Transcript: Podcast/Episode 8

From Pain to Possibility


Episode 8: Integrative Postpartum Care, with Megan Jenkinson

Intro: You're listening to From Pain to Possibility, with Susi Hately. You’ll hear Susi’s best ideas on how to reduce or even eradicate your pain and learn how to listen to your body when it whispers so you don't have to hear it scream. And now here's your host, Susi Hately.

Susi: With this episode, I'm delighted to interview Megan Jenkinson. She is a physiotherapist, kinesiologist, and Pilates instructor, with a specialty in women's health and movement. She draws on all of these practices when working with her clients to provide comprehensive whole-body approach to rehabilitation. Megan has developed her own system for pelvic floor and core recovery over her years of experience working with postnatal women. Her online program is designed to teach women the principle of reconnecting with their bodies through awareness and movement. The program is customizable to the needs of each individual, and she also provides personal online consults and support.

So welcome, Megan. I am super excited to have you on this podcast because you and I go way back. I don't even know how many years. It was certainly before I had the kids, and they're now three, at the time of this recording. I think it may have been two years prior to that, after—

Megan: Yeah, I think it was probably—yeah, 2011 or so.

Susi: Yes, because—

Megan: Maybe, yeah.

Susi: Or 2012. We could probably have a podcast just about that, right?

But you know what. How I met Megan—and this is important, I think, for the context of what we're going to get into, talking about Pilates and movement and physiotherapy and biopsychosocial model and really what we can look at in terms of movement and how this can be helpful for a variety of healthcare professionals, including physiotherapists—and that is I had fallen down my stairs and had sprained my coccyx back in December of 2010. And then through 2011, I recovered really, really, really well. There was just this little niggling little bit, because I'd gotten back into cycling in 2011, getting ready for a big ride called the Ride to Conquer Cancer. And I was just getting some really niggly stuff as I was increasing my load with the riding. 

And I'd been in a situation where I was on a boat where they have the big wheel, where you captain the boat. And I was sitting on one side, and my feet were up against the other side, if you can imagine that, and I could feel this great pressure between my feet, pushing on one side, and my butt almost kind of is snugged in there, and the niggling thing that I was feeling just kind of dissipated. I’m like, “Ooh, that’s interesting. How can I mimic this?” 

And I remembered my Pilates experience way back in, like, the 1997, ’98 time, and being on the Reformer. I thought, “Ooh, I should go check out Reformer work.” And I kind of fell into your lap because the studio that was around the corner from me, I chose them because they're in the neighborhood. And then she, the woman who owned it, said, “You need to check in with Megan.”

And so, buhdah, here we are, many, many moons later, right?

Megan: Yeah.

Susi: Even our relationship inside of that has shifted and changed in how we work together. So that's all a big, long story about why we're here now.

So I think what I would like you to share is your evolution from physiotherapy to now, and how you evolved from maybe what we can call, like, maybe how you typically maybe used exercise in a therapeutic context, and now, because you and I have had lots of conversations about how that's changed.

Megan: Oh, absolutely. Yeah. And I think, well, I graduated 2002 from physio, so it's been a long evolution of lots of little things influencing me along the way. I would say for sure, I've actually thought about this the last couple of days before our conversation. I actually think a little bit of when I first graduated, I worked a lot in pediatrics, and that always comes back to me. I honestly think those were the seeds for me. And this, because as I'm thinking about when I worked with kids—and I still work with kids a little bit—but you really have to look at a bigger context. It's never just about the exercise. So I think that started it for me. 

And then, as I moved out of pediatrics and was really interested in women's health, and that was from my own experiences of having kids and being postnatal and realizing that I really had no idea how to reconnect with my body in a way that was helpful and to try different things. And so I really started to explore and look at movements in different ways. And from women's health, I went on to explore Pilates.

Susi: And when did you start utilizing the Reformer from a teaching perspective?

Megan: Yeah. So I started more at my first—I went to Pilates classes and sought out an instructor myself, actually in a very similar way to you. I just intuitively felt that working on the Reformer might be a good way for me to reconnect with my own body. So that would have been in 2010. And then, in a very short period of time, I think within six months of working with an instructor, I just realized that I wanted to do the training myself. And so the following year, over the course of the following year, I did the training, and then in 2011 started teaching myself.

Susi: And so how has the evolution been from—or is there even a distinction between how you're utilizing exercise now and when you're working with a body and how the seeds of your pediatric works have fueled that, or at least have informed that, versus when you were working as a physio? Because there is a distinction in terms of that change of you watching the body and how you're applying movement and exercise.

Megan: For sure, yeah. I think that distinction probably, eally, it only started to happen as I started to teach Pilates. So like I said, I had the seeds of it there, but I didn't really recognize it until I started to teach Pilates and then worked more into women's health and start to move away from this paradigm of kind of prescriptive exercise for certain things and recognizing that it was a little bit different for everyone, and there was really more of a continuum there of—there wasn't essentially this formula that you could apply to x condition, but it was more this whole paradigm of movement and awareness and connecting with your body. So I think it started to shift for me when I started to actually just teach movement.

And really what happened was I actually, probably important to note, I jumped out of the physio world for almost two years, and strictly taught Pilates and was not even essentially working that much as a physio, and then I went back. So I think that time away really helped—

Susi: When you—

Megan: —because then I was able to—

Susi: Sorry, go ahead.

Megan: Sorry, go ahead.

Susi: So when you stopped the Pilates for two years, was that a conscious decision to stop?

Megan: Yeah, that was a conscious decision. I just realized I couldn't do what I was doing anymore, and I couldn't fix this new thing that I wanted to do into the model of the physio that I was being. And so for me, it was like it was black and white, at the time. I realize now it's not. But at the time, I actually had to leave the clinic setting, and I went and taught—and that’s where we met—I taught in a Pilates studio, teaching Pilates, and I was able to explore and do what I wanted to do with movement there.

So then, within the two years of doing that, I started to find ways—because I didn't want to lose—after a while, I kind of started to miss the physio part. I had to figure out a way that I could bring them together again. And so, I think it was right timing that I was able to find a clinic and some clinic owners that had a similar vision that wanted to integrate some movement practices. And so then I went back to the clinic, and we were able to figure out how to merge it together.

Susi: And it's interesting because the physiotherapists and the OTs, even the nurses that I've trained, I would say the common refrain from all of them is that they wanted out of the profession. And then—

Megan: Yeah.

Susi: —they come back, and they come back around. And it’s, for me being a trainer and working with them for, I mean, at least a year or more through various programs I run, it’s so interesting to watch their evolution, because I don't know where someone's going to end up when they do training with me. I just get to watch and witness the journey. And they all come around in another way, but I think initially there's—maybe it's not conscious, sometimes very conscious, like they're upset with the paradigm, and they—or, just they want it, it doesn't fit who they are. It's not to say the paradigm is wrong; it's just that it's not a fit for them. And it feels like a really—

Megan: And I’ve encountered exactly me, yeah. 

Susi: Yeah. It feels like a scratchy, small sweater, right?, that doesn't fit anymore. 

Megan: Yeah.

Susi: And it's just like, “Get this thing off of me. It doesn't work for me. It doesn't resonate with me. And just, out of the way.” And then, every single one of them has kind of come back and went, “Wait a second. There's some really good things about this profession that I've trained in. And I'm actually really skilled at this profession that I'm trained in. And, my goodness, I can actually use those skills back in this new thing that I'm doing with movement,” or in my case, with the yoga that they're learning. And there's this mindfulness peace as they weave it in, that there is this just a new state of being-ness in utilizing the movement in a therapeutic perspective that then as they merge the two, it's as if that which really turns them on when they got into their program as students and when they graduated with the new excitement that they had for it, it was returning, but just in this elevated, integrated way.

Megan: Yeah, I mean, yeah, that's exactly it, that returning. And I think, well, for me anyway, I needed to leave for a while before I could return with that new perspective. And it's probably the same for most, and then just realizing—

Susi: Well, what’s interesting—

Megan: Sorry, go ahead.

Susi: Well, what’s interesting with you is you were predominately working pediatrically, right? And now you're doing a combination, where you're still seeing kids, like, seeing pediatric infant—When I've come into this space, and I've seen you with little kids, like little infants, and then you've  got quite a strong adult population.

Megan: Yes. Yes. And actually, mostly women, just because of the women's health background or the courses and things that I've taken and just the specialty of our clinic. So women’s health, pelvic floor. And then it really does fit nicely with the infants as well. And as far as pediatrics went, that was always my favorite was the infants. So I’ve kind of kept up with that. And, yeah, it’s been a really nice mix.

Susi: Now, something that we've spoken lots about during our sessions when I'm on the Reformer and we're playing around with movement is we can get very curious about compensation patterns. And something that we both had a lot of fun with was, after I had my twins and I had a C-section, and it was a scheduled C-section, so there wasn’t a lot of birth trauma there, but I had no abdominal control. And you, having known me prior to that, and my own excitement about biomechanics and movement and recovery and healing, we were able to really play into, let’s rebuild these patterns, because I had no choice.

Megan: That was so cool to feel like you can really start at ground zero.

Susi: Yeah. And we got to see how, like, there was compensation, obviously, that I was doing because all humans compensate, and we can see the compensations that were arising out of me being a mom to twins and needing to do things that weren't within my capacity because I had to do things that were outside of my capacity, and then learning what my capacity was and becoming more and more conscious of what those patterns were. And there was this piece that I'll be speaking about in a future episode around recovery postpartum and recovery from C-section and recovery from diastasis, because I did have a diastasis. I don’t think we ever really measured the amount, but there was one. And we—

Megan: I think somewhere, like, right at the start it was measured. I could probably look. But it definitely was there. You're right.

Susi: Yeah, it was certainly there. And it was top to bottom. It was right between pubic bone to bottom of the breast bone. 

But what we found really fascinating was how the less I compensated, the more abdominal tone and closure that diastasis had. And something I'd like you to sort of talk about from your perspective is, we know that closing the gap with diastasis is not the thing, that’s the thing. If there is this underlying abdominal tone under the diastasis, it’s really important. And yet the closure part is—there is a significance, I should say, to it. So say more about what you’ve seen with your clients, and then also what you saw with me, around movement patterns, and when we brace in other places, like the ribs or the pelvic floor or jaw, and how that relates to the abdomen not recovering its tone postpartum.

Megan: Right, right. Well, so, you're right in that because now what’s talked about in therapy circles is that it's not about the gap or it's not about the distance; it's about the tension created in the abdominal wall. So I think that's true. Although, like you just said, the gap coming together could be a result of more tension. But really, what everyone is looking at is the tension. 

What I find is the tricky part or the part that sometimes is not well understood is how to create that tension, and I don't think it's what most people think it is. So, most of the thoughts around creating tension in the abdominal wall would be about engaging the deep abs kind of idea. And that's really not all it's about, although for some people that could be part of it, learning to engage their transverse abdominis or something. I have found, and I've only found this by working with women, and actually working with you really helped me see this in a very tangible way, that if you can address the compensation patterns happening in other areas of the body, then, actually, that deep abdominal tension that we’re looking for naturally occurs. So those compensation patterns are essentially taking away from the abdomen firing or engaging or working, so kind of taking a back seat. 

So, in a lot of ways, with a lot of women I've worked with, if we can address those compensation patterns and improve movement patterns, then the abdomen just naturally comes on board.

Susi: Yes.

Megan: Then, you have the tension you’re looking for; where so many programs will just focus on, “You just need to engage your TA, your TA, your TA, or your pelvic floor.” And it’s not that those aren’t components of it, but I think it's like what you said. It's like layering tension on tension. So you have the compensation patterns, and then you're just putting more tension of trying to engage your abs, and then everything’s just tight and nothing's actually working in that fluid, coordinated way.

Susi: Yes. And what's really fascinating, like, I still remember the big aha I had around this with you. And we were on the Reformer, and we were doing a movement that in yoga would be Downward Dog to Plank. And so those people who are familiar with Pilates, the feet are on the backside of the Reformer, and the hands are at the shoulder rests?

Megan: Yeah. The hands are at the shoulder rests, and then your feet on the platform at the end. Yeah.

Susi: And so then, I move forward through the hips and the shoulders. And what was so fascinating was noticing that there was this very, very sort of slight kind of feeling I had inside of me, like a light kind of disconnect is the best way to describe it. And I could do the movement. We saw me being able to go right into Plank. But there was a point just before my going there that's like, there's something that's not quite right here. And then we found—like I was like, “Okay, there’s something not quite right here,” and then you put your hands in there, and you could say, “Yep, right at that point, your abdomen stopped engaging, and it kind of got really soft.” 

And sort of early on, where there was better connection and better coordination through my abdomen, it was when I went past that phase that we could feel the split happening again. And that was when it really first, really first, opened my eyes to a conversation I've had for a long time around compensatory patterning. And it was classic because I could actually go into Plank, but I wasn't doing it functionally. So I could go partway, and I had to stay in that range. 

And then we discovered, “Oh, look, you're bracing in your rib cage. Oh, look, you're bracing through your forearms. Oh, look, you're bracing in your ribs.” And then, we could really kind of go, “Oh, this is really interesting.” 

I think it took me another eight weeks after that to find and feel what that control was. And what was really fascinating was that I didn't have to use my will or use my brain to make it happen. If anything, I had to use my will and my brain to not make it happen.

Megan: Right. You had to stop thinking so hard about it, you mean, and just kind of find the movement?

Susi: Yeah. I just needed to let the movement find me, almost. Like, I just had to feel—

Megan: You had the movement find you, yeah. Yeah.

Susi: —I had to let my brain step back from it all and just go, all right, let’s just feel it for real, not try think it—try to think about feeling it. Just feel it and almost let the myofascia respond to my movement as opposed to going, okay, I better engage my TAs here.

Megan: Yes, yes. Exactly. And upset, yeah. And then finding that, so—and I know we’ve worked on this a lot, and this is how I work with my clients, is finding that range of movement that you are listening or that the myofascia is connecting. But then if you move too far beyond that, then you get that disconnect, which is what we were feeling in your abdomen essentially like a bulging or a loss of tension. If you keep moving into that, then you’re just not learning a new pattern, because you keep pushing past it.

Susi: Which is—

Megan: And what was really interesting with that one, as I'm remembering, how good you actually looked, you know?

Susi: Yeah. Like when I went too far.

Megan: You know what I mean?

Susi: Yeah. Like when I went too far.

Megan: Well, as I stood back at a distance and took a video of you, I’d be like, “Oh, wow. She looks really good doing that.” It didn’t look bad, but it only looked at the smaller components of it. There were things breaking down, like the subtly of it.

Susi: Yes. And what’s interesting what you said a moment ago about when I went too far, there was a disconnect. And here’s what’s really cool: when I went too far, I was disconnecting from my awareness, and I was disconnecting from my body, and there was a disconnect physically that was going on.

Megan: Yeah. I was feeling the physical disconnection, but there was more, yeah.

Susi: Right? And so this awareness piece is so important, right? Like, when we lose the awareness, we lose the connection, and we literally lose the connection. And so such an important part of the work that you do and that I do is we've got to improve the awareness because you can't change anything you’re—

I keep blasting through my good-looking Plank, but I wouldn’t actually gain what I needed to gain, right?

Megan: Yeah, yeah. And I see this over and over when I have people come in, and they've been given different exercise programs from different people, and they come in either with back pain or diastasis or these different things. And I do tell them often, “Well, the exercise or the movements you were given are good movements. They're not bad. And you actually technically look pretty good doing them. But let's go a little deeper and see what's really happening.” And when we look at it on a deeper level, they're getting pain from doing what they're doing. They're creating tension. They're not getting improved core engagement, which is what they're generally looking for. They're not connecting to those things. And so, yeah, it's just a pattern, or a thing that I see all the time. And so working with someone's awareness first, “Okay, so these exercises aren't serving you in the way that you've been shown to do them. So let's figure out a way that we can maybe change them or back off the range of motion or have awareness in some different ways.”

Susi: Yes. And so it's utilizing this idea of the exercise is not the thing; it's the how we're doing the exercise.

Megan: Absolutely. Yep, yep. Mm-hmm.

Susi: And so it highlights—a conversation I've been having with some other physiotherapists is it's not so much the quantitative measure of, like, do 10 sets three times, although you could have that as an outcome. But just doing three sets of 10 doesn't mean you're going to get the outcome you desire.

Megan: Exactly. I mean, a perfect example is glute exercises. There’s lots of different glute exercises that will be given by PTs, and it's with the right intention that they're trying to strengthen the glutes. But over and over, I'll have people show me their glute exercises, and their glutes aren't even really coming on board because their low back is gripping or their rib cage is locked down or they’re holding their breath, and really not—the exercise they’ve been given with the right intention is actually not achieving the goal.

Susi: Yes. So just giving the exercise without actually teaching the movement pattern that goes with it.

Megan: Yeah. And actually, when you were saying that—so it's not about the exercise, but it's about how, that's absolutely true. But I also think the way that I see this maybe taken [out of] context is PTs showing—so it’s about how you do the exercise, but meaning it needs to be performed with this specific technique and alignment. And I think that's where you and I probably have a different view on that. So the how being more of the sensation or connection in with the body. Would you say that's true?

Susi: Ooh, yes. Let's talk more about that. So, yeah, because the how itself can become exercise in and of itself.

Megan: Yes. So I see that all the time, where it’s not about the exercise; it’s about how. But then the person’s teaching how as in, like, you have to have your feet here, and you’re just fine here, and making it like an absolute “This is how everyone should do it.” You know what I mean?

Susi: Yes, yes. When in reality, the how is dependent on what the person's awareness is of their own movement patterns.

Megan: Yeah, yeah.

Susi: Which becomes—

Megan: It’s not like “This is the right way to do across the board for everyone,” which I know that you do similar things within your yoga.

Susi: Mm-hmm, yes. And so if you could offer to physios, because there's more and more physios who are becoming interested in this way of working, and some of them, I would say when they have conversations with me, they'll say that there's something missing, but they're not entirely sure what it is. And not to put words into their mouths, but as they then work with me, they’re like, “Ooh, I think this is part of the missing piece.” And then there's others who are very clear of what's missing. They know that there's that how they're doing the exercise prescription is not working for a number of reasons. They're seeing that their patients or their clients aren't maintaining a home program, or they're coming back and they're just not doing it right. In some cases, they’re at their wits’ end; other cases, they’re like, why isn't this working? They're getting really curious about why. What else can be offered? So in those cases, what would you suggest to physiotherapists who are curious and want to move into this direction of the how we’re doing the movement but not how from a templated, across-the-board “You must have your feet here and your shoulders here and you…” yeah.

Megan: Yeah. Well, I think in a lot of ways, the paradigm, or the way physiotherapy is delivered right now makes it difficult. So there needs to be some new ways, because if you think about—so, I worked in a private practice when I first started in physio, for a very short period of time. I didn’t even mention that because I didn’t stay very long for these reasons, because I was given 15 minutes with each patient. So that in itself doesn't lend itself to being able to be present and listen to the person in front of you. So there's that. So I think there are clinics, and I know ours is one of them, where you can have a little bit more time. So it needs to start there in a very practical way. 

And then beyond that, once you do have a little bit more time, it is actually just that presence. And I think, actually, when given the time and slowing down enough, most physios do have this skill. We've just been maybe trained out of it a little bit because of our work environment. But most physios are really good at sitting down and taking a history and listening to the patient when they give them the time, and I think that’s a key piece.

And then from there, it's learning to be present with the person, and then, also, really take in more of what they're telling you about their body versus just trying to figure it out yourself. I think that's—well, that's how I was trained in physio is, like, take the history, but then figure out what the problem is and fix it, rather than having the patient or the client kind of be partnering with you, because then you can give them the tools, and they can give you lots of feedback. My clients tell give tons of feedback about their own body of the things that I can’t see but they can feel, and I think that's important information. And it's that qualitative information versus quantitative, and so I think it's shifting out of that mindset that everything needs to be able to be measured or else it's not true.

I don’t know if that totally answers your question.

Susi: Well, where it leads me to is this idea of qualitative and quantitative, where when we're in an evidence-based practice, the quantitative is really very important, and there is a place for it. The limitation, though, is we're all human beings, and we have a variety of experiences. So like me with a diastasis and a C-section, with all my experience, I’m different than someone who has diastasis and C-section and doesn't know anything about body movement.

Megan: Exactly.

Susi: So, then, how you would work with me versus someone who doesn't have awareness is very distinct. So it's unique—

Megan: Exactly, right. So—go ahead.

Susi: So needing this—it's this qualitative experience that feeds the quantitative measure so that then you can see the out—because the outcome is still quite good. It's not utilizing the quantitative. You still, you see the gains quantitatively, often a lot faster because of being able to—I’m going to use these words—you’re able to process with the qualitative, what’s going on in their world and what they are feeling.

So here's a question for you, because this is what will come up from other professionals, and I want to get a little more granular on this so people can have a takeaway. You, I'm sure, have had clientele come into Pilates who don't have a lot of awareness. And so you're saying things about qualitative and how your clientele give you information that you can't see. That will only work, though, if they are aware enough to feel what's going on. And so—and I know I do this in my own practice when I'm working with someone who's not aware and helping them become aware. So what are some tools that you use to support someone to become aware of what it is that they're experiencing?

Megan: Right, right. So I think the important thing there that I have learned to do is still get them moving in some way. So I don't want to stall out and get back on breathing, and making sure that their pelvic floor is doing absolutely the correct thing, and all of these things. I want to find kind of a way in to teach them some level of awareness. So it depends what they're coming in for, but maybe a good example is—because I see a lot of women with pelvic-floor concerns—so say someone who has a tight hypertonic pelvic floor and maybe some incontinence. And so one of the things we want to work on is getting their pelvic floor to function better. So we kind of experiment, and I just choose one thing. So maybe it's just breaths or maybe it's just learning to kind of let go around the pelvic floor, just grabbing onto, hopefully, something that they can connect into. Or it might just be noticing that they hold their breath, and let's just not hold your breath and move. So picking one thing.

And then, finding just some nice, sort of comfortable movements that feel safe to them, that we can integrate that one thing. So say it’s, “Hey, let's not hold your breath, because you're bracing and holding your breath. And we'll just start to move, and we'll start to just feel how that feels to not hold your breath.” And then, I find once they can get that, then I layer on the next thing and the next thing. 

So I think that's maybe another thing that happens in movement and maybe within physiotherapy too, is too many things coming at the patient at one time. And so I really like to focus in on just the one thing, and then when we get back, and we choose the next thing and the next thing.

Susi: I like that. So it's like you're choosing what seems to be the most important thing that will make the progress that is required in order to do the next thing.

Megan: Right, yeah. And I let them help me choose what that thing is. We'll talk about it. And if the thing that I think is going to be the thing doesn’t work, then we fix something else. Or, for instance, I had a woman I worked with for the last several months that has had great gains, and really all we did was—so she’s got lots of back pain and lots of back tension, and so if you can move and just not rip your back, then that's a win, and I don't really care about the rest of it right now. But as soon as you feel that back start to grab on, like, what that would—lower back muscles, then we back off. 

And then she was able to, rather than—she had to come from—she actually had been to tons of different practitioners, pretty much everyone under the sun. So she actually had a million things she was trying to think about, and none of it was working because she was overwhelmed. So I think for her it worked really well to just think, “Okay, I just have one thing I need to think about.” And then she was able to find movements that she didn't grip her back, and then we could say, “Okay, so what's the next thing?” and we kind of go from there.

Susi: And that’s really great because I know in many different movement professions of all kinds and even in all professions, period, when someone is coming in to solve a problem, whatever it is, any professional can fall into the trap of, “Well, this is what I see is the problem, and this is what we need to start with.” But if that doesn't resonate for the client, then it's going to be really, really difficult to make it happen. And yet when the—because the client has a ton of experience about their own bodies and about their own state so that they can come in and say, “Hey, this is the thing that is the thing for me.”

Megan: Yeah, yeah. And they teach me a lot, so I’ve learned to work with people in the way that I have because people have given me this feedback, including you and others, where I can actually see what works, because I'm letting the client give me that information, and then we’re trying it out and seeing that it works, rather than me just relying on what I have in my brain that I think is going to work. Yeah, I get taught things all the time, and it’s fun.

Susi: Yes. And it’s something I learned a long time ago from a mentor who highlighted the power in the healing profession and how in very typical medicine, there's a power over type of relationship with the health professional, knowing it all, being the expert, and then the client or the patient needing to take what the professional is saying and doing it. And so it can be very uneven or imbalanced, perhaps is the way to say it. Whereas, if we come at it from this perspective of the client actually has a ton of information that they have lived in their bodies that they can share, and the professional has a ton of information from their own lived experience and being a professional, that when you bring the two together, then you're now on an even level. And what’s really powerful, I've found with that, is then there's an experience for the client of being listened to. And I hear this from a lot of my clients who had persistent pain and have overcome it, and that's the feedback they give me. It's that I feel like that I am important, meaning them, and that I've got valuable information, and there is a support there. 

And we can go in, probably, into another hour conversation about this. But there's something around the relationship and the honoring of that relationship, that if I use those words, that then enables them to feel more and be aware of more because what they're saying has significance and importance in the process of their recovery.

Megan: Right. Absolutely. Yeah.

Susi: And you’ve actually shared recently with me a story of a woman who’s come to see you. She’s got a kinesiology background, so she's got knowledge. She's got intellectual knowledge. And she was having some trouble finding support from a variety of different professionals around her knee, I think, or her shoulder. Can you say more about that as what you've done with her and how you've worked with her? because I think that really highlights some of what we're talking about.

Megan: Mm-hmm. So, it started as knee pain, and she went to physio for that, and she's been given tons of strengthening exercises. And I think it was working well at the beginning, but she wasn't getting totally where she needed to be, and the knee was so weak. And so she was then given these really high-load exercises to strengthen her glutes and around her knee and everything. And then from that process, she actually ended up having a back injury from doing the rehab exercises. And then from that sort of went into a cycle of persistent pain, and this, I think, lasted up to a year. 

And so she just kind of abandoned all of her therapy because none of it was working. It actually seemed to be getting worse. And so she kind of just relied on her own exercises at home, with her kinesiology background, but, of course, was still in persistent pain. 

And it wasn't until she started to explore pain science herself and read about it that she started to realize, hey, wait, maybe there was a different way to look at this. Maybe what I was being given, so the reason it wasn't working, because nobody was really looking at me in terms of all of me and my whole body and my thoughts and my beliefs, all the pain science kind of stuff. And so, then she constantly started to get shoulder pain, and she thought, “Well, I'll go try one more time. I’ll find a different physio, and I'll go in.” 

And she was really curious about why is this shoulder—because it was on the same side as her knee and her back pain—why is this shoulder now acting up? She said, “I really wanted to go in, and I really wanted someone to look at the whole picture. And I went in, and the physio just treated my shoulder and just looked at my shoulder, even though I was asking how it all—but I wasn't given an answer.” And she was really quite upset about it and just felt defeated that nobody could put the whole picture together. And she was starting to put it together herself, but she needed help navigating it, and so she came to me because she said she saw that I did the Pilates, and I looked at movement, and she wanted to try a different approach.

And yeah, it was really great because we were able to just look at everything and say, “Okay, I think the movements and the exercises that you were given were way too high load, and your body was essentially going into fight-or-flight mode the whole time. And let’s just find a different way to connect in with your body.” So we kind of just started back at the beginning and getting her to move with more ease and breathe. 

And I didn't even look at her knee, in fact. We worked together for a month or so. And unfortunately, we have a little break in working together right now, but I didn't really even look at her knee, because it wasn't really about her knee. And she just felt so relieved that she had a plan that she could look at that just incorporated everything together.

Susi: And—

Megan: It was actually, it was—sorry. I was going to say it was really hard to see how emotional and upset she was about the whole thing, that she couldn't get the help that she needed. Or she couldn’t before she worked with me.

Susi: Mm-hmm. And she felt her symptoms start to go down, right?

Megan: Absolutely, yeah. Actually, even within the first session, because I kind of was able to give her permission to just stop kind of bracing her whole body against the pain and just breathe and just move. Rather than having a specific goal or outcome, like, “We need to strengthen your knee. We need to strengthen your glutes. We need to strengthen your core,” instead, of it being about that, which it had been previously for her. It was just, “Well, let's figure out how you might be able to move with more ease and what might feel good and what might your body be telling you,” just some of those awareness kind of things. And I think it was just relieving for her that she could just let go of all that armor that she’d built up. 

Susi: So, here’s what I’m hearing you say. And I mean, it’s easy for me to process this because I’m in agreement with you, and I think people who are listening to this and might not be in agreement, and so there's something that I want to frame out here because of what I said earlier around, it's not saying that working at a component level for the shoulder is wrong or bad. That’s not at all what’s being said.

Megan: No.

Susi: It’s more that there is this qualitative experience that a client or a patient is having, that really resonates deeply for them on a belief level, and so there needs to be a match between the client and the practitioner of how they work. And so if the practitioner is not working from that perspective, then we're not going to have a hand-in-glove fit. And so there's absolutely a time and a place to be like, “You know, actually, you need to strengthen your knee,” or “You need to strengthen your shoulder.” And there's a time, like with this client that you're talking as an example, in all of her bones and all of her sense of self was thinking, “This is what I need.” And then, you know, kudos to her. She just kept at it. She just kept looking, which is sometimes what we have to do. 

I think we've all had experiences, in some regard, of looking for the right fit. And then when we find the fit, it's like, “Oh, this is the right fit.” And then, because not everyone is right for you, not everyone is right for me, and so it's finding that fit that is the fit. And what you've done is you helped acknowledge the qualitative experience that she was wanting and that she intuitively felt she needed in the process of going towards that quantitative outcome. So it's a different process. It's another process. But by no means is it any better than the other, because, in truth, medicine and physio and any traditional movement practice, whatever profession you want to look at, the reason why it still exists today is that it still works for lots of people.

Megan: For sure, yeah. And I agree with you; we do need both. So you're right. I don't want to give the impression that the other one is bad, because sometimes there is a time when you, like you said, just need to look at the shoulder or just need to look at the knee. But there's also—yeah, I think there needs to be maybe a little bit more space or more time given within rehab of looking a little bit bigger and casting a little bit wider net.

Susi: Yeah. And part of me gets super excited as we talk, because there's so much persistent pain out there, and there are so many people who have persistent pain or chronic pain, and they might be in a model that doesn't quite fit. And so, perhaps, those folks, and maybe some of those folks are listening to this now, and I hope that maybe there's an opening for them that they're saying, “Oh, interesting. That actually has some resonance for me.” So then they can start moving on their hunt on looking for someone who is a sort of a qualitative-combined-quantitative practitioner, of any sort. And that could be—and we can see it in all fields. I am someone who likes acupuncture, and I've been with acupuncturists who are more full body-mind and some that aren't. There are some that are very templated in their approach. And you almost think that, “Well, if acupuncture, it's traditional Chinese medicine, isn't everyone in a whole-being perspective?” and the answer is no. So it—within every practitioner, whether it's physio, [unclear 48:06], nursing, physician, chiropractic, there are some that—there's a spectrum, so it’s just a matter of connecting into what part of the spectrum really resonates with you and finding the practitioners who resonate there as well.

Megan: Mm-hmm, mm-hmm.

Susi: So, along that line, then, you, at the time of this recording, I think you’ve launched it now, haven't you?, the online program that you're offering women who are postpartum. So say a little bit more about that, because I think this is super cool because this is a customized, personalized program that can be done online, which, where we are now,, we’re recording this during the COVID times, which we’re doing a lot of online stuff these days.

Megan: That’s why I said that I’m unfortunately not working with people now.

Susi: Exactly.

Megan: A little break right now.

Susi: So say more about the program that you have and who it's catered to, so that those who are listening who are in that situation, I know people who are in the situation might resonate with what you're saying, can be connected.

Megan: Yeah. Yeah, so, I have an online program that I call Essential Core, and it is catered to women. Now, when I first started making it, it was really, like, a postnatal program, and it certainly is that. But I’ve expanded it in a broader way. It really can be for any woman postnatal, but that could mean 15, 20 years, 10 years. It's just more about restoring kind of balance and connection around the core pelvic floor, so if you have diastasis or some pelvic-floor concerns or just generally feel like your core is kind of not on board or where it needs to be, essentially. 

It's an eight-week program that takes you through the steps that I work on with my clients, and it involves weekly videos and movement flows, ways to look at releasing tight compensation patterns in the body and all the ones that I see, some ball rolling. And then it also incorporates being able to message directly with me to help you troubleshoot some areas. 

And it's interesting because I actually first launched it in January, and it was launched as a comprehensive program that included kind of one-on-one coaching and video calls with me. And then with the COVID that came out, that’s happened here, with them not being at the clinic and realizing that all of these women were at home and not able to access help, I decided to change it a little, where I offered the program as a standalone at a lower-price point. And then if people want to, essentially, upgrade or feel like they need more of that one-on-one consultation, they can book that separately. So, I felt like it made it more accessible to more people.

Susi: Great. Great. Well, perfect. 

So then, where can people find you if they want to connect with you, whether it's to have a consult or to check into this program or any other service you might have? How do they find you?

Megan: So if you go to, you'll see the information for my program there and contact information, email to me, as well as on Facebook, Instagram. Megan Jenkinson, PT.

Susi: Perfect. 

Well, thank you Megan. This was a lot of fun. 

Megan: Thanks, Susi. Yeah. I love that you're having a podcast now.

Susi: I know it’s crazy, and it’s fun, and I’m looking forward to having another chat in the future.

Megan: Okay, great. Take good care.

Megan: Thanks a lot, Susi.

Go Back to Podcast: Episode 8