Pilates and Pelvic Health: A Powerful Partnership for Wellness with Dr. Caitlin Oliveros, PT

Recently, as part of our Expert Spotlight Series, our founder Lauren chatted with Caitlin Oliveros, founder of Studio Duyan Physical Therapy + Wellness in Woodland Hills & Calabasas, CA. She is a licensed physical therapist, certified Pilates instructor, and meditation teacher. Her areas of expertise include: pelvic health, scoliosis through the Schroth method, and hypermobility/Ehlers-Danlos Syndrome. Her personal experiences with chronic conditions inspired her to create a safe space for individuals to receive honest, intentional, and effective care.

From debunking myths about Kegels to explaining why pelvic health is about more than just your pelvic floor, Lauren and Dr. Caitlin dive into the life-transforming power of pelvic floor physical therapy. Whether you're dealing with pregnancy, postpartum recovery, or even pelvic pain that radiates elsewhere in your body, Dr. Caitlin shares how pelvic health PT can offer lasting relief and strength. 

In addition, they chat about why this specialized care should be a part of everyone’s wellness routine and how small practices like intentional breathwork can make a big difference in your overall health. Plus, as a certified Pilates instructor, Dr. Cailtin shares her expert take on why Pilates and pelvic health together can help clients achieve lasting results in both their physical therapy and fitness journeys.

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

1. Why Pelvic Health PT Has the Unique Potential to Transform Lives

Lauren:

How do you explain the importance of pelvic health if you're talking to somebody that maybe either knows just a little bit or maybe even hasn't heard about it before?

Dr. Caitlin:

I mean, like anything that's new, I explain what it is. I have to mention what the pelvic floor is: it's muscles and connective tissues that support our organs and bodily functions like reproductive health, peeing and pooping. But I also sprinkle a little bit of humor in it. I just find that when people are dealing with problems in their life or changes that they don't expect or don't want in their life, sometimes lightening up the mood can be helpful. So I'll introduce myself as a pelvic floor PT and I say, "I help zip up your core. I help you laugh without leaking, and I help you get laid without pain."

So, that's one way that I explain it. But for an actual patient, I really try to explain that pelvic floor therapy or pelvic health is almost a really intimate relationship between patient and provider. It's unlike other types of physical therapy out there, which may not be as personable. Because with pelvic health, the provider really needs to know your story and why you're coming in to seek care and what you're hoping to expect after the care is completed because it is kind of life-changing. And for a lot of women it can be long-term. So understanding is another big part of explaining what pelvic floor therapy is, but I find that sharing the stories is more effective in explaining what pelvic floor therapy is than giving them an anatomy lesson, in my opinion.

Lauren:

I think it's helpful to hear you talk about it that way because from what I've seen and experienced personally, it is such personal issues that people can be experiencing when they're seeking pelvic floor care or pelvic floor physical therapy. So I think hearing about it in that way from you can be really helpful for folks. I think for me and what I'm seeing, pelvic floor PT is different from other support that people can receive in the healthcare community in an amazing way, in the sense that it's very one on one, it's very much that the people who are working in this space want to help you. They have the time to listen to you and really get to know your whole story versus, "Tell me the symptom you're trying to address and we'll quickly work on it and move you along." And so I think in that way, it's really a standout in the healthcare community and so impactful, especially when it's such an intricate part of your whole body system and can impact so many things you don't even know about.

2. Kegels Should Be a Prescription Medication, Not a Generic Pill

Lauren:

One thing that I feel like I've seen a lot is a lot of myths or misconceptions around pelvic health, especially as I think we're seeing it talked about more and more in the last few years. What are some of the major ones that jump out at you as the biggest ones or the ones that you feel like we need to talk the most about, to be like, "Hey, that's not true"?

Dr. Caitlin:

I'm ready to talk about it, and I would be surprised if you haven't heard it, but Kegels.

So I feel like Kegels are being treated as this kind of generic pill when it really should be treated as a prescription medication. A lot of people think that, regardless of what they're going through: constipation, pelvic pain, prolapse, whatever the case may be, that Kegels will solve all of that, which, it's not Windex. That's a reference, sorry, it's a reference to My Big Fat Greek Wedding. But yeah, it's not Windex where you just spray it on, like the dad in the scene. It doesn't solve everything. I think that it's safe and effective for some people, and it must be prescribed by a pelvic floor expert who will instruct you on how to do it specifically for your condition and for your body. I've been surprised that a popular brand, I think a few years ago, said something in their promotion about how everyone should do Kegels, and that just tells me that this brand that a lot of women buy from and trust is able to say something like that and add onto the misconception and the myths.

I think then there's still an issue about debunking that it's not the solution to everything. Pelvic floor is more than Kegels. It's a lot of things. It's lifestyle modifications, it's diet modifications, it's about how you sleep, how you react to intimacy. It's how you hold your trauma in your body. There's just so much more to pelvic health than a lot of people think, and Kegels is just one tiny aspect of it.

Lauren:

Yeah, I feel like that's a great one because I think to that point, one of the things folks don't often understand is how some of your pelvic floor symptoms could be from laxity and lack of strength, but also it could be due to tension and that you can't relax. And so when those folks do Kegels, it exacerbates the problem.

But when people don't really understand how that works and understand what's going on with their own body, they may be doing something that has been advertised as great for everyone, and it turns out that it's only making things worse for them. Then they have to undo all this hard work that they've been doing. And I do think that companies have this real responsibility to make statements and put things out there that are true, and it is really unfortunate when, for advertising, that isn't the case.

Dr. Caitlin:

I mean, with Hem Support Wear, what I love about it is that even your tagline says that you're thoughtful. And I was talking to one of the ladies through email before actually connecting with you, and the reason I was even on here is because I sent you guys a message about your product and how I liked it, but not just that: it was the service and the thoughtfulness. You even provided us this beautiful letter and care package along with it. But yeah, I feel like everything has to have intention behind it. And so, same with Kegels. It's like what's the intention behind that? Everything that anyone should do should be rooted in intention, otherwise there's no real purpose and it is just there to be a filler. That doesn't sit right with me.

Lauren:

I think that's a great one and really important for people to hear, especially just to increase their education of how it all works. And then maybe Kegels are right for you, but maybe they're not, and there's other things that can be really helpful if you're having symptoms.

3. The Power of Breathwork: Bite-sized Practices for a Healthier Body and Mind

Lauren:

One of the things I love about pelvic health is how it is such an individualized approach, but at the same time, there are some general things that can apply to all types of bodies. If somebody wants to start improving their pelvic health, what are some easy things that we could adopt into day-to-day practice just for good pelvic health in general?

Dr. Caitlin:

I'm a big advocate for just breath work in general. So you could take that literally: breathing as the action, but also figuratively: as in resting and relaxing. Either way, the concept still remains the same. But the physical aspect of carving time for intentional breaths is so important for anyone, regardless of what they're going through, because it allows you to have a reset in your body. So a clear mind will allow you to have a healthy body. And so, kind of like how I start my day with that little intention and that little time of gratitude, I make sure I work in some breath work at that time because before I can see my patients, or before I can start doing errands, or go on a jog or whatever, I want to make sure--again, coming back to intention--that I know what I am about to do, I know why I am doing it, and I should feel good about doing it.

And so for a lot of women dealing with pelvic issues, sometimes taking that step back could actually reveal a lot. Many of my patients, especially busy moms who are often stressed and carry a lot of tension, discover that by taking just a few minutes for intentional breathwork and time for themselves, they can actually tackle tasks that once seemed impossible. This practice helps them manage their daily challenges and also any health obstacles they may be facing. It's just a matter of perspective, and we just have to make them bite-sized. And the breath will reveal that. And physically it's so good for you: vagus nervous stimulation, down training, relaxing that nervous system, and releasing your muscles, even. So the breath is really powerful.

Lauren:

I really like to hear that, especially because for many people who are first getting introduced to pelvic health, it's often after having kids. Maybe it's their first kid or multiple, and it's at a time in your life when the mental load of all of that is, for most people, more than they've ever had in their whole life. And it can be challenging to take that time to pause and rest and reflect. And so I think when you incorporate the breath work like that, it can really help you to pause and take that inventory of, "What is going on in my mind and body and how am I really feeling?" and how, I just like you said, it can be such a powerful tool and seemingly simple. And of course there's a lot to it, but definitely one we could all take away and start today. So thanks for sharing that.

4. Why Pelvic Floor PT Should Be “The New Gym”

Lauren:

I think a lot of people get introduced to pelvic floor physical therapy during pregnancy and postpartum, but I know people who are not pregnant or postpartum can benefit from pelvic health as well, as you progress through the different stages of life. Will you just talk a little bit about how pelvic health and working with someone like a pelvic floor physical therapist can come into play at those various life stages?

Dr. Caitlin:

Oh yeah. I mean, you're right. A lot of the women that come in to see me are moms or moms-to-be. In prenatal stages, it's all about labor and delivery prep and support to avoid any pelvic symptoms that may happen in postpartum. And so in postpartum, a lot of things that we might see are things like abdominal separation, prolapse, feeling like the organs are going to fall out, or leaking.

But even past that, thinking of menopause, there could be more dryness. So maybe having intercourse is a little painful or difficult or even more exacerbated prolapse symptoms of that pelvic weakness. But even if you are not a mom or you don't intend to bear children, I just find that all people--men, women, everyone--can benefit from pelvic floor PT because there's a lot more to it than just that area.

I, myself, deal with some pelvic pain, but sometimes that pelvic pain isn't felt in the pelvis. I've felt it go through my leg, down to my toe, and I found the root issue to be in the pelvis. So it's just better to just be aware of what's causing some of the things that are happening to you, especially pain or tightness.

But I also feel that just being connected to the pelvic floor has unlocked, for a lot of people, a type of strength and stability that they have been looking for. So I see a lot of active or even athletic patients who struggle with the lower belly pooch, or they say that they've been doing Pilates class or a barre class or whatever for years, but still something is missing. And when they connect to the pelvic floor and core, they finally feel that strong sense of stability that they've been searching for. It's very intuitive. I feel that once you are aware of what the pelvic floor is, what pelvic therapy is like, you realize that you may or may not need it, but I feel like most people will benefit from it, regardless. It should be the new gym, I think. I feel like health should be a gym. People should come to PT, OT, mental therapy, everything just for a more holistic approach to self-care. It is self-cae.

Lauren:

Yeah, absolutely. And to your point of feeling pelvic pain in other places, but then it being that root cause, I think a lot of people, over the course of their life, they've got aches and pains and things that are bothering them, and I think if we could move things in a way where it does become the standard of care and it is routine and it's more proactive versus reactive, I think that would be better for everyone because it's so connected and then it takes up so much mental space when you aren't feeling a hundred percent. And so it just is this vicious cycle if you can't get the care and do the work that you need to do. So I think the more we can shift things that way, the better, for sure.

Dr. Caitlin:

I feel like pelvic health is so taboo because a lot of it is found to be embarrassing, maybe even shameful. Intimacy is also hard to talk about, even for some people to their own partner. And there's a lot of problems that can be not just uncovered, but resolved through pelvic health in that way. I just feel like making it normal, aiming for that normalcy by talking about it, even this interview, it's a great way to just inform and educate people and make it that. Let's make it that standard. Just common.

Lauren:

I remember I was at a women's wellness business networking event where it was women founders with companies that were supporting women's health and wellness, and I was chatting with a couple of the founders before their talk, and I was talking to them about Hem Support Wear and what I worked on. And it was so interesting because the discussion around whether or not they saw a pelvic floor physical therapist was coming from, "Well, I didn't need that" and "I didn't have to do it." It was almost like they did well because they didn't need it. And I was like, "God, it's really disappointing that in that conversation, that was the stigma." My perspective was I was so thankful that I had the connections and resources to be able to seek that care. I wish that it was available for everyone in that way, and I wish it wasn't a badge of honor that you don't need it. That conversation was eye opening to me. And that's the needle I feel like we're working to shift.

5. Pelvic Health + Pilates: A Match Made in PT Heaven

Lauren:

One last thing I'd love to ask you about, with you being a certified Pilates instructor and having the reformer in your studio, will you talk to us a little bit about how you see this intersection of pelvic health and Pilates? I think we're starting to see that more Pilates is having this big resurgence, and I would just love to hear your perspective on that.

Dr. Caitlin:

The Reformer is really great as a feedback tool. So what I mean by that is, although some of the things that pelvic floor PTs may do on the Reformer are not exactly what you may see in a Pilates class, it can help you to refine your movement and connect with your pelvic floor for safer and more stable movement in your classes. I have also seen this crossover.

I think the Reformer is a great feedback tool because I find that when I put a client there, they're able to actually feel their pelvic floor lengthen or contract a little bit easier than if I had them do some exercise just using their body weight. Sometimes the extra resistance or the ability to stretch actually gives them more sensitive proprioception or sensation. So I've really liked how we can incorporate that into therapy. And also the clients enjoy it because they feel like they're in Pilates class and the carryover.

So I think that's what makes it so great. We are already incorporating something in therapy that they probably already do or are interested in doing. So the effects of our sessions in physical therapy using the Reformer or mat Pilates, or just even strategies, people naturally start applying them in everyday situations.

So yes, I've just seen higher effectiveness through the Reformer, and it makes pelvic PT less scary. In fact, people actually look forward to it, or at least my patients look forward to it because they're like, "Oh yeah, I'm going to have pelvic floor PT and I'm going to be doing some workouts too. So grow that booty."

Lauren:

I am starting to see that intersection more and more, and I think hearing about it is cool, and I think it will definitely resonate with people who are interested in it.

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.