Inside the Box

Welcome back, and what a way to kick off Season 4! Taryn Hallam first joined us back in 2022 to talk birth choices, an episode that went on to become our most downloaded of all time. Now she’s back to open Season 4, bringing the research on a topic that deserves far more clinical airtime than it gets: vaginal laxity.It’s a condition that affects more women than most clinicians realise, and yet it remains under-asked, under-assessed, and under-discussed in clinical practice. Taryn has done the work of pulling together what the evidence actually says and making it accessible for clinicians who want to do better by their patients.In this episode we cover:•What vaginal laxity actually is, why it happens, and how common it really is in clinical populations•The distinction between somatic and psychogenic sexual disorders and why it matters for how we assess and communicate with patients•The relationship between vaginal laxity and pelvic floor changes, including levator hiatal size and levator ani avulsion•The important nuance in the data: 98% of women with vaginal laxity had a vaginal birth, yet 89% of vaginally parous women had no laxity at all. So what does that actually mean when a patient asks whether her birth caused this?•Why the direct correlation between levator hiatal area and laxity sits at just ~23%, and what that tells us about the limits of a purely structural model•Vaginal laxity as a symptom, something experienced rather than objectively measured, and how that should reshape clinical conversations•The role of sensory signalling and processing, both peripherally and centrally, in how laxity is experienced•Why lubrication matters, and the interesting finding that laxity appears more prevalent in pre-menopausal women•Why PFMT seems to help, even though the research tells us it can’t reduce a distended levator •Neuromodulation and TTNS: could the mechanism be normalising sensory processing through sacral nerve roots rather than producing structural change?Whether you’re a clinician or a woman who has experienced symptoms of vaginal laxity yourself, or you’re simply curious about the topic, you’ll find plenty here that’s relevant.Subscribe, leave us a review, and share this episode with a colleague who needs it in their ears.

We’re closing out 2025 and wrapping up Season 4 with one of our favourite formats – the “Can I Say This Out Loud?” episode, inspired by the iconic Dolly Doctor. This is the space where nothing is too awkward, too specific or too “Is it just me?” to bring into the light.In this finale, we dive into the real questions sent in by our Inside the Box community, covering everything from pelvic health curiosities to the myths that just won’t quit.Here’s a snippet of what we unpack: • Vaginal trainers and vaginal weights – gimmick or genuinely useful? We break down where the science stands, who they may help, and when they’re not the answer. • Peeing in the shower – harmless, helpful or something to rethink? We explore the physiology, the myths and what matters most for bladder health. • Preparing for birth – both caesarean and vaginal. From pelvic floor considerations to practical planning, we talk through what to focus on, what to let go of and what supports women best as they approach birth in all its forms.As always, we bring evidence, experience and a healthy dose of honesty to the questions many people are thinking but rarely ask out loud.Thanks for being with us for another season. Your curiosity, conversations and courage to ask the “slightly awkward but deeply important” questions are what make this community what it is. We’ll see you in the new year for Season 4.

We’re flipping the script with a brand-new segment: "Can I Say This Out Loud?" - the unfiltered Q&A where no pelvic floor question is off-limits.In this episode, Caitlin takes the mic and puts Kat and Tash in the hot seat to answer your burning (and sometimes blush-worthy) questions about all things pelvic health.We dive into the questions you’ve been too afraid to ask out loud (until now), including:How do I know if I have a prolapse? Can you have an overactive pelvic floor and a rectal prolapse at the same time?Why do I still leak when I sprint or land even though I do pelvic floor exercises?And yes… are we, as pelvic floor physios, struggling with anything ourselves?This episode is full of raw honesty, real talk, and expert insight from three women who live and breathe pelvic health. No taboo, no judgement, just evidence-based, relatable truth.So, can you say this out loud? Hell yes you can. And we’re here for all of it.Got a question for a future episode of Can I Say This Out Loud? Slide into our DMs @insidethebox_pod

In this episode, we sit down with South Australian Senator Marielle Smith, a passionate advocate for women’s health, equity and access; to explore what real change looks like at the policy level, and how it translates to everyday women seeking care.What We CoverMarielle’s Story & “Why”A look into who Marielle is, what a typical week in Parliament involves, and the personal experiences that fuel her commitment to women’s health advocacy.Senate Inquiry into Perimenopause & MenopauseKey findings from the national inquiry, including gaps in diagnosis, education, and access to care—and what women across Australia said they need most.The 2025 Federal Investment in Women’s HealthWhat the upcoming funding means for:Perimenopause supportHRT accessibilityPelvic pain managementBetter pathways for frontline, multidisciplinary careMedicare & Pelvic Health PhysiotherapyA practical breakdown of what Medicare currently covers, where the major gaps sit, and why improving access to pelvic health physiotherapy is essential.What’s Next in Women’s Health PolicyMarielle shares what she’s working on now from expanding early-access services to strengthening allied health integration and her vision for improving women’s health in the years ahead.Follow Marielle @senatormariellesmith

In this episode, we are joined by Dawn Sandalcidi, a renowned paediatric pelvic health physiotherapist, to explore the often-complex world of bladder and bowel dysfunction in children. Dawn brings her decades of experience, clinical insight, and trademark enthusiasm to unpack what can be one of the trickiest, yet most rewarding areas of pelvic health.Key Topics Covered include:Putting the puzzle together in paediatric continence - Dawn shares how no two children are the same and why understanding the bigger picture of bladder, bowel, and behavioural patterns is key to successful outcomes.Making therapy fun - Practical ways to engage children in physiotherapy, from playful cues to visual learning tools and reward systems that make progress feel achievable.Constipation in children – assessment, diagnosis and treatmentWe unpack how common constipation really is, what warning signs parents should look for, and the step-by-step approach to effective treatment and maintenance.The importance of maintenance - Why resolving constipation isn’t the end of the story. Dawn explains the relapse risk and the importance of long-term management for healthy habits.What to expect as a parent and how to prepare for appointments, what the assessment process looks like, and how to manage expectations through what can be an emotional journeyNavigating toilet phobia and refusal - Gentle strategies to reduce anxiety and help children feel empowered, not pressured, when it comes to toileting.Positioning and the pelvic floor in little people. Simple adjustments that make a big difference. Dawn breaks down why toilet posture, stool supports, and relaxed pelvic floors are essential for success.Follow Dawn @kidsbowelbladder 

In this episode pulled from the archives, Kat and Tash sit down with Rosie, founder of Everform Therapywear, to unpack the story behind one of the most innovative Australian brands in women’s recovery wear.From juggling motherhood and business growth to redefining how compression supports the pelvic floor, Rosie opens up about the real journey of creating purposeful, evidence-informed garments that help women heal, move, and feel confident in their bodies again.💬 We chat about:The evolution of Everform Therapywear — from an idea to a trusted recovery essentialWhat it’s really like to build a business while raising small childrenHow and why therapywear supports pelvic floor recovery after pregnancy and birthCommon myths about compression and the pelvic floor — and how not all garments are created equalThe importance of collaboration between clinicians and creators in women’s healthRosie shares her passion for empowering women through wearable recovery, combining science, style, and support in a way that’s redefining postpartum care.Exclusive Listener Offer: Enjoy $30 off your next Everform order with the code INSIDETHEBOX30 at everformtherapywear.com.au

This week on Inside the Box, we're diving deep into the multifaceted world of chronic pain, and how to treat it with both science and empathy. Our guest is Nicola Michell, the founder of City Physio in Sydney’s CBD, a titled Pain Physio who thrives on complexity, loves a challenge, and is on a mission to prevent chronicity where possible.Nicola brings a rare mix of clinical insight, real-life experience, and passionate advocacy for better chronic pain management—especially for women. She’s also a mum to Audrey, chronically sleep-deprived, a strength-training junkie, black coffee lover, and still somehow finds time to keep up with Grey’s Anatomy.In This Episode, We Explore:The Complex Nature of Chronic PainWhat makes chronic pain so misunderstood—and so difficult to treat?Physio’s Role in Chronic PainHow can we, as physiotherapists, evolve our approach and better support patients in pain?Sleep & Pain: A Two-Way StreetWhat we now know about the relationship between chronic pain and sleep disturbancesNicola’s practical tips for helping your body access restorative sleepPain on a PlateThe impact of diet on chronic pain conditionsNutritional insights for women’s pain management—what helps, what harmsPerimenopause & Hormonal ShiftsWhy oestrogen plays a critical role in pain modulation, and how changing hormones in midlife can affect pain experienceThe Caregiver’s BurdenHow traditional female caregiving roles increase the emotional load—and how this intensifies chronic pain experiencesThe Science of Threat & ConditioningClassical conditioning, perceived threat, and how the brain “learns” painHow this knowledge can reshape the way we talk to and treat people in painWhether you're a clinician looking to deepen your understanding, or someone navigating chronic pain yourself, this episode offers science-backed insights, honest conversation, and practical tools for a more holistic approach.Connect with Nicola MichellInstagram: @nicola_cityphysioCity Physio: https://cityphysio.com.au 

In this episode, we’re joined by Chloe Cox, a highly experienced pelvic health physiotherapist with a special interest in complex pelvic floor presentations. Chloe brings warmth, depth of knowledge, and a passion for helping people better understand how the pelvic floor contributes to both continence and bowel health.We cover:The role of the pelvic floor in bowel function – what it does and why it mattersCommon symptoms patients may experience when the posterior compartment isn’t working wellAssessment strategies for the posterior compartment, including coordination, tension, and strengthHow to optimise doing a poo – practical, evidence-informed tipsHow pelvic floor muscle training differs when we’re working with bowel function compared to urinary incontinenceThis conversation is full of clinical pearls for practitioners and plenty of take-home messages for anyone wanting to better understand the often-overlooked connection between the pelvic floor and bowel health.You can find Chloe by following her @chloe_thepelvicphysio

In this episode, we’re joined by Dr Laura Whitburn — physiotherapist-turned-researcher and Senior Lecturer at La Trobe University — whose work shines a light on labour pain and intrapartum communication. Laura’s research explores the psychological, social, and environmental influences on the childbirth experience, with a focus on creating safer, more supportive care for women in labour.We dive into:Laura’s journey from physiotherapy to anatomy teaching and research in labour painWhat drew her to explore the complexities of labour painThe “distressed-to-dissociated” pain spectrum she introduced at Better BirthsHow distress and dissociation present during labour, and when dissociation might actually be protectiveThe critical role of communication in shaping a woman’s pain experienceHow psychological safety impacts labour and birth outcomesPractical strategies for clinicians and birth partners to foster supportive, safe environmentsHow women preparing for birth can use this knowledge to advocate for themselvesThe one thing Laura wishes every woman and clinician knew about labour painThis conversation is both insightful and empowering, offering evidence-based perspectives alongside practical tools for anyone supporting birth.

In this heartfelt and deeply important episode, we sit down with Amy to talk about her journey through secondary infertility and recurrent miscarriage. Together, we explore the physical, emotional, and relational challenges that come with infertility and loss, and the often-silent suffering that so many face behind closed doors.We cover:The reality of secondary infertility and the complexities that make each experience unique.Navigating the heartbreak of recurrent miscarriage and its impact on identity, grief, and hope.The role of relationships—how partners, family, and friends can be both anchors and challenges through this journey.Advocating for yourself in the medical system and finding a path that feels right for you.How to support loved ones who may be struggling silently with infertility and loss.Amy’s openness offers comfort, validation, and insight for anyone walking this path, as well as for those who wish to better understand and support the people in their lives who are experiencing it.If you or someone you love has been affected by miscarriage or infertility, please know you’re not alone. 

In this episode, we sit down with pelvic health physiotherapist Nat McConochie to unpack some of the most important topics in perinatal pelvic health, guided by the latest ACSQHC (Australian Commission on Safety and Quality in Health Care) guidelines.Together, we explore:What the ACSQHC guidelines are and how they shape evidence-based best practice.How common OASI (Obstetric Anal Sphincter Injury) really is—and why understanding the numbers matters.Risk factors every clinician and expectant mother should be aware of.The truth about the Epino device—does the research support its use?Paradoxical puborectalis—what it is, why it matters in late pregnancy, and how we can optimise function before birth.The role of physiotherapy in recovery—how to start rehab the right way for the best long-term outcomes.Early EAS (External Anal Sphincter) strengthening vs levator ani avulsion risk—finding the balance in early postpartum rehab.Supporting decision-making around mode of delivery after OASI—how to guide women through the evidence and personal considerations.Whether you’re a physiotherapist, a birth worker, or a mum wanting to better understand your body, this conversation is packed with clear, practical, and compassionate guidance to help optimise recovery and protect pelvic health.

In this deeply moving episode of Inside the Box, we sit down with Professor Susan Walker, a Maternal Fetal Medicine Specialist from the University of Melbourne. With decades of clinical and academic expertise, Professor Walker brings insight, compassion, and clarity to some of the most challenging experiences in women’s health.Together, we explore:What defines a high-risk pregnancy and how care is tailored accordinglyThe clinical and emotional realities of early infant loss and stillbirthHow clinicians can better support women and families navigating griefThe importance of language, presence, and compassion in moments of unimaginable lossStrategies for debriefing and safeguarding our own mental health while working in emotionally intense spacesWhether you're a clinician, a student, or someone seeking to understand more about maternal care in complex scenarios, this conversation is a powerful reminder of the need to honour both our patients’ stories—and our own capacity for care.Please note: This episode contains sensitive content. If you're currently grieving or feel vulnerable to discussions around infant loss, please take care as you listen.

In this episode, Caitlin sits down with Ann Traeger-Spees, a titled pelvic health physiotherapist and sexual psychotherapist, to talk about the very real — and often misunderstood — world of Genito-Pelvic Pain/Penetration Disorder (GPPPD).They unpack the clinical complexity of GPPPD, how pain is often not the only piece of the puzzle, and why pleasure deserves a far more prominent role in treatment and recovery.Together, they challenge traditional physio frameworks and explore the layered intersection between psychosexual health, body literacy, and trauma-informed care.But this conversation goes far beyond the clinic room.Ann and Caitlin also dive into what it means to be a parent navigating open, shame-free conversations about sex, consent, and pleasure — especially with children assigned female at birth.This episode is for you if:You’re a pelvic health physio seeking a more holistic, person-centred approachYou’re a parent wanting to break generational patterns of shame around sexYou’re curious about how our clinical and cultural lens on pleasure is evolving

In this raw and relatable episode, we sit down with Eli Moulton to talk about the messy, beautiful, and complex chapters of life as a mother and entrepreneur.Eli opens up about navigating a challenging birth and postnatal period, launching a business while adjusting to new motherhood, and the emotional toll of multiple rounds of IVF. We also dive into the realities of mental health, relationship breakdowns, and the path to finding her person.Now facing a surprise pregnancy, Eli shares what birth might look like this time around and how she’s approaching it differently. We also explore the importance of carving out time for yourself and why prioritising self-care isn’t selfish—it’s essential.Whether you're a mum, a business owner, or just someone who appreciates honest conversations, this episode is a must-listen.You can follow Eli’s story here @eli__moultonEli’s incredible business @plusone_dresshire

We’re kicking off Season 3 with a behind-the-scenes catch-up—new business ideas on the boil, evolving parenting approaches, and the values driving our next chapter. We also chat about what we’re seeing in clinic right now: the themes, challenges, and shifts that are showing up in women’s health. Think of this episode as a reset and a real talk, setting the tone for a big season ahead.

Tamara Woods is an experienced pelvic health and musculoskeletal physiotherapist dedicating more than 17 years to her career in physiotherapy. Tamara works at Southern Nest (Hurstville) or Anaria (Miranda) and hosts the online membership platform “The Pelvic Health Community” where she mentors and drives knowledge sharing for Women’s Health physiotherapists.  Tamara also co-created the birth education course “Born Ready” and teaches on the APA (Australian Physio Association). Tamara is a wealth of knowledge who is extremely passionate about providing comprehensive care for women. In this episode we talk about:Tam’s journey and career Pelvic Organ Prolapse (POP), what is it and how do we define it Conservative management strategies for POPWhat is a Pessarry and how do we use it What is the future for POP management, particularly in the Pessarry space? You can find out more about Tamara and her Pelvic Health Community here:https://www.pelvichealthcommunity.com.au/about

Dani is a mum of two young children and has a Master’s degree in Psychology.Dani has her own practice -  The Mother Cup Psychology here in South Australia and works a little differently from your average psychologist – she views her clients from a growth mindset perspective – utilising their strengths to help them better navigate the motherhood journey. She aims to remove some of the barriers influencing women’s ability to seek help offering in-clinic sessions, sessions out in nature, telehealth sessions for people across Australia and home visits for those who have less capacity to get to appointments.She believes that motherhood, and the associated matrescence period, have multiple transition points where a women can either struggle, or grow and evolve with the correct support.Dani assists women to find themselves again, regain confidence, and help them negotiate the significant changes that come with parenthood.In this episode we discuss: Matresence and the transformative change of your identity takes during motherhood Post partum depression, anxiety and rage - what’s normal when discussing mental health?When to seek help?Signs to look out for and who might be more at riskSelf reflection strategies and finding space for ourselves Practical tips to help you cope; and How to lean on your partner and be vulnerable in times of needUseful links and resources:PANDA - Perinatal Anxiety and Depression Australia - supports the mental health of parents in the first year of an infant’s life PANDA National Support line 1300 726 306panda.org.auGidget Foundation Australia (Perinatal)- specialist support through face-to-face, telephone and telehealth counselling and group therapy for families suffering emotional distress during pregnancy and early parenting.1300 851 758 Gidgetfoundation.org.auCOPE  - Centre of Perinatal ExcellenceEvidence based and timely helpful information available to parents by registration.1300 726 306Cope.org.auReady to Cope App – for antenatal mental health preventative supportArticle on Matrescence https://www.npr.org/2021/08/08/1024674033/theres-a-name-for-the-ups-and-downs-of-new-motherhood-its-called-matrescence

Dr Carina Siracusa has been practising for over 18 years in the field of neurological and paediatric physiotherapy and is board certified in pelvic health physiotherapy and oncology physiotherapy. She is a professor at South College in Knoxville, Tennessee and treats neurological pelvic floor patients at OhioHealth in Columbus, Ohio. She has taught pelvic floor physiotherapy courses for the Academy of Pelvic Health Physical Therapy in the US and has developed multiple specialty pelvic floor courses, which she has taught all over the world.In this episode we chat about:What is “normal” for how often you do a poo?Mechanics of the digestive systemWhat is constipation and how to differentiate between slow transit and obstructed defecationWhat is the best poo consistency?How should you sit on the toilet for the best chance of pooing easily?The interplay of the pelvic floor muscles and opening your bowels Constipation in kids and fears around using the toilet Effects of constipation on bladder urgency and urinary incontinence Top bowel habits Links: Some teaching and resources from Carina https://www.medbridge.com/educate/instructors/carina-siracusa-physical-therapy

Melissa Vranjes is a certified holistic sex and relationship coach from New Zealand. Melissa is deeply passionate about supporting women to feel liberated in their bodies and in the bedroom. Melissa has worked with hundreds of clients, developed online courses on sex and intimacy, and has witnessed the empowerment, fulfilment and freedom that women experience when diving into this work.Her mission is to create safe and empowering spaces for women to come home to their bodies so that they can harness the power of their sexuality and experience more embodied pleasure in life.In this episode we chat about:Libido, desire, pleasure and motherhood Where do you even start with connecting with yourself when you are tired, in pain, stressed out, touched outThe key to communicating with your partner around sex and readiness for intrcourse Tips for health professionals working with women with pain, vaginismus, dyspareunia for bridging the gap between pain free and pleasurable sexual experiences Practical tips women can do to step into their bodies and move them closer to an intimate relationship with themselves and their partners Melissa’s favorite books for exploring female sexuality and connection with self (For patients and for health professionals) Melissa’s own experience with sex and libido during pregnancy and post parutm Links: https://melissavranjes.com/@melissavranjes (Instagram) Books we discussed in the episode:Come as you are - Emily NagoskiHow to not let having kids ruin your sex life - Dr Karen Gurney

Quiara Smith is an Occupational Therapist with further speciality training and experience in paediatric pelvic health conditions. Quiara has worked in Occupational Therapy for over 13 years and currently practises from her private clinic Aloha Integrative Therapy in California. In this episode we cover:The top 3 presentations of pelvic health conditions in kids to her clinic: Constipation, withholding and incontinence The common signs of pelvic floor dysfunction in children and how do we distinguish this from typical development timelines The biggest misconceptions parents (and professionals) have about the role of Pelvic Health OT’s The link between neurodivergence, sensory processing and continence issues How common is faecal impaction? What are the short and long term management strategies?Bed wetting in the preschool/ school aged childA discussion around interoception - Can you train this? How do you train this?We finish the conversation with Quiara’s take on how we can best support our children’s pelvic health as parents.Links: @alohaintegrativetherapy www.alohaintegrativetherapy.com 

In this episode Kat, Tash and Caitlin reflect on the year that was, discussing exciting things for 2025Personal Journeys:Kat opens up about overcoming postpartum mental health challenges and the lessons learned from a business venture that didn’t go as planned.Tash reflects on juggling solo entrepreneurship while welcoming her second baby into the world.Caitlin shares her experience with postpartum anxiety, her first panic attack, and how she’s tackling the pressures of being a people pleaser.Celebrating Wins & Setting Goals:Kat and Caitlin celebrate the magic of building a team with an incredible culture and share their commitment to nurturing it in 2025.Tash and Kat reveal their ambitious running goals, while Caitlin focuses on embracing team sports and progressing in lifting and gymnastics.What’s Next for 2025:Kat shares her plans to expand her mentorship work and help others achieve their potential.Caitlin dives into launching her personal brand and building her online treatment presence.Tash explores the possibility of growing her team and what that might look like for her business.This episode is a celebration of growth, resilience, and ambition. We’re so proud of the conversations we’ve shared this year and can’t wait to continue driving important discussions in women’s health in 2025.

Sage King (she/her) is a diversity-friendly naturopath and nutritionist, specialising in reproductive health including fertility & IVF optimisation, Endometriosis & Adenomyosis, PCOS, PMS & PMDD to name a few. As an educator and speaker, Sage contributes to practitioner education on topics such as preconception care, LGBTQIA+ inclusivity and reproductive health, the intersection between hormones & neurodivergence & alongside her colleagues runs monthly group mentoring on clinical foundations of reproductive health. Sage has contributed to research alongside NICM Health Research Institute investigating the impact of naturopathic interventions on premature ovarian insufficiency and pregnancy outcomes.In this topic we discussWhat is PMDD (Premenstrual dysphoric disorder) Is it a hormone disorder? Is it a mental health disorder? How is it diagnosed?Can it be treated or cured?What are the main hormonal drivers for PMDD and how are they treated?Are these treatments effective in Endometriosis symptoms?Links:Website: www.rhreproductivehealth.comSocials: @sagekingnaturopathyFree 10-min discovery calls for patients: https://www.rhreproductivehealth.com/booking-calendar/free-10-minute-discovery-call?referral=service_list_widgetPatient resources: https://www.rhreproductivehealth.com/patient-educationBlog: https://www.rhreproductivehealth.com/blog

Jo is a well experienced physiotherapist and Director of The Physiotherapy Clinic. She has spent the better part of 10 years learning and working in the pelvic floor, pelvic health and childbirth arena which has lead to her post grad cert in continence and women's health and a masters in women's health medicine. Now Jo has moved into studying medicine and is a PhD student looking into pelvic floor assessment in pregnancy. Jo also heads a birth education platform, Born Ready, and hosts a yearly conference for health professionals working in Women’s Health . Fun fact Jo’s grandmother had 18 children. In this episode we cover:How Jo’s personal and professional experience have shaped the work she is doing in birth preparation Juggling clinical work, motherhood, business ownership, studying medicine and deep diving into research workJo’s current work in the research field on pelvic floor outcome measures in pregnancy, and their relationship to birth outcomesWhat is the role of the physio in birth preparation?What are the most important parts of birth prep to reduce birth trauma How to push effectivelyBirth education and Born Ready Links: Born Ready https://www.bornready.com.au/ 

Marc is a colorectal surgeon with over 25 years experience in the medical field. He has a career-long passion for preventing, treating, and curing problems related to the bowels, pelvic floor and their function. Marc is a specialist with expertise in abdominal and pelvic pain, bloating, constipation (difficulties emptying the bowel), bowel leakage (incontinence) and bleeding from the back passage. Marc is passionate about giving holistic, conservative management strategies to his clients where he can and dives into some very practical and useful tips to keep your bum healthy and happy. In this episode we cover:What are the most common bowel disorders seen by a colorectal specialist? How many of these have a pelvic floor dysfunction component?The journey to becoming a colorectal specialists and why Marc is so passionate about itWhen would you consider a caesarean section for subsequent births after experiencing a 3rd or 4th degree perineal tear in your first birth? Marc describes 3 key factors required for decision making.Missed 3rd or 4th degree anal sphincter tears after having a baby, what are the treatment options? Is surgery able to help this? How late is too late?The use of sacral neuromodulation in the treatment of faecal incontinence Fecal urgency and difficulty holding poo after a cesarian section - when will this get better? Whats normal? What can you do a bout it?Stool bulking (fibre) vs stool softners - how do you know which one?Haemorrhoids, fissures and painful poos - what’s normal, what’s not and what can you do about itHow long is too long to do a poo (this one will surprise you!)Marc finishes with his mantra for optimal bowel health “Eat well, keep moving and don’t rush”Links: https://www.thebowel.clinic/about

Dr Dean Conrad is a specialist obstetrician and gynaecologist based in Sydney. Dean is staff specialist at The Sutherland Hospital and a conjoint lecturer with the University of New South Wales. He has a special interest in minimally invasive laparoscopic and robotic pelvic surgery and specialises in the treatment of fertility and pelvic floor dysfunction, including non-mesh treatments for urinary incontinence. His passion for education has taken him across the country as an educator, proctor and surgical mentor for doctors, advancing the knowledge and awareness of endometriosis and pelvic floor dysfunction.  In this episode we cover:What is stress urinary incontinence (SUI)?What are the two main causes of stress incontinence and how do we assess it in clinic?Measuring mid urethral closure pressure in urodynamics What surgical options are currently available (Mesh and non mesh options) for treating SUI and how effective are they?A deep dive into the Birch Colposuspension for surgical management of SUIIs there a place for urethral bulking? And how effective is it?How has Fatherhood shaped his outlook in his professional lifeLinks: Instagram @drdeanconradWebsite www.anaria.com.au/dr-dean-conrad

Jess is a 3x Olympian, 2022 Commonwealth Games Marathon champion and 2x com games bronze medalist. She is also a mum of 2 and a qualified physiotherapist.Jess birthed her 2nd Baby, Ellie, just 10 months before she finished 13th in the Paris olympics in the Women’s Marathon. In this episode we discuss:Ellie’s birth story (Planned Cesarean Section) Post partum recovery timelines after a c-section and return to running Training for her first marathon after birth (South Korea)The lead up to the Paris olympics, her training, sleep schedules and diet Juggling multiple night wakes, breastfeeding and the demands of olympic training Mindset and physical training in the lead up to Paris What’s next in store for JessLinks: You can follow Jess’s journey online @jess_tren

Zali is a dedicated and compassionate physiotherapist in Women’s Health with a special clinical interest in the sporting pelvic floor.  Zali has worked with many elite athletes and sporting clubs including Essendon AFLW/VFLW, Hawthorn AFLW and VIS Women’s Hockey. More than two thirds of elite female athletes in sports like soccer, gymnastics and weight lifting leak urine. In this episode we cover:What types of pelvic floor dysfunction we see in the athletic population (including stress incontinence, pelvic pain and constipation) Educating Female athletes on pelvic floor, what they should know The stats on pelvic floor dysfunction in female athletic populations A deep dive into theories around why our top athletes might leak urine (it’s not a weak pelvic floor!) The stigma around pelvic floor dysfunction amongst elite athletes Treatment options for stress incontinence in sport and how quickly athletes can see improvements in symptoms Links: You can follow Zali’s professional and personal journey online @zali.rayment.physio 

Kate Ivey is the founder and a trainer at DediKate, the online fitness community for rural and regional women, mums and those that don't have time for the gym. She lives on a farm in New Zealand with her husband and 3 kids. Kate and her DediKate team help women all over NZ and Australia to look after themselves and exercise for the physical and mental health benefits. Their short and effective online workouts enable women to fit exercise into their busy lives! In this episode we cover:Kate’s story of putting on 30kgs in her pregnancies and overcoming road blocks in her return to exercise after having her 3 babies Kate’s birth stories and why she is passionate about advocating in this space How Kate turned a dissatisfaction / road block in her 30’s into a thriving online business Words of wisdom and encouragement for Mum’s trying to get back into fitness after having children Therapy and mindset training in your 30’s and key takeaways for Kate after more than a year of working on her mental fitnessKate finishes by answering this questions: “What legacy do you hope to leave on the Women’s fitness industry?”You can find Kate’s online programs here www.kateiveyfitness.com and follow her journey on instagram @kateiveyfitness.

About Liv: My name is Liv, and I am a qualified physiotherapist and clinical Pilates instructor who is passionate about all things movement. I have been working in the industry for 6 years now, and have a special interest in Women's health. I love educating and sharing what I have learnt about the body with others. Whether you are a weekend sports warrior, Pilates enthusiast, newbie mover or returning to movement after injury or some time off, nothing brings me more joy than seeing others achieve their movement goals!In this episode we cover:Liv’s passion for pilates and how she got to clinical pilates instructor and physiotherapistIs pilates worth the hype for pregnant and post partum women?Is pilates a prolapse safe workout?Can pilates help pelvic floor dysfunction?Whats the difference between clinical pilates and standard pilates?Liv finishes by answering this questions: “If you could only pick 2 pilates exercises to do for the rest of your life what would they be and why?”Links: You can find Liv’s professional Pilates journey on instagram @pilateswithlivv 

In this episode you’ll hear from us; Kat, Caitlin and Tash. We unpack life lately:2 of us are pregnant (we’ll let you listen to find out who)The comparison of pelvic floor rehab and return to sport after a second vaginal birth Vs a first The little things we implement (and stuff we dont do so well) when navigating our marriages with smalls kids, businesses and a busy work scheduleExciting new projects for Ivoryrose and The Hills Physio leading into 2024 You can follow our journeys: @ivoryrose_physiotherapy @pelvicfloorwithcaitlin @insidethebox_pod @katwarr

In this QandA episode Kat, Caitlin and Tash answer some of your questions about pelvic pain. Some of the questions we cover:“Ive had painful intercourse my entire life and I tried physio who recommended dilators, but I had no improvement. Do dilators work? Should I try again?”“TENS for period pain, are they as effective as they are made out to be?”“How can I talk to my partner about painful intercourse?”“Are there specific exercises to help vaginismus?”If you have more questions, slide on into our DM’s @insidethebox_pod

In this patient story we are joined by Hiral, a 39 year old Social Worker who shares her story of living with endometriosis. Hiral openly discusses the challenging fertility journey she went on that ended with a hysterectomy, which ultimately changed her mental and physical health for the better. In this episode we cover:Navigating a new healthcare system after migrating to Australia at 23 years oldHiral’s symptoms that lead to a diagnosis of endometriosis Treatment options she tried in attempt to overcome her symptoms Hiral’s trying fertility journey and the mental and physical toll that this long journey took on her and her partner The decision to have a hysterectomy Life after a hysterectomy 

In this patient story we are joined by Anna, a new mum who was faced with severe bladder leakage after the birth of her first baby. Anna shares her story of months of physio, specialist appointments and her saving grace, urethral bulking. Anna went from soaking through multiple incontinence pads a day and being held back from a “normal” life as a new mum to almost no leaking and participating in all the activities and more. In this episode we cover:Anna’s birth story The first days a weeks after Anna’s birth experiencing no bladder sensation and constant urine leakageThe professionals involved in her treating team including OB, physio and urologist How she came to the procedure of urethral bulking. What is urethral bulking, how its done and how much it costsWhat the future holds including considerations for future births and bladder surgery We finish with a discussion around why it is a societal norm for women not to speak up about incontinence and Kat’s opinion on how we can improve that with one simple question! 

In this episode we interview Lauren Ferris. Lauren is an Obstetrician and Gynaecolgist from Sydney, currently in Queensland completing further speciality training in the area of Urogynaecology. Lauren is passionate, personable and very holistic in the way she thinks and treats incontinence. In this episode we discuss:What actually is Urogynae? What are the biggest misconceptions you see about urinary incontinence?What is overactive bladder and how is it diagnosed?How do we treat urinary incontinence? What are all the options and in what order do we trial them?TENS for overactive bladder, Botox to treat incontinence, types of surgeries available and their success rates LINKS:https://www.safetyandquality.gov.au/sites/default/files/2020-11/treatment_options_for_stress_urinary_incontinence_sui_-_transvaginal_tv_mesh_-_information_for_consumers_patient_resource.pdf

In this episode we interview Sarah, a young female living with chronic pelvic pain. Sarah started off with an early diagnosis of vaginismus, which progressed to a term known as vulvodynia. Sarah openly shares her experience with vulva pain and pelvic floor muscle dysfunction, how she was diagnosed and her treatment journey so far. In this episode we cover:Sarah’s early symptoms with painful intercourse and vulval painWhich health professional she saw first and how she went about diagnosing vaginismus and vulvodynia How living with vulvodynia has impacted her relationships Which treatments have made the biggest impact on symptoms so farWe finish with Sarah’s advice to anyone starting out on their pelvic pain journey.  

Associate professor Emma Readman is a specialist gynaecologist from Melbourne. Emma has special interest in menstrual disorders, endometriosis and pelvic pain. Her holistic approach to pain management is one of the main reasons we decided to have her on the podcast. In this episode we cover:What is the difference between pelvic floor myalgia, vulvodynia and dyspareunia?How is are these diagnosed?What treatment methods are available for chronic pelvic pain?How would treatment differ for someone experiencing vuvlodynia and burning at the entrance of the vagina vs someone with deep pelvic floor pain?Botox for the pelvic floor, what's involved, how is it accessed and how much does it cost?Future research and scope in chronic pelvic pain Resources:Change your brain, change your pain - Ebook by Carolyn Vandyken

In this patient story we are joined by Sarah, a young exercise physiologist living with Endo. Sarah shares her story of how she came to a diagnosis of endometriosis and bravely opens up about how, at 25 years old, she was thrust into making decisions about her future, family planning and how she could preserve her fertility.  In this episode we cover:Sarah’s early symptoms and how a trip to the emergency department with severe abdominal pain led to a diagnosis of endometriosis Sarah’s treatment so far and her honest insight into what has worked for her and what hasn’t How Sarah dealt with being told her endometriosis was significantly impacting her fertility and the steps her and her partner took to preserve thisThe impact of endometriosis (and everything that comes along with it) on mental health and relationships We finish with Sarah’s advice to anyone on their own endo journey 

In this patient story we are joined by Laura, a young female living with Endo. Laura’s journey to finding out she had endometriosis started with hip pain and years of physio, scans and specialists - all whilst trying to finish her HSC. In this episode we cover:Laura’s journey with symptoms as a teenager and how she came to a diagnosis of endoWhat it’s like dealing with chronic pain, bladder and bowel issues and a diagnosis of endo as a young female Laura’s treatment so far and her honest insight into what has worked for her and what hasn’t The most challenging thing about living with endoWe finish with Laura’s advice to anyone starting out on their endo journey.  

In this patient story we are joined by Frankie who is living with Endo. Frankie shares a raw insight into her experience navigating everything from onset of symptoms through to diagnosis and her treatment journey. In this episode we cover:Her first period through to onset of endo symptomsTypes of symptoms that led Frankie to seek helpEarly (not so successful) experiences with navigating health professionals How she was diagnosed with Endometriosis and what first line treatment looked likeFrankie’s honest insight into living with endometriosis and its impact on mental and physical healthAll the tools currently in Frankie’s treatment “tool belt” and what has been the most helpful for her symptomsWe finish with Frankie’s advice to anyone starting out on their endo journey. 

In this episode we interview Professor Jason Abbott. Professor Abbott is a Gynaecologist and Laparoscopic surgeon who completed his PhD in the surgical management of Endometriosis in 2003.  Since then, he has established himself as a leading teacher, trainer and gynaecological surgeon both nationally and internationally. He is one of the founders of Endometriosis Australia and continues to dedicate his work to this field. Jason is down to earth, personable and very holistic in the way he thinks and treats endometriosis. In this episode we discuss:What is endometriosis?What are the most common signs and symptoms of endo?How common is endo in Australia?What should be the first line of action for someone who suspects they might have it?How is endometriosis treated/ managed?Who else is involved in the treating team for endo? And what does holistic management look like?How is the field of endometriosis changing and what is on the horizon in terms of research?Links:Alana Healthcare: https://www.alanahealthcare.com.au/services/gynaecology/endometriosis/Endometriosis Australia: https://www.endometriosisaustralia.org/ 

Dr Sophie Bermingham and Dr Laura Willington are consultant anaesthetists working in South Australia. As mum’s themselves, Sophie and Laura have a passion for women centred care. We sat down with them both to discuss all things pain relief and the role of anaesthetics in labour and birth. In this episode we cover:What’s the difference between an epidural and a spinal?Is every epidural the same?How epidurals have changed over the last 20 yearsWhat are the risks of epidurals and spinals and how common are they?Is it normal to have pain at the injection site and how long is it “normal” for it to last?Is low back pain after an epidural common?How likely is it to have incomplete pain relief coverage?The differences between anaesthetic care in the public Vs private systems in Australia  Soph and Laura’s personal experiences with anaesthetics in labour and birth Resources:Information on pain relief choices in labour - https://www.labourpains.org/ 

In this 2 part series we are joined by four mum’s from our Inside The Box Community (including one of our own hosts, Kat). Four mum’s share the good, the bad, the awkward and all the raw insights and realities of getting back to sex and intimacy after having a baby. Today we have Alicia and Kat speaking to their experience. Alicia - Wife, Audiologist and Mum to 3 year old Piper. Alicia and husband Sean have been together for over a decade.Kat - Founder of Ivoryrose physiotherapy, co-host of this podcast and Mum to 2 year old Teddie and Orlando who is under 1. Kat and hubby Christian have been together for 6 years and married for 4.

In this series we are joined by four mum’s from our Inside The Box Community (including one of our own, Kat). Four mum’s share the good, the bad, the awkward and all the raw insights and realities of getting back to sex and intimacy after having a baby. Today we have Maddi and Jo speaking to their experience. Maddi - Wife, mum of 2 under 2, and part-time legal receptionist. Maddi and her husband have been together 13 years and have 2 boys aged 2 and a half years and 9 months old. Jo - Wife, mum of one baby boy and step-mum to a teenage girl. Executive assistant at a big bank. Jo and her husband have been married for a year.

Anisa Varasteh is a clinical sexologist based in Adelaide and owns Relate Sexology. She is a trained professional who specialises in human sexuality and helps navigate people through areas in which they may find themselves stuck, confused, needing more information, or desiring to improve their sexual and relational well being. She is a new mum herself and shares a passion for helping women in the space of relationships and intimacy as they navigate new parenthood. In this episode we cover:What are the most common blocks women describe after having a baby in regards to sex and intimacy?What is normal in terms of sexual experiences and labido post birth?The impact of birth trauma on relationships Strategies to enjoy intimacy again with partners after pregnancy and birth How feeling touched out, drowning from mental load and feelings of resentment towards a partner for perceived freedoms can impact intimacy and how to overcome these?What to do if you and your partner have mismatched desires Words of wisdom for healthy relationships when raising young peopleLinks: Relate Sexology https://www.relatesexology.com/Society of Australian Sexologists https://societyaustraliansexologists.org.au/sys/website Instagram @relatesexology 

In this episode we chat to Caitlin about the beautiful story behind the birth of her second baby, Luna.In this episode we cover:- The early signs of labour- Strategies Caitlin used for pain relief in labour- An almost accidental waiting room birth- A vaginal water birth with Luna arriving in her amniotic sac- How the early recovery has been- The outcome of her six week checkWe hope you enjoy hearing this story as much as we did!Instagram: @pelvicfloorwithcaitlin

Jess Stenson is one of our and Australia’s most inspiring female athletes. Amongst many other things Jess is a mum, a physiotherapist, a professional athlete and running coach. We sit down with Jess to chat about all things pregnancy, birth and recovery and the nuances of being a professional athlete (and competing at the top of her field) at the same time.In this episode we cover:How becoming pregnant impacted Jess’s training and her pregnancy journey Jess’s birth story and early recoveryWho was on Jess’s team post partum and how she was supported in return to running and training What her training journey looked like from birth to the 2022 Commonwealth gamesHow becoming a mum has changed her career as an athlete Advice to new mums looking to return to running  Instagram @jess_tren 

Tanya is a qualified personal trainer and group fitness instructor, Mum of 2 and a very well known social media personality (with over 350 thousand people joining in to watch her journey and soak in all her fitness wisdom). Tanya is known for her unique mix of strength training, high intensity work and mobility. She is also pre and postnatal certified. In this episode we cover:Tanya’s career so farHer experience training during her pregnancies and the insight she gainedTanya’s 2 birth experiences and how they have impacted her trainingHer experiences returning to exercise, how she did it and the impact having such a large following has had on the journeyThe most challenging things for her about returning to exercise after 2 kidsThe biggest myths in the fitness industry surrounding pregnancy and post partum exerciseWe finish with Tanya answering “what do you wish more women knew about exercise and pregnancy?”Tanya’s instagram: @tanyapoppet 

You asked, we answered! In this episode Kat and Caitlin are put to the test as expert guests covering some juicy topics such as how to ensure you choose the right healthcare team for you, how to prepare for birth, what to consider if you have a prolapse and are looking at decisions for future vaginal deliveries, and all the latest of epidurals including when they could be appropriate for YOU. Also sharing with you all the Born Ready Course link which Kat speaks about on this episode - this course is a MUST if you are preparing for birth <3https://www.bornready.com.au/If you would like us to answer any of your questions in future episodes, drop us a DM @insidethebox_pod

In this episode Britt shares with us her birth stories, the first of which resulted in a 3b tear and postpartum haemorrhage. She chats with us around her speedy labour, diagnosis of OASI, the challenges of recovery alongside her journey of healing and how she navigated her decision in choosing to rewrite her birth story in what she describes as a 'blissful' caesarean birth. Happy listening! Trigger Warning: This episode discusses forceps and postpartum haemorrhage. 

In this episode Hannah shares with us her 2 very different birth stories, the first of which resulted in a 3rd degree tear. She chats with us regarding labour, things she has learned, diagnosis of OASI, her journey of healing, and how she navigated the decision around having another vaginal birth.