Leaking when you laugh, hip pain that keeps returning, or sex that hurts are not things you just have to live with. We invited Dr. Courtney Smiach, founder of Rebel PT and a licensed pelvic health physical therapist, to unpack the real reasons behind pelvic symptoms and share practical steps to feel better—without shame and without the “that’s normal” brush‑off.

We dig into the core canister—diaphragm, abdominals, back muscles, and pelvic floor—and why pressure management is the hidden engine behind so many issues: urinary urgency, incontinence, constipation, pelvic heaviness, and stubborn low back or hip pain. Courtney explains how pregnancy changes posture, breath mechanics, and stability, what that means for SI joint pain and pubic symphysis popping, and why smart movement, breath work, and gentle core training during pregnancy can reduce pain and accelerate postpartum recovery. We also explore vaginismus and pain with intimacy as practical barriers to conceiving, plus the nuanced ways pelvic PT collaborates with dietitians, OBs, urogynecologists, and mental health providers to deliver real results.

If you’ve ever been dismissed by a provider or told your symptoms are “just part of life,” this conversation offers a different path: consent‑led care, clear education, and tools you can use right away. Courtney shares what to expect from pelvic PT, when internal exams help and when they’re not necessary, and how to find qualified specialists even if you’re outside North Carolina. Along the way, we highlight the growing (but still under‑researched) field of pelvic health and the community‑driven model behind Rebel PT + Cycle.

Subscribe for more honest, evidence‑informed conversations on pelvic health, pregnancy and postpartum care, mental health, and body image. If this helped you or someone you love, share it, leave a review, and tell us the one myth about pelvic health you want to see retired for good.

For more information on Rebel Pt, check out https://rebel-nc.com/

Show notes:

Trigger warning: this show is not medical, nutrition, or mental health treatment and is not a replacement for meeting with a Registered Dietitian, Licensed Mental Health Provider, or any other medical provider. You can find resources for how to find a provider, as well as crisis resources, in the show notes. Listener discretion is advised.

Resource links:

ANAD: https://anad.org/

NEDA: https://www.nationaleatingdisorders.org/

NAMI: https://nami.org/home

Action Alliance: https://theactionalliance.org/

NIH: https://www.nimh.nih.gov/

How to find a provider:

https://map.nationaleatingdisorders.org/

https://www.psychologytoday.com/us

https://www.healthprofs.com/us/nutritionists-dietitians?tr=Hdr_Brand

Suicide & crisis awareness hotline: call 988 (available 24/7)

Eating Disorder hotline: call or text 800-931-2237 (Phone line is available Monday-Thursday 11 am-9 pm ET and Friday 11 am-5 pm ET; text line is available Monday-Thursday 3-6 pm ET and Friday 1-5 pm ET)

If you are experiencing a psychiatric or medical emergency, please call 911 or go to your nearest emergency room.

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