There’s More To Your Pelvic Floor: Dr. Treadway Explains How Both Men and Women Miss The Signs of Pelvic Floor Problems
Speaker 1:
Welcome back to the Armor Men’s Health Hour with Dr. Mistry and Donna Lee.
Donna Lee:
Welcome to the Armor Men’s Health Hour. You are hearing a female voice talking about men’s wellness here at the Armor Men’s Health Hour. Dr. Mistry stepped away, but this is Donna Lee. And thanks for listening to our podcasts wherever you listen to podcasts for free. We’re located in Central Texas in Round Rock, North Austin, South Austin, and Dripping Springs. We cover a variety of topics and we have a very special partner of ours who’s been with us for a good while, Dr. Angela Treadway. Welcome back.
Dr. Treadway:
Hi, good to be here.
Donna Lee:
So you’ve been with our practice the entire time?
Dr. Treadway:
13 years.
Donna Lee:
The 13 years that we’ve been open. So you’re like a pioneer.
Dr. Treadway:
I am like a pioneer, and feeling the covered wagon every day.
Donna Lee:
Right before we started recording, we were talking about how something could be so funny that you snort and then we made up a word and it was ” snortable.”
Dr. Treadway:
Snortable, snortable. Yes, we have a new category of humor. It is snortable.
Donna Lee:
Well, hopefully one of us snorts in the segment, but I don’t , I don’t know if we will, because I think we’re going to talk about something incredibly fascinating. So during the week you had some interesting patients, of course, as always. But I know you mentioned you had like a commonality between some of the patients tell me about this fascinating topic.
Dr. Treadway:
I did. I did. One day this week, I had four patients in a row, four men that came in with the identical testicle pain symptoms. And I had to do almost identical interventions on them. And when the fourth one came in and he gave me his complaints, I said, “You are the fourth one today.” And he says, “Well, I got the memo. You know, it was going around.” And you laugh, but I didn’t snort, right?
Donna Lee:
Oh, well.
Dr. Treadway:
I refrained.
Donna Lee:
That’s crazy though, four patients with the same…
Dr. Treadway:
In a row, in the same day.
Donna Lee:
And you said one of them was like a sports type person, but he was sitting a lot…
Dr. Treadway:
Okay. So we have the pain categories can be a range of activity . So I’ve got the secondary ones all the way to the CrossFit, anywhere in between. So it can be too much or too little, like we kind of want to get them in the sweet spot of activity. That would be idea.
Donna Lee:
And you said, we’ve talked about different types of pains. You wanted to talk about…
Dr. Treadway:
I wanted to add a couple, because in addition to the guys that came in with the testicle pain , identical situation, also this week, I had a gentleman who had been a bull rider in college and he broke his tailbone. And he is now in his eighties, I think.
Donna Lee:
Tell me he broke his tailbone bull riding and not like walking down the street.
Dr. Treadway:
I think the first insult was bull riding and he decided, “Okay, enough.” And then over time in his work, he was more sedentary and ended up sitting a lot, and ended up sitting in a really terrible position. So when you’re sitting up tall and everything’s aligned, you’re on your sit bones, you’re not on your tailbone–everything’s even in the pelvis. But once you get that really bad slumpy posture, all of your weight shifts backwards onto the tailbone. And there it is. If you’ve been injured, now you’re bearing all your weight there and it feels terrible. So people look for pads, or they look for doughnuts , or they look for anything to unweight that area, but continue to sit in this pattern that not only puts all the weight on the tailbone, but shortens the entire pelvic floor. So pelvic floor, I’m the pelvic floor therapist, so let me give you a little idea what that means. Everything you’re sitting on is has a muscular component and that those muscles completely fill the bottom of the pelvis from the pubic bone to the sit bones, to the tailbone–it’s like a diamond. It’s attached front to back. And if you are sitting in upright posture, it’s in good length, length/tension ratio, kind of, you know.
Donna Lee:
You’re making me sit up a little bit taller.
Dr. Treadway:
I think you just got taller.
Donna Lee:
I’m worried for my bottom.
Dr. Treadway:
But if you’re sitting on your tailbone and you’re in pain and you’re trying to get away from the pain, you might sit tucked and then sit to one side, or sit to the other side. Now your back’s going to hurt, right? Now you’ve got what’s called a , you got a mess going up the kinetic chain. That would be like parking your car with a one wheel on the curb.
Donna Lee:
Oh , good analogy.
Dr. Treadway:
Yeah. So what’s going to happen to your suspension? Well ask a mechanic. It’s probably not a good idea. But similar stuff happens to the human body and what ends up happening instead of you going in for, you know, new shocks, you have pain and probably discs falling apart because they’re getting asymmetrical wear and tear. And that’s how it goes up the kinetic chain. But coming back down to that tailbone, so working with tailbone pain, there can be a component of it that causes bowel disruptions. There can be a component that ends up causing a difficulty evacuating, which causes a lot of pushing and straining, which causes hemorrhoids. So now we have double trouble. Pain from all sorts of structures. And then you add to that the fact that the pelvic floor is about 80% voluntary muscles under your control and they run on a nervous system called the somatic nervous system, which is the voluntary muscles. But about 1% is runs on the autonomic nervous system, which has two speeds, fast and slow, or fight or flight, rest and digest. So that part that runs on the autonomic is inside the anal sphincter. It’s the same muscle that makes a puppy’s tail tuck when it’s stressed out. And we have a tail too , and it will tuck when we’re stressed. When you’re stressed, it’s going to tug, guess what, on the tailbone. So anybody who’s in trouble like that, like my bull rider, will feel extra bad if he’s in traffic or driving or has a, you know, a really stressful day at work. And it’s just, it’s a tough bomb to diffuse. You know? What I do with those patients is educate them, number one, on the whole structure function position. Like let’s get this suspension back in alignment here.
Donna Lee:
Get that wheel off the curb.
Dr. Treadway:
Get the wheel off the curb, as it were. You know, give them an idea how to fix that. And I do on an awful lot with if, if that bone is still in trouble, if that tailbone is still in trouble, I do go in and fix it. Yeah, I do. But I, you know, I get good rapport first. You know, I don’t buy him dinner…
Donna Lee:
Buy him flowers.
Dr. Treadway:
I find a way to slowly, softly break it to them that it’s coming. And then, you know, they’re usually surprised how much better things are.
Donna Lee:
How severe, I mean, what’s the most severe you’ve seen with patients that have tailbone, this specific issue and with pain in their anus?
Dr. Treadway:
Well , if there’s an awful lot of tightness in the anal sphincter, what will happen is that it will get so tight and so contracted and never relax, and then there’s not a lot of blood flow in that muscles . So when they try to have a bowel movement, it’ll tear and so they get anal fissures. So when I’m taking a history of somebody says they’ve had anal fissures, I have a good idea what I’m going to find. I’m going to find a lot of muscle tension. So what I’ll do in the evaluation is, you know, observe the area, observe the movement, the flexibility, the lifting, and the dropping that is necessary. And then I will use a biofeedback device, which is an EMG, which measures muscle activity. And I can actually show them how much tensions in that muscle. You know , how much are they holding it in a fist? Is that what’s going on? Just being able to see it and being able to show them how to intervene on that, I’m usually able to get that down in the first visit. That’s usually, as long as the person’s head and pelvic floor talking to each other, you know, if they’ve dissociated than when I might take some time, but you’d be surprised how just getting information about how this happened. It’s not your fault. It’s not forever. You know , there is, there is a plan here that usually helps at least take the tailbone from being so tucked . Right. You know, it gets the puppy tail to stop.
Donna Lee:
To wag again?
Dr. Treadway:
Yes, get the tail wagging again.
Donna Lee:
We talked briefly earlier in the week about a patient and fecal incontinence. And in urology, I don’t guess we, we treat more urinary incontinence, but you can treat both.
Dr. Treadway:
Right, because of the pelvic rehab provider certification letters after my name.
Donna Lee:
Because of the the 15 letters you have after your name?
Dr. Treadway:
The part that doesn’t fit on the business card anymore.
Donna Lee:
I gave up. I didn’t even put it on your scrubs . I was just like…
Dr. Treadway:
Thank you for not putting it on my lab coat. No one would ever read my name again, like it’s horrible.
Donna Lee:
That’s funny. Oh my goodness. Wo what more can you share about the week that you had, what other interesting patient? I know you had a patient who had a baby, and we do treat women here.
Dr. Treadway:
We do treat women here. Yes, I do postpartum checkups. I do…
Donna Lee:
Is that the typical, like I had a baby and now I sneeze and tinkle on myself?
Dr. Treadway:
Yes, I had a baby and my episiotomy scar hurts and everything’s wrong. So I help them. Yeah . And again, it’s education again it’s utilizing the EMG feedback to show them what they’re doing and to educate them as to what’s going on. Now, sometimes there’s a prolapse involved and the strengthening of the pelvic floor muscles can shore up that prolapse because muscles, every muscle everywhere in your body will develop. Just like if you want to develop a bicep and get some girth and some size in it, you can do the same thing to the pelvic floor to allow you to have better control of continence, to allow you to have more support of anything that’s prolapsing, and some of my postpartum patients have fecal incontinence and we can, it’s the same muscle. It’s the same set of muscles. It’s obviously one’s a urethreal sphincter, one’s an anal sphincter, so they are different, but they are on the same swath of muscle. So when the, when the command comes down from the brain to say “shorten,” it should all shorten. Now, if you’re super talented, you can do one and not the other, but I don’t usually teach that.
Donna Lee:
That’s a whole other class.
Dr. Treadway:
That’s another class for another place.
Donna Lee:
Well, thank you so much, dr. Tredway. If you have any more questions or concerns, you can email us at armormenshealth@gmail.com. You can specifically ask for Dr. Treadway and her response, I will get that right over to her. You can check out our podcast for free wherever you listen to podcasts, they’re free everywhere all over the world. I’ve been joking that Dr. Mistry’s Mr. Worldwide, because we see that people are listening in Europe and Asia. And I don’t know what’s that about, but it’s very cool. Our number is (512) 238-0762. And our email address is armormenshealth@gmail.com. Thank you so much, Dr. Treadway.
Dr. Treadway:
Thank you.
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The Armor Men’s Health Hour will be right back. If you have questions for Dr. Mistry, email him at armormenshealth@gmail.com