The Dr. Tyna Show
Your Vagina Needs Strength Training Too: Pelvic Health 101 | Kim Vopni
Wed, 30 Apr 2025
EP. 209 - In this episode, I’m joined by Kim Voss—better known as the Vagina Coach—and author of Your Pelvic Floor. As a personal trainer and restorative exercise specialist, Kim brings a wealth of knowledge about pelvic health, particularly for those navigating fitness, childbirth recovery, and aging. We cover pelvic floor dysfunction, with a focus on urinary incontinence during strength training—something many experience but few talk about. Kim shares science-backed insights, practical tools, and empowering advice for anyone looking to build strength without sacrificing pelvic health. Topics Discussed: How can you prevent urinary incontinence during strength training? What are the best exercises to strengthen your pelvic floor after childbirth? Can pelvic floor therapy help with recurring UTIs and bladder issues? What role does estrogen play in vaginal and pelvic floor health? How does strength training impact pelvic floor dysfunction or vaginal prolapse? On This Episode We Cover: 00:00:00 – Introduction 00:02:51 – Kim’s background 00:09:02 – Urination and pelvic floor health 00:11:59 – The final pee 00:14:48 – Nervous bladders & tracking habits 00:18:44 – Interstitial cystitis 00:20:41 – Constant UTIs 00:25:20 – Allergy to your partner 00:29:28 – Men’s uterine health 00:33:36 – Vaginal estrogen 00:40:52 – Putting yourself first 00:44:48 – Stem cells & vaginal health 00:47:44 – Hysterectomies 00:52:25 – Pelvic floor PT 00:54:42 – Birth control 00:57:33 – Strength training and uterine health 01:05:46 – Vaginal prolapse 01:11:01 – Glute training 01:12:24 – Where to find Kim Further Listening: Strength Training Playlist Sponsored By: Sundays | As a Listener of The Dr Tyna Show, you can Get 40% off your first order of Sundays. Go to sundaysfordogs.com/DRTYNA and use code DRTYNA at checkout. Lumen | Go to lumen.me/DRTYNA to get 20% off your Lumen. Qualia | Go to qualialife.com/DRTYNA for up to 50% off your purchase and use code DRTYNA for an additional 15% LVLUP | Head over to LVLUPHealth.com and use code DRTYNA at checkout to get 20% off your order sitewide. Liver Love | Go to https://store.drtyna.com/products/liverlove Use code LIVER20 for 20% off Check Out Kim: Website Youtube Instagram Disclaimer: Information provided in this podcast is for informational purposes only. This information is NOT intended as a substitute for the advice provided by your physician or other healthcare professional, or any information contained on or in any product. Do not use the information provided in this podcast for diagnosing or treating a health problem or disease, or prescribing medication or other treatment. Always speak with your physician or other healthcare professional before taking any medication or nutritional, herbal or other supplement, or using any treatment for a health problem. Information provided in this blog/podcast and the use of any products or services related to this podcast by you does not create a doctor-patient relationship between you and Dr. Tyna Moore. Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent ANY disease.
Chapter 1: What is pelvic floor health?
Is it because you have prolapse? Is it because your muscles are non-relaxing? Is it because of the posture you have on the toilet that's not allowing things to empty completely? So you want to have an understanding of why so that you can then choose the right path to fix it.
You are tuned into the Dr. Tina Show with Dr. Tina Moore. For more, visit drtina.com. On this episode of The Dr. Tina Show, I'm sitting down with my friend, Kim Vopney. You may know her as The Vagina Coach. She is the author of Your Pelvic Floor. She is a personal trainer. She's a restorative exercise specialist. She is the pelvic floor guru. And I absolutely love her content.
I love her approach to things. And I thought it was critically important that I bring her on the show because many of you have reached out to me and said... Dr. Tina, I'm trying to start strength training, but I keep peeing my pants every time I do. And I take this seriously, although I was joking with Kim, I've got 99 problems, but pelvic floor dysfunction is not one of them.
I feel for you, my heart goes out to you, especially those of you who have had multiple children. I understand this is a real concern and there is hope. So we're gonna dive in with Kim today. We're gonna talk all things vagina, vagina health, pelvic floor health, strength training, how it goes with it, the steps you need to take and more. So without further ado, let's jump in.
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Kim, thank you so much for coming on the Dr. Tina Show today. I am very excited to have you here. You are a pelvic floor specialist and the vagina whisperer, as I think of you. And so we're going to have a really fun and colorful conversation today. We are. Thank you very much for having me. I'm excited to be here with you. Yeah. So tell me about your background. What do you do?
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Chapter 2: How can you prevent urinary incontinence during strength training?
How did you get into this? And why does it matter?
I'm a personal trainer and I grew up always with a fascination of health and wellness. And when I saw my mom stop exercising, I was asking why. And she said, it's because of your brother and you. So of course, then she kind of elaborated and basically she developed stress urinary incontinence after childbirth. She had chronic back pain. She had a tummy that wouldn't flatten.
And so witnessing this coupled with a childbirth video that I saw in sixth grade, this was just not something I really wanted to participate in. So I grew up very adamant that I was never going to have children, but always had this fascination with health and wellness. So fast forward, I meet my now husband and his sister-in-law allowed us to
brother and sister-in-law, allowed us to witness their birth. And that was the first time I had seen anything different than what we see in the media. The people with the knees at their ears, somebody telling them to hold their breath for 10 seconds, but you know, that whole thing, screaming, yelling, the drama. And this was the complete opposite to that.
And so that was a really, it sort of planted a seed because I wanted a family, but I just didn't want the effects that my mom had dealt with. So I thought, okay, maybe I'll Maybe I'll become pregnant. Maybe I'll have a cesarean. Maybe that'll protect my pelvic floor. I didn't even know the term pelvic floor at the time.
I just kind of thought of it as my vagina and I didn't want my vagina to break. And that was that, right? And so then the following year I'm pregnant. Now I'm thinking, okay, now I really have to be thinking, how is this babe going to come out of me? My midwives had recommended a biofeedback device to me called the Epinoe, which is from Germany.
And this was designed by a German physician who was in Africa and he was using gourds. Sorry, he wasn't. He was witnessing women using gourds of increasing size to prepare their pelvic floor for birth. And so he thought, well, that's a great idea, but that's not going to fly in North America. So how can I make this more mainstream?
And he worked with physios and midwives and other physicians and created a medical device. EpiNo stands for no episiotomy. So the intention was, can we reduce tearing? Can we reduce episiotomy's with the intention of that's not going to prevent all pelvic floor dysfunction, but it would be playing a role in helping people connect with their pelvic floor before birth.
So used one, had a great experience. I didn't have any tearing and I thought, well, I'm good. I didn't tear, so I'm fine. And then I still, I used it for my second. And after my second, I developed stress urinary incontinence. And I thought, well, how's that happening? Because I didn't tear. And that was my limited knowledge at the time. And then I started to
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Chapter 3: What are the best exercises for pelvic floor strength after childbirth?
Chapter 4: Can pelvic floor therapy help with UTIs?
Chapter 5: What role does estrogen play in pelvic health?
people preemptively voiding, you're getting a signal inappropriately. You're getting a signal when it's not actually full. And that is what is going to then train your bladder to just keep doing that. And it'll start to do it at night and you'll be waking up multiple times a night.
Yeah. That's not good. No, so I'm the opposite. I tease people who have a bladder like a chipmunk, like my husband. No, he's pretty good. I actually, and maybe I'm wrong on this, I try to hold it as long as I can. Not like pathologically so, not in a way that's going to cause me backup issues or problems, but I definitely try to go to like full bladder and and then void.
But just instinctively thinking, I've done that since I was a kid just because I want to... Well, A, I wanted to be able to get through a class. Like sometimes there were kids that always had to pee during class. They would get nervous and then they had to pee. So I always try to override the nervous feeling. And I think that's it for a lot of people.
They get kind of like a little nervous something and then they... instinctually feel like they have to pee, but more so just because I wanted to have control of my pelvic floor. I just want to be able to control it. And then I think a big problem that I saw in clinic, I'd love your thoughts on is the, and I saw this more often with women who had pelvic floors that weren't really in good shape.
they weren't in good shape in general. And it happened to me when I was in really bad shape. I was really skinny and out of shape. They don't void completely. So they do like what they think is a full void, but then they don't completely void. And then those women end up with a lot of urinary tract infections.
And I actually, it was happening to me in medical school and I had the lab tech, the head of the lab at the clinic, she said, you have to do the final P. And I said, what's the final P? She goes, you sit there and you relax and there'll be a final P. You have to get that out because it'll sit there in your bladder and get infected.
So I've learned to get that little bit out too with intention, but I'd love to hear your thoughts because maybe I'm doing this all wrong.
Yeah, it's a great point. So normal voiding would be every two and a half to four hours. And when we sit down to pee and poo, technically, we need the pelvic floor muscles to relax in order for the bladder to contract or the rectum to void. And if we are not relaxing completely, then it can hinder that.
And there could be, there's always going to be a small residual, like the bladder is constantly filling. So there's always going to be considered normal amount of residual, not a huge amount, but not enough to signal that you would need to go anymore. But so we should sit down, relax the pelvic floor, bladder contracts, pee comes out and it comes to an end and we're done.
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Chapter 6: How does strength training affect pelvic floor dysfunction?
They start to notice, you know, I don't drink as much water as I thought I did. So dehydration is going to come and play a role. And holding Like you're not using a bladder diary, you just have this awareness, but some people don't. So they use the bladder diary and it says, well, I just went an hour ago. I haven't had any bladder irritants. I haven't had a huge volume of liquid.
This is an inappropriate signal. So then you step in and you do, you can do self-talk to the bladder. You can use distraction techniques like curling your toes or doing calf raises, doing some pelvic floor activation or relaxation to help calm that signal. And within, you know, 10 to 30-ish seconds, it should ideally be gone. And then you just carry on with your day.
How much of that is interstitial cystitis? Like how much of that is just... Because I know that that's a common autoimmune condition. And I know that a lot of women have... sort of a low key version of it. I've seen a lot of that in my clinic and in my training as well. I just happened to, one of my mentors in medicine is like the vagina queen. That's her wheelhouse.
Mine's regenerative injection therapies and that and peptides and hers is like vaginas. And so she really helped me become hyper aware of how many women might be struggling with this. And I do have a touch of it myself. I've struggled with it in the past. it does make you think you have to pee all the time. And it's a really irritable little bladder. Talk to me about that.
Yeah, it's the autoimmune condition, interstitial cystitis, painful bladder syndrome is also another name that's maybe associated with it. And the challenge is it can present like UTIs. It can present because like if you have overactive muscles, it can present from bladder irritants, from low estrogen. So a lot of the symptoms are the same.
And so it's kind of like hypothyroidism versus Hashimoto's. You have to kind of distinguish, is it the autoimmune side or is it something different? And that's where that root cause investigation comes with pelvic floor PT, with a bladder diary, with diet changes, lifestyle changes.
And if with all of that, nothing is changing, it takes a little while to go through the... It's like a process of elimination, a diagnosis of elimination for IC. you want to address all of the other things first. And if it improves, not likely that it is the autoimmune form.
If it's not, and you've tried everything and you've given it kind of that good college try, then possibly an IC diagnosis would happen.
Yes, it is frustrating. It's really frustrating when it goes full bore and it becomes, because sometimes I'll see a cocktail of true UTIs chronically with a woman and aggravating an underlying interstitial cystitis. And then it sort of loops and feeds forward. And so they'll get on a regimen of antibiotics that they feel like they constantly need.
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