Feb. 27, 2026
73. The Truth About Pelvic Floor Dysfunction, Prolapse, and Bladder Leaks in Midlife, with Patricia Linderman
Are you a woman over 40 feeling anxious about bladder leaks when you sneeze, laugh, or jump? You’re NOT alone — but you don't have to just live with it. In this episode of Mind Your Midlife, certified health coach and Pfilates instructor Patricia Linderman joins me to break down pelvic floor health, the reality of prolapse, and the real muscular mechanics behind why we leak and how we can stop it.
What You’ll Learn:
✔ How your core acts like a "can" and why deep, three-dimensional breathing is like taking your pelvic floor for 10,000 steps
✔ Why a tight pelvic floor can cause just as many problems (like pain and cramping) as a weak one
✔ Practical steps to properly perform a Kegel using the "rolled-up towel" method
✔ What women REALLY need to know about the "partner muscles" (glutes and inner thighs) that turbocharge your pelvic floor strength
✔ How to use "bracing" to prevent leaks in the exact moment you are about to cough or sneeze
🎯 OMG Moment:
A shocking reality check: There are more incontinence pads sold in the United States than menstrual pads. Even more staggering, serious incontinence is one of the primary reasons women are forced to enter assisted living. Leaks might be common, but they are an indication of muscle weakness, not an inevitable sentence of aging.
Take Action Today:
- Connect with Patricia at fierceafter45.com and explore Pelvic Floor Pilates at pfilates.com
- Listen to the episodes on breathwork and on talking to your doctor
- Choose ONE small step to build your mind-body connection this week, like taking three deep breaths without hunching over your phone
Why This Episode Matters
Midlife is a powerful turning point. We are often sold the message that pads and surgeries are our only options. By understanding how to train this hidden muscle group just like we train our shoulders or biceps, we reclaim our bodily autonomy and our quality of life.
Take a little bit better care of yourself in midlife.
*Start your day with Energy Fizz and GreenSynergy Elixir: cherylpfischer.com/recommendations (and use the code ARBONNE10)
🌸 Liked this episode? Share it with fellow Gen X women navigating hormone balance, an empty nest, and/or self-confidence!
🫶 Love this show? Leave a review to help more women over 50 find us.
💡Want menopause advice, mindset shifts, or support with midlife transformation?
- Book a free Mindset Coaching / Intro Call: cherylpfischer.com/coaching
Let’s talk health after 50, self-talk, and redefining aging for women — without the “midlife crisis” narrative. Every week I'm adding new success strategies for midlife women.
Connect with Cheryl, Midlife Coach: Instagram | LinkedIn | Website
00:00 - Why Pelvic Floor Health Matters
02:16 - Meet Patricia And Her Approach
03:56 - Symptoms Are Common Not Inevitable
06:15 - Marketing Myths And Medical Gaps
07:21 - Prolapse Urgency And Core As A Can
11:08 - Breathing Diaphragm And Core Stability
13:53 - Three-Dimensional Breathing Explained
16:13 - Sedentary Life Glutes And Inner Thighs
18:13 - Kegels Done Right Step By Step
20:58 - Isolate Don’t Overuse The Glutes
22:53 - Contract All Three Openings
24:38 - Habit Triggers And Rehab Volumes
26:28 - Bridge Squats And Ball Squeezes
28:18 - Find The Muscles Without Bearing Down
29:48 - Bracing To Prevent Cough Leaks
31:48 - Listen Advocate And Get Support
33:38 - Resources Pilates And Fierce After 45
34:58 - One Takeaway Mind Body Connection
36:28 - Closing And Ratings Request
WEBVTT
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Today we're going to be talking about something that we don't talk about very often.
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And that is pelvic floor health.
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Now, don't move on to another episode.
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Stick with me because this is pretty life-changing stuff.
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And I don't know why we don't talk about it more.
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And I believe it will be that for you.
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So if you have had a baby, you have been told about Kegel exercises.
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Or maybe even you haven't had a baby.
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I think we all know what those Kegel exercises are, but we don't do them, or we don't know how to do them, or we don't know why we're doing them.
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And we just figure that as we get older, then incontinence and various other things are just what's gonna happen.
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But what if that's not true?
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Let's talk about it.
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Welcome to Mind Your Midlife, your go-to resource for confidence and success, one thought at a time.
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Unlike most advice out there, we believe that simply telling you to believe in yourself or change your habits isn't enough to wake up excited about life or feel truly confident in your body.
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Each week, you'll gain actionable strategies and oh my goodness, powerful insights to stop feeling stuck and start loving your midlife.
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This is the Mind Your Midlife podcast.
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Your pelvic floor is your muscles, basically at the bottom of your ab muscles, part of your core.
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And my guest today is going to explain that to us really well with a visual that will make a lot of sense for you.
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And it's not something we like to talk about, but it is something that creates for us, if we ignore it, creates for us some issues and symptoms that we don't like, especially as we hit midlife and beyond.
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So my guest today, Patricia Linderman, is a certified health coach, personal trainer, functional aging specialist, and is a teacher of phyllades, which you're gonna hear us talk about.
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That is a pelvic floor training method developed by a Eurogynecologist.
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She is passionate about sharing simple ways to reverse the effects of our sedentary modern lifestyle and transform our health.
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I'm excited to talk about this because it is not talked about often enough.
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So welcome, Patricia.
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Hi, Cheryl.
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I'm so happy to be here with you.
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So important.
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I'm so happy that you do this, Cheryl.
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Well, thank you.
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And we actually, uh if you're listening, I'll tell you, we met years ago.
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And I I'm not even sure I remember how, but we are in the same local area and got connected through some way or another.
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So I love that we're able to do this.
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Yeah, awesome.
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Okay.
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So today we are talking about the pelvic floor.
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And if you are listening, you knew that already from the title.
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You know what you're getting into.
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But let's start with what are some common symptoms or some common issues that women will recognize?
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Yeah, sure.
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I'm so glad we're talking about the pelvic floor.
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And yeah, it does seem like a topic that we don't necessarily bring up all the time.
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And I think that's something we need to we need to rethink because the pelvic floor is a muscle group in our body.
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It's like our shoulders or our arm muscles, and it's just as important.
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And you asked about what people might experience.
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Well, there are lots of things.
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The pelvic floor, just like any set of muscles, can get weak over time.
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And then that leads to the common problem of leaks.
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And uh that could mean just leaking when you jump.
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Like sometimes young mothers discover it for the first time at the trampoline park.
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But um, then it goes to when you might cough or sneeze or laugh or exercise or so on.
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And there's also the latch key phenomenon when you need to use the bathroom, but you're getting home and you're turning the key in the lock, and things start happening that you don't want.
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And then even uh, yeah, we're we're talking about this part of the body.
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Like you might even notice that you pass gas when you cough or something like that.
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These are things that are not necessarily part of normal aging.
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They're common and frequent, but they're not inevitable.
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They're an indication of weakness, and in fact, they're considered a form of incontinence.
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So if you have leaks, you know, this is the prequel to incontinence.
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And uh I got just two facts about incontinence.
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One is that there are more incontinence pads sold in the United States than menstrual pads.
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Oh my gosh.
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Oh, yeah.
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And then two is that more serious incontinence is one of the primary reasons that especially women enter assisted living.
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So if this is the but this is the kind of thing that we can prevent by focusing on our public floor health and just with a few simple routines like how do we take care of our biceps and our shoulders, and and we we can do this, we can do this ourselves.
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I have been seeing, I've been watching a show on Amazon Prime, and I don't have the version without commercials.
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So I it forces me to watch the commercials, and I keep seeing commercials for incontinence pads.
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Yeah.
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I'm kind of ignoring it, but now that we're talking about this, it sort of feels like it seems that this is inevitable.
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And so we better know what we need to buy because it's definitely gonna happen and we just need to deal with it.
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Like that, I feel like is the message that's coming towards us.
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It is the message, and the companies that sell the pads are perfectly fine with that message.
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So those of us who are in the field of health really need to give a different view.
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And I didn't know that myself until I got the special training that I have now.
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Like I was just as I had no idea.
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Even though I've trained as a personal trainer and a health coach, my training didn't have to do with the pelvic floor until I took a specialty uh certification.
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Right.
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Yeah.
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So just quickly back to some other things that people might experience, frequency and urgency of going to the bathroom, overactive bladder, they have a lot of components.
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A lot of factors affect these, including like what are you drinking and your habits, and but but pelvic floor weakness can have something to do with that.
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Prolapse is when our organs, it could be the uterus, the bowel, the bladder, start to sag downward.
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And it is very, very common.
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A lot of women don't realize that they have it or they have the early stages of it.
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And what's happening is these organs are just not being supported by the muscles and the connective tissue in this part of the body, they start to sag downward, and people may not notice it until they feel a really heavy bulge or something that's interfering with our exercise.
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But it's something that we can actually help prevent or help prevent it from getting worse with exercises for our pelvic floor.
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And then incredibly, we think of our core, right?
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We always thinking about our core and we think about our ab muscles.
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But the pelvic floor is actually technically the base of our core.
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So we can think of our core sort of like a can, and our abs are going all the way around, and then our pelvic floor is the base of that can.
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And so pelvic floor strength and stability helps give us core strength and stability, which we tend to start to lose, and also affects our balance, even.
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We have that core strength and stability with a well-toned pelvic floor, we've got better balance, which we all want.
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Yeah, you know, you're right.
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We we all want a smaller slash flatter stomach.
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We want balance.
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We know that that's core muscles, we focus on the abs.
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Nobody says anything about pelvic floor being a piece of that at all.
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No, no, no.
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See, we're cutting new ground, we're breaking new ground here.
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We're on the cutting edge.
00:10:28.180 --> 00:10:30.980
Now, quick question for you related to that.
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Yeah, if we're working on strengthening our core, is there some side benefit that helps the pelvic floor as well?
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Absolutely, yes.
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This is a two-way street, and that's part of the good news that we're gonna share today.
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Okay.
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Okay.
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So if we think of our can, our core is like a can, pelvic floor is the base of it.
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Our ab muscles are connected to our pelvic floor through the connective tissue and muscle connections.
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So actually, when we brace our abs, our pelvic floor braces too.
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So they are related, they coactivate.
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And when we brace our pelvic floor and we do kegels, sometimes our abs will brace too because they're working together.
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They're friends in the body.
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And the pelvic floor has other friends.
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So thinking of our can again, the top of the can is our big breathing muscle, our diaphragm.
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So when we breathe deeply in and out, which unfortunately we sometimes don't do because we're hunched over, but if we breathe deeply in and out, it actually transfers that pressure to our pelvic floor and it starts to just gently go up and down with our deep breathing.
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And that brings blood flow and muscle tone to our pelvic floor.
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I say deep breathing is like taking our pelvic floor for her 10,000 steps a day.
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Breathing is essential, and breathing helps us with that core stability too, because it makes our can stable and not all crushed the way we might be leaning over our phone or our keyboard.
00:12:04.259 --> 00:12:05.540
Yeah, very good point.
00:12:05.540 --> 00:12:16.259
And if I may go on a tiny tangent for a second about breathing, I will put a link to an episode in the show notes where I talked with a breathing specialist.
00:12:16.259 --> 00:12:31.460
And it was, I don't, it makes me feel silly to say this, but when I talked with her, I realized that like why it matters that you take a deep enough breath that your stomach expands as well.
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Because lungs aren't in the stomach.
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So what is going on there?
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And she was explaining your lungs are expanding and that's pushing the diaphragm.
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And now you're kind of continuing that.
00:12:41.700 --> 00:12:44.820
So making it even more important for us to realize.
00:12:45.140 --> 00:12:46.259
Yeah, absolutely.
00:12:46.259 --> 00:12:54.900
I I love that you're gonna link to that because this breathing, the deep breathing, is um it's a great way of taking care of your pelvic floor, believe it or not.
00:12:54.900 --> 00:12:59.460
And also, a lot of women, one thing I didn't mention yet is over tightness.
00:12:59.460 --> 00:13:09.940
A lot of women have over-tightness in the pelvic floor, and that can translate to pain during sex and the feeling you have to push to pee and even cramping.
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I know a woman who went to the hospital because she had really hard, really painful cramps in that part of the body, and it was pelvic floor tightness.
00:13:17.780 --> 00:13:30.660
So that deep breathing, when we when we inhale deeply and the diaphragm goes down, the pelvic floor actually goes down, which is the relaxation phase of our pelvic floor.
00:13:30.660 --> 00:13:38.020
So that deep breathing is really the first line of defense if you're dealing with a tight pelvic floor.
00:13:38.020 --> 00:13:38.980
So that's awesome.
00:13:38.980 --> 00:13:41.460
I want to say one tiny more thing about breathing.
00:13:41.460 --> 00:13:44.900
So we do think about expanding the belly, and that's true.
00:13:44.900 --> 00:13:51.940
The uh diaphragm presses downward, transfers force to the abdomen, pressure, and the belly expands.
00:13:51.940 --> 00:13:58.660
But we really also, it's possible to breathe and just your belly expands, and that's not optimal either.
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What's optimal, they call it three-dimensional breathing, that your whole can expands.
00:14:04.580 --> 00:14:10.259
So you might notice your ribs expanding out to the side and even out to the back.
00:14:10.259 --> 00:14:19.460
And that's the real optimal breathing that reinforces our core stability and uh helps our posture, can help ease back pain.
00:14:19.460 --> 00:14:28.420
The woman I learned this from, Janice Matek, she cured her back pain, was terrible back pain, was cured by proper breathing.
00:14:28.420 --> 00:14:30.740
And then she became a teacher of breathing.
00:14:30.740 --> 00:14:31.940
Wow.
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It is wild to think just breathing in and out.
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We have to do it anyway.
00:14:36.980 --> 00:14:42.340
And just doing that differently, I mean, it's amazing to think what effect it can have.
00:14:42.340 --> 00:14:42.820
Yeah.
00:14:43.060 --> 00:14:43.860
It it really is.
00:14:43.860 --> 00:14:45.940
And then, but we can do a simple test.
00:14:45.940 --> 00:14:52.660
Like when you like right now, you can pretend you're hunched over your phone to look at it and try to take a deep breath.
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Like you can't do it because we're hunched over it.
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We're kind of squishing our can.
00:14:58.180 --> 00:14:59.140
Yeah.
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And you can't do it.
00:15:00.420 --> 00:15:02.420
And that's how we spend a lot of our day.
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And we're we're staying alive, but we're breathing up high in the chest, which is not optimal for our bodies.
00:15:08.259 --> 00:15:09.220
It's not optimal.
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It's it's a stress type of breathing.
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And what we're talking about today, the pelvic floor, it's not doing our pelvic floor any favors.
00:15:17.620 --> 00:15:17.860
Wow.
00:15:18.100 --> 00:15:20.740
Have we covered a lot of the symptoms or are there more?
00:15:20.740 --> 00:15:26.500
We did cover the symptoms, but I just wanted to hint to why we have these symptoms.
00:15:26.500 --> 00:15:32.100
Because yeah, we use our pelvic floor, you know, we go to the bathroom, right?
00:15:32.100 --> 00:15:33.540
Why does it get weak?
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Well, it's our sedentary lifestyle.
00:15:35.860 --> 00:15:37.700
So that ties in with the breathing.
00:15:37.700 --> 00:15:44.500
Like we're not doing our deep breathing, we're not necessarily challenging our abs in daily life.
00:15:44.660 --> 00:15:44.820
Right.
00:15:45.060 --> 00:15:52.660
And then the pelvic floor has two more friends in the body that are very important: the glutes and the inner thighs.
00:15:52.660 --> 00:15:59.379
So it's a cliche that if someone has to use a bathroom urgency, urgently, they're like squeezing their inner thighs together.
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Well, there's a reason for that because the inner thighs coactivate with the pelvic floor, and so do the glutes.
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But what's happening with us, our modern people, we're sitting on our glutes.
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And even when we walk around, we're not necessarily activating our glutes.
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And the same with our inner thighs, they're just sitting there.
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So our pelvic floor is missing out on this muscular stimulation.
00:16:25.060 --> 00:16:30.259
But then the good news is it's super easy to add that back in.
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So, what I teach people to do is you're doing your kegels, which we'll talk about in a moment, and then you can just squeeze a squishy ball or a cushion between your inner thighs, as you do, your kegels, and it turbocharges them because you're activating those muscles.
00:16:45.220 --> 00:16:47.940
And it's also great for your body in general.
00:16:48.259 --> 00:16:48.660
Yeah.
00:16:48.660 --> 00:16:52.580
Inner thighs are just a problem area as well for so many women.
00:16:52.580 --> 00:16:56.500
So, all the better that we can do a bit for them while we do this.
00:16:56.500 --> 00:16:57.620
Yeah, I love it.
00:16:57.620 --> 00:16:58.100
Yeah.
00:16:58.100 --> 00:16:59.140
Interesting.
00:16:59.140 --> 00:17:01.700
Okay, so also one more question for you.
00:17:01.700 --> 00:17:12.740
How does it happen then that some people have this lack of muscular strength in the pelvic floor, and some people have an overly tight pelvic floor?
00:17:12.740 --> 00:17:14.980
Do we know why that difference happens?
00:17:15.299 --> 00:17:15.619
Sure.
00:17:15.619 --> 00:17:16.339
Yeah.
00:17:16.339 --> 00:17:19.059
You know, they're not visible, but they're muscles.
00:17:19.059 --> 00:17:21.220
So think about our shoulders, right?
00:17:21.220 --> 00:17:24.900
Our shoulders can be weak, often they are.
00:17:24.900 --> 00:17:27.220
Our shoulders can also be tight.
00:17:27.220 --> 00:17:28.740
And they can be both.
00:17:28.740 --> 00:17:30.900
They can be both weak and tight.
00:17:30.900 --> 00:17:32.740
And why does that happen?
00:17:32.740 --> 00:17:41.539
So, weakness, think about our shoulders is, you know, maybe we're not pushing and pulling with our arms very much, and they've just gotten weak.
00:17:41.539 --> 00:17:44.740
And then tightness, why do they get tight?
00:17:44.740 --> 00:17:49.299
Well, it could be our habits, our posture, our way of holding ourselves.
00:17:49.299 --> 00:17:56.980
It could be that we have stress or we have trauma and it's caused our shoulders to become shoulders up by the ears, yeah.
00:17:56.980 --> 00:17:58.180
Yeah, up by the year.
00:17:58.180 --> 00:17:59.700
I can wear mine like earrings.
00:17:59.700 --> 00:18:00.420
It's crazy.
00:18:00.420 --> 00:18:02.339
So we all understand that.
00:18:02.339 --> 00:18:05.539
And the pelvic floor is really exactly the same thing.
00:18:05.539 --> 00:18:17.859
So it can get it gets weak through underuse and underuse of those partner muscles, and it gets tight from too much sitting, posture, trauma, stress.
00:18:17.859 --> 00:18:20.739
So uh it's it's all very logical.
00:18:20.739 --> 00:18:25.539
And the really interesting thing, you know, with our shoulders, what would we do?
00:18:25.539 --> 00:18:26.579
What would we do?
00:18:26.579 --> 00:18:32.419
If we have weak shoulders, we know what to do, some pushing, some pulling, maybe resistance bands, right?
00:18:32.419 --> 00:18:34.339
But what if we have tight shoulders?
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What do we do?
00:18:35.219 --> 00:18:45.779
Well, we might go for a massage, we might use our own massage tools, we might go to a physical therapist, we might investigate like why are my shoulders tight?
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Is it my habits, my posture, my stress, my trauma?
00:18:49.059 --> 00:18:51.779
And we can do the same thing with the pelvic floor.
00:18:51.779 --> 00:19:02.099
There's actually pelvic floor physical therapists who specialize in this area of the body, and they're able to do like specialized massage or even teach you.
00:19:02.099 --> 00:19:06.179
And there are specialized massage tools you can use for this part of the body.
00:19:06.179 --> 00:19:11.779
There's a whole world that people are not aware of that can really help their quality of life.
00:19:12.019 --> 00:19:12.979
That's amazing.
00:19:12.979 --> 00:19:13.539
Yeah.
00:19:13.539 --> 00:19:16.899
And it's kind of sad that we're not aware of this.
00:19:16.899 --> 00:19:23.779
And all these symptoms that you've described are things that people definitely deal with very commonly.
00:19:23.779 --> 00:19:24.339
Yeah.
00:19:24.579 --> 00:19:24.899
Right.
00:19:24.899 --> 00:19:32.899
There are 200,000 surgeries approximately per year in the United States for prolapse and incontinence.
00:19:32.899 --> 00:19:35.379
And the doctor who trained me, Dr.
00:19:35.379 --> 00:19:47.299
Bruce Crawford, says that most of those could have been prevented if people would do exercise simple exercises and help their pelvic floor.
00:19:47.299 --> 00:19:55.299
And sadly, a lot of those, up to 50% of those surgeries have to be repeated because they're just not very good.
00:19:55.299 --> 00:20:03.139
You know, they'll put a, they'll put like an artificial mesh in your body to uh substitute for your pelvic floor support.
00:20:03.139 --> 00:20:05.459
And that just doesn't work so great.
00:20:05.459 --> 00:20:14.579
So really starting wherever we are, however old we are, training these muscles, we can prevent a lot of these problems.
00:20:14.579 --> 00:20:16.499
But yeah, people don't know this.
00:20:16.819 --> 00:20:17.139
Yeah.
00:20:17.139 --> 00:20:18.579
Well, that's why we're here, right?
00:20:18.579 --> 00:20:20.019
That's why we're here.
00:20:20.019 --> 00:20:20.979
Yeah.
00:20:20.979 --> 00:20:21.539
Okay.
00:20:21.539 --> 00:20:26.179
So then that is the perfect time for us to talk about what we can do.
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Because I think every woman has probably heard of kegels.
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Yeah.
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