TMI Talk with Dr. Mary

Episode 5 - Why Am I Leaking with Exercise?

For this episode, we have Dr. Jessica Warnecke, an orthopedic and Pelvic Floor Physical Therapist and the owner of Pace Physical Therapy. She works with active women with pelvic floor dysfunction.


I received a question from Cindy, a 50-year-old mom. She said she keeps trying to run but leaks every time she tries. She had her last child 15 years ago, but nothing has changed regarding leaking. She thought of getting surgery or having medications so she is asking us what else can be done to help her. 

Let’s talk about:  

00:35 – Introduction for the guest and what she does  

1:04 - A quick history of how Jess and I met and what we currently do 

2:02 - Introduction to the topic 

2:18 - Initial take on the topic 

2:57- How pelvic floor therapy is not talked about as much as it’s supposed to be talked about 

3:35 – Pelvic floor therapy associated immediately with postpartum

4:30 – Why pelvic floor therapy should be talked about more 

6:11- The difference between working with a pelvic floor therapist and having just an annual gynecology exam

6:50 – Pelvic floor therapists examine a lot, both internally and externally, to see the possible contributing factors concerning leaking 

7:47-  The pelvic floor muscles are just like any other muscle in the body

9:10 – Examining the full body of someone struggling with leaking and what are the exams physical therapists do

11:05- Breaking down the core muscles of the pelvic floor 

12:41 – Pelvic floor muscles need to lengthen and shorten, like any other muscle in the body

13:24 – Determining one’s responses to certain movements to be able to start retraining and building the foundation of the body 

14:03 – Breathing exercises can help people feel connected with their pelvic floor and help with deeper pelvic muscle functions 

18:18 – Why strengthening is not enough and needs to be accompanied by the right breathing techniques

20:53 – Type A people have more tensor pelvic floor 

22:09 – The focused type of breathing and the instant result you’ll get

22:47 – Importance of assessing someone’s stress system, response, and life activities when dealing with pelvic floor limitations 

23:55 – Stress management and correct breath work help in pelvic floor limitation and issues

24:54 – Chronic pelvic floor dysfunction associated with higher impact activity while pelvic floor dysfunction associated with stress or traumas can differ in the rehab recovery plan

25:25 – What you need to look into when looking for a care provider

34:50 – Leaking when breastfeeding, when you are in menopause, perimenopause, and prolapse, and what you can do to address the problem

36:29 – The importance of sleep 

37:49 – The importance of diet and eating good food

38:25 – What you can do for your pelvic floor muscle after undergoing vaginal birth

39:08 - Conclusion


If you want to know more about the work that Jessica does, check out her website.

If you have any other questions or topics you want to talk about, send me a message on Instagram. And if you loved this episode, please leave me a rating and a comment with your feedback. Please share this with your friends and loved ones, too!


I also have a free resource for you if you're struggling with bladder urgency: https://resilient-rx.com/bladderdiary/

I’ll see you in two weeks!