Celebrate Muliebrity with Michelle Lyons

Hello and welcome to today's episode where I'm delighted to share my conversation with Dr Rachel Selman, all about better pelvic health conversations with athletes.
Rachel is a physical therapist and coach, who shares her experience integrating pelvic health into sports medicine practice and discussed her upcoming book aimed at educating athletes about pelvic health issues.
We explored challenges in communicating with athletes about pelvic health topics, including the need for sport-specific subjective questionnaires and annual in-services (for sports AND pelvic health pro's) to normalize these discussions. Rachel explained her approach to making complex pelvic health concepts accessible to athletes and coaches, emphasizing the importance of connecting pelvic health to overall performance rather than treating it as a separate specialized field.
We discussed the role of stress and anxiety in exacerbating pelvic floor symptoms, particularly during high-stakes competitions. Our conversation also highlighted the need for better integration between pelvic health and sports medicine professionals, emphasising the importance of training coaches and athletes to recognise and discuss these symptoms preventatively, comparing it to how they would address other orthopedic concerns. Rachel is doing her part to change the narrative, and is planning to release her first book, Floor It, this autumn and it is available for pre-order now!
Make sure you're following Rachel on instagram @dr.rachelselman for her amazing anatomy education and exercise strategies
Aaaaand...don't forget, my Summer Sale is still on for a few more days, so if you're interested in helping female athletes with their pelvic health, check out The Menstrual Detective, which includes the course 'Pelvic Health for the Young Female Athlete' for free! The code JUNE26 can be used for a €100 discount on ALL of my online courses, from Perinatal Pelvic Rehab, The Menopausal Toolbox, Female Pelvic Oncology and more - but only until June 30th!
All of the course info is at CelebrateMuliebrity.com or you can find out more on my instagram feed, a haven for women's health nerds, @michellelyons_muliebrity
Until next time, Onwards & Upwards, Mx! #celebratemuliebrity

'Why Do I Still Have Pain After My Endo Surgery?' This can be such a frustrating (and complex) situation that so many people with endometriosis find themselves in...but why?
I'm sharing this excerpt from the endometriosis updates in my online Female Pelvic Pain Rehab course - mainly because I've heard it so many times over the years, both from patients and the clinicians who are trying to help them.
There's actually been some interesting new research looking at why this happens and how we can actually help people restore quality of life and improve THEIR functional goals, so I really wanted to make this available even if you're not a student on this course (but if you work with people who have pelvic pain diagnoses like endometriosis, vulvodynia, dyspareunia...I hope you'll consider joining us!)
There are so many potential drivers of abdominopelvic pain that can amplify endometriosis associated pain, along with central sensitisation and pelvic floor dysfunction, including issues like IBS, neuropathic pain, hernias, hip problems and more.
I hope you find this excerpt from the course helpful AND if you're listening to this episode before the end of June... you can use the code JUNE26 at checkout for a €100 discount on any of my online courses, from Female Pelvic Pain Rehab to The Menstrual Detective, The Menopausal Toolbox and more. All of the course info is at CelebrateMuliebrity.com or if you have questions, you can send me a DM on instagram (@michellelyons_muliebrity) or email me at michellelyonsphysio@gmail.com
Enjoy the episode and if you found it useful, I would love it if you can rate, review and subscribe to the podcast!
Until next time, Onwards & Upwards! Mx and don't forget to #celebratemuleibrity

Hello & Welcome To Today's Episode! Today's guest has a unique perspective as she's both a high performance athlete AND a pelvic physio who is passionate about keeping girls and women involved in sport.
Clodagh McIntyre is a rising star in physiotherapy who is both an inter-county camogie player for Tipperary and a pelvic health physiotherapist. Clodagh discussed her journey from UCD graduate to working in private practice, her experiences with stress incontinence as an athlete, and the lack of pelvic health education in physio training programs.
We explored how pelvic health issues affect female athletes, with statistics showing 7 out of 10 athletes leaving sport due to bladder leakage, and discussed the taboo nature of discussing these topics within sporting teams.
We discussed the importance of education and support around pelvic health issues for female athletes, highlighting the lack of standardization in GAA and potentially LGFA, as well as emphasising the need to normalize conversations about these issues and prevent them from deterring athletes from participating in sports.
Clodagh shared her upcoming trip to Kenya with Warriors for Humanity and Self-Help Africa, where she plans to plant trees and help communities, for which she is fundraising.
Please see linked below to her fundraiser! https://www.idonate.ie/fundraiser/clodaghmcintyre 
Our shared passion is definitely showcasing the conversation and embedding pelvic health into female athlete wellbeing : there's SUCH a need for better education about pelvic health at undergraduate and postgraduate levels, as well as within sporting organizations, to support female athletes and prevent them from dropping out of sport due to pelvic health issues.
Want to learn more about supporting the Female Athlete, and promoting pelvic and menstrual health? The Menstrual Detective online course comes with FREE access to the course 'Pelvic Health for the Young Female Athlete, where we look at all the potential drivers for pelvic health dysfunction, beyond isolated strengthening for the pelvic floor muscles. All the details at CelebrateMuliebrity.com
Until next time, Onwards & Upwards! Mx #celebratemuliebrity

Hello & welcome to this episode, where I thought it might be good to see out the end of Pelvic Pain Awareness month with an extract from my new Female Pelvic Pain online course updates to share some great articles from 2026 that I think are moving the conversation forward.
We start with an overview of female pelvic pain assessment, focusing on evidence-based assessment frameworks and clinical strategies. I'm exploring a key research paper from 2026 by As Sanie et al. on chronic pelvic pain evaluation, which recommends an organ-system-based approach considering gynecologic, gastrointestinal, musculoskeletal, urologic, neurologic, and vascular sources, and we'll also explore the 2026 EAU Guidelines in the course conten

I do emphasise the importance of trauma-informed care, including creating safe environments, obtaining ongoing consent, and validating patient experiences.
I've outlined a comprehensive assessment protocol in the course updates, covering external physical examination of the pelvic floor, vulvar structures, and abdominal wall, incorporating strategies to check for issues like hernia and ACNES, the importance of Carnett's test, along with the use of patient-reported outcome measures like the Central Sensitization Inventory and Pain Catastrophizing Scale.
The discussion also highlights the need to address nociplastic pain mechanisms, central sensitization, and the interplay between peripheral pathology and central pain amplification in chronic pelvic pain management.
Some of the talking points:
Review and utilize the VAMP protocol in the vulvar pain module for assessment of vulvar, anorectal, musculoskeletal/myofascial, and perineal/periurethral structures in relevant patients.
Ensure inclusion of trauma-informed care principles in all patient interactions, including ongoing consent, patient-led goal setting, and environmental safety considerations.
Screen patients for risk factors and comorbidities such as obesity, physical inactivity, depression, anxiety, sleep disturbance, ACEs, and genetic/epigenetic factors as part of the pelvic pain assessment.
Use and recommend appropriate patient-reported outcome measures (e.g., Central Sensitization Inventory, Pain Catastrophizing Scale, DAS, PSEQ, Tampa Kinesiophobia Scale) to guide treatment planning and monitor progress.
Encourage the use of bowel and bladder diaries to identify patterns and connections between symptoms and lifestyle factors in patients with chronic pelvic pain.
Provide pain neuroscience education to patients, emphasizing the role of central sensitization and the importance of addressing inflammatory load through sleep, stress management, and non-nociceptive movement.
Review and reference the section on pelvic venous disorders in the vulvar pain module when assessing patients with post-coital pain, heaviness, or dragging sensation with prolonged standing.
Consider the use of 3D anatomy models during patient education to facilitate understanding and empowerment.
In the module, provide a detailed review of the physical exam, including tests for the abdominal wall (e.g., screening for hernias, Carnett's test).
Emphasize the importance of a holistic, interdisciplinary, and patient-centered approach to goal setting and treatment planning for chronic pelvic pain patients.

Want to learn more? The updated Pelvic Pain Assessment module is live now - if you're already enrolled, you have access to it now, and if you'd like to join us to explore the new modules on assessment, vulvar pain and sexual health as well as the upcoming new and expanded module on endometriosis, bladder pain syndrome and pudendal neuralgia then visit CelebrateMuliebrity.com and join us before the price increases next month to reflect the extra content (for clarity, if you're already a student, you'll automatically get the upgrade!)

Hello and welcome to today's episode, where I'm discussing neuropathic pain, particularly the Sciatic & Pudendal nerves, with Thomas Dekkers - Tom's background includes his 18-year clinical experience as a spine specialist physiotherapist, his PhD research on athletic back pain, and current role as a clinical specialist in neurosurgery at Cork University Hospital.
In our conversation today, we explored how dermatomes can be unreliable for diagnosis, particularly with pelvic pain conditions, and discussed the role of neuroinflammation in persistent pain states.
Tom shared his approach to managing neuropathic pain, emphasizing the importance of first avoiding activities that aggravate symptoms before gradually reintroducing movement and exercise.
We also discussed the problematic nature of the "core stability" terminology in physiotherapy and the need for more biopsychosocial approaches to patient care.
The conversation highlighted the challenges of managing chronic pain conditions and the importance of proper patient education and goal-setting in treatment plans, including neuroinflammation, when compression can lead to inflammation throughout the nervous system, including glial cell activation in both the dorsal horn and thoracic spinal cord.
We talked about that when patients completely color in body maps, it raises concerns about nociplastic pain, particularly given the anatomical proximity of nerve roots and the potential for irritation to spread.
Tom explained how he helps patients understand that pain can be influenced by multiple factors beyond just anatomy, including sleep, stress, and social aspects, and described his process of developing individualized treatment plans with patients, setting realistic expectations about pain management over 6-12 months, and focusing on improving functionality rather than achieving complete pain elimination.
We also covered:
Sciatic vs Pudendal Pain
Neurodynamics Testing and Applications
Nerve Glide Pain Management Discussion
Nerve Pain Management Approach
Core Stability Terminology Discussion
While pain knowledge has advanced significantly, treating chronic pain patients remains challenging due to the complexity of widespread pain patterns and the need to identify key contributing factors rather than addressing every symptom - I hope this conversation has given you some food for thought and some actionable steps to steer away from overwhelm when you're working with people with persistent pain.
You can find Tom on instagram @tdekkersphysio and info about his courses at thomasdekkers. com
Want to learn more about managing female pelvic pain? My online course, Female Pelvic Pain Rehab course is going through a major overhaul, update and expansion. Already enrolled? you'll get access as the new modules are available - the vulvar and sexual pain modules are available now, and you can look forward to new modules on endometriosis associated pain, bladder pain syndrome, pudendal and other neuralgias and more, through an up to date evidence based framework, that takes you from understanding pathophysiology, assessment and treatment strategies. Want to learn more? All of the course info is at CelebrateMuliebrity.com
Until next time, Onwards & Upwards, Mx! #celebratemuliebrity