98 | Your Healthy Pelvis with Dr. Tanya Goodrich
98 | Your Healthy Pelvis with Dr. Tanya Goodrich
Tune in for an enlightening and comforting conversation with Dr. Tanya Goodrich, a renowned expert in women's pelvic health. An often-overlooked topic, pelvic health plays a crucial role in women's well-being.
With over 15 years of experience, Dr. Goodrich combines her unique background in dance and physical therapy to educate and empower women, aiming to erase the stigma surrounding pelvic issues. As the founder of Healthy Pelvis Physical Therapy, she specializes in addressing a wide range of concerns, from pregnancy and postpartum care to menopause and sexual health.
Dr. Goodrich's engaging and approachable style makes these complex (and sometimes embarrassing) topics accessible and relatable. Whether you're experiencing pelvic health issues or simply want to learn more about maintaining a healthy body, this episode is packed with valuable information and practical tips.
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Intro: Welcome to A Pleasant Solution, Embracing An Organized Life. I'm your host, certified life coach, professional organizer and home life expert, Amelia Pleasant Kennedy and I help folks permanently eliminate clutter in their homes and lives. On this podcast we'll go beyond the basics of home organization to talk about why a clutter-free mindset is essential to an aligned and sustainable lifestyle. If you're someone with a to-do list, if you're managing a household and if you're caring for others, this podcast is for you. Let's dive in.
Amelia: Welcome to Episode 98, “Your Healthy Pelvis with Dr. Tanya Goodrich.”
Tanya Goodrich, PT, DPT, a distinguished figure in women's pelvic health, brings over 15 years of experience to her practice and advocacy efforts. With a background in dance from the California Institute of the Arts and a Doctorate in Physical Therapy from the University of California, San Francisco, she possesses a unique blend of expertise.
As the founder of Healthy Pelvis Physical Therapy, Tanya specializes in addressing a wide range of pelvic health issues, including those related to pregnancy, postpartum care, menopause, pelvic pain, bladder and bowel dysfunction, and sexual health. She extends her influence beyond clinical practice, serving as a recognized speaker on these topics and providing guidance to organizations like Evernow, focused on menopause care, and Blossom Birth and Family, a nonprofit supporting women and families in the Bay Area.
Through her comprehensive approach and dedication to education and innovation, Tanya Goodrich continues to make significant contributions to improving women’s pelvic health and well-being.
Amelia: So welcome to the podcast, Tanya.
Tanya: Thank you so much for having me.
Amelia: You and I, we met on this amazing retreat for female founders. And the first thing I heard about you was that you were a former ballerina and I took dance growing up. So I loved learning that about you. And at the event, you humorously kind of gave us an overview of the anatomy of our pelvis, and answered a wide range of questions all during our lunch. And everybody was super engaged and entertained and comfortable. And afterwards, the crowd was like, "You need to be out there on stages. Like, definitely do a TED Talk." You're so great at presenting this information.
So I would love for you to just kind of start by telling folks a little bit about how you came to love pelvic health.
Tanya: Thank you so much. That was such a lovely introduction. Yes, pelvic health is my passion. And who knew that I would be talking about all TMI subjects like bladder, bowel, and sexual dysfunction. But I really feel like it is really my life's purpose. And it gives me so much joy to help educate and empower women about their body and to erase shame and stigma surrounding pelvic issues. And I try to make it funny and light because really it should be talked about like any other part of the body.
So yeah, so we can talk about all the TMI things today and how I got into pelvic health was kind of interesting. My background is in dance. I was a hardcore ballerina growing up and then switched to modern dance and actually have my degree in undergrad from the, got a Bachelor's of Fine Arts in dance from California Institute of the Arts. So kind of wild.
And then I decided I was gonna kind of, wanted to do physical therapy. And I thought I was only gonna do physical therapy for dancers. But then during my second year at UCSF, I was basically kind of thrown into just pelvic health. My instructor said, hey, you should follow our women's health instructor around. And I was like, okay. And I did, and I was like, wait, what? What are we talking about? And then I did some research and I was like, my goodness, this is... so important, so underserved, and our country is so far behind.
And I literally went back to my friends and I said, isn't this fascinating? And they all said, "No, we want nothing to do with all that crazy talk." And then I just like light bulbs were going off in my head and I was like, I think I'm supposed to do this. And really this is back in 2008. So I have been in this field for a very long time. I have been a pelvic PT now for 15 years and I still love talking about it and that's my story. That's how I got here.
Amelia: I love it. Taking myself back to 2008, I had a one-year-old. And I wish you were in my life at that time. And we'll get into all that here in a moment, because it's so crucial for mothers, birthing parents, to have this education through that time period. So yes, you've really been in this game a long time.
Tanya: Yes.
Amelia: So I'd love to start all of my conversations by having everyone take a step back and think a little bit about what organization, kind of whatever that means to you, looked like or didn't look like during your childhood.
Tanya: That is such a great question because first of all, we met at an organization founders retreat, which is part of why I went because I would say I am not an organized person or my brain actually feels disorganized. And as an adult, I came to realize that I definitely have ADHD, which is less commonly diagnosed in women. And I also feel like it has been my superpower because I'm able to hold multiple tabs open in my brain. I, it's funny because the word "disorganized, but passionate" comes to mind. So perseverance, I would say. So as I've gotten older, I've gotten better with organization. It's something that I continually try to work on. So a work in progress organization is what I would call it. Yeah.
Amelia: We all are, right? Like that is what life is and we're kind of always on this journey. So thank you for sharing that. All right, let's get into the good stuff. You said TMI earlier, right? Potentially awkward for some folks, but really a reality for many of us.
And I mentioned it in your intro and you shared, pelvic health covers so many topics from urinary and bowel concerns to sexual health, pain and discomfort, and to the hormonal changes that occur as we age. So I'd love for you to kind of just start with the basics. What's the role of the pelvic floor?
And why is it so crucial to the health of women of all ages?
Tanya: Fantastic question. Yeah, so a lot of people sometimes don't even know what the pelvic floor is. And that's okay because it's not necessarily something that we learned in school. We did not learn this in health class. So the pelvic floor is essentially, if you can think of your pubic bone and then you think about your tailbone, it's the muscles that connect the pubic bone to the tailbone and it slings forward and back like a hammock. And essentially you have your uterus and your bladder, and your rectum all hanging out kind of on your hammock.
And so a lot of times we don't even notice or think about our pelvic floor until we have dysfunction or pain in that area. And so I really think it's like the unsung hero of the body. And it really is just connected. The reason why it's called the pelvic floor actually is because if you think of your torso like a house, right? So your rib cage, and diaphragm are your roof. And your core is like the front door, right? Your back is the back of the house and your pelvic floor is your basement. It's the floor of your core.
So it really is. When people talk about the core, they're also talking about the pelvic floor because it is directly connected. So that's the pelvic floor. That's why it's so important.
Amelia: It makes total sense to me and I love that you described it in that manner because I have a diastasis and so when we look at my core, the front door is a little bit open, I would say, right? And that's all from, yes, yes.
Tanya: Mm-hmm.
Yeah, yeah. Which you can still work on. Yeah. So we can talk about that too a little bit if you want, but yeah.
Amelia: Yeah, it's, you know, all of these parts are working together and with pregnancy and childbirth, the body relaxes and changes. So yeah, just what's one quick tip if someone is experiencing muscles there?
Tanya: Yes. Yeah, just, yeah, because you threw out diastasis recti, which I think some people maybe have never heard of or feel like they haven't and don't know how to fix it, but it is very common. And that's, it's the connective tissue that connects both sides of your abs together. So when you're pregnant, that line gets dark, the linea negra, and that is the connective tissue. Now I like to joke that the baby goes like, hi-yah, and kind of opens that connective tissue, right? It's just a nice image for it.
Now what happens is that we want to rehab that area and you probably weren't taught exactly how to do that just so that the abs can come back together. And it might not totally close, but you want just a functional closure. There we go.
Amelia: Yes, absolutely, which is a lot of the work that you do with women in your practice. And I have worked with someone in the past and I think it's something you need to continue to maintain over time as well. I think listeners would love to know about this kind of peri menopause, menopause period, because awareness is really increasing. We're starting to talk about it more. And, you know, the more we share our stories, like the more other folks feel seen and heard. And I actually thought there's a new documentary on PBS called "The M Factor" that was really, yeah, it was really informative and accessible and…
Tanya: Yes. I'm so glad you saw that. Yeah.
Amelia: Thanks, yeah, I mean, it's again, right? You hear it somewhere and then you're like, I gotta go find that out. So I imagine this is like another critical time in women's lives where paying attention to our pelvic health becomes important. So yeah, what are some of the most significant changes that women experience during perimenopause and beyond.
Tanya: Yeah, yeah, we can talk about it. ‘Cause this is like one of my favorite things to talk about. So perimenopause and menopause is a really big deal. And it's finally, as you were talking about having a moment where we're, there's more research. We're talking about it. We're finding out that the kind of studies that were done 20 years ago were incorrect. You know, hormone replacement therapy is not the big bad wolf that we thought it was.
And the reason why it matters so much with the pelvic floor, is that there's so many estrogen receptors down there in the vulva, in the bladder. And as we go through this menopause period, which can be as early as 35, right? So note we haven't really thought of that before. It creates a lot of dryness, right? Kind of like your face as we get a little older, we need more of the serums and the creams and our hair. The same thing is happening down there, which is not great because it creates some little cracks down there and then we're more likely to get an infection.
So UTIs, dryness causes pain with intercourse and also creates more of the kind of sagging of the bladder a little bit. So it creates all this irritation, but it's not doomsday because first of all, just hearing about it and knowing that there's something to do is huge. And basically, ideally we're getting some type of potentially hormone replacement therapy.
And even if you can't, you could at least get the local estrogen cream, which is a hundred percent safe. And a lot of really wonderful Euro gynecologists are talking about how every woman over the age of 35 should be on a vaginal estrogen cream. And it's a big deal. So that's something that I want to talk about. And yeah, it's really important that we take and erase the shame and stigma about it and we just talk about it and share our stories because it's the last statistic I saw was that up to 80% of women in perimenopause postmenopausal as well have this genitourinary syndrome of menopause. It's super common.
Amelia: So can you give me a picture of kind of, so someone has awareness that they need to work with someone like you. Can you give me a little bit of a picture of like a before and after kind of story or show the journey of improvement that someone could have?
Tanya: Mm-hmm. Great.
Yeah, so essentially as pelvic physical therapists, our job is to work with any type of dysfunction down there. So that's like if you're leaking or if you're having prolapse, which is just a fancy word for heaviness or feels like the vulva or vagina is sagging low, especially at the end of the day, if you're having pain with intercourse, if you're having constipation issues, anything that's happening down there, if something isn't feeling right, that's where we come in because OB-GYNs are fantastic at delivering babies and making sure, checking for cancer, but muscles and connective tissue and function is where we come in.
And it still, I feel like not enough people know about it or even go just to get checked out because, you know, we're just kind of told, I feel like generations and generations ago, since I don't know the beginning of time, for that women, if there's a problem down there, just do Kegels.
And that is not okay because that's just a throwaway term and it doesn't really have much meaning. So we really care about women getting checked out to see if you're able to squeeze down there and release, but then more importantly, how it connects to function. So laughing, coughing, sneezing, jumping, all of the good stuff. We want to stay healthy and continue to do those without any suffering or pain.
Amelia: I love that you mentioned the word “release,” because that was something that I was surprised to learn in my own journey. I don't think women realize that sometimes they may be walking around holding or tightening, and that release can be part of it. And when you identify that in your body, the difference between clenching or holding and releasing…
Tanya: Yes. Yeah, I love that you're talking about this because actually in our clinic, we don't even call them Kegels, we call them blueberries. And that's because first of all, Kegel was named after an old dude named Dr. Arnold Kegel And so we're kind of done with that. The idea of a blueberry is it helps to have an image down there because you can't see it. So the idea is that your pelvic floor needs to be able to squeeze and relax. But having said that, a lot of people hold tension in their pelvic floors.
It's a very easy place to hold tension. And so they're walking around holding a blueberry all the time. I like to joke that you might be part of the secret "butt clencher society." And my god, I need to release. And so it's huge to have that awareness. So you shouldn't just be doing a thousand Kegels a day, for example, if you're already tight. So great, great point.
Amelia: Such good awareness and I'm sure listeners are wondering like, "Am I, am I clenching or am I releasing right now?" Right.
Tanya: Right? Yeah, and it might resonate like, my God, I am a secret butt clencher. You know, it really, it really, I see it all the time. The light bulbs go off.
Amelia: Yeah, such fascinating, fascinating work. So in preparation for our conversation, one topic that came up that also surprised me was osteoporosis. I was like, we got to talk about this because it reminds me of the magical "someday maybe" like future that folks dream of when they have time to stop and get organized, right?
It's like that future down the road, osteoporosis as well, stereotypically we think can be so far away from us, but I'm guessing that women in midlife should be thinking about it now and like preventing it. So how does physical therapy kind of make a difference in bone health?
Tanya: Mm-hmm.
Yeah, again, so important. One of my favorite things to talk about, and it actually kind of blows people's minds because I really feel like we have been neglected. Like they haven't really told us enough information about osteoporosis. And so what I like to start by saying is that osteoporosis, like pause for dramatic effect, is 100 % preventable. Nobody should be getting osteoporosis. None. Zero.
Amelia: Yes, tell me more.
Tanya: There's a group in the UK, a group of doctors called Sticks and Stones, and they're trying to eradicate osteoporosis by 2044, like polio. Like it should not be around. And that is so exciting and encouraging to me because it basically means that just because your grandma had it or your mom had it does not mean you have to get it.
Amelia: That's crazy.
Tanya: So I want to talk about how you can prevent it, right? yeah, so the coolest thing about bone is that it's living tissue. It's constantly changing. And up until the age of 35, we're making more bone than we are getting it taken away. But at around perimenopause, menopause time, because of that change in hormones and the decrease of estrogen, we really start to lose bone mass because estrogen is a key player in laying bone down. So we need to make sure that we're maintaining strong bones and muscles. So bone, so 10% of your bone remodels every year, which means that every 10 years you have a completely new skeleton. Isn't that mind-blowing?
Yeah, so I love that, like I love explaining that because it means that bone is constantly changing. So there's constantly stuff that you could be doing to work on it. And if you have what's called osteopenia, which is the precursor to osteoporosis, you can actually reverse it because bone is dynamic and changes.
So what are we supposed to do to have healthy bones? Well, it's a few things. We want impact, right? If you think about astronauts, right? The other extreme, they go away. They don't have gravity. They lose bone mass, right? Gravity is a good thing. They're getting an impact. So as we get older, I actually hear a lot of women say, I shouldn't run or I shouldn't jump.
Amelia: Hmm.
Tanya: And that's not true. We want to be impacting. Even just like the side, you know, on the curb, on the sidewalk, even just doing some of those jumps are really good and just like impact. But guess what? I'm also a pelvic health specialist. So if someone's leaking, do they want to be jumping? No, it all fits together. So that's where awareness is key. So the first thing I talked about is impact, right? So we want to make sure that we're walking, but walking is okay.
It's not quite enough and I'll talk about a secret way that you can make walking stronger or better and that is simply just adding a weighted vest. They're kind of popular a little bit kind of in vogue right now but I love it because it's super easy. You can just get one on Amazon and start with 10 pounds and then wearing it around the house to get comfortable with it but taking a walk with that on is great. It's and it's such an easy add-on because you can just take a walk with it. Yeah, it's awesome.
Amelia: Mmm. Yeah, secret tip.
Tanya: And the other thing that we need to be doing is strength training because muscles connect, talk to bone and bone talk to muscle. There's a really cool bidirectionality there. So we need to stay strong. We need to keep those muscles. And again, as we get older, we lose muscle mass. So we have to do more just to maintain. So we need to be like lifting and lift in like strong.
Amelia: Which is always, yeah, No, this is great. I love the impact. I love the strength training and for listeners, right, you can take those small steps into, if you haven't been strength training for a while, like it is definitely something I'm gonna focus more on in 2025 because I think it can be a little bit intimidating, but we all kind of look around at women who have just lived life and are physically so strong, we're always like, "Wow, look at look at how amazing and healthy she is!" So predicting for ourselves, right, that we can invest in our own bone health. As we move forward. I love that idea. So impact, and then strength training. What's number three?
Tanya: Yeah, so the next piece that we focus on is diet and nutrition, right? So bones need calcium, right? We kind of know that. And it turns out that maybe calcium in terms of like a supplement is not as good as we thought it was. So we really try to get it through our diet. And I like to tell people just to Google calcium rich foods and see which ones are your favorite because you'd be surprised at which ones are there. It's not just milk and a lot of people are lactose intolerant.
There's a ton of other gorgeous green vegetables that are full of calcium. So that's my suggestion is to see what's your favorite and really get those in. And then the other piece of diet and nutrition is really just knowing. I mean, I feel like the memo's out on smoking, right? Smoking is not great for your bones and really the same is true for alcohol.
So really minimizing those two things is going to have a positive impact on your bone health. So those are four things right there. So if you're on that track of getting more calcium and getting some strength training, it's like you said, you don't have to start from zero to lifting 100 pounds, right? Go slowly. I like to do just even Apple fitness is how I get my strength training in with just some dumbbells and you can progressively start to load. So start with five pounds.
Right? And then just kind of move on. It's great because we're about to hit 2025. So it's a new year, a great start for fresh goals and to start simple and progress from there.
Amelia: Yeah, every day is a fresh start and we can just choose to make changes along the way. Well, this has been super informative and I just love letting people know that you exist, right? That there are resources in terms of physical therapy for these particular areas. So if you have, concerns definitely reach out to Tanya and her community.
Tanya: Yeah, and we do wellness telehealth now. So you can be anywhere, you can be in Tennessee and you can get a telehealth appointment with us. And yeah, under wellness now, which is so exciting. And we can definitely troubleshoot a lot of things and get you started on the right foot. So I tell people it's a great way to get started. and it's healthypelvis.com, super easy.
Amelia: Great, and we're gonna...
You're ahead of me. I was like, we're gonna share all the information here in a moment. Well, I first wanna close by looping back to where we started. Tanya, what is one creative way that you employ organization now as an adult?
Tanya: Yeah, I feel like I've gotten better at honestly just writing things out from my head instead of just keeping my to-do list in my head and just getting it out on paper is a great start. And yeah, like good old fashioned, I need pen and paper, not like, like, I don't know. So that's been really helpful for me. It's just kind of going a little low tech. I can be somewhere and put it in my phone, but then when it actually comes to the day, I like to be like, what am I doing today?
And so that has helped me a lot.
Amelia: For sure, and do you use the same kind of notepad or journal and carry it around with you? Or do you have something, one at home and one at work?
Tanya: Yeah, so I actually have like, I like fresh loose paper for that day and I carry it with me. That's as funny as that sounds.
Amelia: Yeah, no, it makes total sense. Basic works and it gets things like you said, right? It doesn't need to stay in your working memory. You can just get it down and out and refer to it later.
Tanya: Right? Yeah, things that I want to get done that day and that has helped me a lot.
Amelia: So good, so good. Well, thank you so much for chatting with me, Tanya. You are...
Tanya: Woop! This was so fun! Thank you so much for having me!
Amelia: Of course, you are such a bright spot and I would love for you to tell folks where to go to sign up for your amazing Healthy Pelvis monthly newsletter and learn more about your California locations and it sounds like telehealth as well and to connect with you.
Tanya: Yeah, so it's super easy. You just have to go to healthypelvis.com and it's all there. It's easy to book. And also if you want to just email to get a sense of what it is, that's also fantastic. So all the information is on healthypelvis.com.
Amelia: Amazing. Have a great rest of your day.
Tanya: You too!
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