The Hole Shebang

Return to running after baby is one of the most searched questions in postpartum recovery, and the guidelines most clinicians use were co written by this week's guest. Grainne Donnelly, Advanced Practice Pelvic Health Physiotherapist, Editor in Chief of the Journal of Pelvic, Obstetric and Gynaecological Physiotherapy and editor of the new Elsevier textbook Sports Medicine and the Pelvic Floor, joins Kristen to talk about leaking during exercise, pelvic floor dysfunction in female athletes and what a decade of new research has changed about postpartum return to sport. From compression shorts and pessaries to the evolutionary reason human pelvic floors work so hard, this is the conversation for anyone who runs, lifts or coaches.

This episode is brought to you by SRC Health. Shop SRC garments at blueberrytherapyshop.ca and use the code SRC15 for 15% off.

In This Episode

• [02:29] The short straw: how a maternity rotation labelled a waste of six months became a career
• [04:57] Nearly half of 325 athletes at the Lima U20 World Championships reported pelvic floor symptoms, and why the research is only catching up now
• [08:55] Assessing a young athlete: history, bladder diary, real time ultrasound and leaking as a warning sign of underfuelling (RED-S)
• [15:44] The 2019 return to running guidelines: why they were written and what they screen for
• [19:56] What changed: the 881 woman study, the three week minimum and why 12 weeks is an average, not a rule
• [24:13] The product menu: pessaries, Uresta, Poise Impressa and the compression shorts her PhD put through gait analysis
• [30:28] Run quieter and lean in: free strategy changes that reduce load on the pelvic floor
• [33:31] The evolutionary chapter: what walking upright cost the pelvic floor, sparked by a chance meeting with Dan Lieberman
• [41:27] Load capacity in practice: the six double unders method
• [44:41] The Chrome browser brain: why understanding a symptom changes the symptom

What You Will Learn

How to tell a load capacity problem from a structural one, what a graded return to running actually looks like, which support products exist and how they work, and why pelvic floor symptoms touch at least one in three women without being anyone's fault.

About Grainne Donnelly

Grainne is an Advanced Practice Pelvic Health Physiotherapist and founder of Absolute Physio in Northern Ireland. She co wrote the returning to running postnatal guidelines (2019) with Tom Goom and Emma Brockwell, is Editor in Chief of JPOGP and edited Sports Medicine and the Pelvic Floor: Science to Practice (Elsevier, 2026). Her PhD research at Cardiff Metropolitan University investigates compression garments for pelvic floor symptoms in runners.

Theme Song: Jump Around by House of Pain and Maniac 2000 by Mark McCabe (she filled in the form twice and we kept both)

Resources and References Mentioned

• Sports Medicine and the Pelvic Floor: Science to Practice (Elsevier, 2026)
• Returning to running postnatal guidelines (Donnelly, Brockwell and Goom, 2019)
• The Lima 2024 World Athletics U20 study on athlete pelvic floor symptoms (Giagio et al.)
• Grainne's research on ResearchGate
• Products discussed: pessaries (fitted at Blueberry Therapy), Uresta, Poise Impressa, Efemia and Diveen urethral supports, targeted compression garments (SRC Health garments)

Keep Listening on The Hole Shebang

• Pelvic Floor for Athletes: Your Hidden Force Absorber with Dr. Rachel Selman
• The New Postpartum Exercise Guidelines That Ditch the Six Week Rule with Dr. Margie Davenport
• Menopause Joint Pain: Why Everything Aches and What Helps with Michelle Lyons
• Birth Prep: The Movement Work Nobody Taught You with Gina Conley

Connect with Grainne

Website: absolute.physio Instagram: @grainnedonnelly_absolutephysio

Our Sponsor: SRC Health

SRC makes medical grade compression garments for pregnancy, bladder leaks and mild pelvic organ prolapse. The Restore short is the one Kristen reaches for most in clinic. It supports your pelvic organs while you and your pelvic floor physiotherapist do the strengthening work.

Blueberry Therapy has carried SRC garments for years. Shop the full range at Blueberry Shop, same price as buying direct and shipped from the clinic in Canada. Use the code SRC15 for 15% off.

Many extended health plans cover compression garments with a prescription, so check your benefits before you assume you are paying out of pocket.

Ready for Support?

Blueberry Therapy offers pelvic health physiotherapy, pessary fittings and return to sport planning in Dundas, Ontario and virtually across the province: blueberrytherapy.ca

Subscribe to The Hole Shebang at podcast.blueberrytherapy.ca, leave a review if this episode helped, and connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth.

Pelvic girdle pain affects about one in two pregnancies, and most women who have it are told a story about relaxin, loose ligaments and an unstable pelvis that research disproved back in 2012. In this episode of The Hole Shebang, Kristen Parise sits down with Dr. Sinead Dufour, PT PhD, Associate Clinical Professor at McMaster University, to explain what pregnancy related pelvic girdle pain is: a sensitive, protective nervous system rather than a structural failure. They cover the real risk factors, the three step treatment model, symphysis pubis dysfunction as a harmful label and how virtual pelvic health physiotherapy is reaching women who could never get to a clinic.

This episode is brought to you by kGoal. Shop kGoal smart pelvic floor trainers at blueberrytherapyshop.ca and use the code kGoal15 for 15% off.

In This Episode

• [01:01] Twin mama first: how twins during a PhD pulled Sinead into pelvic health
• [03:46] One foot in the clinic, one in research, and why both get better
• [07:14] One in two: how common pelvic girdle pain is in pregnancy and the first postpartum year
• [08:50] Normal pregnancy aches versus pain that persists
• [11:23] The relaxin story, and why twins with 3.6 times the relaxin disprove it
• [14:29] Not a stability problem, a sensitivity problem: nociplastic pain explained
• [17:08] Beliefs beat biomechanics: the harm in the label symphysis pubis dysfunction
• [19:42] The eight or nine established risk factors, and none of them are structural
• [21:48] Guarding, the threat response and what good treatment looks like
• [23:52] Three steps: making sense of pain, exposure with control, lifestyle
• [34:18] Virtual pelvic health care, and when you still need hands and eyes in person
• [40:09] The Ontario fix: pelvic health in the public health nurse visit, and teaching teens their bodies
• [44:47] Theme song: Bitter Sweet Symphony

What You Will Learn

How to tell an ordinary pregnancy ache from pelvic girdle pain that needs care, why the relaxin and instability explanations failed the evidence, which risk factors matter (previous trauma, second pregnancies, fear, depleted energy, smoking, higher BMI, a history of episodic low back pain, synthetic progestin use and lack of belief that things will improve), what modern treatment involves and how virtual care opens the door for women far from a pelvic physiotherapist.

About Dr. Sinead Dufour

Sinead Dufour, PT PhD, is an Associate Clinical Professor in the School of Rehabilitation Science at McMaster University, where she teaches across medicine, nursing and rehabilitation science. She practices virtually through the National Pelvic Health Collective, is a founding partner of The WOMB perinatal care centres, led the SOGC guideline on conservative care of urinary incontinence and co authored FIFA's decision aids for pregnant and postpartum footballers. Her course Reframe Pelvic Girdle Pain retrains clinicians worldwide.

Theme Song: Bitter Sweet Symphony by The Verve

Resources and References Mentioned

• Reframing beliefs and instiling facts for contemporary management of pregnancy-related pelvic girdle pain (British Journal of Sports Medicine, 2022)
• Understanding and managing pelvic girdle pain from a person-centred biopsychosocial perspective (Beales, Slater, Palsson and O'Sullivan)
• Reframe Pelvic Girdle Pain: A 21st Century Approach (Sinead's course for clinicians on Embodia)

Listen to More Episodes Like This

All at podcast.blueberrytherapy.ca:

• Chronic Pelvic Pain: Real Even When Your Tests Are Normal with Carolyn Vandyken (Ep101), Sinead's research collaborator on the nociplastic pain side of this story
• The New Postpartum Exercise Guidelines That Ditch the Six Week Rule with Dr. Margie Davenport (Ep66), who named Sinead on air as a leader in remote pelvic care
• Empowering Exercise During Pregnancy with Dr. Christina Prevett (Ep6)

Pregnant or postpartum and dealing with pelvic girdle pain, incontinence or prolapse, or wondering about a pessary fitting like the ones mentioned in this episode: the Blueberry Therapy team offers pelvic health physiotherapy in Hamilton and virtual consultations across Ontario at blueberrytherapy.ca.

Our Sponsor: kGoal

kGoal makes smart pelvic floor trainers that show you what your pelvic floor is actually doing. Doing Kegels in the dark is the most common reason they do not work, and real time biofeedback replaces the guessing with something you can see.

Blueberry Therapy carries the full kGoal range. The Classic is the insertable trainer most people start with. The Boost is a sit-on-top trainer you use fully clothed, which makes it the one Kristen recommends for pelvic pain, early postpartum and anyone who finds insertion uncomfortable. Both train the pelvic floor to release as well as contract.

Shop kGoal at blueberrytherapyshop.ca and use the code kGoal15 for 15% off. Not sure which trainer fits, call the clinic at 289-238-8383 and a member of the pelvic health team will help you choose.

Connect with Dr. Sinead Dufour

• McMaster experts page
• National Pelvic Health Collective (virtual care)
• Instagram @dr.sinead

Subscribe to The Hole Shebang at podcast.blueberrytherapy.ca, leave a review if this episode helped you and connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth.

The first 1000 days of life, from before conception to a child's second birthday, set the foundation for lifelong health, and most of us have never been told the window exists. In this episode of The Hole Shebang, Kristen sits down with Dr. Deb Sloboda, professor and Associate Chair of Research in Biochemistry and Biomedical Sciences at McMaster University and Tier 1 Canada Research Chair in Early Origins of Health and Disease, to walk through the developmental origins of health and disease in plain language. They cover preconception health for both partners, why the placenta is a fetal organ with a sex, epigenetics explained as dimmer switches, stress hormones in pregnancy, the gut microbiome and The Art of Creation, her arts based science translation project now headed to the British Science Festival.

This episode is brought to you by kGoal. Shop kGoal smart pelvic floor trainers at blueberrytherapyshop.ca and use the code kGoal15 for 15% off.

In This Episode

• [01:02] From French major at Guelph to falling for embryology at the Ontario Veterinary College
• [04:10] What the developmental origins of health and disease means
• [06:30] The first 1000 days, the window nobody talks about
• [08:18] The placenta is the baby's organ, and it has a sex
• [11:14] Male preconception health, the gap in research and healthcare guidelines
• [12:36] The six month preconception checklist for the partner with the sperm
• [14:17] Birth weight, famine cohorts and the metabolic thread in the research
• [18:00] Epigenetics explained: dimmer switches on your DNA
• [20:30] Stress in pregnancy and the placenta's cortisol gatekeeper enzyme
• [25:57] How first and third pregnancies reshape the gut microbiome differently
• [30:42] The Art of Creation: rappers and sculptors inside a pregnancy lab
• [35:57] Art Gallery of Hamilton to the British Science Festival in Southampton
• [38:00] The five words a Hamilton rapper said after a month in the lab
• [41:16] Art workshops for clinicians and where to find Deb
• [42:35] Theme song time

What Listeners Will Learn

Listeners will leave understanding that health trajectories begin before birth, that preconception advice applies to sperm as much as eggs, that the placenta actively protects a baby from everyday maternal stress, and that serious depression in pregnancy deserves treatment rather than guilt. They will also hear how art carried this science to the public better than any lecture.

About Dr. Deb Sloboda

Dr. Deborah Sloboda is a professor and Associate Chair of Research in the Department of Biochemistry and Biomedical Sciences at McMaster University and holds a Tier 1 Canada Research Chair in Early Origins of Health and Disease. She has published 147 papers and 17 book chapters, won the 2015 Nick Hales Award, the 2017 Hamilton YWCA Woman of Distinction Award in Science and McMaster's 2024 President's Award for Excellence in Graduate Supervision, and is a founding co president of the DOHaD Society of Canada. She leads The Art of Creation, an arts based knowledge translation program.

Theme Song: Once in a Lifetime by Talking Heads

Key Topics Covered

• Developmental origins of health and disease and the first 1000 days
• Preconception health and sperm health
• The placenta, epigenetics and stress during pregnancy
• The gut microbiome in pregnancy
• Arts based knowledge translation

Resources and References Mentioned

• The Sloboda Lab: slobodalab.com
• The Art of Creation: artofcreationstudy.com
• Sloboda Lab on YouTube (LT the Monk's spoken word piece and the art pieces)
• The Art of Creation results paper (Journal of Developmental Origins of Health and Disease, July 2026)
• DOHaD knowledge and diet quality in pregnancy, from the Mothers to Babies study (Maternal and Child Nutrition)
• Maternal diet, placental hypoxia and fetoplacental immune balance (Biology of Reproduction, 2025)
• Paternal obesity and placental blood vessel development (Biology of Reproduction, 2022)
• Paternal obesity and the sperm epigenome (eLife)
• Dr. Sloboda's publications on Google Scholar

Listen to More Episodes Like This

Find them all at podcast.blueberrytherapy.ca:

• Secrets to a Healthy Pregnancy Journey with Dr. Kristi Adamo (Ep18)
• Healing the Gut for Hormone Balance with Stephanie Singh (Ep7)
• The Fertility Factors Nobody Talks About with Rachel Corradetti Sargeant (Ep31)
• It's More Complicated: Understanding Hormones with Dr. Stacey Ritz (Ep28)
• Understanding Severe Maternal Morbidity with Dr. Giulia Muraca (Ep9)

Our Sponsor: kGoal

kGoal makes smart pelvic floor trainers that show you what your pelvic floor is actually doing. Doing Kegels in the dark is the most common reason they do not work, and real time biofeedback replaces the guessing with something you can see.

Blueberry Therapy carries the full kGoal range. The Classic is the insertable trainer most people start with. The Boost is a sit-on-top trainer you use fully clothed, which makes it the one Kristen recommends for pelvic pain, early postpartum and anyone who finds insertion uncomfortable. Both train the pelvic floor to release as well as contract.

Shop kGoal at blueberrytherapyshop.ca and use the code kGoal15 for 15% off. Not sure which trainer fits, call the clinic at 289-238-8383 and a member of the pelvic health team will help you choose.

Connect with Dr. Deb Sloboda

Website: slobodalab.com and artofcreationstudy.com Instagram: @sloboda_lab and @aoc_study LinkedIn: linkedin.com/in/deborah-sloboda

Connect with The Hole Shebang

If this episode made you feel less alone, that is the entire point of this show. Subscribe, leave a review and tell us what you want to hear next. If you are planning a pregnancy or in one now, Blueberry Therapy's multidisciplinary team supports every stage, book at blueberrytherapy.ca.

Follow The Hole Shebang on Instagram at @blueberrytherapypelvichealth

Menopause joint pain is more common than hot flushes, yet most women have never been told the two are connected. In this episode of The Hole Shebang, pelvic health physiotherapist Kristen Parise talks with Michelle Lyons, the Irish chartered physiotherapist behind Celebrate Muliebrity, about the musculoskeletal side of the menopause transition: why joints, tendons and muscles ache when estrogen falls, which perimenopause symptoms start before periods stop, what protects brain health and bone density, and how vaginal estrogen plus pelvic floor physiotherapy changes bladder symptoms, comfort and confidence. Michelle has spent 30 years in women's health, teaches clinicians worldwide and hosts the Celebrate Muliebrity podcast, which passed 100 episodes this year.

This episode is brought to you by kGoal. Shop kGoal smart pelvic floor trainers at blueberrytherapyshop.ca. and use kGoal15 to save 15%.

In This Episode

• [02:43] The symptoms nobody connects to menopause: hip pain, rotator cuff trouble and back pain, and why they beat hot flushes for prevalence
• [06:30] Osteoarthritis is inflammation, not wear and tear, and why that changes treatment
• [08:24] The realistic starting plan: sleep hygiene, morning light and what to do about wine
• [11:17] Hormone therapy, heavy perimenopause periods and the iron deficiency almost nobody checks
• [16:21] Brain fog: hydration, iron and the honest state of the estrogen and dementia evidence
• [18:24] What is proven for brain health: leg strength, aerobic exercise and a Mediterranean style diet
• [24:40] Bone health: four prunes a day, tahini for calcium, impact and balance training
• [27:28] Pelvic health concerns keep one in two women from exercising
• [29:34] Genitourinary syndrome of menopause: dryness, leakage and the bladder that fills faster
• [31:54] Vaginal estrogen plus 12 weeks of pelvic floor physio, the combination that works
• [37:04] Celebrate Muliebrity at 100+ episodes and Michelle's theme song

What Listeners Will Learn

Listeners will come away knowing how to spot perimenopause early, what blood work to ask for, which lifestyle levers have real evidence behind them and why treating pelvic health is the gateway to staying strong, active and confident through midlife.

About Michelle Lyons

Michelle Lyons, PT, MISCP, is a chartered physiotherapist from Ireland with 30 years of experience in women's health, licensed in Ireland and the US. She is the founder of Celebrate Muliebrity, where her online courses include The Menopausal Toolbox, and she hosts the Celebrate Muliebrity podcast. She co founded the Women's Health Physiotherapy community and founded Global Pelvic Physio.

Theme Song: You Gotta Be by Des'ree

Key Topics Covered

• Menopause joint pain and the musculoskeletal syndrome of menopause
• Perimenopause symptoms, heavy periods and iron deficiency
• Brain fog and what protects brain health
• Bone density, osteoporosis prevention and impact training
• Genitourinary syndrome of menopause, vaginal estrogen and pelvic floor physiotherapy

Resources and References Mentioned

• Michelle's courses and podcast: celebratemuliebrity.com
• Global Pelvic Physio group for clinicians, moderated by Michelle
• Canadian research on vaginal estrogen with pelvic floor muscle training by Joanie Mercier
• Pelvic health physiotherapy at Blueberry Therapy: blueberrytherapy.ca

More Episodes Like This

Find them all at podcast.blueberrytherapy.ca:

• Menopause and Muscle: It Is Not Too Late to Get Strong with Dr. Stuart Phillips
• Your Vagina Is Shrinking and Nobody Told You: The Hormone Conversation We NEED with Dr. Carrie Jones
• Sleep, Sex and Menopause with Dr. Woganee Filate
• Perimenopause and Hormone Replacement with Dr. Alison Shea
• Sex After Menopause: The Truth Your Doctor Won't Say with Shirley Weir

Connect with Michelle

Website: celebratemuliebrity.com Instagram: @michellelyons_muliebrity

Our Sponsor: kGoal

kGoal makes smart pelvic floor trainers that show you what your pelvic floor is actually doing. Doing Kegels in the dark is the most common reason they do not work, and real time biofeedback replaces the guessing with something you can see.

Blueberry Therapy carries the full kGoal range. The Classic is the insertable trainer most people start with. The Boost is a sit-on-top trainer you use fully clothed, which makes it the one Kristen recommends for pelvic pain, early postpartum and anyone who finds insertion uncomfortable. Both train the pelvic floor to release as well as contract. Use the code kGoal15 for 15% off.

Shop kGoal at Blueberry Shop. Not sure which trainer fits, call the clinic at 289-238-8383 and a member of the pelvic health team will help you choose.

Enjoyed This Episode?

Subscribe and leave a review, it helps other women find the show. Book a pelvic health assessment at blueberrytherapy.ca or call 289 238 8383. Perimenopause and menopause pelvic health support is one of the things our multidisciplinary team does best.

Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Birth prep is not the same thing as birth education, and most pregnant people are only ever handed the second one. In this episode of The Hole Shebang, Kristen Parise sits down with Gina Conley, founder of MamasteFit and author of Training for Two, to talk about the physical preparation that actually makes space for a baby: pelvic floor function, pelvic mechanics and the movement patterns that carry you from labour into postpartum recovery. If you have searched for birth prep exercises, wondered how to prepare your body for birth or been scared by a prolapse diagnosis, this conversation is for you.

This episode is brought to you by kGoal. Shop kGoal smart pelvic floor trainers at blueberrytherapyshop.ca. and use kGoal15 to save 15%.

Gina brings an unusual path to this work. She spent seven years in the army, including a combat tour in Afghanistan, before a difficult first birth sent her back to school for a master's in exercise science. She is now a birth doula who has supported close to 200 births, a mom of four and, at the time of recording, training for her first 100 mile race.

In This Episode

• [01:00] From the army to the birthing room: how Gina's path led to perinatal fitness
• [06:46] Birth prep versus birth education, and why the difference matters
• [07:19] Why wide leg stretches are only one quarter of real birth preparation
• [11:30] Body asymmetry, the pelvic floor and the four movement patterns to train
• [16:44] How a baby moves through the inlet, mid pelvis and outlet, and how to make space
• [20:45] The pushing position debate, and why pressure gradients matter more than gravity
• [29:28] The bounce back lie and adjusting postpartum expectations
• [29:51] Prolapse debunked: why symptomless does not mean broken
• [44:54] What is next for Gina, from Beyond Postpartum to teaching the professionals

What You Will Learn

You will come away understanding why a functional pelvic floor is about movement rather than Kegels, how to think about creating space at each level of the pelvis and why the same prep that helps in labour supports postpartum recovery, including after a cesarean birth. Gina also reframes prolapse and diastasis so a diagnosis feels like a starting point rather than a life sentence.

About Gina Conley

Gina Conley holds a master's in exercise science and is the founder and CEO of MamasteFit in Aberdeen, North Carolina. She is a birth doula, a seven year army veteran, a mom of four and the author of Training for Two (2024). She runs MamasteFit and the MamasteFit Podcast with her sister Roxanne Albert, a labour and delivery nurse and nurse midwife.

Theme Song: an Avicii track (to be confirmed)

Key Topics Covered

• Birth preparation and pelvic mechanics
• Pelvic floor function beyond Kegels
• Labour positions and pushing
• Postpartum recovery and the bounce back myth
• Pelvic organ prolapse and diastasis recti

Resources and References Mentioned

• Training for Two by Gina Conley (2024): mamastefit.com
• MamasteFit Pelvic Mechanics course and Beyond Postpartum program: mamastefit.com
• The MamasteFit Podcast with Gina Conley and Roxanne Albert

Listen to More Episodes Like This

• Empowering Exercise During Pregnancy with Dr. Christina Prevett
• The New Postpartum Exercise Guidelines That Ditch the Six Week Rule with Dr. Margie Davenport
• The Bounce Back Lie and What Postpartum Recovery Actually Looks Like with Michelle Gauvreau

Our Sponsor: kGoal

kGoal makes smart pelvic floor trainers that show you what your pelvic floor is actually doing. Doing Kegels in the dark is the most common reason they do not work, and real time biofeedback replaces the guessing with something you can see.

Blueberry Therapy carries the full kGoal range. The Classic is the insertable trainer most people start with. The Boost is a sit-on-top trainer you use fully clothed, which makes it the one Kristen recommends for pelvic pain, early postpartum and anyone who finds insertion uncomfortable. Both train the pelvic floor to release as well as contract.

Shop kGoal at Blueberry Shop. Not sure which trainer fits, call the clinic at 289-238-8383 and a member of the pelvic health team will help you choose.

Connect with Gina Conley

Website mamastefit.com. Instagram, TikTok and YouTube at @mamastefit.

Connect with The Hole Shebang

Subscribe and listen at podcast.blueberrytherapy.ca. Learn more about pelvic health physiotherapy at Blueberry Therapy in Hamilton, Ontario at blueberrytherapy.ca. Leave a review and tell us what you want to hear next.

Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth.

Chronic pelvic pain is one of the most dismissed conditions in women's health. Years of symptoms, multiple clinicians, clean imaging, and eventually the quiet suggestion that it might be in your head. In this episode of The Hole Shebang, Kristen Parise sits down with Carolyn Vandyken, registered physiotherapist, co-founder of Reframe Rehab and recipient of the Canadian Physiotherapy Association's Medal of Distinction, to explain what is happening when pelvic pain persists without a tissue cause. They cover nociplastic pain and central sensitization in plain language, why diagnostic labels like vulvodynia can act as nocebos, how overlapping pain conditions like migraines, IBS and low back pain cluster around the pelvis, and the biopsychosocial approach that treats the whole nervous system instead of hunting for one tight muscle. Carolyn also shares the lifestyle changes that calm a dysregulated system, including her 150 minutes of walking a week.

This episode is brought to you by SRC Health. Shop SRC garments at blueberrytherapyshop.ca and use the code SRC15 for 15% off.

In This Episode

• [00:40] Working with her daughter: co-owning a clinic and co-founding Reframe Rehab with Brittany Vandyken
• [03:53] What biopsychosocial care means, and why clinicians stay stuck in the biomechanical model
• [09:09] For the woman with years of pelvic pain and clean imaging: your pain is real
• [10:30] The Age of Diagnosis: when labels like vulvodynia become nocebos
• [13:29] Overlapping pain conditions, and new research putting pelvic pain at the centre
• [16:12] STAND UP: stress, trauma, anxiety, neglecting rest and distress
• [20:07] What CBT training changes about a physiotherapy session
• [22:06] Invitation over prescription: why patients skip exercises they never chose
• [25:32] Trauma informed care and the pelvic floor as protector, dysregulated rather than dysfunctional
• [27:59] Central sensitization and nociplastic pain, explained for the listener at home
• [31:41] The inconvenient truth: sleep, food, stress practices and 150 minutes of walking a week
• [33:58] The sandwich years: why perimenopause looks like a dysregulated nervous system
• [35:29] The teaching ripple: Sinead Dufour, Kim Vopni and Jill Mueller
• [41:04] Where to find Carolyn: Embodia and the Year of Mentoring
• [45:07] Theme song: Walk Beside Me

What Listeners Will Learn

Listeners will leave knowing that persistent pain with normal tests is real, common and treatable. Carolyn explains how an overprotective nervous system produces pain, bladder urgency, gut symptoms and muscle guarding at once, why the pelvic floor braces to protect you, and why releasing muscles without regulating the nervous system keeps patients stuck. She walks through the questions worth asking a prospective provider, the risk factors that load the system, and the evidence-backed lifestyle changes that start recovery at home.

About Carolyn Vandyken

Carolyn Vandyken is a registered physiotherapist with more than three decades in practice, co-owner of Physio Works Muskoka in Huntsville, Ontario and co-founder of Reframe Rehab, the teaching company she built with her daughter Brittany to break down the silos between musculoskeletal pain, pelvic pain, pain neuroscience education and psychology. She co-wrote Why Pelvic Pain Hurts with Adriaan Louw and Sandra Hilton, co-authored the definitive reviews on the overactive pelvic floor and sexual dysfunction, and her 2018 study with Dr. Sinead Dufour found that 95 percent of women with lumbopelvic pain had signs of pelvic floor dysfunction. Her honours include the YWCA Women of Distinction Award (2004), the Ontario Physiotherapy Association's Distinguished Education Award (2015) and the Canadian Physiotherapy Association's Medal of Distinction (2021). Her Year of Mentoring on Embodia draws faculty from five countries.

Theme Song: Walk Beside Me by Celtic Woman

Key Topics Covered

• Chronic pelvic pain with normal test results
• The biopsychosocial model in pelvic health physiotherapy
• Nociplastic pain and central sensitization
• Diagnostic labels, nocebos and the power of words
• Overlapping pain conditions (migraines, IBS, TMJ, low back pain)
• Trauma informed care and co-creation
• CBT tools in physiotherapy and graded exposure
• Lifestyle medicine: sleep, nutrition, stress practices and walking

Resources and References Mentioned

• Reframe Rehab
• Carolyn's Year of Mentoring on Embodia
• Physio Works Muskoka
• Why Pelvic Pain Hurts by Adriaan Louw, Sandra Hilton and Carolyn Vandyken
• The Age of Diagnosis by Dr. Suzanne O'Sullivan
• Lifestyle and Chronic Pain across the Lifespan: An Inconvenient Truth? (Jo Nijs and colleagues)
• Corina Avni's research on pelvic pain and chronic overlapping pain conditions
• Canada's food guide

Listen to More Episodes Like This

All episodes at podcast.blueberrytherapy.ca

• Episode 91: Pelvic Pain Is a Symptom, Not a Diagnosis with Dr. Alopi Patel
• Episode 47: Rewiring Pain: From Velociraptors to Victory with Dr. Laura Katz
• Episode 30: The Missing Link in Endometriosis Care with Physiotherapist Jill Mueller
• Episode 82: Prolapse and Pessaries: Losing the Shame with the Vagina Coach Kim Vopni

Our Sponsor: SRC Health

SRC makes medical grade compression garments for pregnancy, bladder leaks and mild pelvic organ prolapse. The Restore short is the one Kristen reaches for most in clinic. It supports your pelvic organs while you and your pelvic floor physiotherapist do the strengthening work.

Blueberry Therapy has carried SRC garments for years. Shop the full range at blueberrytherapyshop.ca, same price as buying direct and shipped from the clinic in Canada. Use the code SRC15 for 15% off.

Many extended health plans cover compression garments with a prescription, so check your benefits before you assume you are paying out of pocket.

Connect with Carolyn

• Reframe Rehab: reframerehab.com
• Instagram: @reframerehab
• Clinic: physioworksmuskoka.com
• Courses and mentoring: find Carolyn Vandyken on Embodia

Work with the Blueberry Therapy Team

Persistent pelvic pain deserves whole person care. Our physiotherapists, psychotherapists and naturopath work together under one roof, which is exactly the interdisciplinary model Carolyn describes in this episode. Book a free discovery call at blueberrytherapy.ca

Subscribe to The Hole Shebang at podcast.blueberrytherapy.ca and leave a review if this episode helped you. The only awkward conversation is the one we're not having.

Connect with The Hole Shebang on Instagram: @blueberrytherapypelvichealth

Low libido after a baby or through menopause is one of the most common and least honestly discussed changes in a woman's life. In the 100th episode of The Hole Shebang, Kristen Parise welcomes back the guest who started it all, Dr. Nan Wise, cognitive neuroscientist and certified sex therapist, for the deep conversation they only grazed the first time. Together they look at why the postpartum months and the menopause years look so alike in the brain, what spontaneous and receptive desire really are, and why rebuilding pleasure outside the bedroom matters more than any pressure to have sex. If your desire has gone quiet and you have been told to just live with it, this episode explains what is actually happening and what you can do about it.

This episode is brought to you by SRC Health. Shop SRC garments at blueberrytherapyshop.ca and use the code SRC15 for 15% off.

In This Episode

• [00:21] Why Nan is the perfect Episode 100 guest, and why the first conversation is still the show's most downloaded
• [01:08] Postpartum and menopause as the two most vulnerable thresholds, and how the chemistry of caretaking quiets desire
• [05:25] Spontaneous desire versus receptive desire, and why arousal can come before wanting
• [08:05] Kindling a fire: making desire intentional instead of waiting to feel horny
• [10:30] The seeking system and the pleasure playground, moving sex beyond genitals and friction
• [11:52] Pleasure outside the bedroom: savouring, gratitude, mindfulness, imagery, and self compassion
• [20:49] Why some older adults have better sex, and why connection beats performance
• [24:12] Donating orgasms to science: what Nan's fMRI research found about the aroused brain
• [30:54] Entrainment and the get in touch plan for couples, including erectile changes
• [42:14] What chronically broken sleep does to dopamine and pleasure, and how to rest anyway

What You Will Learn

Listeners will come away understanding that a drop in desire after a baby or in menopause is normal, common, and workable, not a personal failing. They will learn the difference between spontaneous and receptive desire and why that distinction changes everything about how to approach intimacy. They will get concrete, gentle practices for rebuilding the capacity for pleasure, from savouring and gratitude to Nan's step by step get in touch plan for couples. And they will hear the neuroscience that makes the case that pleasure and orgasm are good for the aging brain and body, not a luxury to feel guilty about.

About Dr. Nan Wise

Dr. Nan Wise is a cognitive neuroscientist, a certified sex therapist, a board certified clinical hypnotherapist, and a certified relationship specialist. She holds a PhD in cognitive neuroscience from Rutgers University in Newark, where she is an associate research professor, and her dissertation research used fMRI to map what happens in the brain during arousal and orgasm. She is the author of Why Good Sex Matters, and her current work focuses on anhedonia, the loss of the ability to feel pleasure, and what she calls healthy hedonism. This is her second appearance on The Hole Shebang, following the show's most downloaded episode.

Theme Song: Kashmir by Led Zeppelin

Our Sponsor: SRC Health

SRC makes medical grade compression garments for pregnancy, bladder leaks and mild pelvic organ prolapse. The Restore short is the one Kristen reaches for most in clinic. It supports your pelvic organs while you and your pelvic floor physiotherapist do the strengthening work.

Blueberry Therapy has carried SRC garments for years. Shop the full range at Blueberry Shop, same price as buying direct and shipped from the clinic in Canada. Use the code SRC15 for 15% off.

Many extended health plans cover compression garments with a prescription, so check your benefits before you assume you are paying out of pocket.

Key Topics Covered

• Low libido after a baby and in menopause
• Spontaneous desire versus receptive desire
• Pleasure outside the bedroom and healthy hedonism
• The neuroscience of arousal, orgasm, and the aging brain
• Slowing down, connection, and the get in touch plan for couples

Resources and References Mentioned

• Why Good Sex Matters by Dr. Nan Wise: https://askdoctornan.com/book/
• Dr. Nan Wise's website, where a book receipt earns a free session with a Core Motion analysis test: https://askdoctornan.com
• Insight Timer, the free meditation app, home of the 40 day mindfulness course, deep rest meditations, and progressive muscle relaxation: https://insighttimer.com
• The Joy of Sex by Alex Comfort, the classic Nan suggests browsing like a menu of ideas
• Beverly Whipple, Nan's mentor and the researcher who named the G spot, and her concept of pleasure mapping
• Dr. Kelly Casperson, urologist and author, mentioned as a great voice on desire
• Science Vs, the podcast whose orgasm episode featured Nan's research

Listen to More Episodes Like This

• Why Good Sex Matters: The Neuroscience of Pleasure with Dr. Nan Wise (Episode 1, Nan's first appearance): https://podcast.blueberrytherapy.ca
• Mindfulness to Improve Sexual Desire with Dr. Lori Brotto: https://podcast.blueberrytherapy.ca
• Perimenopause as Your Sexual Debut: Rewriting the Narrative with Taylor McConnachie: https://podcast.blueberrytherapy.ca
• Super Traits and the Real Reason Your Sex Drive Disappeared with Dr. Jordin Wiggins: https://podcast.blueberrytherapy.ca

Connect with Dr. Nan Wise

• Website: https://askdoctornan.com
• Instagram: @askdoctornan
• Book: Why Good Sex Matters

Keep Going with Blueberry Therapy

If a drop in desire or pain with sex is part of your story, pelvic health physiotherapy can help. Learn more or book a discovery call at https://blueberrytherapy.ca. Nan gave the keynote at our 2025 event, so keep an eye on The Pleasure Principle for what is next.

Subscribe to The Hole Shebang at https://podcast.blueberrytherapy.ca, and if this episode made you feel less alone, leave a review and tell us what you want to hear next.

Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth

Eating disorders in kids and teens surged during the pandemic, and the earliest warning signs are the ones most parents miss. In this episode of The Hole Shebang, registered dietitian Kim Doyle explains how disordered eating starts, what intuitive eating actually asks of you and why a missing period is a signal to act on. Kim watched pediatric eating disorder referrals explode in 2020 while waitlists stretched 12 to 18 months, so she founded Brant Nutrition in Brantford, Ontario to catch the families the system was leaving behind. She also shares her own recovery from disordered eating as a competitive wrestler, including the pelvic floor assessment that changed everything.

This episode is brought to you by SRC Health. Shop SRC garments at blueberrytherapyshop.ca and use the code SRC15 for 15% off.

In This Episode

• [00:00] How Kim became a dietitian, starting with a weight based sport
• [06:35] Summer 2020: the referral surge and 12 to 18 month waitlists
• [11:45] What disordered eating actually means
• [14:45] Kim's own story: cutting weight, restriction and the injury cycle
• [21:50] The labral tear that led her to a pelvic floor physio
• [25:25] Intuitive eating explained (so much more than eat whatever you want)
• [29:00] The pulse practice: a three minute interoception exercise
• [33:45] RED-S and why a missing period should never be ignored
• [38:10] Warning signs of disordered eating in children
• [44:00] Resources for families
• [47:35] What recovery looks like and how long it takes
• [53:00] Where to find Kim and Brant Nutrition
• [56:10] Kim's theme song

What You Will Learn

Listeners will come away knowing the difference between changing your diet for a real physical reason and changing it to quiet a fear, the specific pattern of illogical food rules that flags trouble in kids as young as 8, and how the language adults use about their own bodies is absorbed by the children listening. Kim also teaches the pulse practice step by step and explains what actually happens inside the body during RED-S, including why bone density pays the price.

About Kim Doyle, RD

Kim Doyle is a Registered Dietitian and the owner of Brant Nutrition in Brantford, Ontario. A member of the College of Dietitians of Ontario since 2010 and the International Association of Eating Disorders Professionals, she spent seven years in pediatric home care before founding her clinic in March 2021. Brant Nutrition is a weight inclusive, non diet practice covering pediatric feeding, eating disorder recovery, gut health, mental health and sports nutrition, virtual across Ontario.

Theme Song: Born This Way by Lady Gaga

Our Sponsor: SRC Health

SRC makes medical grade compression garments for pregnancy, bladder leaks and mild pelvic organ prolapse. The Restore short is the one Kristen reaches for most in clinic. It supports your pelvic organs while you and your pelvic floor physiotherapist do the strengthening work.

Blueberry Therapy has carried SRC garments for years. Shop the full range at Blueberry Shop, same price as buying direct and shipped from the clinic in Canada. Use the code SRC15 for 15% off.

Many extended health plans cover compression garments with a prescription, so check your benefits before you assume you are paying out of pocket.

Key Topics Covered

• Pediatric eating disorders and the pandemic surge
• Intuitive eating and interoception
• Disordered eating warning signs in kids
• RED-S, amenorrhea and bone health
• Weight inclusive, non diet nutrition care
• Family based treatment (the Maudsley method)
• The pelvic floor and body connection

Resources and References Mentioned

• NEDIC, the National Eating Disorder Information Centre: Canada's national helpline, provider directory and starting point for families
• Kelty Eating Disorders (Kelty Mental Health Resource Centre): meal support videos and family resources that model how to support a child through meals
• The New Maudsley Approach: carer skills and tools behind the family based treatment Kim uses
• Family based treatment for eating disorders (research review): the evidence behind the leading approach for pediatric eating disorders
• The Intuitive Eating Workbook for Teens: a hands on workbook for building a healthy relationship with food
• When Your Teen Has an Eating Disorder by Lauren Muhlheim: the family based treatment guide Kim recommends

Listen to More Episodes Like This

Find them all at podcast.blueberrytherapy.ca:

• From Your Plate to Your Pleasure: Food, Body Image, and Intimacy with Emily Arthur, RD (Kim's teammate at Brant Nutrition)
• Body Brilliance: Connecting the Dots Between Emotional Eating, Hormones and Pelvic Health with Amber Romaniuk
• Pediatric Pelvic Health: Kids Don't Grow Out of It with Keri Martin Vrbanac

Our pediatric team at Blueberry Therapy treats constipation, bedwetting and pelvic floor concerns in kids, and our multidisciplinary team supports the gut and bowel side of everything discussed here.

Connect with Kim

• Website: brantnutrition.com
• Instagram: @brantnutrition and @brantnutrition_pediatrics
• Email: [email protected]

Keep the Conversation Going

Subscribe to The Hole Shebang at podcast.blueberrytherapy.ca, leave a review if this episode helped you and book a free fifteen minute discovery call at blueberrytherapy.ca. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth.

Shockwave therapy for painful sex is one of the most promising and least understood tools in pelvic health, and this episode of The Hole Shebang breaks it down without the hype. Kristen Parise sits down with Stacey Roberts, a physical therapist and registered nurse who is co principal investigator on a study using shockwave for painful sex, to explain what the technology actually does, why blood flow changes everything for a guarded pelvic floor, and how the same science reaches erectile dysfunction and incontinence. If sex hurts and you have been told to just relax, this conversation offers a real explanation and real hope.

This episode is brought to you by SRC Health. Shop SRC garments at blueberrytherapyshop.ca and use the code SRC15 for 15% off.

What you will learn

Stacey explains the difference between true shockwave and the many devices that borrow the name, how flooding tissue with blood flow lets an upregulated pelvic floor soften and let go, and why she pairs shockwave with pelvic floor physiotherapy in her research and her clinic. You will also hear why the musculoskeletal syndrome of menopause makes so much ache at once, why the marketed pelvic floor chair is often the wrong tool, and the plain truth about painful sex that no glass of wine will ever fix.

In this episode

• [00:00] Sports medicine to a women's health clinic on Australia's Gold Coast
• [03:40] Why a physiotherapist went back to school to become a nurse
• [04:45] The musculoskeletal syndrome of menopause and hormones as anti inflammatories
• [06:50] The Pain Free Formula and reducing pain without surgery or drugs
• [12:00] The one belief about pain she wants to blow up
• [14:00] Shockwave explained, and the wild west of devices that borrow the name
• [15:30] Shockwave for painful sex and the upregulated pelvic floor
• [16:30] The research: pelvic floor physio plus sham versus plus active shockwave
• [20:50] Shockwave for erectile dysfunction, endothelial dysfunction and nitric oxide
• [23:20] Leaking after prostate surgery and blood flow as nourishment
• [25:00] Why the chair is often the wrong tool for a tight pelvic floor
• [34:30] Painful sex and the one thing she would say to someone told to grin and bear it

About Stacey Roberts

Stacey Roberts, PT RN MSN, is a physical therapist and registered nurse with more than thirty years of clinical experience. She owns New You Health and Wellness in Wauwatosa, Wisconsin, teaches shockwave therapy to clinicians across North America, hosts The Pain Free Formula podcast, and wrote The Pain Free Formula. She is co principal investigator on a study using shockwave for painful sex.

Theme Song: I'll Be There for You by The Rembrandts

Key topics covered: shockwave therapy, painful sex, dyspareunia, the upregulated pelvic floor, erectile dysfunction, post prostatectomy incontinence, musculoskeletal syndrome of menopause, hormones, gut health.

Our Sponsor: SRC Health

SRC makes medical grade compression garments for pregnancy, bladder leaks and mild pelvic organ prolapse. The Restore short is the one Kristen reaches for most in clinic. It supports your pelvic organs while you and your pelvic floor physiotherapist do the strengthening work.

Blueberry Therapy has carried SRC garments for years. Shop the full range at Blueberry Shop, same price as buying direct and shipped from the clinic in Canada. Use the code SRC15 for 15% off.

Many extended health plans cover compression garments with a prescription, so check your benefits before you assume you are paying out of pocket.

Resources and references mentioned

• The Pain Free Formula by Stacey Roberts: Amazon
• Find a SoftWave provider in Canada and the United States: SoftWave TRT provider finder
• New You Health and Wellness: newyouhealthandwellness.com

Listen to more episodes like this (all at podcast.blueberrytherapy.ca)

• Painful Sex: When Your Body is Not the Problem with Dr. Jordin Wiggins
• Vaginismus Isn't in Your Head and Here's Why with Dr. Janelle Frederick
• Erections and Heart Health: The Vital Sign Men Ignore with Dr. Elliot Justin
• Pelvic Pain Is a Symptom, Not a Diagnosis with Dr. Alopi Patel
• The Intersection of Menopause and Sexual Health with Dr. Maureen Slattery

Connect with Stacey

Website newyouhealthandwellness.com, her podcast The Pain Free Formula, and TikTok @the_pain_free_formula.

Work with us

Wondering whether your pelvic floor is behind your pain or painful sex? Book a pelvic health assessment at blueberrytherapy.ca, and we offer virtual visits across Ontario. Subscribe to The Hole Shebang at podcast.blueberrytherapy.ca, and if this episode helped you, leave a review and tell us what you want to hear next.

Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth.

Pediatric pelvic health is the part of physiotherapy almost nobody talks about, and it might be exactly what your child needs. Bedwetting, daytime leaks, poop accidents, and recurring UTIs are not things every kid simply outgrows, and they are very often driven by something most parents never suspect: constipation. In this episode of The Hole Shebang, Kristen Parise talks with pediatric pelvic health physiotherapist Keri Martin Vrbanac about how bladder and bowel problems show up in children, what a child friendly pelvic assessment really involves, and the honest answer to the question every tired parent asks about waiting it out.

What You Will Learn

How constipation quietly drives bladder leaks, bedwetting, and recurring UTIs in kids. Why daily pooping does not mean your child is in the clear. What a pelvic assessment with a child looks like, and why it never involves internal work. When to stop waiting for a child to grow out of bedwetting. Why early potty training can set a child up for problems. How stress, school bathrooms, and family change all land on a little pelvic floor.

In This Episode

• [01:02] Keri's path into pediatric pelvic health, and the personal reason behind it
• [03:31] Constipation as an epidemic, and the real estate analogy every parent should hear
• [06:05] Busting the myth that bedwetting and accidents are laziness or behaviour
• [08:36] Why Keri talks about poop loudly, and the "Keri with poop" headshot
• [09:33] What a pelvic assessment with a child actually looks like
• [14:31] What constipation really is, beyond pooping less than three times a week
• [19:38] First steps in treatment: biofeedback, breathing, and toilet posture
• [23:50] The school button story, and why kids will not use the bathroom at school
• [26:58] At what point a parent should stop waiting for a child to grow out of it
• [27:50] Potty training readiness, and why eighteen months is too early
• [30:15] Fluids before bed, and the hormone behind nighttime dryness
• [31:45] Constipation treatment options, from RestoraLAX to the Modified O'Regan Protocol
• [35:53] The book It's No Accident, and the long term cost of leaving it untreated
• [40:33] How family stress and big changes affect a child's pelvic floor

About Keri Martin Vrbanac

Keri Martin Vrbanac is a Registered Physiotherapist and pelvic health physiotherapist who has practised for decades and owns A Body In Motion Rehabilitation in the Kitchener Waterloo area. She works with all ages and all genders, with a deep focus on pediatric pelvic health, pregnancy and postpartum, pelvic pain, incontinence, and prolapse. She is trauma informed, an educator who teaches the pediatric pelvic floor course for Pelvic Health Solutions, a clinic owner, and a mom of two young women.

Theme Song: Masterpiece by Jessie J

Resources and References Mentioned

• It's No Accident by Dr. Steve Hodges, pediatric urologist
• The Modified O'Regan Protocol (MOP), originally developed by Dr. O'Regan and currently maintained by Dr. Steve Hodges
• RestoraLAX, an osmotic stool softener
• Desmopressin, a medication that mimics the natural overnight hormone that reduces urine production

Listen to More Episodes Like This

• The Scoop on Kids Poop: The Secret World of Pediatric Pelvic Health with Clare Bourne
• Floored by the Truth: Demystifying Pelvic Health from Teens to Menopause with Dr. Sara Reardon
• From Physiotherapist to Lactation Consulting with Laura Doyle

Connect with Keri

Website: abodyinmotion.ca Instagram: @kerivpelvicpt and @abodyinmotionrehab Facebook: Keri V Pelvic PT, and A Body In Motion Rehabilitation

Keep Listening and Connect

New episodes of The Hole Shebang every week. Subscribe wherever you listen, and leave a review to help more families find this conversation. Learn more about pelvic health for every age at blueberrytherapy.ca. Connect with The Hole Shebang on Instagram @blueberrytherapypelvichealth.

The only awkward conversation is the one we're not having.