What’s up everyone. Welcome back to the fit to fat fit experience podcast. That’s me, your host, drew Manning from fit2fat2fit.com Most of you guys know my journey, my Fit to fat to fit journey of me intentionally getting 75 pounds on purpose in six months and losing it in the next six months. And that’s when fit to fat to fit was born. And that was over five and a half years ago. And now it’s evolved into a New York times bestselling book called fit, tight fit and it TV show on a E called fit to fat to fit as well. And season two, we’ll be airing very, very soon. If you haven’t checked out season one, please go check it out. It’s an amazing show. Basically, I coach these trainers through what I went through for four months. These trainers have to gain weight and then, uh, and go through that emotional roller coaster.

And I’m their coach throughout the process. I’m the narrator and a producer on the show. And then the next four months, these trainers after gaining the weight, hopefully are more empathetic and have more respect and a better understanding for their overweight clients. They then lose the weight with their clients over the next four months. It’s called fit tight fit. Obviously I’m a little bit biased, but I think it’s an awesome show. And I think my book is awesome as well. If you haven’t checked it out, definitely go check it out. You guys, um, thank you so much for, for tuning into today’s episode. I’d definitely try and bring you guys high quality content, great guests that deliver, you know, a value to all kinds of people. I’ve had people on from, you know, Shaunti Chris Powell, um, Tony Horton’s coming on pretty soon. Um, I’ve had celebrities and I’ve had doctors nutritionists, uh, about a wide array of topics.

So, um, this show is kind of a all encompassing. There’s a lot of benefits to tuning in each week. Today’s guest is dr. Monique middle cough, and I met her through Natalie Hodson. He was my business partner over@dollarworkoutclub.com. You guys know Natalie for the most part, you should know her, um, cause her friends, she lives up in Idaho, but, um, she completed her PhD at the university of Utah and she works as a clinical exercise physiologist and she is also a researcher and his published work in the fields of pelvic floor function, injury prevention, and performance improvement as well. Um, she’s certified higher education teaching specialist and also has her, uh, CSCs to the national strength and conditioning association. So she’s very, very smart. She knows what she’s talking about. She also, she also was a former NCAA D one volleyball athlete, so she’s pretty tall and she’s just so cool and really down to earth.

I don’t want to talk to her about specifically pelvic floor function. What that means. Now this might be geared more towards women this episode, uh, cause that’s what more women tend to suffer with, especially all you moms out there. You definitely want to tune into this episode, uh, to learn how you can strengthen your pelvic floor, but begin into, um, her dissertation that she did, um, for her PhD too. And basically what it was about was, um, showing the difference in strength of pelvic floor, between two groups of women. One was like, you know, you’re, non-active not, uh, not physically active, um, women, none of these women had kids by the way. Uh, but then the next group of wound where you’re, you know, CrossFitters, those are the ones that are working out hardcore five times a week to show if there was a difference in strength and pelvic floor.

And what she found was that there was literally no difference in strength between these women who weren’t physically active. And these women who did CrossFit hardcore, they both had the same level of strength when it came to a pelvic floor function, which is super interesting. And we kind of get into how you can prevent that her new program that she’s launching to help women, um, overcome this through a diet and exercise, which is remarkable because a lot of women just think, well, uh, this is just the way it is after having kids. So I’m stuck at like this for the rest of my life or their surgery, which I don’t want to do. Definitely listen to this episode and share it with someone that you think needs to listen to it. Before we jump into the episode with Monique, uh, have to give a shout out to our so sponsors, our first sponsor of the show is drop an F bomb.com. You’ve heard me talk about these guys briefly. I’ve done some posts about them as well. The bracelet, they’re basically a single serving packages of high quality fats that you can take with you on the road, on the go. They just eating. They just make eating fast, so much more convenient because you have these single serving packages of things like coconut

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And that’s, what’s so good about quest ketos. They make these delicious, uh, high quality, uh, ketogenic foods that are convenient, right? So frozen meals. They have snacks. If you guys haven’t checked out their chocolate bars or their, uh, fudge cups, seriously, these things are Quito, which means they’re high in fat, moderate amount of protein and low in carbs. So they are keto friendly. You guys. Um, and like I said, they, they taste really, really good. Check them out@questkito.com. And if you’re doing the keto diet, this is definitely something you want to have on hand just because it tastes good. And it’s on the go. Uh, one last thing before we jump into today’s episode, you guys, if you haven’t had a chance yet, go check, go to my website, fits right to fit.com. I relaunched my fat to fit program. If you remember over five years ago, um, I did this, I did this crazy journey right where I gained all this weight and then I lost it.

Well, I documented that journey back to fit how I lost the 75 pounds. And I relaunched it because to be honest with you, I put the, I put it together kind of sloppy. I didn’t really know what I was doing. Um, I just kinda threw it together in a way because I wanted to show people what I did every single day to lose weight, because I wanted to show people that it was a true lifestyle change. It wasn’t just some six month crash course diet where I starved myself and worked out three times a day. I showed people exactly how to live every single day for six months. What I ate every single day, how I worked out the workouts that I did were five days a week, 30 to 40 minute workouts per day, which is not extreme at all. I ate around 2000 calories per day, spread out over five meals, which is what worked for me at that time.

And I loved it. And not only did I get back in shape, I lost the 75 pounds in six months, but thousands of people from all over the world did this journey with me follow the exact same lifestyle that I was showing. And you can see their transformations as well. Go to transform.fit, to fat, to fit.com to sign up for the six month transformation program. This isn’t like I said, it’s just some crash diet. It’s a six month transformation program where I coach you through the process of what I went through and how I helped thousands of people from all over the world, uh, transformed their minds, their bodies, their hearts, their souls, everything about them through this transformation program. All right. You guys let’s hang out with Monique now. All right, Monique. Welcome to the show.

Hey, thanks drew. Thanks for having me.

Yeah, no, my pleasure. Are you surviving there in Boise with a thousand feet of snow? Yeah.

Oh, my word. This winter has been quite the experience. Yeah. There’s been a lot of snow and it’s kind of amazing because it’s rained on top of the snow. So it’s just a big icy mess over here.

Yeah. So for those of you listening that don’t know Monique, she is up in Idaho right now. I’m not Boise. Where are you at? Twin falls? Yeah. I only know like two cities in Idaho. So fine. Now did you grow up there? What did you,

That’s a really good question. So I’m originally from Halifax, Nova Scotia. My family lives in twin falls, Idaho, which is what helped to bring me back to Idaho. So I haven’t lived here in 10 years having takes 10 years, but I just moved back a year and a half ago.

Awesome. Okay. So you haven’t been there that long. Okay. I didn’t know that.

Yeah, no. So my suite has been months here and I just adore him. And so it was kind of a perfect move to be able to graduate from the university of Utah and then come back to Idaho. Okay. Your Utah alum.

All right. Did you ever live out here? Did you ever live out here other than going to school?

Oh, you know, not besides going to school, but yeah, I spent four and a half years at salt Lake, like downtown salt Lake.

Exactly. Okay. So, so let’s introduce you to the, uh, our followers. Tell us a little bit about your background, how you got into health and fitness and where you are now. And I won’t go over all your credentials because that could take awhile, but I’ll do that. I’ll do that later.

Super well. Yes. My name is Monique Malkoff. I am a clinical exercise physiologist. My, I got my doctorate at the university of Utah. And what sort of got me into health and fitness? Well, even when I was young, I was always really active and I just sort of was drawn to sports and athletics right off the bat and kind of through hang and sort of excelling. And some of my athletic endeavors, I played through college, um, playing volleyball and just had such a really wonderful time playing. And it was kind of always in this concurrent interest of loving athletics and also really loving biology. I really thought initially when I was younger that I would kind of go into the field of biology largely because I didn’t even know the field of exercise physiology was wasn’t even an available career option. And it was kind of in that transition time, between as soon as I was finished playing sports and I was done with athletics and kind of the competitive nature that I really wanted to explore some of my options and the things that I really wanted to do. So I was a health promotion major first out of all things. And I think that was kind of where I got my foot in the door, just because I, I, I didn’t exactly know some of the, the ways that my interests would change in research and especially in, you know, kind of more basic science. And

Can I ask what health promotion is? Exactly. I didn’t even know you can major in that. That’s interesting.

So kind of in the broader field of epidemiology, where you look at maybe populations and kind of examine the health of a population rather than the health of a specific person. So health promotion is kind of taking that population approach and finding ways and mediums to present health information in a way that connects with people that helps them make behavior changes to improve their health or improve the health of their family.

No, sorry. So many questions now. Uh, w w what did you take away from that? Or what did you learn from that looking at sets of populations?

Oh, well, you know, it was just sort of the inner factory level. So there’s so many things that I, I really don’t know in that field still, but, uh, I always take away that you need to be able to speak to people in a language that connects with them. So, you know, regardless of how important your messages or how complex it is, if it doesn’t connect with people, we’re really not going to be able to make that big of an impact from a health perspective. So it was kind of that initial catalyst that got me interested in, you know, making those connections with other people. And I worked as a personal trainer just as kind of you did in early experience in your career. And that really helped to drive that connection piece of health and myself health with other people in health, as a population.

So kind of taking that excitement that I had about helping other people. I, I always felt that desire to know more information because it just didn’t feel okay to me to kind of present the basics and sort of walk away feeling like I did an okay job. And that excellence piece always drove me to learn a bit more or maybe to get a different certification or get education in a different area. And, you know, 11 and a half years later, I finished all of my, you know, formal academic training because I just could never get enough of one team to know the next piece and the next step.

Hmm. Okay, sorry. Sorry. I kind of threw you off there and interrupted you, but, um, so what did you get, where did you go for your undergrad?

Yeah, so I finished my bachelor’s at Montana state. I did my master’s degree at Boise state, and then I finished just shoot a year and a half ago at university of Utah.

Who do you cheer for when Boise state plays Utah?

That’s for sure. I can see it’s fantastic. And I love Idaho, but the Utes are there. They’re my team. I support them.

Okay. Gotcha. I just had asked cause you know, they play each other every once in a while, but okay. So, um, there’s, there’s so many different topics that I want to talk to you about. Let’s just start kind of basic. Let’s talk about one thing that I’m interested in and that’s kind of, one of the reasons I brought you on was for selfish reasons. Okay. How can I pick Monique’s brain here? Because I want to learn a lot. Um, and that’s what I do sometimes with my podcast, but okay. First of all, for everyone listening, how I met Monique was actually through Natalie Hodson, who’s my business partner, uh, at dollar workout club and Monique was, came to a dinner we had right at her dad’s house right in Emmett, Idaho. And, uh, you definitely stand out. You are six foot two, right? Six, two, six one.

Oh, I wish so drew, I wear heels a lot, but I’m really just five, 10 and one quarter.

Oh, okay. That was the heels. Then I remember looking up at you. I remember looking up at you at times. And so, okay. So one of the things that I’m interested in, because I don’t have the same education you have, so I want to learn from you. And I think I want to can learn and apply these, these things that we’re going to talk about is muscular endurance. Maybe let’s start by defining what that is and how we can improve our muscular endurance. Cause I feel like that is a good sign of good fitness, right? If you have good muscular endurance, you can do a lot of things, you know? So that’s that speak to that first?

Absolutely. So, you know, you’re absolutely right, anytime that we’re talking about fitness in general, we can kind of define it in different ways and we can look at it from sort of the agility balance, speed, power coordination, reaction time, you know, muscular strength or body composition. And as you know, one of those components, muscular endurance is one of those components that helps us kind of gauge our overall fitness. And, you know, just from a definition perspective, muscular endurance, it’s the ability of a muscle or group of muscles to repeatedly resist fatigue. So especially if we’re talking about force or resistance, that kind of resistance to fatigue piece is really, really crucial when we’re talking about endurance. And one thing that I really liked just from the application side is we can look at the science of how our different energy systems provide the, the, you know, the necessary energy for us to perform that motion or activity.

And we have things that help us with short term exercises. If, you know, if we’re talking about, you know, something like the FOSS Virgin system, we have things that help us with glycolysis. So they’re kind of mid range activities around, you know, 30 seconds to a minute. And then we have things from an energy perspective that drive our energy longterm in, in things that we do that are maybe over one to two minutes long. And with that, when we’re talking about muscular endurance and resisting fatigue, that we really have to train our bodies to be able to produce the adaptation that we want, if we want the adaptation to be, you know, more resistant to fatigue and, you know, able to contract repeatedly over time, then we have to train in that way to really produce that adaptation. And sometimes, you know, just from a programming perspective, you can look at different types of exercise programming and see that, you know, perhaps exercises aren’t really building that endurance piece because they’re focused on the strength piece instead of the muscular endurance piece.

Yeah. And I see that all the time, for example, your average gym Gore, that’s doing three sets of 10, you know, the same exercises, uh, you know, month after month after month. And you see them kind of stuck in there, you know, with their results, you know, they’re, they’re kind of plateauing, they’re not seeing any results and they’re like, you know, maybe three sets of 12 or, you know, but what you’re saying is you actually need to go out and apply these different techniques to get the benefits of muscular endurance, rather than just focus on focusing on the strength aspect, which is what you touched on a little bit, but I’m kind of branching out and get in a way getting out of your comfort zone of those same routines that you’ve been doing for maybe years for some people.

Yes. Well, and I think it’s also so nice when you talk about performance, especially for those who are in sort of an athletic environment or, or just working on performance improvement in general, that it’s kind of unrealistic to train something in a short term. Um, maybe a timeframe and expect to be able to repeat that activity time after time, after time without fatigue. And so it is one of those sort of beginner mistakes that we often see in programming where we just don’t have the stimulus that really helps us kind of create the adaptation on the backend.

Yeah. What about things like, for example, marathon running, even endurance like ultra marathons, right? Those types of, um, those types, I don’t want to come freaks of nature, but those kinds of people that can do those things and seem as if like their heart rate is lower than your average person, um, uh, you know, our people just genetically gifted in that way or designed to be able to run those types of races, um, or can someone really trained for a marathon that, you know, can’t run a mile?

Oh, sure. Yes. So I could give a big shout out to my, my professor, dr. Janet Shaw, who is an ultra marathoner, which I just think running a hundred miles seems like an absolute, crazy experience, but marathon. And one of the reasons that I actually wanted to marathon is just sort of test out exactly what you’re talking about is, you know, my body really was anaerobic that short, powerful, explosive, large muscle diameter. And I wanted to be able to make some of those conversions of how can we get those fibers to express some of those, um, maybe properties that will help with endurance. And so having that shift is possible too, if we were thinking about muscles kind of on a continuum where some muscles are really resistant to fatigue, they allow us to perform, you know, multiple contractions over time, really oxidative. So they’re going to be smaller in diameter, kind of the body type that you would picture if you thought about a marathoner and then on the totally opposite spectrum of that would be someone like a bodybuilder who has really kind of used the properties of explosive, powerful energy, larger muscle diameter, and really quick to fatigue, but has a high power capability.

And sort of, you know, if we think about them on a totally huge continuum, there’s a lot of variances that we see within that continuum. And it’s very unrealistic to think about someone being able to make all of their, you know, fibers express the complete opposite, but we can get a shift within that continuum moving more towards that oxidative or more towards that glycolytic expression. And it really changes the way that our body performs, which I think is really cool.

Yeah, no, it is fascinating. I think the human body is so fascinating what you can train it to do. Um, not just physically, mentally, emotionally, spiritually, too. Um, so TA did you, you, you mentioned that you did an experiment on yourself to see if you could train for a marathon. How did that go?

Well, I did it, it was, it was fantastic, but I can, I can tell you, it, it is amazing how you can really feel how your body will naturally express one sort of, uh, dominant fiber pattern. And I really felt like training against that natural expression in my body. So I did it, I crossed the finish line who raw, it was super fun, but, um, I think I really enjoy more of those mid range where I get to, to kind of express both that powerful side and more of the longer distance without being totally on that end of the spectrum.

Yeah. And then on the other end of the spectrum, you have done not bodybuilding shows, right. But you have done,

I’ve competed in figure, which I really do. And that for me is definitely more of a comfort zone to where my body really easily responds to that type of training. And it, you know, I don’t want to have to put quite as much effort in to see that type of result. So I really do think that that kind of speaks to even, um, how we’re asking younger athletes to kind of do that quick sport. Um, uh, maybe I can’t quite think of the word maybe delineation of where you choose a sport really early, and then you stick with that same sport through life. And sometimes that doesn’t allow our bodies to really express that kind of innate talent and an innate, um, specific fiber typing that we have. You know, we sometimes we just naturally choose things that we’re going to Excel in because our bodies are sort of built for that type of activity. But I think there’s also something to be said for kind of the bulk of people who fall in the mid range, you know, not, not extraordinary on either end and how do we train our bodies to, you know, prevent disease to kind of maintain health all the time, no matter what performance we’re asking our body to, to do. And then to also do the things that we’re excited about for hobbies, or, you know, maybe just trying a different type of activity or exercise and to be able to do that well.

Yeah, and I think that’s really, really interesting cause I think most people are that are the same. Aren’t a born, you know, marathon runner or a born bodybuilder, right? Those two ends of the spectrum you’re talking about, most of those are in the middle, but what you’re saying is you can move yourself towards one of those other areas, if you, if you train, but you have to get out of your comfort zone and, and really, you know, apply those methods to become better at it right now. Not that you might be the best in the world at it, who knows you could be right. There are some athletes that have kind of discovered their talents later on in life, but exposure expose yourself to new things. So this is something I talk about all the time is be open to new forms of exercise, new nutritional programs that you’ve never tried before and become your own self experimentation, you know, find what’s outworn for you find what you enjoy. You know, if you’ve never done Zumba, if you’ve never done CrossFit, if you’ve never done bodybuilding for never tried to do a marathon or a five K or a Spartan race, you know, find what you enjoy and be open to new things. Because I think so many of us, it just gets stuck in the same routine. Like, uh, you know, here, I’m doing my three sets of 10 again, you know, bicep curls.

Yeah, absolutely. Absolutely.

Yeah. So you definitely need to be open to new things. Um, I completely agree with you. Yeah. Okay. Let’s shift gears a little bit. And we talked about this over the summer about your dissertation, and I know, I know you can talk about that forever. Let’s maybe short until they shorten it to like 20 minutes

Got started. The mat thing is really interesting. Yeah. So a dissertation is kind of like your child where, you know, it’s not just a document that lives, but it’s kind of this grouping of questions that have the studies that you did in order to help support maybe some of the questions or, or conclusion is that you came up with. And my dissertation specifically focused on pelvic floor function in females and the title was pelvic floor strength and support and healthy nulliparous women, which just means women. Who’ve never had babies factors with strenuous and non strenuous physical activity. That’s it?

It’s for your, for your, for your average person that might not understand what that is.

Absolutely. That kind of layman’s terms I wanted to examine how pelvic floor strength and support was impacted by the types of physical activity that we do. So most of the time in research, if we want to look at kind of a phenomenon or to be able to under or understand or explain something we want to use sort of polarized groups so that we can really make a definitive comparison between the two. So we use two groups in this study to, well, there’s multiple studies, but the one I really want to focus on using two groups, one group of women who, um, have no babies and are in this sort of recreationally active category, uh, predominantly do some walking. There’s no jumping on a regular basis, lifting on a regular basis or strenuous activity on a regular basis. The other group of women also have no babies.

So we don’t have that factor to kind of rule out as a, a different explanation. They are women who are doing CrossFit seriously at at least three times a week on a regular basis for, at minimum, the past six months, most of the women in our study did this for over four years. And we wanted to compare specific parameters in the pelvic floor. We wanted to compare how the actual pelvic support kind of differed between the two or maybe it was the same. We wanted to compare pelvic floor strength. We wanted to compare vaginal resting pressure. And then we want to also want to compare all of the other factors like age and height and body weight, and body composition through a bod pod and all of these other things to kind of compare the two groups to say, how does that work?

Well, I did cause I’m like, how do you measure, what was it, vaginal resting? How do you measure that? Talk about in your day, all the time. Yeah. At least three times a day. Someone asked me that question.

Well, you know, kind of the backstory between, between why this was important to me is that I played volleyball through college and it’s not uncommon to have a significant amount of incontinence in a female sports, especially those that have impact. And so it was kind of this really unique feeling of sort of being surrounded by a group of women who look exactly like me and in some way were nearly all the same height. We eat practically the exact same things. We do the same things. Obviously we have different genetics, but I mean, we’re so similar in so many different ways and a huge grouping of us have incontinence that wasn’t me specifically, but I always had this kind of concern of is, is this going to be me? Am I in that group? I have no idea why you’ll even see things like the NCA.

There’s always towels that are wiping up the body, sweat, um, you know, other fluids that, that may or may not escape. And you hear it constantly talked about and things like CrossFit, like peeing, your pants with activity is just not uncommon. And, you know, it’s kind of taking that, um, me versus them approach of I have nothing that would be different. So is that kind of in my future, is that something I need to be concerned about? So from a, just a personal level, I had a personal interest, but then I also had this kind of scientific concern as well, because, you know, even, you know, stemming all the way back to Socrates, there was always this concern that women who do physical activity incur pelvic floor damage of some sort. And I didn’t know much about it until I was past my masters going into my PhD.

And I w I wanted to know more about the ways that we explain strenuous and non strenuous physical activity, especially as it relates to pelvic floor function. So most of the time when I start talking about this, most of the men are automatically checked out because we kind of think about like a female thing, but we, but yes, but men and women both have pelvic floors. I, you know, anyone’s with upright, the pelvic floor is engaged in some aspect and whether the pelvic floor is functioning, ideally we’ll help you with core strength, balance, posture, support, even breathing mechanics. And all of the things that we do from a motion perspective, the pelvic floor is involved, whether we’re paying attention to it or not. And so I also had this kind of bizarre sense of, um, I don’t know, I don’t know if it was like a pride situation as much as I just sort of felt like, Oh, because I’m very active and I lift weights habitually, and, you know, I do high-impact activity all the time.

We’ll surely everything is strong and supported and stable and good to go. And I think we can really have this kind of, um, comfort level that may not really be supported with evidence. So I want it to look at it a little bit more. And one of the things we found that I thought was the most important finding is that with women who are, you know, nearly the same age who have the same body weight, but totally different body composition. So, you know, the CrossFit ladies had significantly lower body fat, which we would expect Cigna if they currently higher muscular strength in their arms and their legs, which we would expect high heart rates during exercise, which we would expect during a, you know, intense activity. And we were to look at that in comparison to women who do, you know, a non strenuous exercise routinely, we, we found that there was no difference at all, statistically between pelvic strength and pelvic support between the two groups.

And if you would have asked me that beforehand, I would have said, Oh, hands down. I like, no questions asked those who do strenuous exercise are going to have so stronger, pelvic floors, you know, such higher support, you know, all of these things that I had sort of created this picture that really was not reality in answering this specific question. And I also think that we have so many other things in science that helps kind of explain these results or these conclusions, because we know that if we are wanting to have a specific adaptation in the biceps, we trained the biceps to produce that adaptation. We don’t expect to, you know, do calf raises and see, you know, benefits in our biceps and with the pelvic floor, the same holds true that if we’re not focusing on it, that we’re typically not going to employ proven if anything, with time, just with anything else that atrophies, it’s going to get weaker and lose support, which kind of leads us down the road and incontinence, pelvic organ prolapse, pelvic floor dysfunction in general. And, and that was one of my biggest take home messages that we, you know, we really can’t have a false sense of security and feeling like, Oh, just because we do everything else, we’re good to go.

Okay. So two questions and cause there was, that was a lot to digest. Um, one is, is why do you think that, like, what were your conclusions, did you find out, like why was there no difference in pelvic floors visit? Was it because both groups of women are not specifically training to improve that? And then the second question would be okay, how does one focus on their pelvic floor strength and what can they do to improve it?

So really great question. So, um, to answer the first part, I think why we didn’t find the difference is exactly what you had mentioned as a potential explanation, that if we’re not using the specific exercises to help improve that muscle group, we shouldn’t expect to find improvements in that muscle group. And if anything, I think one thing that we fail to think about is the intra abdominal pressure or the pressure that’s on the inside, pushing out when we do things like at lifts, whether it’s at, you know, something intense like a snatch or a deadlift, or if we’re doing something like a bicep curl, we’re producing that intrabdominal pressure, that’s pushing on pushing out the abdomen, pushing back on the back, pushing down on the pelvic floor and pushing up on the diaphragm. So kind of all of those pressures pushing out against the tissue, if we have a weakness, it, it, you know, it tends to be kind of the weakest link, so to speak because we have, you know, bony support provided by the rib cage and the thoracic cavity for the diaphragm.

We have our abdominal muscles, the muscles of the, you know, the back and then we have the pelvic floor. Well, there’s no bony support down there. There’s nothing that helps to support that area from a boney perspective. And so the pelvic floor itself, you know, the muscles and connective tissue that helped to comprise that floor, um, are the ones doing the work. So if we’re at, you know, gaining lots of weight, especially abdominal weight, it’s pushing down and extending those fibers, lengthening those fibers, making them weaker. Um, if we’re, you know, doing things that have high high force, like constant cough, like chronic cough, um, uh, even just continuous sneezing. If we have a lot of allergies, it’s pushing a of pressure on that pelvic floor and potentially weakening those tissues and causing problems. So if we’re not working on it, it’s not improving.

Okay. So, Oh, go ahead. Oh, yes. It’s okay. I’ll let you feel that you’re completely right. Go ahead.

No, I don’t remember what the second part was. Can you, can you remind me

The specifics of, okay. What, like, what are the specifics, uh, exercises or things that people can do to improve their pelvic floor stress?

Oh, great question. So this is for men and women, and I think sometimes we just think, Oh, okay. Are for women who have had babies and now leak urine. But, um, so instead of thinking vaginal contraction, think pelvic floor lift. So we have some fibers, like the levator Ani is the largest group that helps support. And when it contracts, it lifts up. So instead of like a sphincter, so if we’re thinking about maybe going to the bathroom, if we’re sort of cutting off our flow of urine, that would be one of the muscles that, that closes like a sphincter. So the, uh, the fibers come together like a circle. Well, the [inaudible] kind of looks like it. Hammock is a terrible word, but hammock is kind of the best that I can sort of provide the visual without just showing you the actual picture. And so when it contracts, it lifts up. So if we can focus on, cause that’s one of the biggest supportive muscles, if we can focus on, you know, contracting that muscle group to lift up kind of lifting our whole pelvic floor up towards our lungs or towards our rib cage and holding and contracting for, you know, 10 to 20 seconds and then relaxing again, even something small like that, doing that, you know, one to two times a day can really make a difference in the support in our pelvic floor. Okay.

Is this standing in the upright position or is this laying on your back lifting your hips up?

Because it can be easier to, to do this first in a lying position and then to try the same thing standing. I think it’s also, you know, for, for those who are interested, it’s also really nice to be able to make that focus of contraction lifting up and then squeezing together something completely different and then providing body movement. So stepping side to side, stepping forward, stepping backward because it’s so uncommon in our day that we would ever exert high force in one stationary position, you know, outside of something like a dead or a snack or something, or a clean most of the time we’re moving in some aspect, you know, moving forward, stepping back, stepping side to side, twisting, et cetera, especially if you’re an active person. And with that, you have all of those forces pressing down where if we’re not making that contraction, just like if we’re forgetting to contract, you know, the muscles of the core, we, you know, we’re just potentially, um, creating additional weakness, which makes things worse.

Okay. So let me just kinda see if I can create a visual for people. So basically standing up right, tilting your hips forward, squeezing that muscle that you use to stop your flow of urine hold for 10 to 20 seconds. Yeah. Hold the 2010, 20 seconds. Relax. And then set forward step side, step backwards. Just kind of move around a little bit and then repeat for how many sets T two is plenty.

Yeah. I mean, you can do that certainly more, but I also think we can get a little overboard working on some of our small muscles. If it’s something that you’re not struggling with, then, you know, it’s always great to, at one to two times a day, um, if it’s something that you are abilities and rehabilitative phase, especially for new moms, or if you have signs or symptoms of incontinence or pelvic organ prolapse, seeing a specialist like a urogynecologist or a physical therapist who specializes in this can really, really make a difference.

And do they give this same type of advice or do they promote, or do they promote surgery or other

Good question? Well, I think, you know, depending on the severity of the stages that, you know, different options can be explored for sure. But I also think that one of the things I like to look at in physical therapy as a field is finding a therapist who uses biofeedback tools. So you can use, you know, your hands as palpation or being able to touch or feel, but it’s also really helpful when you’re able to have a device like a pressure transducer or a parenting auditor that can help to provide the actual quantitative values of contraction or force of contraction to give you some feedback immediately to know if that was an effective contraction or maybe you just contracted the muscles of your abdomen and completely missed your pelvic floor.

I’ve never heard of this before you said a wearable device, or what is it

Maybe this would be, um, uh, just a therapy device. They have all sorts of wonky things that you can use all over the place. But, um, typically it would be in a therapy setting where, um, it would maybe kind of look like an ultrasound probe, maybe something similar, like a vaginal ultrasound, um, but smaller.

Okay. Gotcha. So, um, for all the women listening, cause I hear this all the time when I’m at the gym, you know, sometimes I go to like the nine 30 class, which is known as the mom class. Wow. That’s when all the moms go, you know, if there’s a double Enders or there’s box champs, all women are like, well, you know, I better go to the bathroom because I don’t, I’ll, I’ll, I’m going to pee my pants or whatever. It just seems as so normal. It just seems so normal and like, Oh wait, it all happens to all of us that, you know, it is what it is kind of thing, but you’re saying that it doesn’t have to be that way.

Absolutely. And I think sometimes we can feel the normalcy of this is normal or other people experience this too. So it’s fine. And sometimes just that commonality kind of prevents us from seeking additional help. And, you know, just if we had weakness and other muscle groups that we would seek some additional help, it’s the same thing for the pelvic floor. So typically we have, you know, pelvic Florida’s function would be the big umbrella that, you know, under, that would fall like urinary incontinence and then we’d have urge incontinence. That would be the feeling of gotta go, gotta go, gotta go. Can’t quite make it to the bathroom on time. The other one would be stress incontinence, which is exactly what you’re talking about. The jumping coughing, sneezing, bouncing, anything where there’s high force that just overwhelms the ability, the muscles to contract and keep that urine inside. That is definitely treatable and especially research just shows us so over and over again, how effective pelvic floor muscle strengthening is at improving symptoms of incontinence. Okay.

Okay. And then are there any other benefits other than that, like why should someone that doesn’t have these issues, do these types of exercises or is it not necessary?

It was extraordinary question. I’ll pay you later for that one. So yes, absolutely. So especially those who are working through issues with balance posture, coordination, a core strength, especially for those who do activity that requires really, really high strength. You know, if we think kind of on the extreme level sort of Cirque de Solei style, it’s extremely, extremely important because it helps us, even from the, um, the perspective of the hips, it helps us to provide that base, that stability to where the other muscles can contract around the pelvic area in general, not just the pelvic floor and to create really precise, controlled movements. So I would say if you’re, you know, if you’re working at, you know, towards an elite level, uh, whether it’s, you know, professional football, ice skating, uh, you know, just the average regular person who’s preventing disease, it’s totally worth talking about and totally worth doing.

So is this something that maybe some elite people are already doing or is this something new that you’re kind of starting to promote? Okay.

I think, I think you always find in certain groups that those who are doing something extraordinarily well have kind of these things that they do intrinsically, whether they’re talking about them or not. And one of the, kind of the emerging areas is not just focusing on our, you know, abdominal muscles, you know, we could talk about the, the four groups and, you know, beat that dead horse, but when you’re kind of looking for the edge and what sets you apart, and what’s different, you know, doing things like working on different muscles that we don’t typically talk about because, you know, they have some sort of weird stigma about, you know, sexual, whatever, uh, that that’s where you find the edge and that’s where you find the ability to prevent disease, prevent any additional problems and to really improve performance.

Okay. Gotcha. Um, let’s talk about you having, did you have to defend this dissertation at all? And if so, how did that go?

Oh gosh. Well, you know, you know, what’s hilarious is I think anytime that you’re doing something big, you always want all the details to go perf perfectly. And I am without question a perfectionist at my court and the day that I defended I was having severe issues with the, um, the, the it issues in our buildings. So we were, I was, I was extra nervous, but if anything, it was kind of, it worked out perfectly because I think some of the, it issues took my mind off of the nerves and it was fantastic. So typically anytime you’re defending a dissertation, you have your, you know, your chair, who is the person who you go to is your mentor, who is your support. And then you have your committee that are there to ask questions, to really dive the information, to make sure, you know, did we come to the right conclusion? Cause sometimes two people can look at something and come to a different conclusion and they provide additional support. And we, we had such a wonderful time. I, I just can’t say enough about my committee, my chair, all together. They did such a wonderful job supporting me and helping me walk through the process. But, um, I didn’t really get any, any questions or anything that were unexpected or, you know, out, out of the range of things that I had thought about before. So it was wonderful. Start to finish. I just love it.

Okay. So people agreed with you then they did it. They didn’t try to

Like a team approach to where, you know, I, I think it’s difficult anytime you put, you know, one person isolated on an Island and you always come up with weird funky things. And when you really bring experts together and you really talk together to be able to maybe solve complex problems or make sure that your methodology really leads you to the conclusions that you want to arrive at, not just from finding what you want to find, but answering the questions in a way that’s appropriate. It can really just improve our scientific body as a whole. And that’s what they did for me. And that’s, you know, kind of looking forward. I, I would love to give someone else that experience of being, being that support for them too.

Gotcha. Okay. So overall was a positive experience hands down. Okay. But, okay. But since then, now with social media and, and, you know, having a website, have you had to defend it in other ways with, you know, trolls or haters or I don’t know, moms that don’t like what you’re saying.

It’s a really good question. So I think one of the things that, you know, we, we tend to just, you know, pursue our confirmation bias. So we tend to click on articles and headlines and things that already, you know, agree with our preconceived notions. And anytime you kind of challenge the norm or you put out something that kind of makes people think about a stigmatized topic in a different way, there’s always potential for maybe people feeling uncomfortable and pressing back. But I would not say that I have been really a victim of haters by any stretch. However, I know that because I’ve taught really large classes that the U I’ve made more men feel uncomfortable. And I do apologize for them, you know, presenting the information, but, you know, I think it’s easy sometimes to just tune out when you feel like, Oh, that doesn’t apply to me. That’s just a women thing. But especially for people who are trainers of it, whether you’re a trainer, you’re a coach and you have any work with women. It’s just so important to know some of the things that we’re all facing. You know, even if you just have a mother it’s really nice to know how our muscular system works and we don’t just get to exclude groups of muscles because they might make us feel uncomfortable.

Exactly. So I guess my next question would be, do you ever get groups of moms kind of saying to you, like, I’m not believing in what you’re saying or what you’re telling them like, Oh, it’s, you know, this, like, I’m going to be stuck with this for the rest of my life. This doesn’t make sense to me. I’ve tried that before and it doesn’t work or, you know, do you get moms asking you about that?

Yeah, well, and I think, I think moms are just incredible in general. And the ability to put up with things kind of blows my mind where women will put up with a tremendous amount of pelvic floor dysfunction before waving the white flag to say, Oh, I think something’s a little off. And, you know, there’s so few things that we would go through outside of our pelvic floor that we would be willing to cope with under this, you know, the same environment. And if anything, I think some of my messaging back has been, you know, just because it’s common doesn’t mean that it’s something that you need to live with and, you know, seeking help getting the right people as your support group and just commiserating doesn’t actually improve the process at all. So if we have a problem work on addressing it, because if it’s a weak link now from a muscular system side, it’s going to be a weak link later. It doesn’t just magically improve itself if we’re not focusing on it and we’re not working towards it.

Gotcha. And so then the last question I have before we, it looks like we’re running out of time here, but the last question I have is, um, what specifically, when, when women give birth, what causes them to, I mean, it seems like it’s almost every single woman that I’ve, you know, met. That’s had a kid and it’s like, well, you know, after having kids it’s just gone, like, what is it about childbirth that we can

Great question. So we know that one in four women, 25% will experience a signs and symptoms of pelvic floor dysfunction and their life. So if we were to just literally categorize all women 25%, we can just expect that they’re going to have symptoms at some point, if you have, especially a vaginal delivery, um, it’s, it’s so much higher and it’s kind of multifactorial, but as we look at the pelvis, kind of as a goblet, and then we put additional weight by having, you know, the placenta, the baby, all the amniotic fluid weighing down on those pelvic floor muscles and connective tissue, it’s expanding any long gating. So that pressure, if you kind of think of it sort of like a hammock and we’re loading that hammock up with additional weight, um, that’s healthy weight that should be there. It’s kind of elongating that fiber and kind of causing that hammock to sort of droop down even further.

And with that, with a vaginal delivery, the leading theater AI is that big group of muscles that helps to support and lift up it often tears during delivery. And, you know, sometimes that’ll be sewn back up and we’ll be good to go, but that didn’t actually fix some of the problems cause the nerves can be crushed. So anytime you have an, you know, nerves that are crushed or damaged, that means that we’re losing that nervous system intervention or innovation. So we’re not able to contract those fibers in the same way. And we can easily go to cell death where we’re having necrosis and that muscle just does not function in the way that it used to. It doesn’t mean we can’t regenerate tissue, but it means that some kind of integral portion of that muscle group has been damaged. And then also with, you know, that would be kind of the muscle that lifts up the muscles that constrict together like a sphincter muscle. Those muscles can just be weak because we had extra, extra weight pressing down, you know, extra, just damage that we incurred during childbirth. And it’s, you know, what we don’t repair. We repeat. So if we haven’t repaired those muscle groups, we’re going to repeat the incontinence over and over again. So taking time to really repair and recover is so crucial.

Yeah. Well, this is great. This is great news for people listening that just think, well, it is what it is. I just got to live with this and I can do about it. This is hope. This is hope for you guys listening. So hopefully people will share this episode with others. Um, and now I remember you telling me you were actually creating a program with Natalie Hodson specifically for this. I don’t know what it’s called a when you guys are releasing, if you want to talk about that. Cause I think that’ll excite a lot of people.

Absolutely. So yes, the, the exact reason we wanted to put out a program for new moms to address abdominal weakness, especially like diastasis rect, dire separation of the abdominal muscles for the rectus abdominis and pelvic Florida’s function is because it’s so common. And when we were kind of looking through some information and I have been surrounded by new mamas recently, Oh, my word that, you know, we’re getting these same questions over and over and what can I do? Where do I go? Where do I hunt down information and women who are just extraordinary at looking for resources, you know, go online and they search in, you know, Google and search a search term like pelvic floor exercise, or maybe even something, you know, not as, um, scientific to put in something like urine leakage or incontinence or something. And we’re getting just a tremendous amount of information thrown our way that may or may not be accurate.

And we just wanted to give a resource that’s clear, it takes away the ambiguity kind of clarifies and takes the shame and the fear away out of a stigmatized topic and just provides some really wonderful guidelines of when do I return to physical activity after having a baby, even if I’m five, 10 years post childbirth, is this something that I can improve? Am I just sort of stuck with this now? And, and we just wanted to give women a great resource that, you know, didn’t cost a million dollars or it wasn’t totally unattainable and that they could really kind of use as a roadmap to help guide down down the recovery process.

Gotcha. And so what’s it going to be called? Okay.

It’s thrown around about three titles that we both like, and so we’re getting really close, but we’re just a few weeks away from releasing it. So the title is one of the last pieces that it’s coming to together.

Okay. Well, if you do find out what it is and let me know before this episode airs, we’ll put it in the show notes. Um, and that way you can point people in that direction. Um, okay. Last set of kind of rapid fire questions. Um, some kind of serious, I’m kind of funny, but just, yeah, just really quick. Um, what is your current workout look like these days?

Ooh. Okay. So I love high intensity exercise and I have taken an entire year off, which has been really hard for me. So I’ve been doing zero high intensity exercise. I had a, I worked through a lot of injuries, so I’m working through a knee injury that is like 99% recovered. So I’m working on the repair. So I’ve been doing moderate intensity, aerobic exercise, uh, very, very short bouts, largely focusing on weight training. Cause I enjoy it. It’s something that really brings me joy.

Okay. And what is your current nutrition program look like?

So I have not been a red meat eater for the past 12 years, so I do chicken fish and eat. I eat a lot of vegetables. Um, I don’t ever drink soda. I stopped when I was 12. I felt that was a very mature move.

Wow. Yeah, it is.

Which is kind of goofy, but yes, I that’s been that story. So I do, I focus on a lot of vegetables. I love fruits. Um, I also love lean proteins, but I kind of do it in different ways.

Okay. So, uh, no process carbs, no grains, no dairy.

Well, I do, I do whole grains for sure. I definitely like whole grains. I do some dairy. Yes. But um, weird story. So I feel like I was like, I always need to explain this one piece. I don’t eat red meat, not for health reasons is because I did a lot of cadaver dissection and it really messed with me. So that was the end of that.

Wow. Oh my gosh. That opens up a can of worms. That’s interesting. I’ve never had someone tell that, say that. Um, so it’s kinda freaked you out a little bit to eat red meat cause

Yes, it was a specific day. Yes. And you can feel free to share this or cut it if it’s a big day where I was doing a, like a quadricep dissection on a vastus lateralis and right. As I took the first Swift cut, I just got like a, just an intense with that really kind of ruined it and I got home and there was steak for dinner and it was like the moment where I’m done.

Yeah. Okay. That is so interesting. That is super interesting. Okay. That makes sense. Yeah. I didn’t know if it was for health reasons or not. I think all of us assumed that

I always feel like I have to like justify like, Oh, this isn’t a how thing this is that I didn’t stomach it well,

So interesting. That’s fun. You’re the first person to say that. Okay. Um, what is your favorite to super unhealthy meal that you indulged on? Like everyone’s,

I would say donuts, it’s like not even a question or a hesitation chocolate donuts are my jam,

Plural donuts, not donut.

I have to see displays in the world and they often will bring donuts, which is like one of those you have to really decide the frequency because I have to just walk away. Okay.

Gotcha. Gotcha. And have you, have you ever been overweight in your life?

No, but I have been underweight in my life, which, uh, so w way in my past I had some Crohn’s symptoms and I struggled with eating disorders and it was one of those, like if anything, trying to be overly healthy, too restrictive, really concerned about parasites and pathogens and you know, really nervous about things and really led to that unhealthy relationship with food, that many women experience with men too. And so the overweight piece wasn’t there, the underweight piece certainly was

Interesting. Um, and obviously, well, not obviously that sounds bad. You were able to overcome that. That sounded really bad. And so sorry. Cause you’re not overweight.

No, absolutely. It it, the first time I talked about it really out loud in front of people was I think maybe three years ago. And it was the first time I had really talked about that experience of how, you know, you can get in a frame of mind and a mindset that can be really destructive in the name of health, thinking that, Oh, I’m doing healthy things for my body. I’m putting in good things. Um, and you can take that to the extreme on either side and really end up in a ditch. So kind of, you know, climbing out of that to really have a healthy relationship with food was really, really crucial for me.

Interesting. Yeah, no, that is, um, that is great. And I’m glad you, I’m glad you shared that. Okay. I will let you go. But one last thing, where can people get a hold of you? Cause I’m assuming a lot of people are going to be coming to you to ask you questions after this episode. What’s your website.

Yeah. So Monique middle cost.com is my website. You can find me on Facebook at exercise and movement science. You can find me on Instagram exercises, sports science. And I just like to share, you know, as many tips as I can, I’m releasing a new series, um, for, um, health education to really help, you know, kind of clarify the complex topics and provide actionable information that we can use in our real life, in a real world, and to apply science instead of using, you know, any sort of just, you know, fear-mongering or things that we’re hearing in our day,

Bro science. Right. That’s so funny. Okay. Well thank you Monique for coming on. I really appreciate it. And I had a blast. Thank you so much.

You’re awesome. Thank you so much. Have a wonderful day.

Thank you guys. Once again for listening to another great episode here on the fit to fat, to fit experience podcast, I really hope you enjoy this episode episode with Monique. If you did, please comment, let us know what you thought about it. Uh, please share it with others that you think might benefit from this and it makes her make sure I’m subscribed to us on iTunes and leave us a review. We really, really appreciate that. Definitely helps our ratings helps us to secure sponsors that I believe in and, uh, companies that, that I am not ashamed to promote at all. Um, so definitely, um, subscribe if you haven’t yet and, uh, check out our sponsors, show them some love. If you guys are doing keto or not, um, check out their products, use the discount codes, you know, drop an F bomb.com. Use my discount code fit to fit and also check out [inaudible] dot com. Check out some of their delicious meals. I know they’re changing up their shipping. They had some issues in the past that have been fixed now. Um, so it should be more, more affordable to ship and, um, I would definitely really appreciate it. I know they would as well, but once again, thank you guys for tuning in to another great episode. Don’t forget to check back next week at the same time for another great episode here on the fit thread fit experience podcast.

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