FMBGN-HW-ReNew Yu-Pelvic Floor Basics That Actually Help

Leaking when you sneeze. A sudden urge that makes you sprint for the bathroom the moment you pull into the driveway. Constipation that won’t quit. Pelvic pain that’s hard to explain and even harder to bring up. We’re getting practical and specific about pelvic floor dysfunction, because “just deal with it” is not a plan and it’s not the standard you deserve.

I’m joined by Dr. Greet Baestaens, a pelvic floor rehab specialist, to unpack what the pelvic floor actually is, what it’s supposed to do, and why so many people get stuck doing endless Kegels with zero results. We break down the two big urinary patterns, stress incontinence and urgency incontinence, then connect the dots to overactive bladder habits that can shrink bladder capacity over time. We also talk about nocturia (waking up at night to pee) and why the cause might be bladder irritation, hydration choices, or even fluid shifting from swollen ankles and legs.

From there, we go where most conversations never do: constipation and straining, pelvic floor tightness and spasm, and why pain can show up in the pelvis, hips, or low back. Dr. Baestaens explains what evidence-based pelvic floor therapy looks like, including symptom journals, muscle testing, biofeedback, ultrasound imaging, and retraining the coordination between the bladder and pelvic floor. If you’re active in the Southwest Florida heat, you’ll also love the simple hydration checkpoint you can use today.

If this helped, subscribe, share it with a friend who needs real options, and leave a review so more people can find pelvic floor rehab resources and stop suffering in silence.

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Dr. Greet Baestaens
801 Tamiami Trl E, Naples, FL 34112
 (239) 682-1306
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Transcript

Welcome To Health And Wellness

Intro/Close 0:00

Welcome to the Fort Myers Beach Good Neighbor Podcast Health and Wellness Series, brought to you by Renew Yu, Natural Health and Beauty, where we make wellness feel possible and turn everyday choices into stronger living. Each episode brings you uplifting conversations, local resources, and practical tips to help you look better, feel stronger, be emotionally balanced, and more connected to the community around you. So take a breath and settle in, because feeling better starts right where you are.

"Cabo" Jim 0:30

Welcome, good neighbors to our health and wellness series. Today we're talking about a part of the body that does a ton of work but almost gets zero conversation, the pelvic floor. If you dealt with leaking or when you laugh or sneeze or urgency that has you mapping bathrooms like you're trying to find a treasure, constipation, pressure, pelvic pain, this episode is for you. Pelvic floor issues are common, but they're not something you have to shrug off as just aging or just having kids. Today I'm joined by Dr. Greet, a specialist in pelvic floor rehab. And we're cutting through the awkwardness to get right to actually what's helpful and what's not. So you can start doing that today. Thank you for joining us, Dr. Greet.

Dr. Greet Baestaens 1:12

Thank you so much, Jim.

"Cabo" Jim 1:14

Yeah. So for somebody who's thinking, you know, pelvic floor, is it just Kegels? It's it's not, but what is the pelvic floor and what job does it do?

Dr. Greet Baestaens 1:26

Well, um, these are two different questions and good questions. So, pelvic floor, what does it do? It really supports our organs that are laying on top of it. For example, our intestines, our uh uterus, uh, you know, our bladder. So it helps to support actually, that's the first function to support our organs, you know, uh inside. And then the second question is Kegels, and I treated thousands of uh patients in my career over 43 years, and uh every time when they would come in and see me, they would say, I did kegels and it's not working. So the reason for that set was Kegels work if you do it in the right way, and that's why the patients would come to me because I would teach them uh to do the Kegels in the right way. Um what is the right way? So, what I would do is explain what the pelvic floor is, I would show them how many muscles we have there, and then uh depending on the testing, how weak or how strong, or sometimes they are in spasm, we would or I would give them a personalized exercise program, kegels, or relaxation, if they would have pain situations in some time, because uh if clients would do kegels, they would say, I do 100 kegels a day and it's not doing anything. Well, if your muscle is so weak, you cannot do maybe one kegel. So it really didn't matter that you do that you did the hundred kegels. Yep, uh, the principle of the muscles at the level of the pelvic floor is the same principle as any other muscle on our body. So they need to be trained in the right way.

Leaks And Urgency Explained

"Cabo" Jim 3:26

Interesting. So thank you for explaining that. So let's talk about what people normalize that maybe they shouldn't. What are the symptoms? What symptoms I guess are common but not normal. If people think, oh, it's just aging, I it was childbirth, blame it on something else.

Dr. Greet Baestaens 3:42

So, yeah, but they most of the time what we see in pelvic floor is uh when they cough and sneeze, they have like a little uh urine coming out, and we call that stress incontinence. And then the other, then you have another category that I would say, you know, they go to the store, they're driving home, and once they click the garage door to open, it's like they have to rush to the bathroom, and that's urgency, or they come home, put the key the key in the door to open the door, and it's then that urgency sets up immediately. So those are two different uh categories that we uh treat, but a lot of people have a combination of both, and so stress and urgency. So that's you know, so it can be stress separate, it can be urgency separate, but a lot of people have actually a combination of both.

"Cabo" Jim 4:43

Very good. So let's break this into big buckets so people can actually, you know, kind of understand and make a comment to what they're actually living with. So, bucket number one, for example, a bladder. Let's start with the urinary symptoms. You know, what's behind the leaking, the urgency, you know, waking up multiple times a night, like so many people do.

Dr. Greet Baestaens 5:03

Well, what is really uh like when you talk about urgency, it's an overactive bladder. It can have different causes, uh, you know, and that's what we try to explain then. Urgency. What I do when they come in, they fill out like a daily journal. So they put in, for example, how many times they go to the bathroom that day and night, like on a 24 or 48 hour uh span. And then I can see you or they're getting up at night, how many times they're going to the bathroom. So, for example, I had patients that go to the bathroom uh 20, 30 times a day, and every hour during the night. So that is not a normal pattern. So the treatment itself is like we have to find out what the cause is of the overactive bladder that is giving them that urgency. And it can be different reasons. It can be what they're drinking, what they're eating. Uh, the pattern that we see if somebody goes more than 20 times to the bathroom, they know every bathroom in town or on their trip where they're so they keep on going every time when they feel that urgency, and now the bladder that is actually normally a normal size of bladder is also going to adjust to the situation, and the bladder becomes smaller. So it's that vicious circle that it's like the more we go to the bladder, the bladder is never full. They go with the first urgency, so the bladder will adjust. So that is uh typical urgency. Now, getting up at night, uh, depending for urgency, how much they also drink and what they drink or what they eat, spicy food, they have to get up. But it can also be a different reason getting up at night. They might have some swelling, uh, and they will get up because the now they lay down horizontally, so the fluid will get better absorbed, you know, and so it goes more to their kidneys, and then they have to go to the bathroom because of that. So it might not be a typical urgency, it might be because they have swelling in their legs or swelling in their ankles. So that could be another reason of getting up. So, what we need to do with any patient that comes in for pelvic floor issues in general, is I have to just listen what they tell me, what their symptoms are. Uh, and a lot of patients think what I have is is kind of normal because they are told by their physician when they say, you know, I'm going so much to the bathroom, the physician will say, That's normal part of aging, just deal with it, put you know, a pad in your underwear. And and so it makes me actually it upsets me when I hear that because I always, if somebody tells me that, I said, Well, maybe you know, your physician should wear a diaper for a day and not be able to go to the bathroom. And that's you know, compares a little bit of feeling what you have. And and you know, it's it's so wrong to say that that there is nothing we can do about these issues, what's actually quite easy to heal. Urgency can also come from constipation, you know, if everything is in packed there and it's pushing to your bladder, your bladder will be irritated. And so there is different uh causes that can uh create urge incontinency. And so the first time I really spend a lot of time talking about their history, what they're doing, what they're eating. And most of the time they are not drinking enough when they have a pelvic floor issue. They drink less and less, and so again, now the urine is very concentrated and can create urgency again. So it's it's complex, but it's pretty easy to treat.

"Cabo" Jim 9:04

So speaking along that, you talked about constipation and the straining effect it has on the pelvic floor. What's the biggest mistake people make trying to fix that situation?

Dr. Greet Baestaens 9:14

Well, this they start uh, you know, uh go to over-the-counter products and they try to take that, and and nothing is helping. Uh constipation, you know, can have different uh causes also. It can be number one, sometimes because the pelvic floor is too tight. The pelvic floor can be in spasms, so they cannot relax to have that bowel movement. And then, you know, the the stuff is sitting in your bowels forever, and now your body becomes toxic. So it's I have people that come in and they say, I didn't go to the bathroom or have the bowel movement for more than a week. So that is a serious issue. So uh most of the time it's when they have uh you know constipation, they don't drink enough. Um, sometimes you have to create actually a habit when to go to the bathroom, and most of the time we work on pelvic floor relaxation when that is the issue, because you have to relax your pelvic floor to be able to get a stool out. So, but that is a big issue, you know, for pelvic pain, urgency, um, you know, uh intercourse, uh, and and so on. So it's it's a complex thing, but again, easy to treat.

"Cabo" Jim 10:40

So now we get to the part that uh bucket number three that confuses a lot of people the pain intention, pelvic pain, hip, back pain, painless sex. How can dysfunction be too tight instead of too weak?

Dr. Greet Baestaens 10:53

Well, there you know, it can be most of the time when I see there is actually too tight of a pelvic floor, they might have uh a bad experience, maybe with the first intercourse, so it was painful. Now the muscles are reacting or trying to protect that area. Um, otherwise, as I say, you know, it can be a compact stool that's sitting there, so it kind of uh makes it, you know, it's it's painful because there is just a lot sitting there. And related to the back, all these muscles are connected, so they can uh have back pain and pelvic floor pain because of you know tightness of the pelvic floor. So, but most of the time I see a lot of uh or I saw a lot of uh athletes, for example, they pull in their pelvic floor when they lift, so they know that they have to do that, but they created an uh a spasm in in the pelvic floor. The muscles are now always too tight, and when the muscle is always too tight and they need to work at a certain time, they're not gonna work because they are so tired already. So there is a big, you know, and in any muscle, you need to be able to contract very well and you need to be able to relax very well, and when that is in balance or synergy, that's when you don't have an issue. Now, stress incontinency, most of the time we see that with people that are younger. And in Europe, if somebody's pregnant, we do already pelvic fluor reab before they would deliver a child as a precaution or prevention, and then we continue treating them afterwards because, of course, the pelvic floor is stretched out, so we want to get it back in the normal form. Um, but uh what we see with stress incontinency is you have the pelvic floor and on top of it the bladder, and actually, when the pelvic floor is weak, it's just gonna like a hammock, it's gonna hang a little bit more down, so the support is gone, and then when they sneeze and cough, the bladder is gonna bounce around and there is no support at that point. So, what we want to do is treat the muscles, get them shorter again so that hammock tightens up again and supports actually that bladder so that the bladder cannot bounce around and you have a little gush coming out when you sneeze and cough.

Kegels Done Right

"Cabo" Jim 13:29

Interesting. So, which takes us to the question everybody asks, and we touched on it previously a little bit. Kegels, good versus bad. Are kegels always the answer? When do they help? When can they make things worse?

Evidence Based Pelvic Floor Rehab

Dr. Greet Baestaens 13:41

Uh, well, kegels are very helpful. I never use the word kegels. I call actually the exercises we give, you can call them kegels. I don't call it kegels. It's a workout for your pelvic floor, like you work out any other muscles in the gym. That pelvic floor needs to be uh worked out too. So you have better blood circulation, better blood circulation, more nutrition, more oxygen, better tissue. So that will avoid any problem. Uh, if people want to call it kegels, that's fine. Kegels then are good, but they have to be done in the right way. And if your muscles are very weak, in the beginning, we will do the kegels just more like a gentle contraction of the pelvic floor to create more awareness. Some people cannot even do one kegel, they don't know what a kegel is, what a contraction is, they have no awareness. So we need to connect the muscle brain again to really feel, and we use a lot of biofeedback with that that they can see on the screen when they uh do a contraction, that uh you know, you have to build it up slowly. It's like you do weight training, you have to start with low weights and then build up. You're not gonna start doing 100 repetitions with a weight either. So, why would you do a kegel so much? You have to really do the testing first, see what the muscle is able to do, and then build up little bit by little bit. And kegels have also there is a you know different muscle fibers in the pelvic floor as any other muscle. We have quick fibers, we have slow fibers, and then we have fibers that help you with endurance. So all these separate fibers need to be trained in a different way. So kegels help, yes, only when you do them right.

"Cabo" Jim 15:30

So let's talk about evidence-based rehab and what that actually looks like. What's the process in a pelvic four rehab plan that from basically from assessment to improvement?

Dr. Greet Baestaens 15:40

So we we like I said, we do a daily journal. You know, they come in, we have the daily journal, uh, we see how many leaks they have, how many pads they wear, uh, is it a small pad, is it a thicker path, how many a day they have to change it. So that is actually you know one thing we start with. Then sometimes we do manual muscle testing, and so testing the muscles, and if they you know have a grade one, two, three, or whatever, I grade them for their strength. That will be also one of the process process, the part of the process what we do. And then once uh we can actually see with the biofeedback, and there is numbers like microvolt, how what is your rest level when you contract how high you go, and the difference between that number or those numbers will give us a real strength that we can compare as they move on in the therapy. Now, that's one part is uh biofeedback that we can use, but we also use a lot of ultrasound. We can see literally, if we go to the pelvic floor, uh we can see the muscles moving up and down. So if they're hardly moving, we know that they're very weak, and we can take pictures and you know, so the ultrasound is also used in that uh effect as treatment. Also, the Ryu device is used. Remember the Ryu device we use for connections between nerve ends, our pathways to the brain, and the pathway back. As we age, that pathway degenerates. So the Ryu can actually regenerate that uh loop going to the brain, the central system, and the way back, what really is very important for urge incontinence. Also, sometimes there is an imbalance between the pelvic floor and the bladder. When, for example, we urinate, the bladder needs to contract, and the pelvic floor is relaxing or should be relaxed. Then when we are done, you know, normally, automatically our pelvic floor closes up and the bladder relaxes. That's the synergy between the two. That's all nerve-related. If that system is broken, we have to really work on that nerve part.

Hydration Tip For Active Days

"Cabo" Jim 18:03

So we live here in Southwest Florida. We've got pickleball, golf, launch, and we've got a lot of heat going on as well. What's one smart adjustment for active people that uh you know that can help stay hydrated for their bladder symptoms?

Dr. Greet Baestaens 18:19

Well, I think the general thing, what I say is, you know, normally they say drink eight glasses of water of eight ounces and so on. I always say, you know, look in the toilet and see that your urine is not totally clear, but like light yellow. So that is a sign of hydration that you are hydrated well. So it's not, I will not say you have to drink drink this or that, because then depending on how much you sweat and workout, still your urine needs to look clear. If it looks dark, you definitely need to drink more.

"Cabo" Jim 18:59

Because when it's dark, it's pulling out a lot of the nutrients and stuff inside, right?

Dr. Greet Baestaens 19:04

Yeah, and also it can create a really uh urgency in your bladder because it's going to irritate the bladder inside if it's dark, or it can create UTIs, or you know, it's it's it really needs to be a healthy fluid, yeah.

Finding Help And Free Consult

"Cabo" Jim 19:19

Light bulbs. So let's last thing. How do our listeners take the first step? If someone's embarrassed, unsure where to start, what's the first step and what message do you have or want them to remember?

Dr. Greet Baestaens 19:31

You know, and in general, it is you have to go to a practitioner that has the experience, that has tons of experience to know what they're doing. Because I see many, you know, uh physical therapy practices coming out. And if you don't have the experience, you really don't know what you're doing. I always say to my my patients, I saw it all. You can tell me anything and everything. And just having a good consultation with a good practitioner that knows what they're doing, and I think that's the same in wellness, that's the same in any field of the wellness field, medical field. You have to know that you talk to somebody that knows what they are doing and have a consultation. And if I can listen to them and listen to their issues, and I can help them with my experience, with my knowledge over the years, with my, you know, I always did uh continuing education. I was teaching women's health in Andrews University in Michigan. I traveled all over the United States to help set up practices, bo Carotan, uh, you know, in in uh Texas, all over, really, over the United States that I would go to teach them how to do it right. And then it's the experience as you go, because different different symptoms will come up and different, you know, everybody you need to to to treat really personal and see what the cause is. That's the key thing.

"Cabo" Jim 21:14

Everybody's a little bit different. So, speaking of good practitioners, how would listeners go about reaching out to you if they wanted to learn more, had some questions?

Dr. Greet Baestaens 21:22

Say that again, Jim?

"Cabo" Jim 21:24

So so how would listeners go about reaching out to you if they wanted to learn more or they had some questions?

Dr. Greet Baestaens 21:30

Well, they can just uh have a consultation with me, and that's why you know, again, we make it affordable for everybody because we do free consultations. And you know, if they're not a good candidate, because in in some cases, if they have severe prolapses and they need surgery, I would refer them to a surgeon. But if it's like, you know, just urgency, stress incontinency, pelvic pain, uh actually uh prostas. The dietis, so you know, paying around uh prostate, and I do a lot of that, or I did a lot of that also. Uh they can come male, female for a free consultation, and then we talk about the history, and then I give them options what to do, starting from there at Renew Yu in Naples, Florida.

"Cabo" Jim 22:22

Yep, and that information will be in the bio here. So, any last words for listeners today?

Dr. Greet Baestaens 22:28

How you know if you have a physician that says pelvic pain, leaking, urinary incontinency, uh constipation is part of aging, you need to get rid of that physician and go to another one that is up to date with what we can do these days.

"Cabo" Jim 22:44

Very good. Well, thank you again, Dr. Greet. It's been a pleasure speaking with you. And uh, we'll see you out there soon, okay? Okay, thank you, Jim.

Intro/Close 22:53

Thank you for spending this time with the Fort Myers Beach Good Neighbor Podcast, health and wellness series brought to you by Renew Yu, Natural Health and Beauty. If today's episode helped you, share it with a friend and check the show notes for local resources and next steps you can try this week. Until next time, be gentle with yourself, celebrate the small wins, and remember, better days are built one breath, one choice, and one good neighbor at a time. Also, to nominate your favorite health and wellness expert to be on the show. Go to fmbgoodneighbor.com, that's fmbgoodneighbor.com, or call 239 427 4100. Until next time, remember to cabo until you wabo and keep being a good neighbor.