are not generally just from the pelvic floor. The pelvic floor is part of the system that is your body. So sometimes an issue, even leakage, could be because of something happening with your foot mechanics or your hip mobility or strength or how your breathing or your posture. There are so many different factors that can influence the pelvic floor, and the answer may not be, "Just make it stronger." We have to look into, well, why is there so much burden being placed on your pelvic floor that's causing the issue?

Lauren:

Right. Yeah, I love that point, too, because I feel like that's the other piece is it can feel like, oh, you're only focusing on this one thing that may or may not be functioning properly, but to the point you're making, it's this whole body system and your pelvic floor is a crucial part of it, and the systems all interplay together.

So it's so important to at least have a high-level understanding of what the options are so that you can seek the proper help and at least get pointed in the right direction when you start to have things go in a way that are not ideal for you.

Dr. Kaleigh:

Yeah, absolutely. And I think any good pelvic health provider is looking at the whole body, the whole system. Sure, someone's issue might go away if they're just strengthening their pelvic floor, but as soon as they stop doing Kegels over and over, it might come back and they're frustrated, like "Why is this happening?" So yeah, we have to look at the whole person. We're more than just pelvic floors.

3. Dr. Kaleigh’s Top 3 Tips for Pelvic Health

Lauren:

And I know, too, that one of the things that's so great about pelvic health physical therapists and pelvic health professionals is that a lot of times you all are in a space where you can give a lot of one-on-one attention and very specialized individualized guidance. Are there best tips or practices that you would recommend that are more applicable to a general population without having to be as individually tailored? If I'm just thinking, "How do I keep good pelvic health in mind or between habits, exercise movements, practices that are just good things to keep at the front of my mind in my day-to-day activities?"

Dr. Kaleigh:

Yeah, definitely. There are absolutely some just general recommendations I could make that can help support everybody's pelvic health. The first would be to get enough fluid and fiber to support healthy digestion because constipation can strain your pelvic floor. So supporting stool that's easily passed and healthy, happy, easeful bowel movements is a great way to support pelvic health.

Another one would be to stay active because your pelvic floor muscles are primarily involuntary. They should just engage when they need to and they turn on when your body is moving. So if you are generally active in whatever makes you happy: walking, yoga, strength training, you are taking care of your pelvic floor strength as well.

And then another would be to address stress. We tend to hold stress in a couple places in the body, most commonly the shoulders, which I'm sure a lot of people are like, yep, that's me. But also the pelvic floor! We just tend to have less awareness of the pelvic floor, so you might not be noticing that, but your pelvic floor tends to clench when you're feeling stressed or afraid or overwhelmed. So managing stress and anxiety and really thinking about that whole being health again, that whole person health is supportive of your pelvic floor.

4. A Powerful Success Story: Pelvic Floor Therapy and Vaginismus

Lauren:

One thing I did want to ask you about if you feel comfortable sharing would be telling us about a success story that you've had with somebody that you've worked with?

Dr. Kaleigh:

Yeah, I'm happy to say there have been lots. One that comes to mind is a client I was working with who has a vaginismus diagnosis, which is the involuntary spasm of the pelvic floor muscles when trying to insert something and associated anxiety with the idea of inserting something. So a lot of difficulty with gynecological exams and tampon use and intimacy. And we worked together for, I want to say about a year, and then she became pregnant, and then I supported her through her pregnancy and then I supported her postpartum. So that was an awesome story because I just was able to see her really come full circle, and it's a good example of how I could support her pelvic health in lots of different ways through different stages.

Lauren:

Amazing. Thanks for sharing that. I think it's so important too to hear the success stories because if you're somebody that's experiencing that or another, anything that can feel debilitating and where you don't have necessarily certain choices, it's so great to hear that you can work with someone and have this long ongoing relationship of support the entire time. It makes me feel hopeful for those kinds of situations, so thanks for sharing that.

5. Feeling Hesitant About Seeking Pelvic Health Treatment? Here’s Why You Should Reach Out Anyway 

Lauren:

Another thing I feel like I've kind of come up against is people who might feel hesitant to seek help. What would kind of you say to help encourage them to potentially reach out?

Dr. Kaleigh:

Yeah, I think that's such a great point because it takes some bravery, I think, to go to a pelvic provider and say, "Hey, I need your help with this."

I think first and foremost, you have control over your body and you don't have to do this if you don't want to. And it's also so important that you're working with someone who you feel comfortable with and who is really asking for your consent throughout the time working together. So if you have a first visit with someone and you feel like you didn't really jive and oh yeah, they just kind of said, "Okay, take your pants off and hop up on the table." Maybe that's not the provider you want to continue with and know that you can always decline any of that internal pelvic floor assessment or treatment. I've definitely worked with folks who are not comfortable with that, and that's fine because luckily the pelvic floor is influenced by lots of other things. So we can still make progress without direct pelvic floor treatment if that's not something someone's comfy with.

But I think encouraging someone to just either have a phone call with a provider first to get a sense of things, ask questions, or meet them initially before jumping into a full treatment plan is a great idea and it's very valid to want to do that.

Lauren:

Thanks for sharing that. I think it's also helpful for people to hear from healthcare professionals that it's okay to just do the phone call or to just kind of do an interview or a first thing, and then to have that check-in and be like, "Does this feel right for me?' And if not, switch, because I think sometimes too folks can be like, well, I've met up with this person and that's my choice and who I move forward with. So I think it's really helpful to hear that you can pivot and that it is in your control to decline certain things. And just because they say, "Hey, let's try this or do this," doesn't mean that you have to say yes to everything. I think that's another anxiety that folks may have about feeling hesitant to seek care. And when you get to hear providers like yourself be very empathetic and listening and supportive of those kinds of choices, I think it helps more and more people feel more brave to reach out if they are feeling hesitant. So I think that that's great.

Dr. Kaleigh:

Yeah, definitely. It's so important.

Lauren:

Thank you. One other thing I did just want to check in with you on as we're wrapping up, is there one thing you wish folks knew about pelvic health or a soapbox item that is your favorite to talk about?

Dr. Kaleigh:

I feel like we have touched on some of the important things, like Kegels aren't the answer to everything, and everybody has a pelvic floor, and your pelvic health is about more than just your pelvic floor. But I think the biggest thing I want people to know is that pelvic floor issues are common. You're not alone but peeing when you don't want to be peeing or having heaviness or pain with intimacy, that's not normal and you don't have to just deal with it. There's lots that we can do to support you and get rid of those symptoms.

Are you a pelvic floor healthcare professional? We’d love for you to be a part of the Hem Support Wear community! Learn more about our resources, including our clinic sample kits, healthcare-focused monthly newsletter, and more. If you’d like to be featured in our Expert Spotlight series, let us know!

**Medical Disclaimer: This post is intended to provide information and resources only. This post or any of the information contained within should not be used as a substitute for professional diagnosis, treatment, or advice. Always seek the guidance of your qualified healthcare provider with any questions you may have regarding your healthcare, conditions, and recommended treatment.