Pelvic Health Myth Busting with Rosie Davie

Welcome to another episode of the ’Create Your Kindspace’ podcast, with me your host Caroline Laurenson. Create Your Kindspace is all about wellbeing and the different ways in which we care for ourselves and those around us.

So right before the festive holidays I caught up with Rosie Davie, a physiotherapist who traded the rugby field for a mission to transform women's health care. I think it’s a topic that we don’t talk about enough and advice can often be unhelpful or outdated, so I’m so delighted to have Rosie help shine a light on the issues and share her top tips and advice.

Timestamps:

00:02:15             Introduction to pelvic health

00:04:39             From sports physio to pelvic health specialist

00:12:11             Understanding the gender health gap

00:17:33             Breaking down pelvic health taboos and the lack of education

00:19:43             How marketing preys on women’s vulnerability

00:25:02             A holistic approach to women's health

00:36:57             Supporting women post trauma

00:39:02             What’s next for Rosie’s business

00:45:25             Creating a kindspace through movement, puppies, family, friends and the beach

00:49:39             Where to get in touch with Rosie

Links:

Website: https://rosiedaviephysiotherapy.com/

Instagram: https://www.instagram.com/rosiedaviepelvichealth/

LinkedIn: https://www.linkedin.com/in/rosie-davie-a47237156/

Access Rosie’s Pelvic Health Resources: https://rosiedavie.teachable.com/p/aboutrosie

Transcript:

Caroline: So welcome to the show, Rosie. I am so glad to have you here. And we're going to be discussing a really important topic, but also a sensitive topic, I guess, that a lot of people maybe don't like to talk about. But I think it is really important. So Rosie is joining us today to talk about all things pelvic health. And I'm just really interested to find out more about your background and also share some really crucially essential things that we should know about how to look after that aspect of our wellbeing. Because I was actually reflecting on this before and thinking it's almost a bit like when you go to the dentist and they're like, oh, have you been flossing? And all that. And you're like, hmmmm, not really. And you know it's something you should be doing. I think it's a really similar thing, isn't it? Where you're like, I know, kind of what I'm supposed to be doing, but I don't really pay enough attention. So thank you so much for joining us.

Rosie: Yeah, no, thanks so much for having me. I absolutely love any opportunity to speak about what I do for a job. And I think it could be a very taboo subject, like you said. And I think for many of us walking around in general life unless we've potentially gone through a pregnancy or a birth ourselves, pelvic health is not really spoken about much between those two time frames. I just like to bust as many myths as possible and try and get females feeling as confident as possible. Because I think, like you said, it's like going to the dentist and your teeth getting flossed. But there's also lots of things that we can start doing that probably we're already doing, that we don't actually realise it can be such a good impact on our pelvic health as well for life. Yeah so I like to make pelvic health easy. I like to make it simple, and I like to make it not added stress on the ever never-ending list of things to do. I like life to do.

Caroline: Oh, yes, that is music to my ears, yes.

Rosie: I've treated so many women over the years, hundreds, probably actually thousands now. And I think as females, we've always got that overload in our brains of all things we keep in check of a house. And even if that's with children or not with children are looking after parents or neighbours or if it's jobs or if it's looking after our partners. Sometimes we're looking after the dog. We always take on that mothering role of which we look after others quite a lot. And I think as females, I tend to see barriers being a big thing to why pelvic health isn't so good. So I like to try and make it as easy as possible so people can influence their own pelvic health, practically and actually enjoyable rather than being, oh, no, I haven't done that and added on the guilt trap.

Caroline: I love that. Yeah, so we will definitely get into all the tips and things as we go through our chat, but maybe we could go back to, as a bit of an introduction, your background. So how did you get into public health physio? And maybe you could tell us a bit about your journey into business as well as part of that?

Rosie: So I've been a physio now for over 12 years, but initially I was really interested in sports. I really wanted to work in professional sport. I did a lot of background in rugby was where my extra, I called it always an extra job. So I've always worked for the NHS, although after COVID, I left. So now I don't. But when I worked for the NHS, I always had a bit of an extra side on business. I've always had this itch where I want to do more, I want to learn more, I want to experience more. And for me, physio's always been a job that I've absolutely loved. I've never experienced a job where I've not enjoyed. I can't even imagine that. So for me, it's like I always wanted to be a better physio. So I joined my local rugby team and I was really lucky at that time because they were semi-professionals. So we covered a lot of the Glasgow Warriors, which is a professional rugby team here in Glasgow. And then we got a lot of the Scottish rugby players down, but post-injury and things. So we worked at quite a high level. Anyway, there I learned that probably working the level of working patterns, shift patterns in professional sport, maybe wasn't what I quite wanted. I'm a very sociable person. I like seeing my friends and family too much. I actually found professional sport quite competitive to work in as well. And for me, I'm not really that person that copes well with different strong personalities. I actually went away from professional sport. And it's so interesting now because I have done a 360 and I went into pelvic health through actually, it was a, I did a musculoskeletal post, which is where if you got a sore shoulder, a sore knee or a broken ankle, you would come to physio. So you'd walk in, you'd see a physio for an appointment, and then you would leave. So I worked in there for years and a post came up to cover maternity posts in pelvic health. And I was so keen and everyone was like, Why do you want to do that? Because it's a taboo. Even at university, none of us get taught about the pelvic floor.

Caroline: Ah, so as a physio, that isn't one of the modules that you cover.

Rosie: No, it's like this empty. And it's so interesting. Now, looking back, it actually makes me quite angry, actually. When you look at skeletons, you look at anatomy posters, they give you a lot of the muscle groups of the body, but there's this section of the pelvis that just is missing. Yeah, it's a strange... Maternity was an option in university, but you have to choose between maternity and sport. And most of us as physios see ourselves doing sport. So a lot of us chose sport. I don't think anyone even actually chose the maternity section. So I had no knowledge of it. And that for me is an issue because I felt if I'm treating females throughout my job, I want to know more about this space, so I need into it and the physios I worked with, I have such fond memories. They all became basically the mother hens of me being quite young. And it was quite an older place to work. Lots of physios wouldn't work in it unless maybe they'd had children themselves. And I was really young. I was in my early 20s, so I hadn't had a family. I still haven't had a family now, but lots of physios go in to it after having children. And I came from a very sports background. Anyway, there was no career progression for me in Ayrshire and Arran, so I went to Glasgow for a senior pelvic health post after that. Never looked back. I've worked in all sections of pelvic health, like so older females to females having issues prior to pregnancies, through pregnancies, and through postnatal periods as well. And I was really lucky in my post, particularly in Glasgow, that I covered all age ranges. So my job was great. And through this, patients began to ask me, do you not do anything outside the NHS? Do you not do any classes? Do you not do any teaching? Can we not see you privately? And I thought, Oh, private? I don't even know where to start with a business. And how do you start a business? And what happens if it fails, if it doesn't do well? And what happens if it's not successful? Or I do something wrong? And I did my toe in. I just went for it and it got, it got so busy. It got so busy that I was working probably an extra job on top of my full-time physio job.

I love to work.

Caroline: Wow, so you were still working in the NHS when you started that?

Rosie: Yeah, it's full-time in NHS and working Saturdays. I was covering the odd rugby game still as well on Saturdays. Then I was teaching through the week and the evenings and then starting a clinic, and the clinic became too busy. My husband at the time, who was my used to pick me up and drive me back home because it was so late and I would start back at the NHS the next day. And from there, I just slowly reduced my hours in the NHS and I always thought, I just can't do this full-time as a business. I won't be that popular, I won't be that busy. This is a luxury people to pay for. And I can't believe where I am at now. I'm probably the most I popular.. the busiest Pelvic floor physio in the West Coast of Scotland. I'm so busy. And now the way that I've worked or the way where I'm at now, I've gone back into professional sports. I'm actually teaching the Scottish Rugby Union Girls team before their Six Nations next year about pelvic health. So I've done a full 360 and I'm back in. So yeah, that's a really long sentence, but I suppose that's my journey of where I'm at. And I never want to go back to men's sport now. I absolutely love treating females.

Caroline: That's amazing. You come back to that sport connection as well.

Rosie: Yeah. I'm really passionate that everyone should be active. I think exercise is a huge part of my life. It's been a huge part of my being brought up and my relationships and my friends, groups, and people that I've been able to meet through sport. It connects us socially as well. And I think there's lots of challenges and barriers in females' lives to be active. It can be busyness, it can be time, it can be childcare, it can be pelvic floor symptoms that stop you from being active. So part of my job is to make sure that females are educated on the benefits of exercise. So yeah, it's why I'm probably quite strong-minded in pelvic health actually.

Caroline: Yeah, it's so interesting because before I met you, I guess it was a bit of a revelation to realise that there are specialists in this area because I guess my experience has been like, if you have any an issue, the first place you would go is your GP. You'd be lucky if you get 10 minutes with them and you'd be lucky if you get basically a pamphlet with, here's what you need to be doing. And there's never any follow up or anything like that or any deeper investigation. And I know in my experience, when I went to the doctor's, it turned out it was a urinary issue, but they had kept on telling me, go do pelvic floor exercises. And I kept going back and saying, this is not helping. I need someone to actually do some tests or properly look at what's happening. But for such a long time, they made me feel like it was in my head a little bit. Yeah. And then you wonder why women don't talk about these things because quite often it's the medical profession, they don't really have that understanding of what's going on.

Rosie: Absolutely. When we look at even the research, it's only been until recently that females have been included in medical studies about our bodies, so our hearts, our brains, our skin. Our hormones regulate all of that. And as females, we are a bit more complex in the fact that our hormones change every week, and then they change as we age. So it's been a long time that we actually haven't been included in research, and that's caused a bit of a misassociation between treating us like men when our bodies don't react the same way as men. And females, and as health care providers, or as personal trainers, or anyone working with females should understand that hormones play a massive role in our whole system. And if people don't understand that, then they don't have a grasp of how to treat a female. And I think just like you said, GPs, I always say, are general practitioners, so I think they are there for general ailments, general complaints. I'm really lucky to be a specialist in pelvic health. And when I say pelvic health, a lot of people associate that with Kegels or pelvic floor exercises. That's part of my job. I'd probably say it's maybe 5 %. A lot of it's looking at your full system, like how's your hormones, screening you for perimenopause, screening your mental mental health screening you for any sexual dysfunction that you have, any bowel dysfunction, your nutrition, your eating habits, your stress habits, your movement habits, everything. And then it's making a plan, individual plan. I think that's where general practitioners struggle because they don't have the time and they also just don't have the understanding. Actually, menopause is not really a subject in which it's taught to doctors. Then we have a huge problem there because I've had women who have terrible migraine start in their 40s, sending them for brain scans, sending them for tests, really increasing their anxiety. And actually a lot of it is to do with oestrogen and menopause and perimenopause. And actually, if we knew more or if we were better educated around that subject, we could treat that patient a lot quicker, a lot more with reassurance. She probably has anxiety already because if her hormones are changing, and that will affect loads of things. So yeah, I think for me in the ideal world, I don't think this will ever happen, one of me will be in your GP practise. So you will not see your GP for bladder ailments, for bowel illness, for pelvic floor symptoms, for postnatal checkups, for pregnancy well-being things. They will all come to Pelvic floor physio. And we can get specialist training to prescribe medication, to fit pessaries, which we can talk about, and do things for a client. So then we take our really good knowledge we already have, we make us even better, and then that patient gets a really good treatment plan when they come to see us. And we know straight away if you need to go to Uro-gyn or you have to go to Urology or you have to get a scan of your bladder or antibiotics. We can easily know that by just chatting to you.

Caroline: So the referral process is a lot more straightforward because for me, it just went on for such a long time. And then when I did actually go to see the consultant at the hospital, I was like, Oh my God, I'm not crazy. There is actually something wrong with my bladder and stuff. So yeah, it just... I think for me, it was a revelation to realise that actually in a health setting, in that first touch point, that there's people like you that can help guide you through that process. Because it is, it's emotional as well. It caused me a lot of stress.

Rosie: Yeah. I think the health gap, the gender health gap is absolutely massive. It has been proven by research that a woman might take a few visits to her GP to get the right outcome, whereas if a male was to present, that they would get an outcome done that day. They get referred a lot more easily. But then if we also look at the recent report of gynaecology waiting lists, what is it? It could fill eight times Wembley. Currently, the waiting lists of females waiting for gynaecology appointments. Are we meeting barriers to referrals because our GPs are subconsciously thinking, if I refer her, it's going to take three years. So are they hoping that things disappear? Are they hoping things just get better? So, yeah, there's a lot of the whole system needs shaken up. This is really why I left. The system doesn't really support the proactiveness of health. Our system is a reactive system, so it solves a problem when it's there

Caroline: Or when it's escalated to the point where it has to be solved.

Rosie: Yes. And it's causing that person medical trauma. They haven't been listened to, they haven't been heard, and they feel that they're making it up, and they feel that they're losing their marbles. And as females, in pelvic health, that is so apparent, especially and then sometimes we can be missed, all with over diagnosed in pelvic health with certain things that can happen to your body. Words like diastasis, that muscle separation you can get.

Caroline: Oh, I had that. Yeah, gosh. My stomach was the weirdest shape ever. The coning shape. Yeah.

Rosie: And that's actually a normal thing. That happens to everyone in pregnancy. But we like to over diagnose sometimes and then make females, especially, very fearful of their bodies, where actually we know it's not a weakness, it's not an injury as such. But then there's lots of miscommunication, and then people get told not to exercise and not to lift the baby and not to do heavy lifting and watch their posture and watch how they're standing. And it's like females don't need any added stress at a time that life is already quite hectic, especially with a newborn baby. We have to understand that actually, no, this can be treated later on or actually this is okay, this will resolve itself in six months or it might not, but it's actually okay to have. There's a lot of me reassuring women in clinic.

Caroline: Yeah, yeah, that totally makes sense. Because I guess I was a bit worried about it, but then I knew that it would resolve itself eventually. But yeah, I guess I mean, especially if it's your first pregnancy, it can be really stressful, and especially if you've not had any prenatal support to understand how your body is going to change and what that might mean for the postnatal period.

Rosie: And there's none of that. There's not really... Unless you do maybe a class, but I don't think any antenatal education really talks about our job and what we can bring. I don't think your body's really talked about in any way of how a pregnancy will change your body and what scope of difference might you have after a pregnancy. And that's where the issues are, and that's why I wish there was more proactivity in it, because if women knew more before it happened, we could be like, oh, this is okay. This might change in a few months. I can control these parts. I can't control these parts, or I can go here, or I can go there for support. I think at a time that our mental health is really highly anxious, we're an extremely big group to market to as well. So people market products to us because we're vulnerable and because they know the waiting times are so big and because the gender health gap is so large. Businesses like those margins because it means then their customer is looking for a solution quite quickly. And that's where I also get quite angry because sometimes their solution, their problem that they have in their mind isn't actually anything to worry about.

Caroline: Yeah, gosh, you've made a really good point there about that vulnerability around when we go through these big life changes, and you can see it happening as well with all the menopause stuff as well and how that's... I mean, to be fair, actually, it's good that the issue has been raised, and now everyone's talking about it a bit more, and helping to put pressure on the systems that need to help us to better understand women's bodies from a medical side. Then we have the commercial side where they are, you can see that marketing is starting to prey on that.

Rosie: Oh, yeah.

Caroline: The amount of... What is it I see all the time on my feed, it's like, oh, have you got a menopause belly? That's what you see, isn't it? And then it's like, here's this… I'm in my forties now.

Rosie: It’s all coming up.

Caroline: This is what I see on my feed. And yeah, it's like, oh, here's this magic solution that's going to get rid of your menopause belly. And I'm like,.

Rosie: This is normal. This is like, okay. It doesn't have to change. Yeah, I did a course update. There's an amazing lady that lives in Australia that works as non-clinical now. She takes all the research from the whole of the year. Maybe actually the past two years, and then she does an educational course with all of us, not all of us, but those who pay for her to do that. So it means that my research up to date is very, very good. So I get a yearly update in all the research, what's coming through, what do we past think, what do we think now, what are we seeing, what do we still not know about, just so I can really, really keep my skills and my clinic as best as it possibly can for the person that I'm treating. I'm very passionate people are paying money for a service, it needs to be really good. That's one thing that I'm really headstrong about.

Anyway, it was this slide that she put up. It was talking about a female's body of how we go from a baby right the way up until we're 100. Roughly speaking, right? 105, I'll say, 105. It shows how our bodies adapt through life for certain age-related changes. When we're babies, we go to toddlers. When we're toddlers, we get this transition of hormone changes. And then soon we, by our early teenage years, we then come into puberty. Puberty changes our body. And then we move into this teenage years and into young adolescence where our body is still adapting and we're learning about how our bodies are different. And then comes the pregnancy and then comes this postnatal transition, and then comes this perimenopause transition. And then comes the post menopause transition, and then comes 30, 35, 40 years post-menopause bodies. And as females, it's weird. A lot of us don't question the puberty transition. Like, oh, this just It happens. We have breasts, our hips get a bit wider. We go body hair, our periods arrive. Even some of us don't question that quite a lot if you play sport. And then you get into postnatal and you're like, what does this mean? I've got a prolapse or my boobs have changed or my skin's changing or my tummy looks really squidgy and round and we really quickly want to change our bodies at postnatal. And what I'm trying to encourage patients to understand and almost have some acceptance over is our bodies are made to change. They're made to adapt and change with our life and where we are at certain stages. And some of that shouldn't be scary. And I think as females, in particular, we have a hard concept of body changing. And that's also part of the reason probably why I'm quite passionate in working in pelvic health for my own struggles with body image and things like that growing up. I think that really... I've spent so much time with females in clinic now that I have absolutely no issues with myself now because I hear what females say about themselves on a daily basis. And it's almost crazy that people even have those thoughts. I'm really trying to educate on normal change. And if you look how you did prior to pregnancy, postnatally, that's usually genetics. That's usually nothing that you're doing exercise-wise or these core rehab things, or that's just plainly genetics.

Caroline: Yeah. So there's actually not as much... You can't influence it as much as you might think. It's just that the body is naturally going to go at the pace that it needs to go to get to recovery.

Rosie: Absolutely. Yeah.

Caroline: Yeah. Gosh, it's so interesting because I feel like your job, you've got this unique opportunity to not just support on the health side, but also more holistically with that mental health side as well. So I just think it's so interesting the way you've described that and how you help women on that journey because we don't get the education that we need when we're younger. Like, literally, you spend so much time in school learning about how our bodies are going to change. And then if you fall pregnant, usually you'll get some support with an antenatal group or something like that, or you'll at least have some support from a midwife who's obviously a specialist. And then it comes to this later stage and you don't get anything. You get the pamphlet or you get told to do pelvic floor exercises. And that, from what you have just said, is the tiniest piece of this puzzle.

Rosie: Yeah. And we have to understand the pelvic floor. It's a really important muscle, I'm not going to lie, but I think we misunderstand why it's important. I think for a lot of us, we don't get taught where it is, we don't get taught how to exercise it, we don't understand if our muscles are a little bit tight in comparison to too weak. I don't think we'll ever have a total list for someone to self-diagnose. I always think coming to see a pelvic floor physio, we can really assess you and really get to understand what your risk factors are or of your tissues by assessing you. But I think the research and evidence really comes and says that being taught pelvic floor exercises should happen from a one-to-one physiotherapy and patient treatment. And what we're not matching up with that is we're giving people leaflets. We're giving people... Even reading that, like does someone understand where their pelvic floor is? Do they understand that there's three holes in that area? Do they understand where those three holes are? What they actually do? Because some patients of mine in the NHS didn't actually know that that was even their structure or how they were made. Do we actually understand what difference is between the vulval area and the vagina? No, a lot of us don't. A lot of us just call it our vagina and that's actually the wrong terminology.

Caroline: Yeah, the whole thing is just…

Rosie: Yeah, because females should know exactly where they're sore or be able to locate and talk to a healthcare professional and be able to actually say the words of her anatomy so she can get the best care and treatment.

Whereas a lot of us don't understand. We just see this general area, which does make my job a bit of an investigatory sometimes. But yeah, I think for a lot of us, that baseline education is not there. And then when we go through a pregnancy, it's a lot to do with the baby. The baby's feeding, the baby's burping, the baby's changing nappy, the baby's sleeping schedule, the baby's growth markers, the baby's development, the baby is sitting up now, now they're crawling. And that's lovely. But babies don't thrive unless the mother’s thriving. And we do know from the point of view of postnatal depression, a lot of that can happen through birth trauma, a lot of that can happen through their body's changing, a lot of not exercising because they can't, because their body is not doing things.

Caroline: Yeah, because you're tired as well.

Rosie: Yeah, absolutely. And understanding how exercise can differentiate between different levels of your life as well. Because a lot of us need to exercise for aesthetics, I think, being younger. My role was always team sports. I was really, really lucky. But a lot of females see exercise as aesthetics. My friends would say, oh, I've got the wedding soon. Yeah, I've been running loads. I've been walking loads. I've been going to the gym.

Caroline: Yeah, I've got a deadline.

Rosie: Yeah, and I'm like, that should be It's a regular thing. Anyway, and then we go through this perimenopause, and no one even talks to us. And that's the most stressful time of our lives, isn't it? Because we'll have elderly parents, we'll have maybe teenage children that are going to their own hormonal changes.

Caroline: Joy, Joy.

Rosie: I mentioned that really lightly. Maybe our careers have got to a stage where we're balancing a lot. Maybe we employ staff, maybe we're quite high up, maybe we're in the corporate area, so we're taking on more responsibility at work. And then no one ever assesses anything to do with our minds, our ability to cope with all of that, when our hormones are starting to decline at a rate which are not supporting our life, which then causes problems of stress, anxiety, leaving jobs, being unable to cope with the work demand, bladder's causing havoc, being unable to have a sexual relationship with your partner. And then feeling like you're failing in some way and going mental, like you just said, when actually a lot of it could be helped by just having someone sit there and talk you through all these things and ask you all these things. I've had so many people... One lady, she was 35 going into early perimenopause, and she'd left her job as a head teacher. So she was a mum of a five-year-old. She was leaving her job as a head teacher. Her sex life was changing. She couldn't run anymore. Her bladder was causing her to need to pee all the time. So she stopped running because again, she thought that was a bad… from pregnancy and hearing about pelvic floor, she knew some understand that that is normal. So she stopped running. And then she wasn't coping because the exercise wasn't there. Her relationship was changing because she couldn't have intercourse. Well, that was important for her and her husband. And then her job was really stressful. So she left a job in which she'd worked really hard to get to that position and probably was the right person for it. But left. And not one person over that journey of signing her off work, of giving her antidepressants, not one person asked her about her hormones.

Caroline: Yeah, or tried to find the root cause.

Rosie: Just gave her antidepressants and said, yes, stress.

Caroline: I bet that happens to a lot of women.

Rosie: Women get told they're stressed a lot. You know. You're really stressed.

Caroline: Just take a day off.

Rosie: Go for a spa. I think as women, we're actually really resilient and we can multifunction in high stress environments. It's what we see with businesses running on female grounds. We see a lot of profit and a lot of success of businesses under females. I question if a lot of it is stress. I think a lot of it is not being heard.

Caroline: Gosh, yeah, that is absolutely 100 %, yeah.

Rosie: I think what makes probably my clinic quite special is probably the fact that I treat patients very holistically. I want to know all about their life. I want to know about their partners. I want to know about their children, I want to know about their house, where they live, what their work's life, what their work-life balance is like, what their relatives are like, their family support's like. I want to know about everything about their whole environment, because that really influences how I treat that person. Physio should be supportive, it shouldn't be demanding, and it shouldn't be that I'm the ruler over your body. I should facilitate your own change to happen. Sometimes it's getting to understand and listen. A lot of physios don't actually listen to people. Medical professionals are not very good at listening. Usually patients know what's wrong with them. Like for your example.

Caroline: I kept going back and I'm like, This is not the problem. Do some other tests.

Rosie: I am the living experience I'm feeling this in my body. No, just go away and do this. That's not listening to someone. Actually, a lot of my patients do tell me their own rehab or what they have to do when I talk to them, they already know. It's just sometimes a bit of encouragement, a bit of a holding hand of how to add that into their life, a bit of a stepping guide of what to do first. They can choose maybe what to do first. Is it drinking more water? Is it taking five minutes out of your day sitting down to move your standing desk up? Is it to get off of your chair and just do 10 squats? Is it to have a commute where you're walking to work a little bit rather than constantly driving or taking the train? Is it that you have to begin to exercise again, then load your body and add some resistance? How does that look for you? So my clinic tries to aim to support women at any point they're in of their life, not when it's the right type. Because I don't think that's never been the right time. We're always going to have things that make us busy or that are more important than us. And that's the problem I have because as we get older, our pelvic health starts to get a little bit harder to treat. We can still access the care and we can still get better. But if we're past the age of 60, 70s, we're lacking in vaginal oestrogen for the last 15 years and we've not exercised because we got told that leaking with exercise is really dangerous, we've got a prolapse and we should not lift weights. When I'm meeting you in your 60s and you're not on oestrogen yet, you aren't taking any vaginal oestrogen and there's a lot of deconditioning, it is going to be a hard journey to build that bridge, build you back up again you know. I like women to get in early. I like women to get a checkup as soon as they possibly can, in their 40s or 30s if that's the right time for them. And then they have those skillsets and the knowledge to take them into their '60s and '70s.

Caroline: Gosh, wouldn’t it be amazing if we all got checkups?

Rosie: Oh, it'd be so nice, honestly. It is right now, it's a big privilege to be able to come in to see a physio privately, I understand that. It's quite an expensive physio appointment as well because a lot of us are really highly skilled. I'm not saying MSK physios aren't, but there's a lot of things we have to know about that makes us almost like a combined physio of everything. And then we… Sometimes, though, what I like is if someone can afford one appointment I like to try and give them little nuggets away to try and think about, okay, in six months time, if you add this in, and then in a year's time, aim for this. If you carry these things on, you'll come off and on, depending on what life is throwing at you, but you need to get back on track again. And then by the time they're 60, they're actually healthier as a person.

Caroline: Yeah. And you've got that resilience as well. Yeah. It's just armed with that little bit of knowledge and reassurance.

Rosie: Yeah, absolutely. I think it's a really special place to work. I think I'm really lucky. And I think the only thing that frustrates me as there isn't enough of us. It's not a, shall we say, I don't know, can we call it a sexy place to work? You know professional sport I think still eats the biscuit slightly, but I think it's coming, it's coming a hot topic. I think young physios now are reaching out to me and they'll be like, how did you get into pelvic health? What's your background? How did you get trained in this area? People are more interested in it, but I want to make sure physios are interested for the right reasons and not interested because it's a lucrative place to work sometimes because there isn't a lot of us and the waiting lists are very long and large. It's also a very, very heavy place to work, sometimes emotionally as well. And you need to be aware of all the things that you'll face in that career to make sure it's the right career choice for you.

Caroline: Yeah, because the people that you're supporting, they could have been through different traumas and things that have impacted them. And they'll maybe be opening up to you for the first time. They'll be opening up, and that can be a lot to take on.

Rosie: You realise how much negligence there is sometimes in the care system, slightly… how much it's not proactive and how much it is reactive. And with maternity reports coming out these days, then it's a shining a light on some of the trauma, the post-birth trauma, PTSD diagnosis, postnatal depression rates that I'll see in clinic, which is really so sad. And I think people have to be very aware that you are sometimes a huge anchor for patients. For example, me and my husband went to the gym this morning and I had two individual patients calling my name across the gym and running over to speak to me. You become one of their really good friends because they've given you some of their darkest secrets or their most intimate problems, and you've treated them and made them feel so at ease and so comfortable that sometimes you can, as health care professionals working in the space, and there being long gynaecology waiting lists, you can get quite a lot of people contacting you and desperate to get in to clinic. I find that really challenging.

Caroline: Yeah, I can imagine.

Rosie: Yeah, I find it really hard to be like, I'm full until January. I'm sorry. I just, yeah, I struggle so much with that. But that's something that I've had to get used to being the receptionist. Whereas before in the NHS, I would just get my list. I wouldn't have to talk to anyone on the phone. I wouldn't have to respond to anyone being upset or crying down the phone at you. I wouldn't have to… so it just shows you the lack of support there is, really.

Caroline: Yeah. Oh I'm so glad that you have gone on this path because it sounds like it's definitely needed. One thing that we talked about before was your, I guess, your ambitions for the future and how you might be able to scale this and grow what you do so that you can help more people. So I don't know if you can share any plans or little seeds of what you're working on.

Rosie: Yeah.My brain is constantly dancing, ha-ha with ideas. So I think, I actually say now that I own a business now, and that's taken me a long time to say that. And this year has been quite a journey of trying to scale something for different reasons. One, because I do get a lot of patient flow through my website, and there's only me. So I tried this year to employ other physios. I tried to build a clinic in different areas of Scotland, so one being Glasgow and one being Ayr. And then I began to do pop-up clinics around Scotland, in Campbelltown and Islay, which I absolutely loved. But then my husband…

Caroline: Yeah, so more of the rural area.

Rosie: My husband likes to remind me that I only have one body and one mind and one space for so many people. I like to try and treat everyone. So where does my passions lie? My passion lies in having access to evidence-based care, from be able to bring me into some virtual capacity. Next year, I'm launching small modules. I think I'm going to call it Pelvic Health with Rosie. That isn't the boundaries just now, but it's on teachable platform. So people can find it on my website as well. But the first care package, I'll be looking into are C-sections. So how do we prepare for elective C-section surgery? How do we recover from having a C-section? And what does that scar mean for our body? And how do we regain strength in those areas post-C-section? So that'll be the first launch. And then I'll be looking at adding different little courses on so people can have access to Pelvic Health Physio from me anywhere, especially in Scotland. I'd love to help more mums that can't access anyone and probably even physio because they stay too rural. Or pelvic floor physio, they're like, what is that? I've never heard of that in my life. My GP has never mentioned that, and that's probably because they don't have a pelvic floor physio locally. So that's what I'm working on just now is building some online presence where I don't think it will replace me in person, and it shouldn't do that, but it will give someone enough information that she can start to abolish worries, make a plan, and be able to actually work out exactly what's driving some of her symptoms. Is it dehydration? Is it her bowels that are causing an issue to heaviness or pressure? How do you actually poo properly? All these hot topics that no one talks about. How do our hormones impact our vaginal health that causes pain with sex? Why is it that we're more at risk of UTIs as we get older? So all of these things are areas that I want to be able for people to access, financially cost-effective, easy to listen to. It's not overwhelming, it's small bite-size information videos. You can come back to it whenever you want. You can listen in your headphones like a podcast. So the online platform will have options for all women to be able to learn. And then from there, what I hope that will give people is empowerment. Empowerment to go to their GP and be like, I started doing this, this and this. This has improved. This is still there. I know what that is. It's hurting here. I want to go and see a pelvic floor physio. Or it gives people the education of being like, pelvic floor physio, it's quite a cool place to go. There are not going to be people that tell me to stop exercising or stop doing what I love. There are people that support me and facilitate me, and I want to go and see one privately. Or it might encourage people to book online with me, and then I can see them virtually, and I can see them in my virtual clinic, basically. But I do have some ladies who travel from Manchester up to Glasgow to see me, and Skye.

Caroline: Wow.

Rosie: Skye and Manchester are probably my furthest travelled. I've seen two ladies in Amsterdam virtually as well. So I think access to pelvic health can be virtual and in person. So yeah, just growing that part of the business. I think for me is the next step because definitely not being a manager, not having staff, and not having loads of premises is definitely better for me, I've worked out this year.

Caroline: You've been through quite a year, haven't you? Yeah, it's been expanding and contracting and learning all those lessons.

Rosie: And getting tugged and trying to sense which way to get tugged when actually it's so hard because you just want to help people. I mean, that's not happening because you're getting distracted by other things or maybe the help is not the thing that you would have liked to have happened. It gets really difficult. I think for me, that involves around me being my own clinician, running my own business, and then me trying to educate outside of that as much as possible. That's what 2025 brings.

Caroline: Nice. I feel like in terms of scalability and being able to help as many people as possible an online platform and using something that's readily available, like a Teachable type platform is a really smart way to go. I cannot wait to see all of the content because we need Rosie in our lives.

Rosie: Hopefully. Hopefully people all feel the same, Caroline. It's a strange concept making yourself accessible everywhere on people's screens. It's so funny. But again, as we were talking about earlier, it's that imposter syndrome that a lot of us have. We're running businesses and when we want to do a good job, it's like new mums that say to me, we panic over certain things, so they worry quite a lot about being a good mum. And I say to them, well, you wouldn't be a good mum if you weren't worrying.

Caroline: Yeah, exactly.

Rosie: So it's like imposter syndrome. It's like you worry that you aren't doing the best job, but actually what you are providing is what people need.

Caroline: Yeah, absolutely. I think anybody would be lucky to have you supporting and guiding them. So thank you so much. Gosh, the time just disappears on these interviews sometimes. It's just so lovely to have you. So before I let you away, there's a couple of things that I always like to ask my guests. So when it comes to the Rosie behind the scenes, what are the things that you gravitate to? When you're feeling out of balance or maybe a little bit stressed, how do you create your kind space?

Rosie: I think this year it's been a massive learning curve of facilitating my own kind space. I think the gym is a massive one for me, movement. Sometimes what I like to do, because the gym can't... An hour's gym session can always happen, every day, depending on how work's been or how demanding certain clinical lists are. So what I have done, rather than give myself a hard time over that, I'll literally just get off my chair and I'll do a ritual of downward dogs, some body weight squats, lots of thoracic rotations, and then I’m like, I've moved. So rather than saying exercise now, I've replaced the word exercise with movement. I'm like, what movement have done today? And has that felt the right movement for me? So that's a big one. My other one, which is so funny, I wouldn't have said this when he was a puppy, but is our rescue dog, Benji. I can totally see how people say therapy dogs.

Caroline: Oh, yeah.

Rosie: It's like, he smells amazing. He's got the most amazing manner. He absolutely loves me and my husband. And yeah, he's definitely a big part of that, I think. And the other part is probably my cheer lead group, I suppose. My husband, my friends, family, surrounding myself with people. I tend to go to Ayr sometimes if I want to get out of Glasgow, just to the beach, the space, fresh air, an ice glass of wine occasionally. I don't know if I should be promoting that for my mental health. Ha-ha.

Caroline: I think that's okay.

Rosie: But yeah, those are the things I like to do. I think this year it did get to the stage where I was struggling to fit those things in because of how much I had on my plate. So I've seen what life's like without fitting our own oil in. And then soon that oil begins to burn out. So I think that's a really important aspect moving into 2025 that I'm really going to focus on. And sometimes it's just breathing, just sitting there and just taking these massive big breaths and like phew, sighing everything out.

Caroline: Instead of the feeling like, go, go, go all the time. I have to get all these things ticked off my to do list?

Rosie: Go slow. I'm slowing right down. I had the whole world in my ears at the start of this year. I was going to grow, I was going to get bigger, I was going to treat… help, so I went more more women. But actually, I could always do what I can do, and I need to slow down. So I'm there to support more women to come because it got to the stage this year that I almost stopped the business. I was like, this isn't healthy for me. I can't sustain this. And I think 2025 is going to be about going at my own pace and just not having any date set or until I'm happy, I'm happy with that product and then I'll launch it. I'm not going to be having these big big flags waiting for me to cross finish line at certain times because things happen in life and you can't control when sometimes stress hits you and you have to have the capacity to deal with unwanted things that happen throughout the year. So yeah. That’s a big kindspace.

Caroline: That's a really good perspective to have. And I feel like you've got a really nice blend of things that you can… you know tools in your toolbox that you can call upon when you need that support. So that is so good.

Rosie: Absolutely. Absolutely. Thanks so much for having me, Caroline. I feel as if we've just had a conversation over a cup of coffee rather than anything.

Caroline: That's exactly the vibe that we're going for. So that's good. And the very last couple of questions is if people are wanting to find you online and connect with you and find out more about their pelvic health, where should they look?

Rosie: Yeah, so at the moment I've got three areas which probably doesn't help people, but I've got Instagram, if those that use it, it's just Rosie Davie Physiotherapy. If you just type that in, it will come up really easily to find me. And the other thing is the website, which is rosie davie physiotherapy dot com. So it's just my name plus the physiotherapy word. And then the Teachables is on the website. So my online... So far I've got pregnancy education on there and postnatal rehab on there and a bunch of movement, almost like strength pilates, movement videos for women to access any time to keep themselves moving and exercising. And there's some pelvic health education in all of them, obviously. Yeah, those are the three main ones that I've got, but the website probably has everything from there as well. And if anyone... I'm happy to... If anyone wants to email and things like that, I am good at getting back to people through a couple of weeks time. And if looking for pelvic floor physio is closer to them, I am quite good at recommending people because we've got a big POGP chat on my phone where all our pelvic floor physios gather. So I can ask for recommendations if anyone else is looking for a bit further afield. But obviously, I love to treat as many people as I possibly can on my own weird way of treating this very holistic way. So yeah, but that's where most people will find me.

Caroline: Yeah, so we'll pop the links into the show notes as well, so everyone's got it. Thank you so much for being such a beautiful guest. I hope we'll catch up again soon.

Rosie: Yes, thank you so much. Thanks for having me.

Caroline: I am sure I am not the only one after this discussion feeling empowered that our pelvic symptoms are not just something that we have to put up with as women. Yes, our bodies go through significant changes through pregnancy, motherhood and beyond in the transition to menopause, and these changes they are natural, but there are proactive and holistic approaches that can help us to improve how we feel and also allow us to still do the things we love. I think the call to action here is to prioritise our pelvic health and if we’re not getting the answers we need, seek out specialist support from someone like Rosie.

Thank you so much for listening all the way to the end, before you go, I have a little favour to ask, so if you’ve liked this episode, please screenshot it, tag us on social media @createyourkindspace and maybe share what your key takeaway was from the episode. It would also be so wonderful if you could rate and review this podcast as it helps other people to find it. Thank you so much.

Disclaimer:

The information on this podcast is not intended to be a substitute for professional medical advice, diagnosis or treatment. You should seek the advice of an appropriately qualified healthcare professional before making decisions about your own circumstances. You should not disregard, or delay seeking professional medical advice because of any information contained on this podcast.

Unless specifically mentioned on the podcast, Create Your Kindspace and Caroline Laurenson do not formally endorse or have any affiliation with any product or service mentioned in the podcast. The opinions and content provided and/or shared by any third-party guests, any third-party material or third-party website referenced in this podcast does not necessarily reflect the opinions or policies of Create Your Kindspace and Caroline Laurenson.