I tried thinking of catchy titles, but the more I thought, the more I kept coming back to the fact that I’m not witty (like at all – and if I do say anything remotely witty it’s normally an accident and/or I crack up at myself and then I just look weird, so that’s that, oooohhhh weeeellllllllll) and there’s really no reason to beat around the bush this blog is all about what I do!
So most of my family and friends know that I am a physical therapist (physiotherapist to everyone outside the US) and some know that I have moved towards working almost exclusively within a speciality, but most of the time if I get that far explaining what I do I normally just get an “oh” or “okay” and the conversation ends. Unless said person recently hurt themselves and then I normally get told about it also (which don’t get me wrong, I have no problem listening and giving out advice in this case, but just know that I normally spend 60-90 minutes the first time I meet someone to hear about the said problem they’re coming in for and to figure out a plan of action to help address it, and they’ve seen a medical doctor before coming to see me, so a 5-10 minute chat is not impossible, but not the most ideal situation to get advice and give out recommendations).
The great thing is that pelvic health, specifically pre and postnatal health especially, is actually starting to be talked about more in the media these days so more and more people are realizing that 1)It’s something we should be addressing more within our health and fitness system and 2)It’s not so weird or taboo to talk about this stuff. The not so great thing is that it is becoming a “trendy” topic and with that there’s now lots and lots of advice and recommendations coming out from not the most qualified sources and I cringe often when I read articles, but I digress.
On that note I want to say yes, I am a health professional, but this is just a blog with general information, I am not giving out medical advice and you should definitely consult with your physician or health professional for any medical advice.
Continuing on… A little background on my road to Pelvic Health PT
I knew in PT school I wanted to specialize, I just do better with a more specific goal and “area” of study. Pelvic Health is actually very broad and there’s tons of areas you can delve in to specialize even more, but doing general Physical Therapy is waaaaaay broad and a speciality was more my jam. I practiced as a PTA (Physical Therapist Assistant) for four years before starting PT school and it wasn’t until I was a year in to PT school and working at a clinic that had a pelvic health specialist that I even knew the specialty existed – which is now crazy to me – crazy sad actually. So I got interested by hearing about it from a colleague and even though I wasn’t working with those clients I decided to take the plunge and take an introductory course on pelvic health. Another very personal reason was at that point I had been dealing with my own issues of urgency/incontinence for about 3 years – I had never been pregnant or had a child, and no specific injury that caused it, but I was dealing with it as a young 20 something (and ya know it’s not that uncommon). With my own journey with these symptoms and working as a PTA I didn’t know that PT could help me – like I said above, crazy sad. The only options I was given (at first, until I advocated for myself and found the right doctor) was medications with awful side effects. No beuno. Spoiler alert PT is what helped me. So no, it’s not the answer for everyone but it’s a dang good option for a lot of people.
I also had to know within my first three months of PT school if I even wanted to do a speciality to start planning my clinical rotations – so that also gave me the push to take the course. Nothing like dropping almost 1K for a weekend on something I didn’t know if I would even want to do afterwards. Buuuuut thankfully I fell hard and after that weekend I was obsessed and set on becoming a pelvic health PT and haven’t looked back since.
I did get one 2 hour lecture on pelvic health in school but then I found a great clinic out where I was going to be moving after I got married and was able to secure my final clinical rotation at a facility that specialized in pelvic health (we saw general orthopedic patients at times, but infrequently) and learned from some really great PT’s. Shout out to Her Health PT in Columbia, MD – if you’re in the area and need a PT I highly recommend this clinic! After graduation and passing my boards (woo!), I then got a job at John Hopkins and began working with general outpatient patients and pelvic health patients 50/50 and then transitioned to all pelvic health when I went back to work after having my little guy. I have been fortunate to be able to attend more continuing education courses and also have continued to learn and be mentored by two amazing PT’s in the pelvic health world with SO much knowledge (I also highly recommend them if you’re in Baltimore!). It has been hard living so far away from family and friends in Ohio the past 3-ish years, but the friends, mentorship and experiences I’ve gained being out on the east coast and working where I have has been invaluable.
Traditionally pelvic health PT has been called women’s health PT and while this is not incorrect, it doesn’t tell the whole story of who we (as a profession) as a whole treat. Pelvic health physio’s can treat men, women, children and anyone in-between, so while the treatment and association specifically in the US may have started out with an emphasis on women patients, that’s just a part of what encompasses pelvic health physio today. I personally have only treated women within the pelvic health realm and it is my personal comfort zone to be completely honest, but there are lots of great physio’s working with men and children – but in general there are not nearly enough of us.
Some of the general diagnoses or dysfunctions that I see and treat are:
- Incontinence (unintentional leaking of urine or feces)
- POP (pelvic organ prolapse)
- Pelvic pain (pudendal neuralgia, vulvodynia, vaginismus, painful intercourse/penetration, vestibulitis, dyspareunia, muscle spasm, endometriosis,scar pain,etc),
- pregnancy and postpartum dysfunctions (diastasis recti/DRA, core weakness, low back pain, tailbone/coccyx pain, c-section scar pain, etc)
As I’m continuing to work with patients and with becoming a mother myself in 2016 I have an increasing interest in the prenatal and postpartum population. It was amazing to me being a pelvic health physio and going through pregnancy and seeing just how much our system (health system, policies for working mothers, etc) is not set up to to allow mothers-to-be and especially postpartum mothers to succeed or have adequate resources. Much of the focus is on the health of the baby and getting to week 40 and then after that the mother is essentially on her own. Yes, there is a 6-week checkup but for most that appointment leaves much to be desired when it comes to checking on the overall health of the mom. I’m not saying we should not be worried and very much concentrated on the health of the baby, but the lack of resources and concern overall for the mother is lackluster and the U.S. is waaaaayyyy behind in maternal healthcare to most other developed nations. In many countries a referral to a pelvic health specialist is a required and normal part of your postpartum care. I wish, I wish, I wish this was the norm for the U.S.
Also, so much of what women experience postpartum is thought to be “normal”, i.e. “I pee when I laugh or jump, I had a kid, what do you expect?” – this is common yes, but common does not equal normal! If this or some variation of this comment is you I want you to know there are medical professionals who can help, research has shown that conservative methods – physical therapy specifically – is very effective in treating these symptoms and a medication or surgery is not your only option, not by a long shot. And it’s not just doing kegels, there’s so much more to pelvic floor PT than kegels, if especially after the the 6 or 8 weeks postpartum you just don’t feel “right” or “normal” in your pelvic/vaginal area – speak up and find a provider that will listen to you. Some heal slower and it may be “normal” and healing along fine, but getting yourself checked out is never bad idea. Comments like these get me very frustrated especially because it’s so normalized. I love that more people are talking about it and it’s becoming normalized in that sense, but this side needs to be shared more, that you have options and don’t have to live with your symptoms – no matter your age. To quote Brianna Battles of Everyday Battles (awesome strength coach and trainer making waves in the postpartum fitness world, I recommend checking her information out also), “Postpartum is forever”. If you are interested in learning more about PT leave a comment below or send me a message I would be happy to try and connect you or point in the direction to find a physio/PT.
So… yea… I have an increasing interest in this area to say the least and there are so many avenues to explore, it’s exciting and daunting at the same time – there’s so much to learn! And my continuing education class list is always growing, much to the dismay of my hubby.
So there is a little snip-it (in probably way too many words, brevity is not my strong suit!) of what got me in to pelvic health PT and what it is. Every day there are better and more resources on pelvic health PT and I will probably refer to them often when I post about it. I have and continue to learn from amazing and wonderful physio’s and health practitioners that are churning out great work. Here are two articles from Tracy Sher (who I learned from at my initial Pelvic Health course!) on common misconceptions about pelvic health PT and what is pelvic health PT if you want to read a little more on what it is. Also a link to Julie Wiebe’s webpage/blog. I have learned a lot from her and she focuses particularly on returning women postpartum to high level fitness (another specific interest area for me). She teaches about the “diaphragm/pelvic floor piston science concepts” that can apply across the spectrum to a variety of populations and she’s just amazing. I am going to another one of her courses in November so be prepared to read more about her in the future!
Hope everyone had a lovely weekend!
<3 – Brittany