Kim Vopni (00:01.442)
Hi Ellen, hold on a minute, why am I live streaming? Just a second.
Kim Vopni (00:09.518)
I'm not sure where this is live, why would that be live streaming?
Kim Vopni (00:17.71)
I don't know, shouldn't be live streaming, but if it is, well, my hand just clicked that, what is that?
dream.
Kim Vopni (00:29.198)
Okay, maybe it's just live streaming here. I'm not sure. Sorry, I've never seen that pop up before. So anyway, let's start again. Hi, Ellen. Welcome so much. Hi, Ellen. Welcome to the show. I'm really excited to have you here. We met eons ago. Yes.
Ellen Heed (00:34.164)
Sure.
Ellen Heed (00:44.306)
You know, you came to my house and had some conversation and we did some work and it was that was it seems like a lifetime ago in a way.
Kim Vopni (00:54.03)
Yeah, it was a lifetime. was with Kimberly Ann Johnston and she introduced me to you. I had met that was when I met her in person. We had known each other online for a couple of years. We met in person. I went down to California to spend a weekend with her and that led us to your home and I just became fascinated with your work ever since. So I would love for you to start out by talking about who you are, what brought you to this work. I know in the bio you shared with me, you
have mud wrestling and garment executive, which I don't know about that part of your background. So I'd love to hear that, but then also transition into the work that you're doing now.
Ellen Heed (01:31.508)
I've had a very wide variety of different professions. I went to school for dance at California Institute of the Arts in the 70s. I started in 1975 there and had a brief career as a professional dancer and that's where the mud wrestling comes in because you do the kinds of day jobs that you can do as a professional dancer.
And that was one of them, know, Chippendales back in the day. So it was kind of weird. You know, they said, come on in as a cocktail waitress. And then they said, now you have to get in the mud. I'm like, what? I'm hired as a cocktail waitress. I'm like, if you want to stay a cocktail waitress, that's the deal. And it turned out the mud was, you know, a lot of foam and stage paint. So.
Yeah, was Los Angeles. It was the late 70s and things were different in those days. But at some point my body wasn't ready. I'm very hypermobile and my knees gave out and the fifth dislocation of a patella, I'm like, can't do this. I'm of getting carried to the chiropractor because I can't walk. And then I was in the music business at that time, it's another day job.
Kim Vopni (02:44.675)
Yeah.
Ellen Heed (02:51.816)
working at a synthesizer factory making drum machines. Didn't really want to do that. That was sort of a man's world and I was more interested in things that were of the body. And I got involved in fashion design by accident. I took a flat pattern drafting class at a local community college and met somebody who just bought a knitting machine and she wanted to make sweaters but she didn't even know how.
You know, she could knit a sleeve and a front and a back, but she didn't know to sew them together. My grandmother taught me to sew, you know, at a very early age. And it was just, I was used to making clothes for myself and my dolls as a kid. And so I'm like, yeah, I can sew your sweaters. then that went on for a couple of years. And then she decided she didn't really want that business. And I inherited it in a way. And then I was in the garment business making knitwear.
for 15 years. And it was a lot of creative output. It was fun, it was challenging. I went to New York a lot and sold a lot of sweaters, made a lot of sweaters basically in the same room where we did our sessions. That was a factory at one point. yeah, it was very much a cottage industry. I had eight employees in there, know, knitting away on very loud machines and somebody sewing and somebody packing and somebody.
Kim Vopni (04:04.29)
No way.
Ellen Heed (04:16.564)
ironing and so on. Yeah, so that was how I spent my 30s basically, till I was maybe mid 30s till later, around the 37, 38, I stopped because I was done. It was 15 years of cranking hard on creativity, signing hundreds of sweaters every year and then making and shipping. Exhausting.
Kim Vopni (04:17.848)
Wow.
Kim Vopni (04:40.515)
Okay.
Ellen Heed (04:46.196)
And I hurt my back sitting at a knitting machine all day and went to yoga and met Anna Forrest, who was a huge influence on me. And I studied yoga with her. I took her first teacher training in Los Angeles. And then I took another one a couple of years later. And she said, asked me how I liked the training. I said, great. Except every single person in the room fell asleep with the anatomy lesson. Every one out of 30 people were snoozing. She said, well,
Kim Vopni (05:12.845)
Wow.
Ellen Heed (05:15.378)
why don't you teach it? I'm like, I don't know anatomy. She says, don't worry, you will. And that began a whole new career. I started teaching anatomy for yoga teacher trainings in Los Angeles in the early 90s. And it went all the way up until 2017. And I traveled the world with Anna, her career blossomed and she went hither and yon. I would show up and teach a three-day anatomy intensive for her teacher training.
Kim Vopni (05:19.918)
You
Ellen Heed (05:44.956)
And then I got interested in massage and I had a very charismatic teacher who basically pointed out that the perineum was, scar tissue in the perineum was deeply dangerous to the mental health of his patients, he felt very strongly. But he couldn't do much about it being male in his estimation. He said, I want to start referring people to you. And I'm like, well, I don't know how to clean up scars in the perineum.
you will. So I kind of figured it out and along the way I took a sexological bodywork training for scope of practice in California, that's where I used to live, and pretty soon I was teaching anatomy for sexological bodywork trainings as well and I introduced scar tissue remediation as a
Kim Vopni (06:15.116)
Yeah
Ellen Heed (06:36.716)
a subset of sexological body work because there was scope and a different frame of mind, a more holistic embodied frame of mind rather than having somebody just to have something done to their body. How could we enroll the client in participation in their own scar tissue remediation through use of castor oil, self massage and understanding and being inclusive of genital education and sexual function education because people don't understand that scars really can
deeply interfere with sexual function. And I got very impassioned about this and my teacher ever pushing me along said, well go get a PhD then. And I did, Joe Kramer who founded Sexological Bodywork invited me into a PhD program to be a somatic sexologist and that's kind of what happened. I became a somatic sexologist and learned a lot about
the giant gaping hole in care for scars because they're kind of a blind spot in a lot of ways in conventional medicine because conventional medicine and surgery caused a lot of scar tissue. But there's still a lot of miseducation about the dynamic nature of fascia in conventional medicine and still taught as inert.
And I just don't buy that. I felt scars go away like that. How can something that's inert disappear? That's my question. But when you feel it enough times of a scar changing its whole conformation within nanoseconds, it's there and then it's not. Something's happening there that science has yet to explain, at least to my satisfaction.
Kim Vopni (08:00.13)
Yeah, yeah.
Kim Vopni (08:04.802)
Yeah. Yeah.
Kim Vopni (08:20.046)
What is for the people that don't know what is a sexual logical sex a logical body worker.
Ellen Heed (08:27.464)
Right, a sexological body worker is somebody who is trained to touch the body and work with breath and work with genitals, very much like a massage therapist would work with any other part of the body as an education providing one-way touch situation. So if somebody has erectile dysfunction or they have numbness or maybe scar tissue from a birth injury or a cesarean section or something like that,
and or I've had male clients who've had hernia repair surgeries who have pain upon ejaculation as a result of their midline and the mesh and there being a complication there and learning how to free the tissue that would attach to the genitals so that pain is no longer present. That's sort of a therapeutic application of sexological bodywork. There's a lot of sexological body workers who are firmly committed to working in the arousal end of the pool.
which is great, but that was never my intention. I went in expressly to get scope of practice. was like, hmm, a year of sexological bodywork or several years of PT school. And sexological bodywork was more in line with my interests because I wanted to teach about sexuality in relationship to scars, especially how scars affect sexuality negatively. Because if you cut off nerve flow, blood flow and lymphatic drainage,
Kim Vopni (09:51.374)
Right.
Ellen Heed (09:55.486)
You're going to have a problem and that's what scars do.
Kim Vopni (09:58.082)
Yeah, yeah. Okay, perfect transition into the scars. So a really big reason why I wanted to have you on was for this specific topic. I talk a lot about the influence of scars, but not nowhere near as deep. This sounds like that's a weird choice of words in some sense, but nowhere near as deep as you would you cover it. you just have such an amazing breadth of knowledge with
with scars and as you talked about scar you use the word remediation. So I guess maybe can you talk about the choice of that word and then what what is a scar and what can what can specific to the pelvic floor what can scars interfere with.
Ellen Heed (10:35.794)
Yes.
Ellen Heed (10:45.076)
Fantastic, thank you, that's a beautiful question. So, let's talk about remediation first. Scars are living entities within the body. And so we could talk about scar resolution, and sometimes that happens, but if the conditions don't change, the fundamental conditions of the tissue, meaning the inflammatory milieu, now we're getting into this idea that I have there for...
foundations of health within the body. So one is biochemical. If there's inflammation or a tendency toward inflammation in the tissue, which could be body wide and that at its foundation could have to do with a gut flora imbalance. Let's just say the gut assisted lymphoid tissue or GALT in the small intestine is inflamed. That's a recipe for body wide inflammation. Body wide inflammation triggers. So here we go into the weeds, grab my hand.
Kim Vopni (11:37.314)
You
Ellen Heed (11:38.708)
So what happens is there are these things called fibroblasts. A fibroblast is a cell that is, you can think of it like a pasta machine that extrudes collagen. But it has a choice. According to the signals it gets from the milieu, and if the milieu is inflamed, the choice the fibroblast makes is to make a stickier, stronger kind of collagen, which we know as a scar. So scars are made of
Collagen or fibrin fibrin is sort of like the substrata the thing that collagen is made out of it has something to do with fibrin But let's say your blood sugar is high if your blood sugar is high your blood will start to carry more fibrin in it and that fibrin comes even through the capillary wall and gets deposited in the extracellular matrix that's the space between your cells and so if it's Deposited in the space between your cells in something like the vulva
that fibrin could block nerve delivery, blood delivery, and lymphatic drainage from the very cells that are supposed to be excreting lubrication or that are supposed to be in the tissues that are supposed to be engorgeable. If your engorgeable tissues don't engorge as part of arousal, literally cannot then push the lubrication from inside of a cell to the outside of cell, which we know is vaginal sweat. That means dry,
A lot more friction means tissue damage and the tissue damage then translates to guess what? Scar tissue, like even in the vault, the ceiling of the vagina, a lot of people have scars there. And that's a place that's supposed to be deeply engorgeable tissue, but it cannot engorge in many people because there is this thin layer of scar tissue that prevents its engorgement. Therefore, they're missing an entire...
sensation menu of arousal that feels really different than clitoral arousal. And so it's an entirely different sensation. leads to potentially higher levels of arousal, which could result in an ejaculation experience, for instance. But if it's scarred, probably less likely to happen. And the scar can happen as a result of
Ellen Heed (13:57.712)
under-lubricated sexual experiences penetration with insufficient lubrication, which is common in early sexual experiences for most people with vulvas, right? They don't know and they are not aroused enough and maybe their partner is going too fast to penetration so they can't actually take the 45 minutes it takes for full engorgement and arousal to occur. That means less lubrication, it means more friction, it means more tissue.
I don't want to say the word damaged because I don't want people to feel like they're damaged, but it is an insult to the tissue disruption in the continuity of the function of the tissue, which is to engorge and lubricate. Those things don't happen properly because of scars, then we're not going to have the full array of sensation available to us.
Kim Vopni (14:30.584)
disruption.
Kim Vopni (14:49.496)
So that kind of blows my mind because I have only ever thought of scar tissue as being something from a tear or which I mean you could argue that what you've just said could be micro tears. But I think of it as like childbirth tearing and I think of it as surgical intervention. I didn't necessarily even consider it as being little micro tears from. Yeah, that's super fascinating. So would there be any difference to
Ellen Heed (15:02.28)
My critique.
Ellen Heed (15:07.997)
Yeah, what?
Kim Vopni (15:17.442)
the possibilities of remediation based on the, how the scar was formed. So if it was cut or if it was torn.
Ellen Heed (15:26.356)
Yes, if it was cut, well, it's interesting, the statistics, and I did a lot of looking at statistics when I wrote my doctoral dissertation, that was in 2018, I was finished. So it's been a good, you know, seven years since then. things have, research has just taken off at light speed, especially in physiology and statistical information gathering as a result of AI. So it's...
a very different landscape at the rate of changes being documented is much faster now. So we've come a long way in those seven years towards understanding what happened. So my figures are based on my eight 2018 race. So I just disclaimer, this may no longer be true to the degree it was then, but at the degree it was true then was that 97 % of vaginal births have some kind of tissue trauma associated with them. That's quite a high prevalence.
And so that tissue trauma could be a tear, it could be a skid mark, it could be overstretching, it could be prolapse, it could be a thinning of the posterior vaginal wall allowing intrusion, what we call a rectocele, to kind of pop up into the vaginal space. And all of these phenomenon are going to interfere with sexual function at some rate. They also interfere with elimination function, how many people have to split, use their thumb to push that rectocele.
so they can have a bowel movement. That's very real. And so that's a kind of scar because it's a thinning of tissue that then allows this dysfunctional lump of VCs to kind of get stuck, not inside the vagina, but in a pocket of space just beneath between the vagina and the rectum. Right. So we have to be very clear and gentle and saying, you know, there's no shame here, but this is a problem for many people. So yes, surgery causes
an incision through tissue, which then has to approximate. And the way it approximates, that means the edges that are cut apart have to come together. And when they come together, they form a scar. But here's the thing. Once the approximation is complete, the scar has a choice. Is it going to be done now because the approximation is complete? Or if the person has an inflammatory condition in their body as a whole, they tend to run toward inflammation. Let's say they have a little arthritis.
Ellen Heed (17:52.582)
and maybe they have some gluten sensitivity but they don't know that yet and they're still eating gluten, that could create this inflammatory milieu which then triggers the scar to keep going. The scar does not stop once the incision is closed. It's going to grow along all kinds of connective tissue scaffolding, looking for a bone to attach to. So part of my methodology is to actually listen to bony movement.
to find out what's moving and what's not moving. I'm holding my hands on the pelvic bones, it's useful to have a model here. Holding my hand, so if somebody's laying in front of me and I've got my hands this way on their pelvic bones, I'm listening to see, does the bone on this side move at the same rate as the bone on this side if it doesn't or if it feels like there's a strong pull coming inward. My question is, is there a scar that's causing that
that's causing that feeling of this whole bone is curling in on itself.
Kim Vopni (18:52.514)
Would it always be looking for a bony site to attach to? Like you mentioned, it's kind of keeps going looking for bony scaffolding. Would it always be searching for bone in particular?
Ellen Heed (19:02.26)
my experience, it's almost always looking for a bone that's, I mean a scar that's in the pelvis, so particularly a c-section or an episiotomy or a birth tear, will look to a bone, look for a bone to kind of anchor, I guess. Although we know that there is also many adhesions within the abdomen that are not attached to bones, but are that attach the loops of intestine together and over time that could become
Kim Vopni (19:16.482)
Anchor two almost. Interesting.
Ellen Heed (19:30.696)
bowel obstruction and that is a very popular way to die for people in their late 80s and 90s. I mean not because they're choosing it is just what happens because scars are ubiquitous. They are part of being human every human being has some kind of scar of something even if it was a skinned knee, right? But we also undergo surgeries and we undergo organ removal for one reason and another and even
a laparoscopic approach is not going to guarantee that there is no scar. We don't see as much scar tissue because there's not incision, except for the little hole to get the trocars into the abdomen. But statistically, there's no difference in the amount of scars in the long term. Just as much scar tissue, even though we don't see it, comes from a laparoscopic surgical approach over time.
So when you're dealing with an older audience, somebody in their 50s who may have had a hysterectomy in their 40s, and as a 50 and then 60 and then 70, they would have as much scar tissue as somebody who had had an open abdomen procedure. So, inflammation, lack of lymphatic drainage, so that's edema, and the accumulation of fluid, which is going to lead to what?
inflammation, which is going to then encourage the scar to keep growing and keep growing. And scars will just keep following. I connective tissue is everywhere, right? So we have superficial fascia, we have deep fascia, we have fascia around every single muscle fiber of every single muscle within the body, many opportunities for micro adhesions to macro adhesions to form. So I train people to get very sensitive in their fingers and feel
Kim Vopni (20:52.206)
Mm-hmm.
Ellen Heed (21:20.392)
for what's moving and what's not moving because something when all the tissue is moving in an even rate and then you run into a wall of something that's not moving, why? Is it something going on in terms of inflammation? Is it an actual scar? Is there a biomechanical impediment like maybe a scoliosis that's lifting one hip high or is there something going on emotionally and there's a protection pattern in the body? So that's what we're discerning for.
when we're palpating. But the remediation piece is that as long as inflammation is active in the body, scars have the propensity to regrow. Even if we remediate them through castor oil packing and massage and working with different kinds of enzymes, you can take enzymes that will break down fibrin by taking certain supplements. There's lots of ways to work with this issue.
Kim Vopni (22:16.558)
So remediation meaning, and you alluded to it at the beginning where can, scar tissue can within milliseconds be like disappear, be gone. So remediation meaning it's like, you I think of like you've had a flood in your basement and the remediation team comes in and they get rid of all the evidence that there was ever a flood there. Yeah.
Ellen Heed (22:24.596)
disappeared.
Ellen Heed (22:37.518)
Yes, so we get rid of the evidence of a scar, but then we have to revisit every so often to make sure nothing's growing where we don't want it to grow. And I don't mean cancer, I just mean scar tissue coming back to the same place it once was. As the body remembers, there was an injury or a surgery here. And so it's more likely to have those fibroblasts getting information of exactly what kind of collagen to produce.
Kim Vopni (22:48.664)
Right. Right.
Kim Vopni (23:03.576)
got it. Castor oil, I want to come there. I there's a friend of mine who has a well known castor oil brand, she talks about castor oil packs. What is it about castor oil that is so magical, specifically for scars? I know it's magical in many ways, but specific to scars.
Ellen Heed (23:22.004)
Specific to scars is racinalic acid, a very potent anti-inflammatory. So it's deeply penetrated. And the way people think about castor oil these days is a lot, it's very pack-based. Let's put on a castor oil pack. I love the packs that you can strap on and wear all night that don't require heating pads and all kinds of extraneous stuff. Where you're not immobilized, you could wear it around the house or you can wear it in bed and be assured that you're going to get castor oil delivery.
to an area of scarification. We have to talk about the liver here because the liver is often quite scarred as a result of inflammation, as a result of high blood sugars or alcohol abuse or sometimes chemical exposures of one kind or another. Insult the liver, the liver got quite a high percentage of connective tissue in it. That connective tissue becomes fibrotic. Then the liver isn't available to do its job of blood filtration, which actually promotes more scars.
this emphasis of why we put castor oil pack on the liver is to bring the lymphoid behavior of the return the lymph like behavior to the liver. The liver is a giant lymphatic organ. Every time we breathe, it's moving massive amounts of lymph through it, which increase its ability to filter blood. So if the liver is scarred,
our blood is going to be thick. If our blood is thick, then that is that much more fibrin and sluggish blood movement. We have to think of our extracellular matrix like an estuary. The fluid comes in, that would be the plasma leaking out of capillary beds to kind of influence and wash through this extracellular matrix space. And if the blood is carrying fibrin or the blood is thick, it's going to be a trickle instead of a flood.
and the tissues aren't going to be cleansed, which is going to then what? Make them more vulnerable to inflammation. A lot of times the body is shunting chemistry that it doesn't know what else to do with into the ECM. So it would dump the residue of complicated metabolic processes that we call toxins end up in the ECM, know, like something like fibromyalgia.
Kim Vopni (25:17.857)
Interesting.
Ellen Heed (25:36.538)
is a case of the body shunting toxins and that makes or tender points when you're pressing when you're diagnosed and there's all those points on the upper back layer like if seven out of 10 of these are sensitive condition, right? But that means that
it's likely to be scarified from the inside out from a biochemical insult that's coming from the blood. So we are self-toxifying, it's sort of an icky thing to say that we're self-toxifying, we have self-toxifying potential. So we also in stream focus a lot on cleansing. Cleansing the liver, flushing the liver, using castor oil packs to flush out the ECM because what happens is the castor oil
activates lymphocytes, there's a very meager, very meager, poorly researched one little paper that said we saw those lymphocytes get active when we put castor oil in the blood. like, good for you. That's something that's explaining why castor oil. But I have to say, looking at the evidence of what changes in tissues when castor oil packs are used, there is no doubt
Kim Vopni (26:32.59)
you
Ellen Heed (26:51.55)
When you have a client and they're using a castor oil pack daily and they're coming in every week for body work and you're working for instance on their liver, at about week four their liver starts to get soft. It's not as hard as a rock when you press into it. So they're making a change there by activating enough lymphatic action. It encourages lymphatic drainage. That's the big benefit of castor oil is to promote lymphatic drainage.
Kim Vopni (27:20.814)
Would you only, so that's applying it externally as a pack and generally applying the pack on the liver and skin.
Ellen Heed (27:25.235)
Yes.
On skin. Yeah, you can put it on your C-section scar, you could put it on your liver, you could put it on your thyroid, you could put it on, you know, any place that's injured, for instance.
Kim Vopni (27:39.564)
What about internally into the vagina?
Ellen Heed (27:42.118)
I had the good fortune of having a client who was a pharmacist, a pharmacologist, a surgeon, and a concert pianist. He was one of those super gifted people. And I said, hey, doc, can I use castor oil internally? And he said, yes, if you know where the emergency room is and you're prepared for the one in 200,000 people that's going to go anaphylactic to castor oil.
And I'm like, okay, that's pretty good odds. I'm going to test. And he said, always patch test. Patch test means if I'm going to use it on somebody's vulva or inside their vagina, I'm going to ask them to put some castor oil on before they come to see me. And if there's no redness, swelling, itching, or burning, we're probably good to go. I have yet to see someone go anaphylactic to castor oil. But he was an epidemiologist also.
Kim Vopni (28:28.278)
I have never heard that. Wow.
Ellen Heed (28:32.526)
in LA County and he said the number of firefighters of wildfires when the castor plants which grow all over Southern California would burn, they would come in with ricin poisoning because ricin oleic acid, ricin, ricin is a nerve gas and it's present in the castor oil seed. So it has a poison as well as this potent anti-inflammatory effect. So ricin is not the same as ricin oleic acid. Ricinoglyc acid is the good part of castor oil.
Kim Vopni (28:43.999)
Wow.
Ellen Heed (29:01.062)
Risen is the poison part of pasture oil.
Kim Vopni (29:03.96)
Hmm, interesting.
Ellen Heed (29:05.364)
I mean, oil itself is not poisonous, but it does irritate smooth muscle. So that's why they use it to initiate labor for some, because it's the uterus to contract if labor is stalled, or it would certainly give you the runs if you, yeah.
Kim Vopni (29:17.986)
Yeah. So if you, so say somebody did a patch test and then if everything was fine, would you then treat internally with castor oil or you would, and cause I'm also thinking like soaking a tan, like an organic tampon in it.
Ellen Heed (29:27.667)
Yes.
Ellen Heed (29:32.404)
You can totally do that. That's a self-care thing that somebody can do because let's say you know that you had a tear in the cervix and you can't reach your cervix. Well, you could insert a tampon and put the castor oil close or you could put it in a diva cup and put a diva cup over the cervix. And that's actually a midwife told me that that cervical ripening was one of the techniques she used when...
Kim Vopni (29:46.136)
Mm-hmm, mm-hmm.
Ellen Heed (29:56.402)
when someone's time was coming near for birth that she would do it the last three or four days before the expected date of labor onset. Yeah.
Kim Vopni (30:02.414)
Interesting. So what do you notice under your fingers? The difference between using castor oil on a scar versus not? Is there any sense? Is there any change?
Ellen Heed (30:14.957)
yes, that's the thing. Mucosal membrane is fenestrated. That means there's space between the cells of the inside of your mouth, the inside of your nose, the inside of the vulva, the slippery bits of the vulva are mucosal membrane and there's spaciousness between the cells. So the uptake of castor oil is really different than the tight barrier of the skin. it's more castor oil gets in.
and it gets in faster. So it's anti-inflammatory effect can be felt in real time. what the first session I ever did with birth-related scar tissue was with a friend of mine, a fellow sexological body worker who came in and said, I had my baby three months ago, sex is painful. didn't know if I'm going to say, what are you doing having sex in three months?
Kim Vopni (31:09.326)
You
Ellen Heed (31:11.668)
Questioned that but I didn't because I didn't know any better. It wasn't my I Wasn't working with I had never worked with postpartum scar tissue when she came in, you know The vulva kind of looks like this. It's sort of but hers was like this was sideways There was so much swelling in her pelvis. The whole thing was distorted and deeply bruised at three months postpartum no good and so in real time By the end of an hour of work. She was completely normal
Kim Vopni (31:19.928)
Mm-hmm.
Kim Vopni (31:27.512)
Wow.
Ellen Heed (31:41.022)
completely normal and no more, you know, swelling. That's how fast castor oil can work.
Kim Vopni (31:47.566)
So that's castor oil and also your manual therapy. Yes. Yeah.
Ellen Heed (31:50.58)
and skilled massage, manual therapy. So I'm working the tissue, working the oil into the tissue and also trying to get the tissue to move because when it's swollen, it's not as mobile because it's tight and full of fluid. So just massaging the fluid, excess fluid out of it, it started to normalize. was remarkable. We were both shocked how fast it changed.
Kim Vopni (32:14.008)
Do you know if there are any so there's sexological body workers and you can find these practitioners global as far as i know. And so the other the people i refer to almost ad nauseam is pelvic floor pts do you know of any pts who have taken the stream course.
Ellen Heed (32:20.936)
Yes, there are trainings in many countries.
Ellen Heed (32:34.236)
No, I have not yet had a PT. Although I have had many PTs who come to me or came to me when I was in Los Angeles and I had a much busier clinical practice. I mostly worked teaching, but I had, I don't know, three PTs who were coming to me for work, for birth injuries that they had. And they learned a lot and I learned a lot from them. It was a very fruitful kind of like a collaboration, healing.
between what they knew and what I knew. And they took some of the information they learned from me into their practice. But I think there's a generative relationship to be had with pelvic floor PT, but STREAM has a different scope because we talk about biochemistry and we really talk about emotions. Our hours, our sessions start at two hours. There are sometimes 20 minutes. So there's no time. You have to get in, get out, but the body is going to go into a kind of a
Kim Vopni (33:25.326)
Yeah. Yeah. Yeah.
Ellen Heed (33:33.158)
often protective frame because there just isn't enough time. So we work directly with autonomic nervous system to slow things down so somebody can feel safe, so their blood pressure normalizes, so their tissues and the smooth muscle aspect of their tissues can relax. When that happens, there's much more likelihood, and I found this out in the research for my dissertation, that people who are relaxed and basically fairly well balanced in their biochemistry,
are much more likely to have those rapid dramatic results from a scar tissue remediation session versus somebody who's tense, nervous, frightened, upset, just had a fight with their partner or is freaked out about childcare or worried about finances and just kind of, but how this all maps back on prolapse is people don't think prolapse is anything other than a biomechanical event. And I disagree so strongly with that.
Kim Vopni (34:19.448)
Yeah. Yeah.
Ellen Heed (34:32.358)
I think it's also emotional. I think it's certainly biochemical because when I watch my students heal from prolapse, which they routinely do, complete healing reversal, their bladder goes back up, their uterus changes position spontaneously. It happens after they've been had a really functional introduction to the GAPS diet, which is profoundly anti-inflammatory.
Kim Vopni (34:57.186)
So can you explain for those that don't know what the GAPS diet is?
Ellen Heed (35:00.338)
The GAPS diet, GAPS stands for Gut and Psychology Syndrome. It was created by a woman who's a neurologist, but also a nutritionist named Natasha Campbell McBride. And she's in the UK and she worked with GAPS primarily as a therapeutic intervention for autism and had a lot of success with her own son who is now no longer autistic and many other people who have sort of
change the trajectory of the condition. And I don't consider autism, I mean, I'm autistic, I don't consider autism a disease, I consider it advantage. But it's on the spectrum and it depends on the severity of the spectrum. There are certainly very severe forms of autism, which have been documented, have been helped fairly dramatically when people are compliant with the GAPS diet. So the GAPS diet is basically no starches, that's where it begins. And then it's a very
kind of draconian, it's the opposite of an elimination diet. You start eating almost very few foods and then you gradually add one food at a time, one food, one food, and you really document the results and how you're reacting to it because you can retrain your immune system to perceive almost any food as self. People who are allergic to nuts could get rid of their nut allergies. People who have dairy problems, you can even train your body to recognize gluten is friendly.
if you're gluten intolerant. I'm not saying celiac, but gluten intolerant. You can cross many bridges nutritionally by tiny, tiny introductions, like an eighth of a teaspoon of something, and then see how you feel. If you can do an eighth, can you do a quarter? If you can do a quarter, can you do a half? Oop, you reacted a half, go back to a quarter. But keep poking the body until it recognizes, I don't have to react.
Kim Vopni (36:56.43)
When you talk about the people who have full resolution of prolapse, so I am a biomechanical thinker, and so I think of muscles, think of ligaments, I think like the supporting structures. If there's been disruption, so I think also of levator anion, which is the term that's typically used, there will be certain, in my opinion, now correct me if you've seen different, but I think of
Ellen Heed (37:15.048)
Yes.
Mm-hmm.
Kim Vopni (37:24.418)
There will be some people where no matter what you do, there will be a mechanical disadvantage that is not able to be overcome. Yeah. Right.
Ellen Heed (37:31.73)
Yes, the vulva is not going to detach without surgery. But that doesn't mean that there aren't other muscles that can be brought online in order to do similar jobs as the muscle that has detached. But you have to have sufficient association with the tissue to actually connect to those muscles to get them to work. And a lot of times people are so very checked out of their pelvic floor.
that there's a large emotional process to bring them back in. And so that's a lot of the work that we do with STREAM. It could look wholly unlike anything to do with pelvises for six or eight weeks. It could be talking, it could be doing exercises about boundary making, it could be doing exercises about relationality and sort of parsing the stories that people tell themselves from autonomic states of being.
because people get very fused. This happened to me because, and the result of that is, and so it's very reductionist thinking. And if someone is wholly bought into, can't heal because I had an emulsion and the muscle just isn't there. Well, there's such a thing as neuroplasticity and muscular plasticity. And if you believe that we are adaptable beings, which I certainly believe, then you can retrain your body according to that belief rather than I have this limitation that
Kim Vopni (38:32.034)
Yes. Yes.
Ellen Heed (38:58.426)
because of an event.
Kim Vopni (38:59.842)
Right. Yeah. What when would you say? So no avulsion. Somebody comes in and there's different grades or stages of prolapse. Have you seen more advanced have the same the same reversal or the same response as somebody who's yeah. Okay.
Ellen Heed (39:22.516)
It depends on how old they are. If someone is under the age of 60, yes, I just don't have enough data on people who are between 60 and 80, because that's not usually my stream demographic. And I work most closely and have the most data about my students, what they're eating, the exercises they're doing, the self-work that they're doing, their relative ability to pull their diaphragm up, up, up, up, up.
really activate in a hyperpressive or even Udiana Banda kind of way. If they are literate and able to do that. I also work with the exercises of Janet Holm, PT who I reached complete respect all respect genius pelvic floor her book, solving the mystery of the pelvic rotator cuff, for me. That's my favorite pelvic care anatomy book.
Kim Vopni (40:11.79)
Mm-hmm. Mm-hmm.
Ellen Heed (40:18.548)
I love the concept. Her exercises, the abdominal core power exercises, when turbocharged with hypopressives are deeply effective.
Kim Vopni (40:29.644)
Yeah, yeah, I'm a huge fan of hyperpressives that changed my life and, and it's a huge part of what I teach as well. I think it's incredible. I have never done anything with cast I've used castor oil packs on my liver. I've never done any internal work with scar tissue. And I remember my PT once this, this is a PT who I used to see and I remember her saying
When i was first having symptoms of recto seal saying that i had a lot of scar tissue internally and i remember in childbirth i didn't have any external tearing like that the perineal tearing and so i kind of. wish when she said that i'm like what i didn't have i didn't have any tearing and as you just described here now looking back like that of course there's tissue i've always just said tissue tissue disruption but i never really considered that that's what the scar tissue is.
Ellen Heed (41:24.148)
had a student who had a son who was born like this. She said, I gave birth to the number four. It sort of looks like the number four. And she said, was howling during her birth. Like, he's coming out my arse. She saw him, so it's an arse. so we're going to get graphic. Now, I do lot of intra-anal work. And I had her face down over a wedge, so her butt was way up in the air. And I had one finger intravaginally, intravaginal, and one finger intra-anal.
Kim Vopni (41:40.716)
Yeah, that's okay. We get graphic here.
Ellen Heed (41:53.18)
and I was working with an obturator internist with the intervaginal finger and I was working with a piriformis origin on the front side of the sacrum, which was here. So I'm in and it's way up here and my finger's on that point and suddenly I hear, I hear feel, over here, over here, over here, the tissue pulls my fingers in another two inches deep and there is this spot. And suddenly something goes rrrr
Kim Vopni (42:01.292)
Yep. Yep.
Ellen Heed (42:22.344)
She had an adhesion inside of her rectum that she wasn't aware of that was causing the most crazy hyperlordosis. Constant pain and swelling in the whole left side of her body. It all resolved after that adhesion let go. I know, things like that just blow my mind. And she felt it and I felt it. She's like, what was that? There was no pain.
Kim Vopni (42:38.883)
Wow.
Kim Vopni (42:45.326)
You
Ellen Heed (42:48.756)
She's also a sexological body worker and had done a lot of work on her scar tissue and her pelvic floor, but she hadn't been on a wedge before and it just supported a little bit deeper reach. sometimes position has, so this is biomechanics, right? You'd have to be able to get to where the adhesion is. Sometimes if somebody were laying flat on the table, that wouldn't be available.
Kim Vopni (42:56.792)
Mm-hmm.
Kim Vopni (43:04.014)
Mm-hmm.
Thank you.
Kim Vopni (43:10.434)
Yeah. And you're always using castor oil when you're doing internal if the person is not reacted. Yeah, yeah, that's so fascinating. Okay, I'm going to move on from from prolapse here. We've talked about the scar tissue piece, we've talked a little bit about the inflammation, you've talked about the gaps diet. And when you talk about the
Ellen Heed (43:14.248)
Yes, if the person is non reactive. That's right.
Kim Vopni (43:34.67)
whether it's a stream practitioner, whether it's a sexological body work, whether it's just somebody who has come to see you there, you're addressing the gaps diet, how they're behaving, the exercises they're doing, you know, all those things. So what would, what are you guiding people to do? As you've mentioned gaps diet, what other things would you be recommending? The what, sorry.
Ellen Heed (43:54.654)
Well, looking for the rate-limiting variable. So there's four foundations, biochemistry, biomechanics, emotion, and scars. My job is to find the rate-limiting variable. What is the one thing that if it changed would move their healing forward? And so it's going to be quite individual. So I take a very detailed history. I let my fingers do the walking. They find all kinds of adhesions in all kinds of places. And then it depends on what their
initial reason for coming to me is I'm not going to suddenly, you know, do an about face and give somebody the whole gaps speech if they came to me for a pelvic floor problem. If I feel a lot of inflammation in their bladder or in their vulva or in their anal sphincters or something, or I see a lot of bloat and hardness, I'll say we have to address this inflammation. Well, how do I do that? Okay. Well, I'd like you to read this book and then we'll have that discussion.
Kim Vopni (44:53.23)
Okay. When you talk about exercise, you've mentioned hypo oppressive. Are there other exercises that you, you mentioned Janet spoke as well, other exercises that you recommend?
Ellen Heed (44:58.899)
Yes.
Ellen Heed (45:02.492)
Yeah, you can see Janet Holmes' abdominal core power in its full 1980s glory with bad spandex.
Kim Vopni (45:10.21)
Yeah, it's good. I've seen it. Yeah.
Ellen Heed (45:12.862)
But it's for free on YouTube. What could be better? So people can do that. And I do those exercises all the time. It helps relieve some SI joint pain that I have from sitting in a chair, you know, working away at my computer for hours on end. And sort of a chronic thing, although it's gotten much better in the last, since I really dove into gaps. There's no pain now in my SI joint and there has been pain since 2018's dissertation days.
Kim Vopni (45:40.546)
Yeah, interesting.
Ellen Heed (45:41.138)
Yeah, it's a very, I'm taking my own medicine. I have time and space to do it now in because I do, we do almost all our own cooking now in England. And I just decided to take a deep dive into gaps and see how it would be this time. Cause I do it once a year, I go through the gaps intro, which is a slow introduction of foods. See how I feel, but this time I hung out much, much longer.
Kim Vopni (45:46.968)
Yeah, yeah.
Kim Vopni (46:05.486)
Mm-hmm, mm-hmm.
Ellen Heed (46:11.322)
in the early stages of the intro.
Kim Vopni (46:15.394)
Yeah. Before I let you go, I want to just ask a question about self care. So when, like you just mentioned, the person on a wedge, obviously I couldn't necessarily put myself on a wedge and into vaginally and indirectly treat myself, but we have pelvic wands, right? So, so pelvic wand with castor oil, but that could break down the silicone maybe.
Ellen Heed (46:33.535)
Right, but Pelton wands can be very effective. Not a silicone wand, you could get a hard plastic wand, but those really are a little dangerous. You have to go slowly because they're not sensitive to what they're touching and you could maybe apply too much pressure. And I've never heard of anybody damaging themselves, but they always give me a little pause. I would much prefer a finger there which can get feedback from what it's touching.
Kim Vopni (46:42.786)
Yeah, yeah, yeah.
Kim Vopni (47:01.602)
Yes. Yeah. Yeah. Yeah. I'm a huge proponent for internal treatment with a person who you feel safe with and comfortable with and but yeah, yes, exactly. Exactly. And I think like the more I'm talking to you, I've kind of always thought this, but I feel like I feel like stream should be part of the pelvic PT program. I know they do scar tissue work, but I just feel like you just go so much deeper.
Ellen Heed (47:12.338)
and who knows what they're doing.
Ellen Heed (47:25.812)
It.
Ellen Heed (47:31.006)
Well, I go deeper and it's hard to justify the time in the PT model, which is very much time for money and very governed by standards of care. So that means insurance will reimburse for it, but only for X amount of time. And the pelvic floor has its own time. That's really the truth. There's just things that are not gonna happen.
Kim Vopni (47:39.331)
Yeah.
Ellen Heed (47:59.44)
in even an hour long session that would happen in a 90 minute or two hour session.
Kim Vopni (48:04.226)
Yeah. Desir. my gosh, I'm forgetting her last name is Kent. Tamilyn. Sorry. Does does how closely aligned is what you're doing? Does totally different. Okay.
Ellen Heed (48:11.796)
Tamiylin kit.
Ellen Heed (48:18.322)
Not all. Totally different. That work is very energetic in nature. From what I understand, I've never done it, but many of my students have and they talk to me about it. I'm like, okay, that sounds a lot more like energy work. We are hands-on, tissue, palpation-based. What's the information we're getting? How do we interpret it? And what are the interventions we recommend?
Kim Vopni (48:40.526)
Got it, got it. Okay. I feel like I need to have you back because I want to go deeper. I still want to go deeper, but that was super fascinating. just, I just love your work. always been so, I admire what you're doing so much and so grateful for all the people that you've trained and where can people find more about you potentially even come and get trained with you. You said you're not doing in-person work anymore, but also where could people find a stream practitioner or a sexological body work?
Ellen Heed (49:07.303)
Right, well, to find a stream practitioner, you can go to the stream website. It's scar tissue remediation.com. scar tissue remediation.com. It's kind of a long URL, but there it is. And there's a practitioner list there and there's people all over the world now. We people in Europe and people in Australia and people in, gosh, all over the place, Canada and in the US and in the UK soon.
very excited about that. And then there are many sexological bodywork organizations depending on which part of the world there are. So there's one in Canada, there's the ACSB, that's the American, AC, American, something of sexological bodywork, American Association or something like that. And then there's the Institute of Somatic Sexology in Australia. And so,
Kim Vopni (49:51.694)
Bye, check it out.
Yeah, council maybe. Yeah.
Ellen Heed (50:05.192)
There are professional organizations of sexological body workers that are regional, but if you just say sexological body work put in country of choice, you'll probably get a listing of practitioners. Not all sexological body workers, they get an hour of scar tissue training. An hour, not a day, an hour. So it's not the same as stream, that's why I say stream. Yeah.
Kim Vopni (50:15.288)
Got it.
Kim Vopni (50:22.904)
Wow!
Kim Vopni (50:28.514)
No, yeah, yeah. Amazing, amazing. Well, thank you so much again for joining me, for sharing your wisdom, for everything that you do. And I can't wait to share this with my listeners. Thank you.
Ellen Heed (50:40.874)
I'm so excited.
