Episode 123 · November 28, 2023
Pelvic Floor Health is as easy as 1-2-3 with Christian McSoud
with Christian McSoud, Physical therapist specializing in women's pelvic floor health; co-founder of Pelvic Pathways
36 min
Pelvic Floor Health is as easy as 1-2-3 with Christian McSoud
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In this episode
In this episode I sit down with Christian McSoud, a physical therapist who has spent over twenty years in the field and about fourteen of those specializing in women's pelvic floor health. Christian and I have known each other for years, but we'd never really had a conversation this in-depth about what she actually does — and once we did, I realized how much I didn't know. This is one of those topics that isn't exactly easy to talk about, even among close women friends, but that's exactly why I wanted to open the door.
Christian walks us through what pelvic floor health really means, the issues she treats (everything from stress and urge incontinence to bowel issues, pelvic pain, and pain with intercourse), and why so many women live for years with something they never mention to their doctor. She's practical and reassuring — it's never too late, and the fix isn't always surgery or endless Kegels. I even admit something on air that I learned from her Instagram that I probably shouldn't have been doing all these years.
We spend the back half of the conversation on real, doable tips — how much water to drink and how to space it out, why hovering over the toilet backfires, and how to gently retrain your bladder out of those "I just pulled in the garage and now I have to go" triggers. I love that Christian ties it all back to purpose too, reminding us that how we live inside shapes how we handle everything outside. If you've ever wondered about this and didn't know who to ask, this one's for you. Keep going — small changes add up.
Key takeaways
- Bladder leakage is common as we age, but it is not "normal" — and it's rarely too late to do something about it. Not using your muscles is actually more detrimental than aging itself.
- The fix isn't always surgery or Kegels. Some women have a weak pelvic floor and others a tight one, which is why an internal assessment matters — the same diagnosis can call for very different treatment.
- Restricting fluids can backfire. Concentrated urine is more irritating to the bladder lining, so sipping water steadily throughout the day often means fewer bathroom trips, not more.
- Aim for roughly 64 to 88 ounces of water a day (more if you're sweating), spaced evenly, and go easy on common bladder irritants like caffeine, carbonation, alcohol, and artificial sweeteners.
- Stop hovering. Sitting all the way down, sitting up straight, opening your legs, and taking a deep breath lets the pelvic floor relax so you can fully empty your bladder — and avoid the habit of pushing.
- You can retrain your bladder out of "triggers" (pulling into the garage, unlocking the front door, running water) with urge suppression: stop moving, do 4–5 quick pelvic contractions, then a slow calming breath before walking to the bathroom.
- Normal daytime voiding is about every two to four hours, with zero to one trips at night until around age 65. New research also shows strength training can help with menopause hot flashes and bone density.
“Not using your muscles, not exercising them, not being active is actually worse than aging.”
“Research used to show women would live twenty plus years dealing with a pelvic floor issue before they ever even brought it up to their healthcare provider.”
“It's definitely never too late.”
“How we first live inside will determine how we deal with things outside.”
About Christian
Physical therapist specializing in women's pelvic floor health; co-founder of Pelvic Pathways
Christian McSoud is a physical therapist with over twenty years of experience and about fourteen years specializing in pelvic floor physical therapy, in which she is certified. She treats men and women in Tulsa at Urologic Specialists of Oklahoma and is the co-founder of Pelvic Pathways, an online platform offering pelvic health education and programs for women. A mom of three boys, she loves walking, hot tea, and traveling.
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