Episode #75: How trauma relates to pelvic floor health with Sandra Boyse
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Today, Rhonda is honoured to welcome her friend and colleague: Sandra Boyse! We talk about Sandra’s journey into - and the importance of - trauma healing through pelvic health physiotherapy, how she operates her practice, and the ways this type of work can benefit YOU!
Sandra Boyse is a physiotherapist specializing in pelvic health with a home office in Dorchester ON. She is a mom to a 6-year-old girl and 4-year-old boy. Sandra is a big advocate for all things women’s health and empowerment!
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LINKS AND RESOURCES MENTIONED IN EPISODE
Sandra’s Website (Home Health Physio)
PODCAST LINKS & RESOURCES
Check out Rhonda’s FREE Resource Library
Pelvic Health and Fitness Podcast
Book with Dayna (Rebirth Wellness)
SHOW NOTES:
(0:49) - Rhonda welcomes Sandra Boyse to the podcast!
(1:18) - Sandra shares more about herself and what got her into the field of physiotherapy and then pelvic health
(3:58) - Sandra shares what treating in a hospital as a physiotherapist - especially during a pandemic - looked like for her
(6:56) - What did Sandra’s transition out of hospital work - and into building a home treatment office - look like?
(13:52) - What does Sandra feel about working from home - and what challenges does she face?
(16:10) - What does Sandra’s day-to-day look like running her practice from home?
(19:07) - Sandra shares why she is passionate about helping women heal from trauma in her pelvic physiotherapy practice
(27:19) - As an internal pelvic physiotherapist, Sandra shares if there is treatment that can happen without that internal assessment
(28:26) - If someone is listening and has similar symptoms to what we’ve talked about today, what would Sandra recommend their first step be?
(29:32) - What Sandra talks with her clients about regarding mental health
(31:24) - Sandra’s final take home message!
(32:03) - How people can find - and work with - Sandra!
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Episode #75: How trauma relates to pelvic floor health with Sandra Boyse
We're excited to have you join us for this episode of Pelvic Health and Fitness. I'm Dayna Morellato, Mom, Orthopedic and Pelvic Health Physiotherapist. And I'm Rhonda Chamberlain, Mom, Orthopedic Physiotherapist and Pre Postnatal Fitness Coach. On this show, we have open and honest conversations about all phases of motherhood, including fertility, pregnancy, birth, postpartum, menopause, and everything in between.
We also provide helpful education and information on fitness, the pelvic floor, and many aspects of women's health, including physical, mental, and emotional wellness. Please remember as you listen to this podcast that this is not meant to treat or diagnose any medical conditions. Please contact your medical provider if you have specific questions or concerns.
Thanks so much for joining us. Grab a cup of coffee. Or wine. And enjoy!
Welcome everyone to another episode of the Pelvic Health and Fitness podcast. Today I'm honored to welcome my friend and colleague, Sandra Boyse. Sandra is a physiotherapist specializing in pelvic health. With a home office in Dorchester, Ontario.
She is a mom to a six year old girl and a four year old boy. Sandra is a big advocate for all things, women's health and empowerment. Thank you so much for joining me today, Sandra. Thanks so much for having me, Rhonda. I'm excited to, so I would love to hear more and I'm, our listeners would love to hear more about you.
What got you into the field of physiotherapy? Um, I know you do the pelvic floor focus as well. Um, what got you there? Yeah, so growing up, my aunt went back to school to be a physio later in life, and we had a shared family cottage. And so she would always have like, her anatomy books and her physio books and stuff at the cottage.
And I was just like, them. And my mom did x rays and ultrasounds in a hospital. So I went with her to take your kid to work day, but ventured down to the physio department instead and just like fell in love with how people could help people get better. And And just kind of became fascinated with it since then.
The public health side of things came a lot later in life. So I worked in a hospital for nine years. Um, during the pandemic became super burnt out working there and decided to venture off and open up my own clinic in Dorchester. But I also postpartum ran into some issues with incontinence and had to seek out a pelvic physio for myself, which, as you know, as a physio, you kind of have to like suck up your pride a little bit to go see another physio thinking like I should be able to heal myself.
I should know how to fix this. Um, but you know, in physio school, there's a very, very brief chunk that is devoted to the pelvic health side of things. So definitely didn't know how to fix that for myself, but found how helpful it was going to a pelvic floor physio and knew that when I did start my own practice, that was something that I really wanted to be able to help women through is all of the pelvic issues.
And I also had a lot of pelvic pain growing up too, not knowing that that was likely related to pelvic floor muscles. And yeah, that probably would have saved me a lot of hassle had I known that earlier on. Oh yeah, so many of us, so many of us physios have a similar story of realizing, yeah, it's just such, you know, an important area of the body that just we're not taught about.
Yeah. Which is mind blowing. It should be, I think, a more core component, uh, core, no pun intended, component of the program. Right. Um, and maybe that will change who knows. Right. Yeah. Yeah. Yeah. I would love to hear more about your experience. I know we've talked in person about this, but treating in a hospital as a physiotherapist, especially during a pandemic, can you share with us a little bit about what that looks like for you?
For sure. So, where I was, I was at the Woodstock General Hospital and it was really nice in the sense that we rotated units every six months. So, it was really great for me because I got to experience, like, all the different areas of the hospital and learned so much. Um, I happen to be working in the ICU during the pandemic during like the worst part of the pandemic.
So the hut was really, really eye opening for me. Um, I was predominantly doing chest physiotherapy. So all of my patients were ventilated. I would be going in and trying to get like basically the mucus out of their airways mobilized as I don't know if that's as awesome as that sounds, um, and working really closely with the nursing staff there, um, it took about six people to prone the patient, so even just like flipping them onto their stomachs was like a really huge process, um, Um, I was quite isolating during that time because, you know, with a lot of the clients you didn't know if they were going to live or not.
Um, people were dying and their family members weren't able to come into the hospital. all of my patients were ventilated so they didn't even know that I was in the room most of the time so it was really like dark dark days for sure but what what was nice um like one of the positives that came out of it was just kind of feeling like part of the team because yeah we worked with the nursing staff closely but Not to that same extent, like once you go through something kind of traumatic together like that, it kind of bonds you and you kind of, you know, go out of your way to help one another a little bit more and check in on each other a little bit more.
So yeah, it was definitely, uh, a crazy experience for sure. And I'm happy to be on the other side of things now. Yes. I can just imagine. I did one of my placements in the ICU, Sandra, and it was by far the hardest placement. Not even just academically, but just on my nervous system. I struggled. I did not like that placement, I will say.
Yeah, you kind of get a really big mixed bag and people medically aren't well either. So that adds a whole other level of care that's required. Yeah, so kudos to you for being in an ICU environment during COVID. I can just imagine how stressful that could be at times. Yeah, thank you. It definitely, definitely wasn't the most favorite memory for sure.
But like I said, you learned a lot. I definitely learned a lot going through all of that. Yeah, so then share a little bit more with us what the transition look like so, you know, deciding, okay, maybe the hospital is no longer for me and then deciding to do your own thing. Like I know, yeah, share us again. I know you personally, so I know some of this story, but share with our listeners what that transition look like.
So coming out of the pandemic a little bit, um, I flipped units over to the orthopedic unit. And so I was treating a lot of total hips, total knee replacements. And when I first started at the hospital, patients would usually stay for two, sometimes three or more nights after their surgeries. And because they weren't allowed to do a lot of, um, the elective surgeries during the pandemic, they were trying to save hospital beds for COVID patients.
They were trying to really ramp them up coming out of COVID, and they also kind of found a loophole in the system where if the patients didn't stay overnight, in a hospital bed that they could still do the hip and knee replacement and just send them home on the same day. And so as a physiotherapist, we were required to, you know, make sure the patients were safe up moving to go home after their surgeries.
So, as you can imagine, we go to see them post surgery, day of, and they're either vomiting coming out of the anesthetic, their legs are still numb, like it wasn't really a great time for the patient to be up and doing physio. So a lot of times the nurses would say, you know, come back in a couple hours and check on them then.
So my, my shifts quickly turn from eight till four to eight till eight, sometimes later. A lot of times we wouldn't know we would have to stay late until we're already at work. And being a mom of younger kids, it was a struggle to make sure I had somebody to pick them up from daycare. So I decided to, yeah, venture out on my own to give myself a little more time, freedom, flexibility, all of the above.
Yeah. So that's kind of what motivated me. And I was really reluctant at first because there is another physio clinic. I'm from a small town. And so a lot of. And I was just kind of self limiting beliefs thinking, well, there's already a clinic here like who's going to come and see me at my house when I'm just starting out.
Um, so it was quite pleasantly surprising to see the support from the community and from everyone around here who really. Trusted me with their healthcare and came to see me in my home despite there being another clinic here. So it was kind of cool to see that until you really like challenge those beliefs, um, that they're exactly that they're just beliefs, but they're not, not truth, right?
So. I love that. That was, uh, cool. That's amazing. Yeah, I think so. That happens to so many of us, right? That we create all these barriers that might be real, but they often are bigger in our minds than they actually end up being. Right. And I think that's cool that you've proven that to yourself, that Yeah, you can be successful working from your house, um, and still get some clients fill that case load.
That's amazing. Um, I know, I think you shared with me when we met in person, did you go to people's houses at first or was that something you considered at first? Thanks for reminding me of that. I almost forgot about that. Yeah, when I was in the hospital, there was a lot of people who couldn't make it to back to the hospital for their physiotherapy after receiving the knee and hip replacements.
Um, usually you can't drive for the first six weeks, right? So if you didn't have significant other living with you or somebody to drive you, that kind of became a barrier to, um, coming back to the hospital for physio. So I started doing home care physiotherapy, thinking that I would fill that gap or that void.
And so I was going to people's houses, which was really nice, but super time consuming when you're driving all over the place. So shortly after that, I opened up my home clinic. And once that became busier, then I kind of slowly transitioned out of doing the home care visits. That's so cool. Yeah, so I do often have other healthcare practitioners that listen to the podcast.
So if anyone's listening that might be curious, how was it transitioning your home into a space that people come to see you? Was that a tricky transition or did it happen pretty seamlessly? It was surprisingly easier than I would have thought. I'm lucky in the sense that Right off of my front door. I have an office that it used to be a kid's playroom, but I've now transitioned into my own office, which is kind of fun to have your own little space at home That's so cool getting to decorate it and make it mine so it was easier than I thought it was going to be and I started out for any of your listeners like It doesn't have to be like, everything at once, right?
Like I started out with this like, inexpensive, collapsible therapy, like massage table, and then eventually transitioned to like, an electric bed that goes up and down. So kind of things happened slowly in stages as, as I was able. So it wasn't, you know, a ton of costs and, and, you know, Arranging everything up front, right?
Yes, yes. I'm jealous because I feel like I, so right now I always record in my basement. This is my little office, but I should make it more of my own, but I feel like I don't, I don't love being in the basement. So I think there's something like hindering me. But I keep saying to my husband and, you know, in a perfect world, this would happen sooner than later, but in the economy we're in, I would love to find a house similar to that, that has a main floor office with lots of sunlight.
Like I'm definitely impacted by sunlight. Um, so yeah, that's amazing that you have that. Yeah. At least you've got your picture in the background. Yeah, I tried. Yeah, I could still spruce it up a bit, but again, it's, uh, Yeah, I think more so I'm leaning towards like one day we'll have a house that I can have a main floor Office because I love that idea that you can make it your own because I still feel like this is like storage You know, it's like it's not really my own space.
So I I think that's cool that you have that I totally get that. Yeah, it was definitely super convenient that this house was already kind of set up for that. Amazing. And how do you find, because I know, again, I struggle with this sometimes, how do you find working from home? Um, again, I think it probably helps that you have a separate space that you can close the door at the end of the day.
Do you find though, what are some challenges that you find working from home? The hours that I'm able to provide to my clients for sure, because nobody wants little kids running into their pelvic floor. Good point. So whenever people ask me for evening hours, I'm like, I'm so sorry. But as of right now, the age that my kids are at, it's just not possible.
We can't trust that they're going to stay out. Yeah, that's a challenge for sure. Making sure that my house is always tidy. Uh, I tease with my clients because they're like, Oh, your house is clean. I'm like just this main area. Like I still can hide my messes, like on the upper and lower floors. Definitely pros and cons.
Um, it is nice being home and having the ability to like run and put a load of laundry in between clients or not have to pack a lunch every day. So. You know, pros and cons as, as you know, from working from home to, um, to each leaving, leaving work at work is a little more challenging as well, because you are always at work technically, but, you know, trying to set some firm boundaries around that.
And it was definitely a learning curve too. And it's still a constant, I feel like kind of ebb and flow where there's certain times You're maybe a little more focused on work and you throw a sick kid in the mix. And now all of a sudden that becomes a little bit higher of a priority. So I relate to that too.
Oh, exactly. Yeah. I feel like, yeah, it's, it is such a perk as a mom, especially. I think it's kind of nice that you're forced to have those boundaries with your hours too. I find that for myself, like I, I do a couple of evening things, but. Um, I think, you know, forcing yourself to set those boundaries to be home with your kids is not a bad thing.
Yeah, and it's definitely nice for flexibility when the kids have like appointments or events or whatever, being able to kind of flex your schedule, which at the hospital is a lot, a lot trickier to be able to do that for sure. Yes. I would love to hear what your practice looks like these days then. So yeah, you're, you're fully at home doing your thing.
What does your day to day look like in terms of like types of clients you see who is maybe your ideal client? I know you prefer to kind of do a mix, right? So tell us about that. Yeah, I actually kind of prefer the pelvic health world of things. However, it's hard to be like, I'm strictly doing pelvic health because there's always other stuff that comes up.
And as you know, like the body as a whole, one thing can lead to another. So it's a, it's hard to set firm boundaries on that. Um, I would say probably 60 to 70 percent of my clientele is pelvic health. Um, the other. portion is just general orthopedic condition. So, you know, your typical back, shoulder, hip, etc, etc.
Yes, I also recently started dabbling into the online world a little bit. So I'm running some virtual fitness classes. I have a prenatal postnatal zero to 12 weeks, and then 12 weeks to two years that I'm doing virtually. And then a generalized like strengthening class in the evenings after my kids are asleep virtually.
So that's kind of a loophole around that. And then I also have a pelvic floor, like a pelvic prep class that I run probably quarterly, virtually as well. So it's fun to kind of dabble into the online world a little bit as well. Having a mix of things. Yes. I love that. Yeah. I, I think it's so neat, you know, just seeing different examples of physiotherapists doing things differently online, right?
We have such a cool little online community of physiotherapists that we're connected with and just seeing people doing so many different things, right? Like one of our mentors, Emma, just seeing her, you know, really venture into coaching other physiotherapists right in the business world. It's just so neat.
You know, I feel like coming out of school, it's like I am either a hospital or clinic, right? And that's all you know. And, you know, I think post pandemic that opened a lot of doors for physiotherapists to provide virtual services, which, yeah, I know personally, I'm thankful. I'm sure you're appreciating that too.
Totally, totally. It allows that whole other level of flexibility again, too. And same thing with your Canva work, right? I think that's so awesome because it's not the traditional, like, physiotherapy route, like you said. But it's something that you're interested in and there's such a need for. So I think it's so awesome that people are able to explore all the realms of possibilities.
Thanks, Sandra. Yeah. It's, it's, again, we live in such a cool time that yeah, all, all these online services exist that we can sort of dabble into things and just see what happens, right. It's pretty cool. Yeah. So I know you just sort of touched on a little bit of this in your intro, you know, that you didn't know.
That dealing with, you know, chronic tension in your pelvic floor can lead to symptoms and some of the things that you struggled with, you know, pairing that with, I know you're really passionate about helping women heal from trauma, you know, as that relates to pelvic health. Do you want to just venture into that topic for us?
You know, I think such an important topic, trauma and pelvic health. I know I haven't touched on this in the podcast, so I'd love to kind of have a chat with you about that. so much. Yeah, for sure. And I used to be super reluctant to talk about it, like this wasn't a common or easy thing for me. But since I started speaking out about it a little more publicly, I realized how many people can relate to it, but don't talk about it for that fear of, I don't know, there's so much fear around it.
Like fear of, of being that victim and feeling like people perceive that in a certain way. So the reason why I'm so open and Unable to talk about it now is knowing that there is so many other women that are impacted by trauma or abuse and so knowing that this could help them through it or Feel a little less alone.
Um brings comfort to me For that so going back in my childhood. I um suffered sexual abuse It wasn't from my, my parents or anything, but it was from somebody that was close with the family and kept it to myself for years and years and years. Um, struggled with a lot of things in life, went to therapy, but wasn't really able to fully speak about it in therapy.
Um, it wasn't until like early twenties, I started kind of realizing I was having a lot of pelvic pain. I went for several pelvic ultrasounds, which all came back negative. I even went through, um, like a bladder scope where they like stick a camera up into your bladder to see what's going on in there and everything kept coming back negative.
And I just started to feel like I was like crazy, like I didn't understand. I don't understand why I was like having all this pain, thinking maybe it was related to like stress, especially when I was in physio school, um, and then postpartum. struggled with some pelvic symptoms that were more a little more typically postpartum, like incontinence, a little bit of like prolapse type symptoms.
And then when I went to see a pelvic floor therapist, um, learning about the tightness and the tension and how that directly relates to trauma. So as you know, but some, maybe some of your listeners don't know. Um, when you go through trauma, especially a sexual trauma, your muscles tend to tighten up as like a protective mechanism and even just stress.
in your body can be held in the pelvic floor, as you know. And so I didn't know that until I eventually took all of this training and education. And so working with that pelvic physiotherapist, learning how to stretch all of those muscles, letting go of all that pelvic tension, eventually completely got rid of all of my pain, pelvic pain, pelvic symptoms that I had been having.
And had I had known that earlier would have saved me so much pain, hassle, testing, probing, that totally was not necessary. But again, you don't know what you don't know. So now I'm just trying to make it my mission to like educate other women that this could be potential reason for your pelvic pain if you are a victim of sexual abuse.
So, yeah, at least I'm trying to spread that education and that word a little bit more. Thank you so much for sharing that Sandra and I'm sorry that you went through that and I'm, you know, if anyone's listening that can relate, um, you don't deserve to be treated that way. And there is so much help that can be found, right?
So again, thank you for sharing that today. Um, and I think just such important information to learn that was brand new information for me to, to learn that link between, yeah, stress, you know, how our body literally holds onto tension. In all different areas of our body, right? Like when I learned the connection between like a tight jaw and a tight pelvic floor.
I was like, what? My mind is blown. Yeah, all of these things. And, you know, I, I don't have a sexual abuse history for me though, coming from a history of competitive gymnastics, um, you know, maybe levels of abuse. And I think just, in that environment, you know, being told to be quiet and be small and like, you know, everything was like tense, tense, tense all the time.
That for me was like so much unlearning that had to happen of like, yeah, just not constantly gripping and squeezing everything. And for me, that's what I think led to a lot of my prolapse symptoms. I think learning that too, that like prolapse symptoms can also come from just holding tension in our, in our pelvic floor, right?
Like all these things I'm like, my mind is blown, right? Right. It's all this stuff that you wish you knew earlier. That's now so helpful. And so Probably same as me with you. You're like, if I can prevent this for somebody else, like that would be huge. So you're just like trying to educate as many women as you can about it to try and prevent somebody else the headache and the heartache and the discomfort that you had to experience yourself.
And, you know, I hope we get to a world where. You had to go through so many tests and I'm sure so much friends frustration and like gaslighting right of like probably starting to think like, am I crazy? Like why is nothing showing up? Right? Had someone told you go see a pelvic floor physio. That would have solved everything, right?
But no one did. And how frustrating is that? Right. And I, I think it's nice for us too, that we can on the other side of things, be that open ear, be that person that our clients can come to us and Um, and, you know, feel comfortable divulging things like that to us, and us being able to provide some answers.
And if we can't, you know, outsource and give valuable resources to people so that they can get those answers, because I know how frustrating that can be in the medical world to just feel like you're constantly coming up against walls, or people blaming it on mental health, or other sort of non concrete issues that they can't physically touch or feel.
Totally. Yeah. And I think just so important, you know, obviously for pain and symptoms for people to find help, but also just for like their sexual health, right? Like, I think that's something we, I didn't learn about in physiotherapy school, but such a huge quality of life thing too, right? If folks are dealing with, you know, pain with penetration and that's impacting their sexual health, that deserves to be treated as well.
Right. And I think again, so many people get sort of dismissed of, Oh, just keep having sex. It'll get better. Like drink a glass of wine, all these wine. Yeah. Yeah. Does that just spoil your blood? Oh my God. A lot of these concerns are not being taken seriously. So it, It is nice that we can at least provide some tools and some resources to some of the clients, uh, um, actual things that they can start doing to help them.
Yeah, and then do you want to just touch on as a pelvic, I'm not an internal therapist, but as an internal therapist, you know, if folks are listening that maybe have a similar background, um, you know, story, uh, history of sexual violence, is there treatment that can happen without that internal assessment as well?
Because that, I'm sure that could be something that people are nervous about, right? Yeah, and that's something I definitely take a lot of time explaining and going over with my clients is that the internal exam is 100 percent optional. So if they're not comfortable, it's not happening. They definitely have to feel comfortable.
And there's so much that can be done externally. Still, there's a huge educational component around pelvic health physio. And a large exercise component that can help with a majority of symptoms, um, that people are experiencing with their pelvic floor. So yeah, the internal exam absolutely has to be something that is consented to, informed consent, um, and that people are feeling very, very comfortable around.
So definitely wouldn't push that upon anyone. Yeah, totally. So if someone's listening and again maybe has similar symptoms, so like dealing with either like a tightness feeling, you know, prolapse, bulging feeling, pelvic pain, incontinence, what would be your recommendation for like their first step to take?
Go see a pelvic floor physiotherapist for sure because like as, as you and I know it, you can't really like lump people into groups when it's such an individualized. treatment assessment process. So getting that one to one, um, assessment done, figuring out exactly what your symptoms are, problems are, because it can be like a pelvic floor tightness or a pelvic floor weakness or a combination of both and you don't really know unless you have that full on assessment with a therapist to determine, you know, where your issues lie and how to resolve them based on the problems.
So definitely seeking out a therapist would be helpful. Yes. And then do you talk to your clients too just about getting mental health support along their journey as well? Absolutely. I started printing off for every public health client that comes in, because I usually give them a handout that like explains about the pelvic floor and the symptoms, etc.
But then on the last page, there's also a mental health resources that just has a list of options of care providers that they can seek out if they want to. Cool. Um, at least they have the choice there. Amazing. And I think that's, in my opinion, what pelvic health therapists do such a great job at. Um, you know, to use a physio term, we get really into like that biopsychosocial model.
I think personally the best compared to maybe like orthopedic physios, more so just because, again, as we've just talked about this whole episode, that link between mental health, psychological health, and how our pelvic floor responds, is So important right so I think you can address one without the other and I mean there is issues I'm sure with access right like to be able to afford pelvic physio and mental health care is can be a challenge for folks but I think just knowing that there's that link and just seeking whatever even like free support that you can get is so important.
Absolutely. And like you had mentioned too, when people are stressed, they tend to clench their jaw or For you going through gymnastics, you were told to always like keep everything tight in. And it's crazy how psychological components can really present themselves in your body over time. So I definitely agree that there is a huge link and it is great when we can kind of address all sides of it to help help our patients, clients feel better.
For sure. Amazing. So such a great chat today, Sandra. If you had to sort of like sum up our chat today and leave our listeners with one take home message, what would that be today? Oh, I'm gonna have to go on the side of the sexual abuse because obviously it's near and dear to my heart, but letting people know that it's not their fault.
No matter what the circumstance is, it's not their fault. And so finding somebody that you can speak to, whether it be family, friends, or healthcare professional, um, that's kind of your first step towards healing. So definitely, definitely try not to just keep it in and do speak out about it. So good. And how can people reach out to you, Sandra, and work with you?
I am @home.health.physio on Instagram, or you can reach me by email at sandra@homehealthphysio.ca, and my website is also homehealthphysio.com. Amazing. And yeah, services, you do one on one, and then you said you offer some classes, so for folks that are like, do you do pregnancy, um, treatments as well?
Yeah, pregnancy treatments, I do, um, pregnancy prep, virtual course classes, um, and exercise classes, prenatal and postnatal as well. Amazing. Yeah. Awesome. Great. Thanks so much for having me, Rhonda. It's so great to talk to you. And I just love your podcast and all you're doing to kind of go against the healthcare norms in the fitness world.
So I appreciate all you're doing. Of course. So nice chatting with you. And yeah, it's been amazing to watch your journey as well, Sandra. Okay, take care. Bye. Bye. Thanks for listening to today's podcast. We hope you enjoyed the conversation. If you liked what you heard, we would love if you could share this with a friend, leave us a review, or subscribe to anywhere that you listen to your podcasts.
Thanks for being here.
