Pelvic Health with Heba Shaheed (EP#70)

Tahnee:   (00:01)

Hi everybody, and welcome to the SuperFeast podcast. Today, I am here with Heba Saheed, and she's a qualified women's health nutritionist and physiotherapist. Her expertise lies in pelvic and sexual pain, menstrual health, bladder and bowel health, pregnancy, postpartum and complex trauma. And a lot of that is as you guys know, a massive area of interest for us at SuperFeast. So I'm really excited to have her here today.

 

Tahnee:  (00:27)

She offers one-on-one pelvic health physiotherapy consultations in the Sydney Central Business District area. And this is for complex pain conditions like endometriosis, bladder pain symptoms, chronic constipation. I may not do these words justice, but I'm going to try, vaginismus and vulvodynia and painful sex, you can laugh at my pronunciation Heba. And she's also the founder of The Pelvic Expert where she blogs about pelvic health and provides online pelvic health programs and consultations which especially right now, given that everyone's in lockdown, is really useful for people.

 

Tahnee:  (01:01)

She has also got a really great Instagram account with is how I came across Heba. It's @thepelvicexpert but we'll put a link to that in the show notes as well. And she also has a really awesome website, so if you guys want to go check that out after this, I would highly recommend it. Thanks for joining us today, Heba. It's really nice to have you on the podcast, finally.

 

Heba Shaheed:  (01:19)

Thanks so much for having me. I know we've been going back and forth for a while now.

 

Tahnee:  (01:23)

I know.

 

Heba Shaheed:  (01:23)

But yeah, it's great and I really hope I'm able to provide some insight on this wonderful world of pelvic health. It's kind of a bit, it's almost sometimes hard to understand if you don't really get it.

 

Tahnee:  (01:41)

Yeah. In researching you and preparing for this podcast I listened to a view other interviews you did and I was, because I've got a bit of a background in anatomy too, and I think you made the point in one of them of how a lot of people when they imagine a pelvic floor they're thinking about a banana hammock shaped piece of tissue in the pelvic area that just contracts. And they don't really have much of a three dimensional concept or a visual of what the pelvic floor actually is and how it functions.

 

Tahnee:  (02:15)

Is that fair to say when you start seeing people, that you're educating them as well as obviously working with them?

 

Heba Shaheed:  (02:22)

Ah yeah, absolutely. Education is the first thing. Educating them firstly, part of that is anatomy and that it is a three-dimensional, multi muscle system. I think people picture the pelvic floor as just this one little muscle that goes from your pubic bone into your tailbone, but it's more complex than that. It's got a right side, it's got a left side. It's got muscles that go to your hips, muscles that go to your tailbone, muscles that go to your pubic bone, muscles around your vagina, muscles around your urethra, muscles around your anus.

 

Heba Shaheed:  (02:55)

It's a very complex system and they all have to interplay together. It's more than just muscles, it's connective tissue and fascia and nervous system and an immune system. There's just so much going on down there that we're almost oblivious to how important it is. There's organs there as well. Your pelvic organs, your bladder or your rectum, your uterus if you're a female.

 

Heba Shaheed:  (03:21)

A lot of that is just beginning with education about yes, anatomy, like your physiology. But then even more than that, it's education around simple things like habits. What's appropriate for emptying your bladder? How often should you be going? What position should you be emptying your bowels in? How long should you be spending on the toilet? What should your periods feel and look and how long should they last? And all that sort of stuff. It's a lot of, more advice around simple things like your basic pelvic habits that we often have to educate people. And they're coming to us when they're in their 20s, 30s, 40s, even up to their 80s and not having known such simple concepts.

 

Tahnee:  (04:11)

Yeah. I think back to health ed at school, which was pretty poor. It's such a mystery area for so many of us. And obviously then there's all the cultural stigma around bums and vaginas and vulvas and all those kinds of things.

 

Tahnee:  (04:30)

When you're talking about these general health markers I suppose, something I'm really passionate about educating women around, is it's not actually normal to experience bad periods. For example, I have my period right now, and apart from feeling a little bit more introspective and a little bit quieter, like physically I don't have symptoms and that took me quite a long time to work out through my own journey of course. I think that's the same with things like bowel movements and urination. These are natural processes that require a really complex interplay of the nervous system and the myofascia and all of these things.

 

Tahnee:  (05:16)

They're bio-markers. They're ways of us actually assessing our overall, more holistic state of health, right? So if you were talking to someone, what would you say how many times should we be going to the toilet? And what should we be looking for? And same with bowels. What are the averages, I suppose, if there are any that you would be looking for?

 

Heba Shaheed:  (05:35)

Mm-hmm (affirmative). I can empathise with you on that front of having had periods that weren't great. And I agree with you in that we've kind of normalised period pain to the point that we don't even acknowledge that period pain is not normal. It's to the point where, "Oh I know, that's normal. Everyone goes through it. That's, you just kind of have to put up with it. That's life as a female."

 

Heba Shaheed:  (06:04)

But the thing is, we know that period pain it still comes along with, if you start off your periods having had severe period pain and then you go on to have severe period pain through your whole teens and your 20s and whatever, that actually sets you up for development or exacerbation of both bladder and bowel symptoms. Because, as you mentioned before, it is a very complex interplay of the myofascia, which obviously your uterus is connected to your bladder and your bowels, fascially and muscularly as well, and of course your nervous system, the nerves are all supplying the same kind of area, and then the immune system and so on, right?

 

Heba Shaheed:  (06:46)

In terms of what is acceptable in terms of behavioural habits when it comes to the bladder and urination, unfortunately what I often see in my clinic, because I see mostly complex pain patients is, "Oh yeah, I go about two or three times a day to empty my bladder." And I'm like, "Well, that's not right." And they're like, "I have such a strong bladder, I only need to go two or three times and I can really hold it." And I'm like, "Well, that's not actually something to be proud of, because you're actually putting a lot of strain on your bladder when you do that. Actually what you should be doing, is going around about every three hours."

 

Heba Shaheed:  (07:25)

The bladder capacity, think of a bladder like a balloon. It's deflated when it's empty and then that balloon slowly inflates and the nerves send us messages when the bladder's more on the full end. But, you should also be getting minor nerve messages saying, "Ah, yeah. It's a little bit full," or, "It's moderately full." But if you're only going when your bladder is like stretched to extreme capacity, that's not actually healthy. Every three hours is good. That's about four to six times a day, or six to eight times a day. Six is kind of like a good, round about average number. If you're going less than four times, then I find that unhealthy.

 

Heba Shaheed:  (08:07)

It should be a steady stream, a straight stream. If your stream's going off to one side or spraying, that could indicate that there's something going on. There should be no burning. It should be a steady stream, there shouldn't be any start stop of the flow. The flow should be relatively normal, not too slow, not too fast. Unless your bladder's full, then of course it's going to be a little bit fast. We also need to pay attention to what's happening. I think a lot of people, even when they're coming to my clinic and I'm asking them these questions, they're like, "Oh, I don't know. I don't know if it starts and stops. I don't know if it's a slow flow. I don't really know. I'm not aware."

 

Heba Shaheed:  (08:50)

Or things like you go to sit on the toilet and it takes a few moments before the stream actually starts. That's suggesting that something's off with the muscles there as well. It's like these little things that if we start to become aware, I mean obviously we don't want to be hyperaware in that we're just fixated on it. But it's just like little cues that your body's telling you that the bladder or urinary system is functioning optimally or not. That's that.

 

Heba Shaheed:  (09:22)

In terms of your bowels, the literature is strange, in that it says three times a week is okay to go to the bathroom for bowels. But I really don't believe that.

 

Tahnee:  (09:35)

Yikes.

 

Heba Shaheed:  (09:38)

I really don't believe that that is [crosstalk 00:09:38]-

 

Tahnee:  (09:38)

Is that the scientific literature, I suppose in inverted commas?

 

Heba Shaheed:  (09:41)

Yeah. It goes from three times a week to three times a day, is the realm of acceptability.

 

Tahnee:  (09:48)

Geez louise.

 

Heba Shaheed:  (09:49)

Yeah. I'm not really a huge fan of that. I'm thinking of it biologically and physiologically and mentally, psychologically the impact of not emptying your bowels on a daily basis. I'm a big proponent of, bowels should be emptying every day. If you're eating every day, you should be emptying your bowels every day. And if you're not, then that is suggesting that something is off in the digestive system, or in the immune system or in the nervous system. And it is something that needs to be addressed.

 

Heba Shaheed:  (10:22)

And the fact, the thing is because I work with so many women who have complex pain and chronic constipation, irritable bowel and Crohn's disease and all sorts of bowel disfunction, I know for a fact that every single one of them is able to achieve daily bowel movements. Regardless of whether they came to me having said, "I haven't been in a month," or, "I haven't been in a week." In clinical practice I'm able to get them to go every day. It further justifies my belief that we should be going every day.

 

Heba Shaheed:  (10:53)

And of course, it's just logical that you should be going every day. If you're having three massive meals a day, you could very well be going three times a day to empty your bowels, right? And they could be three type four stools, which is like a long smooth sausage, and that would be considered healthy. I would say at the very least once a day, and up to three times a day is good. But it's more about the consistency of the stool as well. It shouldn't be, "Oh, I'm going three times a day, but it's coming out as small pebbles and I'm incompletely emptying."

 

Heba Shaheed:  (11:27)

It should be a complete empty of a type three to four stool, which is a long smooth sausage, and it should be easy to come out and I should be done instantly, I shouldn't be sitting there for 20 minutes trying to empty my bowel. And there shouldn't be any pain when I'm emptying, there shouldn't be any fissures, I shouldn't be straining, I shouldn't have haemorrhoids popping out. It should be a complete empty and I should feel like once I'm done, I'm done. I don't have to sit there trying to get little bits and pieces out.

 

Heba Shaheed:  (11:58)

And if you're feeling that there is, sensations that aren't as I described, then it is starting to suggest again, that there might be some dysfunction. Whether that's a pelvic floor dysfunction, so for example the pelvic floor muscles, because the pelvic floor muscles surround your rectum, one of the muscles is called puborectalis, it surrounds your rectum and another is your external anal sphincter, these two muscles are part of your pelvic floor and if they're too tight, then they can make you functionally constipated.

 

Heba Shaheed:  (12:33)

A lot of people get confused in that they think, "Ah, I just have to have more fibre. Or I just need to drink more water." It's a very nutrition focused approach, which is important for sure, but there is also a type of constipation that is purely mechanical. It is the muscles of the pelvic floor are extremely tight, and then it's actually physiologically difficult to push your bowel motions out. Or they are dyssynergic in that when you visualise yourself trying to push out your number two, it's actually tightening instead, because you're having this poor coordination. Your brain is sending the wrong message to the muscle.

 

Heba Shaheed:  (13:15)

This is where pelvic floor physio comes in. Because it's like, "Okay, what's going on? How do we figure it out?" How do we... that's why we have such a great success rate with functional physiological pelvic floor dysfunction based constipation. What else? Yeah, I think that's the main kind of things. When we do go to the bathroom for number twos as well, positioning is super important. As I mentioned before, puborectalis slings around your rectum. It's part of your pelvic floor.

 

Heba Shaheed:  (13:45)

When you're sitting on the toilet in just a general normal position like you're sitting on a chair, that puborectalis muscle is kinked, right? But as soon as you elevate your feet onto a stool and you lean forward, that kink relaxes, so that pelvic floor muscle actually physically relaxes just by being in a squat position. So think, eastern countries and so on, where they squat to empty their bowels, that's actually physiologically healthy and normal. We need to replicate that in the western world and that's where you would get a stool, and you'd lean forwards to produce that same effect. And that, again, physiologically, physically releases the muscles and you're able to actually empty your bowels without having to sprain and or without feeling uncomfortable.

 

Tahnee:  (14:36)

Yeah. We have squatty potties in every toilet in our house and office. They are-

 

Heba Shaheed:  (14:42)

Perfect.

 

Tahnee:  (14:42)

They are very popular. But it's interesting just thinking about that, because I was lucky enough to have a birth that I was in control of. And I found the birth also I wanted to squat to deliver my baby. My mum, as I was growing up, always talked about that as being the most natural position to deliver in. I remember when I studied physiology that bend in the pelvis as well, you can really when you start to look at the muscles in the anatomy you can see how being in that squat position just allows everything to relax.

 

Tahnee:  (15:17)

I think one of these misconceptions around the pelvic floor is that we always want to be tightening it, because and I was taught this through more the Taoist tradition but we work a lot with jade eggs and I don't know, you might not be into this, but taught me certainly to actually be able to relax and contract my whole pelvic region. And one of the practises we do is like almost using the vagina like a hand to like swirl them up and then down through the vaginal canal.

 

Tahnee:  (15:49)

The first time I tried that I was just, "Oh my God, I have no connection to the... Like I can't feel anything in there. I don't," it was like one area was quite strong and then everything else was really weak. Is that kind of a similar thing when you're doing internal exams, what you're noticing is that people are quite tight in certain areas, but then really unable to get their brain to talk to their tissue in other areas? Is that what you're talking about with the anal sphincter as well? Things just gripping and holding on?

 

Heba Shaheed:  (16:23)

Yeah. There's varying presentation that would come I guess. I think the biggest thing is that we have a complete lack of awareness of our pelvic floor. That's number one. It's just this disconnect, like our mind, body disconnect between the, well with the pelvic floor and pretty much that whole female region.

 

Heba Shaheed:  (16:50)

If we go back to firstly what you mentioned about birth, yes, we're traditionally and physiologically you're supposed to birth, not supposed to birth, but it's inherently more conducive to birth to be in a squat position, right? Because we know that physiologically that opens up the pelvic floor muscles. And whereas in more kind of medicalized births where they're lying on their backs, that's completely not conducive to birth at all, because just the fact of lying on your back shuts your tailbone, it doesn't allow that tailbone to move. And that in itself tightens up, well not tightens, but it reduces the capacity of the pelvic floor to open, right? Yes, you're in a contractile state rather than a relaxed state, which is what it's supposed to be and then a bearing down state which you're supposed to be in for birth. That's number one. That's birth, right? But then aside from birth, well to be honest for birth you need to be connected to your pelvic floor.

 

Tahnee:  (17:58)

Mm-hmm (affirmative). Totally.

 

Heba Shaheed:  (17:58)

The issue that we see a lot with now is things like obstetric anal sphincter injuries. And that's because it's almost like women have been told, "Push through your butt like you're trying to push out a poo." But that's not the same muscles. They're part of the muscular system of the pelvic floor, but the vagina is very different to your anal sphincter. The anal sphincter in your posterior compartment, which is why you'll end up with an obstetric anal sphincter injury and perineal tears. And your vagina is your medial, like the middle system, but it's also part of the anterior system of the pelvic floor. It's very different, even the imagery that we are giving women is completely inappropriate. That's number two.

 

Heba Shaheed:  (18:55)

We need to be connected to our pelvic floor, but not just, and I guess this is what you're saying, is like part of it is strong, what part of it is weak and part of it is connected, but part of it's disconnected. Well, that's the thing. If a person is visualising the pelvic floor as that little banana hammock thing, then of course you have no idea what's happening in your pelvic floor, because it's beyond that. Like I said, there's part of the pelvic floor that surrounds your urethra, part of it that surrounds your vagina, part of it that's part of your anus.

 

Heba Shaheed:  (19:25)

Then you have another part that is a triangle that goes from your pubic bone out to your sit bone and across to the other sit bone and it creates a triangle. Then you have your perineal muscle, which are also part of your pelvic floor. Then you have a deeper perineal muscle. Then you have puborectalis that goes from your pubic bone and slings around your rectum and goes around to the other side of your sit bones. Then you have iliococcygeus, then you have pubococcygeus. Now I'm just putting words out there.

 

Tahnee:  (19:54)

Then all of those are ligaments.

 

Heba Shaheed:  (19:55)

That they have no idea what I'm talking about.

 

Tahnee:  (19:57)

Well, [crosstalk 00:19:57].

 

Heba Shaheed:  (19:57)

Yeah.

 

Tahnee:  (19:58)

They're all ligaments of the uterus and the bladder and the vagina.

 

Heba Shaheed:  (20:02)

Exactly. You've got all the ligaments which are your, so you've got contractile tissue that's under your control, but then you have ligaments that you can't really [crosstalk 00:20:11] control.

 

Tahnee:  (20:11)

Yeah, not innervated.

 

Heba Shaheed:  (20:12)

Yeah, exactly. Then you have your connective tissue beyond that. You have fascia, pubovesical fascia, you have the rectovaginal fascia. You've got all this complex system that I feel, yeah it might sound like it's hard to understand, but if you're going to go and give birth, at the very least you can develop a basic understanding so that you're able to differentiate between a posterior compartment push, right, as opposed to an anterior compartment breathing and let go and just facilitation of birth. It's not about forcing birth, it's about facilitating birth. It's changing the focus from a straining kind of action to allow the body to generate force from within to facilitate the birth, right?

 

Heba Shaheed:  (21:12)

You mentioned jade eggs. Yeah, in traditional cultures there has been an emphasis, and the thing is today a lot of the, I guess western pushers of jade eggs aren't using it accurately.

 

Tahnee:  (21:30)

Yeah, I know. Don't worry.

 

Heba Shaheed:  (21:33)

A lot of them are more about, yeah.

 

Tahnee:  (21:33)

I have that pet peeve too.

 

Heba Shaheed:  (21:33)

Yeah. A lot of them are more focused on, "Ah, let's tighten up the vagina and tight, tight, tight. And squeeze and tighten." And it's all about squeezing, right?

 

Tahnee:  (21:43)

Yeah, and like better sex and blah blah.

 

Heba Shaheed:  (21:43)

That's right. Like you want to have... The thing is even if you want to have better sex and you want to have better everything down there, it's actually every muscle has the ability to contract and relax. And the pelvic floor is part of that. The pelvic floor musculature, rather than just a muscle, the pelvic floor musculature needs to be able to engage in contraction and relaxation. And traditional cultures who were using the jade egg in more traditional form, we talk about the engagement of the muscles in a contractile state, but also in a relaxation state. It's a bit of, not ballooning, but it's opening. It's letting go as well. And that when you have the jade egg, you shouldn't feel discomfort in there. You shouldn't feel sticky and uncomfortable and painful, but it also shouldn't feel like it's just going to fall out. It's like two concepts.

 

Heba Shaheed:  (22:39)

The jade egg is something that's used in traditional cultures, but in more physical-

 

Tahnee:  (22:47)

Modern context.

 

Heba Shaheed:  (22:47)

Yeah, modern physical therapy context, we use something similar, but it's, what are they called? Vaginal weights. So they use vaginal weights, which are usually like a silicone thing or a plastic type of thing which I'm not really a fan of, so a silicone type of thing with magnets or weights in there that helps. It's a similar kind of concept. And-

 

Tahnee:  (23:10)

Yeah, because I use weights. But just I use crystals.

 

Heba Shaheed:  (23:15)

Yeah. And it's in the sense of that they use them more again, for strengthening and coordination, but again there is that kind of focus on tightening things as well. Usually you wouldn't see vaginal weights being used in somebody who has already a tight pelvic floor. However, in saying that, I could see the benefits of doing that in a sense that you're getting them to be more aware of their pelvic floor. And for them to desensitise the pelvic floor. Because a lot of issues with pelvic floor, pelvic floor pain in particular, is that there is an over sensitisation of the nerves and the muscles and the connective tissue of the pelvic floor.

 

Heba Shaheed:  (24:03)

Can we go back to, what was the last question that you asked me?

 

Tahnee:  (24:07)

I feel like I've gone so many places now, I think I was asking about in examining women and what your actual experience was as a clinician, I suppose. In the back of my mind, because we don't know each other super well, but I've studied with this guy in Thailand who's a Chinese man. Part of his system is you actually have internal massage to relax all of the tissue. And they work on your psoas through your vaginal wall and the psoas attachment at the femur and everything. It's interesting.

 

Tahnee:  (24:45)

Yeah, so [crosstalk 00:24:46]. I was curious as, because for me I had probably six or seven treatments in a period of time. And then obviously didn't find many people here offering that sort of thing. But it's become more common lately, I've noticed. I just wondered, because for me I could really feel where there were areas of tension and pain, and then areas where I was, like you were saying, desensitised or didn't have a lot of awareness. I had that pre-birth and it was, I think, one of the reasons I had such a great birth. Because it had given me some context and some of biofeedback. I was able to, I love manual therapies in general because they teach you how to connect into your body in this new way, the tactile kind of way. I guess I was leading into what is your experience as a clinician and what do you see?

 

Heba Shaheed:  (25:34)

Yeah. I guess my qualification is as a physiotherapist, but I work specifically in pelvic floor right, and women's health. But even more deeper than that, my expertise lies in female pain. I work specifically with women as you mentioned earlier, with women who have sexual pain, pelvic pain, period pain, vulva pain. Very specific to dysfunctions of pain down there. If we talk about the guy in Thailand, in a lot of traditional cultures we know that they utilise a lot of abdominal myofascial work.

 

Tahnee:  (26:23)

Yeah, that's what I'm trained in.

 

Heba Shaheed:  (26:24)

Yes. And intrapelvic myofascial work. And that's kind of in that whole body worker type of thing. And it's a traditional kind of thing, but then there's the Westernised modern thing which is pelvic floor physical therapy or pelvic floor physiotherapy where there's a medicalised version of it. Depending on the physio that you see, because again we're also divided in our approach. A lot of physios are moving towards more of mind focusing thing where it's like change your brain, change your body kind of thing, was my approach is a little bit more hands-on.

 

Heba Shaheed:  (27:09)

I'm like change the body and the mind and the heart all at the same time, integrate them all. I know that I'm very, I don't know, just a bit more progressive in my approach and I'm very open, because I've also studied. I did a lot of South American Mayan type of abdominal massage training.

 

Tahnee:  (27:31)

Yeah, like Arvigo and stuff.

 

Heba Shaheed:  (27:32)

And I've done Ayurvedic and Abhyanga type stuff. I'm very open to all disciplines and all medicines. I'm not the type that's like, "No. It's all just about evidence-based pelvic floor physiotherapy." I'm not like that. And I'm very open about the fact that I'm not like that. And it's not exactly, it doesn't sit well with a lot of the evidence-based physical therapists, but I don't really care anymore.

 

Tahnee:  (28:00)

I was curious about that, because when I saw you, I saw that you were working in kind of in clinic and like quite, like at universities and things. And I was thinking that's interesting that you're so open-minded, because I've, I guess in my career, bumped up against a lot of people who are evidence-based who think a lot of the stuff we practise is really wild. I've seen amazing transformations, and I also believe strongly in evidence-based stuff as well, but I'm like traditional evidence is still evidence to me.

 

Heba Shaheed:  (28:31)

That's right. And clinical practise is still evidence. The thing is I find that the discussion or the disputes kind of occur because a lot of people get so focused on evidence-based being what is researched and done in a trial and done in a research study, but the thing is, most practitioners regardless of whether you're eastern, western whatever, most practitioners aren't sitting in research studies. They're actually with people.

 

Tahnee:  (29:04)

Every day.

 

Heba Shaheed:  (29:04)

Fixing the people's bodies. They've treated thousands of people using their practises. And this is where Ayurvedic medicine and traditional Chinese medicine and all these other traditional medicines come in. They've been doing that for thousands of years with beautiful results, right? And it has nothing to do with sitting in a lab or in a research group or whatever. I think people forget that clinical practise is actually, so there's three type of evidence-based medicine. One of them is research study. But the other one is clinical practise. Thousands and thousands of hours of clinical practise.

 

Heba Shaheed:  (29:40)

And you know what? It comes down to a personality thing. We are all structured, we all have proclivities, right? I have an extreme proclivity for openness. Openness to experience and openness to intellectual things and openness to all sorts of things. But then you have other people who are more about like conscientiousness in like orderliness, or very low on the openness scale. And that's fine. That's who you are, like whatever. We're going to attract whoever is aligned with us. That's the people that I attract to my clinic. Most of the people, well 95% of my clientele are like intuitive, feeling, empathetic type of people who are very disconnected from their bodies, which is pretty much exactly who I am.

 

Heba Shaheed:  (30:29)

I'm very intuitive person, a very feeling person, and I was very disconnected from my body, that I didn't realise that I had all these pelvic pain problems coming up, but they were there from when I was little, I just didn't realise until my periods came, and it hit me like a tonne of bricks that I wasn't emptying my bowels on a daily basis, that I was holding my bladder and only going twice a day. All these little things that you don't even realise, and it comes down to just who you are I guess biologically and psychologically anyway.

 

Heba Shaheed:  (31:05)

The people who are a bit more, I suppose, conservative would end up with the more conservative physios. And then the people who are a bit more liberal end up with the bit more of the open physios or a bit more with the open traditional type of medicine. You're going to attract whatever, and that's fine. There's room for everybody. There's room for everything. And so I guess if we go back to what you were saying about what do I actually encounter in my practice, because I see mostly pain patients, they're coming in with these pelvic floors that are really tight, really uncomfortable, the fascia's yuck the nerves are very sensitised and all sort of things.

 

Heba Shaheed:  (31:43)

And because I have such a touch-based approach, like I do a lot of intra-vaginal massage with them, and I do a lot of abdominal massage. And not just that, I do whole body massage. I work through the whole, if you're looking at meridians or myofascial lines, I work up into their ribs. I work down into their feet. I work into their cranium. Whatever I feel like, because I'm more of an intuitive person, it's like they come in and I don't know. It's just a weird thing that I have. I don't know how to explain it, but I can just look at them and I'll be like, "Yeah, this, this and this." And then I work into it and it frees whatever's holding. It's like it's something deep inside that you just have. You either have it or you don't. Or you can grow it, I guess.

 

Heba Shaheed:  (32:28)

That's why, some people say, "Oh, she's a bit woo." But I don't care. I'm like, "Yeah, I am, but it works." And my patients are attracted to that and they love that. And then while I'm working with them, I'm talking to them, like anatomy and stuff. In talking to them, to their rational mind too. Obviously there's a rational part of this. There's and intuitive part and there's a rational part too. And I'm talking to them. And usually when I'm working on something and it might be the psoas interiorly, right? And they were like, "Oh yeah, my ex-boyfriend was very abusive," or something like. Things come up. You know that when we interact with the psoas, you're talking trauma extroverting muscle. As soon as you start to engage with it, the person starts to remember and wants to get out the trauma that occurred or whatever.

 

Heba Shaheed:  (33:24)

Part of that is also allowing them to verbalise stuff, because we know a lot of stuff is repressed or held in. And because I attract this certain type of clientele who are the type, they're usually very assertive females who are assertive in their life, what they want, they're all like a bit type A type personalities. Type A, type B, I guess, but then they don't put their own needs ahead. They're putting other people's needs ahead of their own. And then they hold things in and a lot of them are quite out of touch with what is actually their feeling, because they're just constantly looking after people around them.

 

Heba Shaheed:  (34:09)

It's like getting them back in touch with, "Okay, what happened to you and how did it change your life?" It's more like I do a lot of coaching stuff with them at the same time. It's an integrated thing. I've been to a lot of other pelvic physios and I can see the difference in the way that I treat, because a lot of them will just sit there quietly and do the work. Or ask you about your weekend or something, and I can never ever remember what I've done on the weekend, so it's like well what's the point of that?

 

Tahnee:  (34:45)

You have a three year old, it's like, "I don't know."

 

Heba Shaheed:  (34:48)

[crosstalk 00:34:48]. Yeah, you're having a deep meaningful conversation where you're freeing a lot of repressed stuff, whether it's microtrauma or a macrotrauma, it doesn't matter, they're still traumas. Even microtraumas have an impact and they're repressing them. And when a body comes to me in that state of, this inflamed state of severe period pain, chronic constipation, bloating and all this stuff, oh man, there's shit going on in there. There's stuff. It's not just, "Oh yeah, I fell over on the weekend." It's not that. This is deep stuff. What do you have to do? You have to have a deep conversation, otherwise that person's going to be going from one therapist to another never really figuring out what's wrong with them.

 

Heba Shaheed:  (35:33)

And they're the ones that end up, because they start with the modern medical stuff and then it's not working, and then they have all this surgery and it's still not working, then they end up seeing traditional Chinese Medicine and Ayurvedic Medicine and any of these traditional type of stuff, Mayan and whatever. And you know what? That's okay, because for you that is what is going to work, because it isn't just a body thing for you. When it becomes this complex and angry really, it is, there's like a poor alignment of your heart, your mind and your body. And it's trying to integrate all of them so that you actually feel like you're in control of your body, and it's not your body that's kind of controlling everything else.

 

Tahnee:  (36:19)

Mm-hmm (affirmative). That's a such a common theme I think with women, is repressed anger and this sense that they have no control. I think especially women that are sensitive and like you were saying, empathetic and intuitive, because they take on so much and then it's this kind of push back or rage against what they've... It's their gift as well. I know you're an empath, and I am as well. It's my gift, it's also my curse sometimes. But I can feel, and that's certainly been my lived experience in my body, is when my own boundaries get brittle I start to really find that my body starts to lean back into the patterns that I've worked really hard to unravel.

 

Tahnee:  (37:11)

I think it's just a constant process. But it sounds like you have such a holistic focus that people are able to work on that multidimensional level which I think, I mean for me it seems outrageous that that idea of bedside manner and all these things have been lost from the Western Medical system. Because, I think about just how important therapeutic touch and therapeutic listening is. I can remember going to older GPs when I was a little kid, who were like grandfatherly and gentle and kind. And just being in their presence was really healing. And I think now the system is really flawed obviously. But I can see how this disassociation of body from mind, from spirit has really led us down this path.

 

Tahnee:  (37:56)

I'm super inspired to talk to someone who's actually gone through that system and continues to integrate, because I think that's really the future of medicine. That we need to have the evidence-based deep research and for me studying anatomy has given me so much power. But on the flip side of it, I have to keep remembering that the body is an integrated system and it's a holistic system and I can't just work on my pelvic floor and not have an overall effect on every single part of my body. It's this kind of dance always I think between the poles, I suppose, the Yin and Yang to use the Taoist ideas. But I mean-

 

Heba Shaheed:  (38:32)

Yeah, well, it makes so much sense because what happened was in the last 50 or odd years or whatever, it really went into a more of a biological focus, like medicine went into a really biological focus. And then in the last kind of 20 years or so, they're like, "Oh no. We have to look at the mind as well." It's now kind of like a bio-psycho process, biological and psychological and then they're like, "Oh well, we know we do better in community." They're at this stage going to go into bio-psycho-social kind of thing. But the thing is, even the psycho-social stuff is still from a biological point of view, because it is like looking at psychology from a biological point of view.

 

Heba Shaheed:  (39:19)

Really, depending obviously on what you believe in and stuff, and I'm assuming that obviously many of the people listening to SuperFeast are going to be more on the spiritual side. We feel like we have a, it's like a deeper connection, it's like a bigger connection, it's not just about my body right now. It's my body, it's my mind, but it's not just my body and mind, it's my heart and my soul as well. I need to be nourished in my soul too, for me to be really healthy. It's not just about always focusing on the physical elements.

 

Heba Shaheed:  (39:53)

And that's part of it. It is part of it of course. You need to nourish your body to nourish your soul, but it's also vice versa. It's interesting. And the other thing that you mentioned before as well was about anger. One of the things that I've studied is when you look at, we have the mind or the head. And the mind and the head is where you hold fear. And then you have the heart, and that's where you hold shame. And then you have the gut or the pelvis, the gut and the pelvic paradigm where you hold anger. And that anger could be like anger to others, or it could be anger to yourself, or repressed anger.

 

Heba Shaheed:  (40:39)

A lot of, that's often what we see. People are angry at themself, or they're angry at their bodies for not working the way that they want to, and it just feeds that cycle of anger. And their pelvic region gets worse and worse and worse. But if you really, really trace it back, you trace it right, right, right, right, back, there is that initial sliver of anger that started, but even before that there might have been an element of shame. There's even the heart isn't integrated. It could be shame, like shame at your own self. Or it could be a shame because somebody put a belief of shame onto you. Like, "Ah, that's not what girls do," or something like that.

 

Tahnee:  (41:18)

Cultural.

 

Heba Shaheed:  (41:20)

Yeah, cultural type of things. But it's somebody else's thoughts and feelings that you manifested of your own shame, or it's somebody else shame. Or even with a partner that you're with, or the parents, or whatever. Or society. And then even more so than that, your head is where you hold fear. Then what happens with a lot of my clients is that they get so stuck in their head, in that they're afraid that, "Sex is always going to hurt. That I'm always going to have period pains. Like, this is my life for the rest of my life. I'm never going to get better."

 

Heba Shaheed:  (41:56)

It's like constant looping of fear in their head. What I try to do, is I try to get right to the beginning. It's like, "Okay, what was the first thought and feelings? What was the first thought?" If we go right back it could be something, a shameful thing that happened when you were two. Or it could be a fear driven thing that happened when you were just born. Maybe you were born to very abusive parents. Or like anger driven thing where you weren't allowed to be your authentic self, for example.

 

Heba Shaheed:  (42:33)

It's like tracing it right back, because a lot of the time you can get so caught up in trying to treat the body, and then you think you're treating the mind because you're giving them pain education advice and all this stuff which is important, but at the end of the day the heart is completely not even involved. But I feel like that's really crucially important especially with the patients that I see, because they're all the kind of the feeling heart centred type of people. And then sometimes it's something as simple as, "I just hate my job. My heart's not in my job, and because I'm in my job," and I've had patients like this where it's like, she wants to be a naturopath for example, but she's working as a lawyer, you know what I mean? And she just hates her job. And I'm like, "Well, if your heart's not in it, your body's going to rebel against it."

 

Heba Shaheed:  (43:21)

It's like even simple concepts like that could be the key that unlocks why a woman is having so much dysfunction.

 

Tahnee:  (43:31)

Yeah. I can hear a little girl. Hello darling.

 

Heba Shaheed:  (43:35)

She's dancing in the room.

 

Tahnee:  (43:37)

Super.

 

Heba Shaheed:  (43:37)

Spinning around, dancing.

 

Tahnee:  (43:39)

Very cute.

 

Heba's Daughter: (43:39)

Dah.

 

Tahnee:  (43:40)

Yeah. It's you.

 

Tahnee:  (43:43)

I'm curious-

 

Heba's Daughter: (43:47)

Dah.

 

Tahnee:  (43:47)

You're in a podcast darling.

 

Tahnee:  (43:50)

I'm curious about complex trauma and pain and stuff, because one of the big epiphanies for me, I mean I was so scared of pain when I was 20. To the point where I've made some hilarious statements that now make me laugh. But I remember being 18 and 19 and saying, "There's no way I'm giving birth naturally. I need drugs to do that. I don't want to feel it." And obviously 10, 15 years later had a home birth naturally and blah blah. I changed. But a lot of the pain science and stuff I researched, I know that's an area you've studied a lot, like pain is just this completely subjective and incredibly difficult thing to measure and track. And so much of it is really due to this, I guess inability to be intimate with ourselves and to really give ourselves permission to have the full human experience, which is warts and all. It's not always sunshine and rainbows.

 

Tahnee:  (44:47)

Is that kind of, I assume that's something because you work so much with really chronic difficult issues, is that something that you're always trying to educate people around? Is that, I'm not trying to say pain isn't real, because I feel like that's a really difficult thing to say, but it's sort of like from my experience, I've changed my relationship with sensation so much that pain and I have a very different relationship now. Is that what you're trying to work with people toward? Is to redefine their experiences, sensation and how they relate to their body?

 

Heba Shaheed:  (45:20)

Absolutely. So it's all about perspective. We can create a relationship with our body that is pain driven. Or we can create a relationship with our body that's pleasure driven. Memories create little tags in your brain, neurotags, that can latch onto experiences as being with negative emotion or with positive emotion. And it depends on which part of your brain that you're using. We know that the right side of the brain is more associated with negative emotion, and the left side of the brain is more associated with positive emotion. Actually, we know that people, the ideal, so positive emotion isn't to do with being happy. Positive emotion is to do with not suffering. We don't want to suffer. And pain is an embodiment of suffering. We don't want to be in pain. If you're the type that is so fixated on not wanting to be in pain, that you'll use that-

 

Heba's Daughter: (46:25)

Mum.

 

Tahnee:  (46:25)

Exactly.

 

Heba Shaheed:  (46:31)

If you're the type that doesn't want to be in pain, you'll become so fixated on that, you can become so fixated on that negative emotion, because you don't want to suffer, but unfortunately that actually propagates the feeling of suffering because you've become so fixated on that part of your brain that, because pain in itself is a negative emotion. Now here's the thing, right? Your brain actually doesn't know the difference between truth or lies. And this is a fact. It doesn't know. It's what you feed it. The food that you give your brain, food that you give your mind, is going to nourish it. If you're feeding it negative thoughts, which is fear of pain, and fear driven messages, and suffering driven messages, negative polarity based messages, then the brain will be nourished by that. And it will become hyper aware of that.

 

Heba Shaheed:  (47:28)

But on the flip side, if you're feeding it positive thoughts, like I'm safe. I am content. If you're sending it positive messages, that will then nourish the brain in that sense. Think of it as like negative emotions and negative messages drying out the brain and making it hard and inflexible and uncomfortable. And positive thoughts and feelings and messages nourishing the brain and lubricating it, and filling it up that the brain is sitting in a soup, and it's relaxed and chill.

 

Heba Shaheed:  (48:01)

Firstly a lot of it is just education on that sort of thing. Like visualisation based education, but then also anatomical and physiological based education in that explaining the actually neurophysiology of pain can be very helpful. But not just explaining that, but also getting them to do little workbook tasks to help them identify their patterns and behaviour. Because, remember a lot of it is beliefs driven as well. If you have this belief, that belief can be changed. We know that the brain is plastic, it's neoplastic. That means that it can be changed.

 

Heba Shaheed:  (48:40)

Within three months, six months, 12 months, you'll have a completely different brain and cells in your body, if you continue to send it specific type of messages. That's why we can see a person, for example myself, I had like a 100 out of 10 pain 10 years ago. Literally every moment of every day was severe, excruciating neuropathic pain. From migraines to pelvic pain, or pain down my leg, sciatic nerve, and just like fibromyalgia type, like just horrific pain. That was because I was so fixated on the pain and the fear that I was always going to be in pain. Remember what I said about the head space being driven by fear.

 

Tahnee:  (49:29)

I know. I call is the loop, like that constant feedback.

 

Heba Shaheed:  (49:32)

That's right. And the thing is, that is very draining. That is very, very draining. Then you've got this rock hard brain that is completely devoid of lubrication, whereas today 10 years on, I can't even remember the last time I had a migraine. I can't remember the last time I had severe period pain. You can very drastically change it. And it's a constant work of it on daily basis. Obviously there are some times where I might regress and it's oftentimes where my mental state isn't well. Like if I fall into severe depression because of whatever, at the end of the day it is my thoughts and feelings. But certain events can trigger it.

 

Heba Shaheed:  (50:21)

And that also comes down to trauma. We were talking about trauma just before, you mentioned trauma just before. Trauma, especially childhood trauma effects your hard-wiring. I was born into a very malevolent, narcissistic personality disorder family. To the point where there were times where I would be left by myself in the apartment crying my head off under the age of one, because of like no safety. No... Obviously that would've triggered a, what's it called? Fight or flight response in the brain. And we know that the nervous system is divided into two. Your sympathetic nervous system which is your fight, flight, freeze or fawn system. And your parasympathetic nervous system which is your relax, reproduce, digest, rest, chill system.

 

Heba Shaheed:  (51:17)

If a baby is living in a chronic state of sympathetic nervous system hyperactivity, fight or flight, screaming and crying and being scared and feeling unsafe and all this sort of stuff, that's going to send your nervous system into overdrive. And your brain is just going to shrink, not shrink, but it's just going to become like that dried sponge. If it's a dried sponge, well all your nerves are coming out from your brain, well then those nerves aren't lubricated. Your immune system is then compromised. Your immune system is largely lubrication, right? It's mucous membranes.

 

Heba Shaheed:  (51:57)

That's what I mean about going right back with my patients is that we're trying to figure out what caused this nervous system to go nuts? What caused your immune system to go nuts? And the musculoskeletal system is only the end product, the end thing. This all started way back when. It's like, "Okay, how do I then manage that?" Because I was one of those kids that when I was young, I had all this auto-immune stuff, like severe asthma, eczema, this condition called vitiligo where my skin turns white if I'm like severely stressed.

 

Tahnee:  (52:34)

Yeah. I've seen that.

 

Heba Shaheed:  (52:36)

It was just like super auto-immune type condition. And a lot of this stuff said, "Ah people say it's incurable. You'll just have to live with it. And maybe you'll grow out of it or something like that."

 

Tahnee:  (52:44)

Those people are wrong.

 

Heba Shaheed:  (52:46)

That's right. Exactly, because it's your immune system. Your immune system doesn't care, like it's trying to tell you that, "Help me. Help me. Save me. I need to feel safe."

 

Tahnee:  (53:03)

This is the thing. If it's this line of defence, our protection and we're constantly being bombarded, like you're going to end up with immune responses.

 

Heba Shaheed:  (53:13)

Mm-hmm (affirmative). If a patient comes to me and then they report to me that they had childhood asthma. I'm not going to be like, "Oh, you just had asthma." I'm going to be, "Woo, hang on."

 

Tahnee:  (53:21)

Yeah, what happened?

 

Heba Shaheed:  (53:22)

"Why did you have childhood asthma? Why did your immune system react like that?" And it's like 99% of the time that my patients will tell me and I'll be the first person that they've ever told, "Oh yes, this happened to me when I was little." Or something like that. There's a really, there's quite a correlation between persistent pelvic pain conditions and childhood trauma, whether we recognise it or not. And it could be just neglect. It could be neglect, it could be severe abuse, it could be sexual abuse, it could be physical abuse, emotional abuse. It could be anything. It could be sibling abuse, right?

 

Tahnee:  (53:55)

I think even like-

 

Heba Shaheed:  (53:55)

Or it could be bullying at school.

 

Tahnee:  (53:56)

Yeah, I had a really, my family are loving and kind. But my parents had a really weird relationship and I'm super sensitive and I think took on a lot of that. And I disassociated from the body really early. I remember my mum having to be like, I'd be like, "I'm sick." And she's like, "Have you pooed today?" And I'd be like, "Oh yeah. I have to poo." I fully had that complete lack of biological connection. And it'd like that was my whole 20's it was working back to that. It's really interesting, because if I look at it, it's like I had a really happy childhood, but even just being in that energy all the time because I was sensitive to it.

 

Heba Shaheed:  (54:34)

Absolutely.

 

Tahnee:  (54:35)

It's like I can't [crosstalk 00:54:36] put blame onto them, but I have to do my own healing now to work out what my boundaries are.

 

Tahnee:  (54:43)

And I'm curious, because you're an empathetic person and you're working with a lot of people's pain and suffering. Do you have boundaries for yourself on how much you can take on? Or how do you handle that sort of work?

 

Heba Shaheed:  (54:54)

Ah yeah, for sure. I have massive, massive, massive boundaries. I only allow myself to work once to twice a week, and it depends on the week, it depends on my menstrual cycle.

 

Heba's Daughter: (55:09)

I'm hungry.

 

Heba Shaheed:  (55:13)

And with my patients, I used to think it was better to have breaks between patients, but it's not. For me, I need to just see them bang, bang, bang, one after the other with no break. Because then I don't allow all of the emotions to overwhelm me between patients.

 

Heba's Daughter: (55:32)

I'm hungry. I'm hungry.

 

Heba Shaheed:  (55:35)

That's my daughter crying out, "I'm hungry. I'm hungry."

 

Tahnee:  (55:38)

I know, we're nearly finished, darling. They eat so much at three. My daughter's like a bottomless pit.

 

Heba Shaheed:  (55:44)

I know.

 

Tahnee:  (55:44)

It's ridiculous.

 

Heba Shaheed:  (55:48)

Yeah, so.

 

Tahnee:  (55:50)

Boundaries.

 

Heba Shaheed:  (55:50)

Yeah, so boundaries. Yes, I discovered for myself that I need to see them bang, bang, bang, one after the other, because I couldn't allow myself to experience the overwhelm of emotion in between patients, because then it would be too draining to see the next patient. And then what I do is, I only, I actually see a lot of patients in one day. I can see between eight to 12 patients in one day, which is quite-

 

Tahnee:  (56:18)

Whoa.

 

Heba Shaheed:  (56:18)

A lot for-

 

Tahnee:  (56:18)

That's heaps.

 

Heba Shaheed:  (56:20)

Yeah. That's why I only work one to two days.

 

Tahnee:  (56:23)

Yeah. Sure.

 

Heba Shaheed:  (56:23)

And it depends. I do these really weird stuff, but before I go to work I tell myself, "Okay, who am I going to be today?"

 

Tahnee:  (56:38)

Good. Yeah. I love this stuff.

 

Heba Shaheed:  (56:42)

Which mask, which costume am I going to put on today? Even like now when I'm talking to you, this isn't the real, like it is, it's a part of me.

 

Tahnee:  (56:51)

Yeah. It's one aspect of you.

 

Heba Shaheed:  (56:52)

Mm-hmm (affirmative). But like the real me is actually very quiet and I kind of stick to myself, like a very introverted type of person. But, I'm like, "Okay, which costume am I going to put on today?" And that almost serves as like a physical barrier between my emotions and theirs. And then I have to physically tell myself, "Everything I feel today, none of this is my emotions. Anything that I feel," so like if I'm with a patient, the patient walks in and I immediately feel depressed, I'm like, "I know I am not depressed. She is depressed. Why is she depressed? What's happening?" Or if a patient walks in and they're like super happy, super excited and I suddenly feel like really bubbly and stuff, I'm like, "I know," I'm like, "Yes, I have the capacity," like obviously you have a capacity to be depressed and bubbly or whatever, "but in this moment every emotion that I'm feeling, is her emotion."

 

Heba Shaheed:  (57:45)

Being conscious of that, so when the person walks in having that immediate consciousness of, "This isn't my emotion." And in that way I'm able to kind of, so I reflect. I imagine myself as a mirror and I'm reflecting her. So whatever I'm feeling is only hers. What I do, and this is a really amazing thing I've discovered is like I feel her emotion and then I allow myself to process her emotion, and then I actually speak out her emotion to her. I rationalise what she's feeling. And then she comes back to me with something, but it's allowed her to heal in that moment, that emotion that she was feeling, because instead of just feeling it inside, we've brought it to her outside. She's extroverted it out.

 

Heba Shaheed:  (58:30)

And that in itself can be really powerful. What I've done, is I've also rationalised that it's not my feelings. It's like being very, very in the moment conscious of everything that you're feeling isn't actually your feeling, and it's theirs, but you're also letting them process their feelings. It's a really amazing thing to be an empath in the sense that you can allow other people to actually sort out their own feeling. It's a really amazing thing.

 

Tahnee:  (59:00)

Yeah, in mirroring them.

 

Heba Shaheed:  (59:02)

Yeah. And then-

 

Tahnee:  (59:04)

Do you have meditation practises or anything as well around that? Or you just-

 

Heba Shaheed:  (59:07)

What is it?

 

Tahnee:  (59:10)

What do you do other... like yeah, obviously you're going to keep talking, so go. I jumped in.

 

Heba Shaheed:  (59:14)

Oh, I was just saying and then at the end of the day I get on the train back home, and all I do is just filter everything out. I'm like, "Okay, what am I feeling right now? Is it mine? Or is it someone else's?" And then just letting it out. And then by the time I get to my car to go pick up my daughter, I've already sorted everything out, because I'm on the train for half an hour or whatever. It's like, "Okay, I've done it." And then it's like I could be super drained if I just let myself, because the thing is you have to filter them. Because in the past I hadn't done that and I would be so exhausted.

 

Tahnee:  (59:46)

Oh it smashes you, yeah.

 

Heba Shaheed:  (59:47)

After a day of work. Ah, my God, like I would be dead literally, and I'm just, "Leave me alone. Don't talk to me. I just cannot deal. I need to be on my own." But if you do that filtering process, and then you reflect on the day. And you reflect on how much you helped them, because remember as an empath helping other people, helps you as well. You feel that sense of, you get energy from that. And then it's the end of the day. And then I go pick up my daughter and I'm fine, because I know what's my feelings and what's not.

 

Heba Shaheed:  (01:00:17)

I could do this every day if I wanted to, because I've kind of gotten really good at filtering my feelings, but I don't want to. Because I know there's a capacity to give, right? And a capacity to give, because we're giving people, but then there's also an importance of individually as well. I need to also be myself and do stuff that I want to do, and it's not always just about work and helping other people.

 

Tahnee:  (01:00:41)

Yeah. And being a mum as well. For me certainly when I had my daughter, my priorities shifted a lot around she needs me more than others do a lot of the time. That's the priority.

 

Heba Shaheed:  (01:00:53)

Absolutely. Especially that zero to seven really, it's like they need you, to nurture them.

 

Tahnee:  (01:01:02)

Yeah. I wonder, I'll start wrapping up, but I was wondering if you had any advice for home care for the pelvic floor for people. Because I get frustrated that the Kegel thing, because I'm like that's not really good enough. But for so many people, it's pretty foreign territory down there. Is there stuff that people can-

 

Heba Shaheed:  (01:01:25)

I'm not really a huge fan of Kegel, I actually am like well what the?

 

Tahnee:  (01:01:30)

Yeah, it's just more tightening which people don't need.

 

Heba Shaheed:  (01:01:33)

Yeah, so I don't. My focus for home care is more around your daily habits. We talked about it right at the beginning. Healthy bladder habits, going every three hours. Healthy bowels habits, going every day. And that means eating well, because we know your diet heavily influences your ability to empty your bowels. And just healthy bladder habits, healthy bowel habits, sexual health habits and vulva health habits as well. Like not using all these creams and douches and washes and all this stuff. The vagina's a self cleaning machine.

 

Tahnee:  (01:02:07)

Leave it alone.

 

Heba Shaheed:  (01:02:08)

Just use warm water. Yeah, just leave it. Don't put anything in there, except if you're having penetrative intercourse or if you're using jade eggs and whatever, that's okay as well. But, just leave it. Let it do its job, kind of thing. You don't want to mess with the PH and all that. And when you're having sex, simple hygiene practises.

 

Heba's Daughter: (01:02:31)

[inaudible 01:02:31].

 

Heba Shaheed:  (01:02:31)

Like washing your hands and stuff beforehand. And wiping from front to back. And emptying your bladder after sexual intercourse rather than before. And using a tissue. Stuff like that. Just simple sort of stuff. And even like the underwear that you wear and the pads that you wear. I'm a very, because I know this, I've seen it, like just simple thing of changing your pads to an organic cotton pad, or a menstrual cup or something, can be very helpful, rather than a lot of these mainstream pads and stuff that are like heavy with perfumes and toxins and stuff like that.

 

Tahnee:  (01:03:10)

Yeah. And that stuff actually gets into your tissues and create issues.

 

Heba Shaheed:  (01:03:12)

Mm-hmm (affirmative).

 

Heba's Daughter: (01:03:12)

[crosstalk 01:03:12].

 

Tahnee:  (01:03:14)

Yeah, inflammation. Okay, well, I think you have a little darling that needs you.

 

Tahnee:  (01:03:21)

I will say thank you so much for your time and for this conversation. I really enjoyed speaking with you. And for anyone who wants to connect with Heba, she's on social media @thepelvicexpert and she's also online at www.thepelvicexpert.com.

 

Tahnee:  (01:03:36)

I saw you have some courses up there. People can have online consultations. There's lots of ways people can reach you. Is there anything I've missed? Or anything else you wanted to add?

 

Heba Shaheed:  (01:03:46)

Yeah, no that's all. If you are in Sydney and you do want to book a consult, if you have any complex female pain issues, my website is www.hebashaheed.com.

 

Tahnee:  (01:03:58)

Okay. Great. That's more for your one-on-one physical in person sessions, yeah?

 

Heba Shaheed:  (01:04:03)

Yeah.

 

Tahnee:  (01:04:04)

Okay. Great. Well I'll make sure all of that's in our show notes. I'll put some extra links in there. I wanted to thank you again. I know you're a busy mum. I really appreciate your time.

 

Heba Shaheed:  (01:04:15)

Thanks for inviting me. It was amazing. I love talking about this stuff, and anything that can help women just kind of reconnect. And men, just anybody reconnect to their body and feel safe.

 

Tahnee:  (01:04:26)

I'm really like stoked there's people like you out there in the world. And we didn't get to talk about vaginal mesh and all these things, that there's so much trauma inflicted on women in the name of trying to help people through this stuff. So, yeah. Things like prolapse guys, if you're listening, painful sex get in touch with Heba or find someone like her who can help you, because you don't have to be tortured. There's other ways.

 

Heba Shaheed:  (01:04:55)

No, and actually pelvic floor physio is actually very helpful for prolapse, more so than these surgeries anyway. So, it's kind of, yeah that's a whole other conversation.

 

Tahnee:  (01:05:07)

Yes it is. I really appreciate your time and I think what you've offered is so helpful, and factual and great. Thank you so much.

 

Heba Shaheed:  (01:05:13)

Thanks so much for having me, Tahnee. It's been a pleasure.

 

Tahnee:  (01:05:15)

Talk soon. Bye.

 

Heba Shaheed:  (01:05:17)

Bye.