Do men have pelvic floors too? The truth about 10 common pelvic myths

Earlier this week, I asked the Twitter and Facebook PT world a simple question:

What are the common misconceptions you hear about the body?

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My initial goal was a fun blog post on common misconceptions about anatomy, etc…but I was not prepared for the huge response I received—over 40 responses with SO many different things that people often misunderstand! Some pelvic, some general—and it made me realize there is SO much bad information out there!! So, what once was one post will become two. Today, we’ll hit on 10 common myths related to the pelvis (you knew I’d start there!). Then stay tuned for a future post hitting other misconceptions related to…well… the rest of the body, fitness, wellness, pain etc.  So, here we go:

1. Men don’t have pelvic floor muscles: They do, I promise. And guess what? The anatomy is not quite as different as you would think! The same muscles that contribute to urinary, bowel and sexual function as well as lumbopelvic stability in women do that in men too. Pelvic PTs treat men with incontinence, pelvic pain, constipation, painful sexual intercourse and much more.

 2. Vaginas need a lot of work to keep clean. No, they don’t. The Vulva (vagina really just refers to the canal itself) is actually self-cleaning. It does not need to be scrubbed with soap. You can totally just shower and run water over it, and it will be just fine. In fact, scrubbing the vulva can irritate it and even kill the good bacteria that prevent infections! I could say so much more, but you really should just read this article on Pelvic Guru by Sara Sauder, PT and this one by Dr. Jen Gunter.

 3. Abdominal pain is always caused by organ problems. Not necessarily. Now, don’t get me wrong, abdominal pain can definitely happen with ovarian cysts, appendicitis, constipation, and much more—but abdominal pain can also happen when the organ is not to blame. This is so common in men and women with chronic pelvic pain. These people often will have very sensitive nervous systems, tender muscles around the pelvis and in the pelvic floor, as well as even neural irritation (lots of nerves run through the abdominal wall!). So, if the organ has been ruled out as a source of pain and the pain persists- it may be worth considering something different.

4. Not having enough sex OR having too much sex OR masturbating too frequently causes pelvic pain. I cannot tell you how many times I have had a patient timidly ask me if there sexual habits or frequency are to blame for their pain. No. Just no. You should be able to have sex as little or as frequently as you want without any problems or pain. Now, being forced to have sex—that may cause a strong protective response of the pelvic floor muscles. But, consensual sexual activity is normal and should be enjoyed by all without worrying about pain. And if you are having pain? Don’t ignore it– go talk with your physician or physical therapist!

 5. Tight pelvic floor muscles are healthy pelvic floor muscles. Guess what? Tight ≠ strong. Flexible ≠ weak. Strong ≠ Well-timed. Functional pelvic floor muscles are non-tender, flexible muscles that are able to activate when they should activate (well-timed). We want the pelvic floor to stretch to allow you to poop and have sex, and we want the muscle to activate at the right time with enough strength to help you not leak urine when you cough.

6. If the doctor says “all looks good” 6 weeks after having a baby, it means your body is completely back to normal. Newsflash here, you’re body isn’t really going to go back to being exactly what it was like before the baby. It’s not meant to, and that is ok! It can still be an awesome, strong and well-functioning body– but you do need to take care of it. Remember that urinary or bowel leakage, constipation, persistent low back/pelvic pain, vulvar pain, and pain with sexual activity are NOT normal. If “all looks good” at 6 weeks, but you are having these problems, find a skilled pelvic PT near you to get evaluated and get some help! And even if you are not having these issues—your body has been through a lot! Take time and care in slowly getting your body back into good movements. Also, check out this article by Ann Wendel, PT on 5 myths surrounding the pelvic floor after pregnancy.

 7. If a woman had a c-section, her pelvic floor was not impacted, and she doesn’t need to think about it. Guess what the biggest risk factor for urinary incontinence is? PREGNANCY. Although mode of delivery is important, simply being pregnant and carrying a baby puts significant pressure on the pelvic floor. Both vaginal deliveries and c-sections impact the body—remember, a c-section cuts through the abdominal wall! Remember that team of muscles that work together for lumbopelvic stability? The abdominal wall is a KEY member. Regardless of your mode of delivery, seeing a skilled physical therapist after having a baby is crucial to help your musculoskeletal system function optimally, manage unwanted pain or leakage, and get back to the fitness activities you enjoy. And guess what? It’s standard care for all ladies postpartum in many countries around the world.

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8. Urinary incontinence is always due to a weak pelvic floor muscle group. I wrote a whole blog on this one, so I recommend you read it here. The short answer is, No. No problem is due to solely one muscle. Our body is a system, and we have to always treat it like that.

 9. Hips and sacrums dislocate regularly in some people. This is such a common one too—I’ll have patients come in and say, “My hip keeps ‘going out’ and I have to do this <does weird hip movement> to put it back in.” OR “My SI joint keeps ‘popping out of place.’” Let’s all be honest about this- dislocations of joints do happen, but it tends to be pretty painful, likely traumatic, and if your hip dislocates, you bet you are going to the ER. That “pop” you hear? It’s likely just a joint cavitation- basically a decrease in pressure causes dissolved gasses in the joint fluid to be released into the joint. Same thing happens when you pop your knuckles. If it happens frequently and is associated with pain, talk with a physical therapist.

10. Sucking in the stomach constantly creates a strong “core” and a flat abdomen. You know what creates a flat abdomen? Eating healthy and exercising regularly. Contracting any muscle constantly is not functional, nor does it really do what we want it to do. Sucking in the stomach actually tends to make it more difficult for your diaphragm to move well when you breathe and also can cause the pelvic floor muscles to over contract and become tender/uncomfortable. It can also inhibit movement, and we know moving well with variety is SO key to a happy body. So, relax your stomach and allow yourself to breathe (remember how important that diaphragm is!)

I hope you gained a little insight with this list—it was fun to write! This is by no means an exhaustive list (over 40 responses, remember?), and I’d love to keep the conversation going! Special thanks to my world-wide pelvic health team! It’s so fun collaborating with such a great group!

Have you heard anything else about the body that does not seem to be right? Ask here and we’ll do our best to answer! Physical therapists out there—what are your other favorite myths to de-bunk? Let’s all work to spread accurate knowledge—knowledge really is power! Have a great Wednesday!

~ Jessica

LIVE Podcast with Ivy Radio on Pelvic Health– Tomorrow 3/11 at 1pm!

Tomorrow at 1pm, I will be chatting live with IvyRadio on all things pelvic health! Tune in tomorrow live at http://www.ivyrehab.com/ivyhealthhub/la-radio/ The podcast will also be available online after the show!

Hope some of you can make it! If you have any specific topics you hope I’ll touch on, let me know in the comments!

Happy Wednesday!

~Jessica

Finding a Pelvic PT

Now, before I get started, I have to say that there are many, many websites/blogs with information on how to find a pelvic PT. But, I felt it necessary to have a post here so that people reading this site who needed a pelvic PT have a quick resource to understand how best to find one, and how to “shop around” and know that the person he or she is seeing is skilled. I hope it is helpful to someone at some point! So, once you have determined you would like to see a Pelvic PT or a Women’s Health PT, how do you find one? 

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Databases and PT Locators: 

There are two main PT locators for Pelvic Physical Therapists and they are: The American Physical Therapy Association’s “Find a PT”  and Herman & Wallace Pelvic Rehabilitation Institute’s Practitioner Directory. The APTA’s directory requires an APTA membership and H&W’s is open to any practitioner. The benefit of these directories is that they will help you locate a practitioner nearby and will provide information on any credentials or areas of specialty that person has designated.  The limitations are of course that there is no guarantee that a person listed is skilled in your specific need, so you will have to do a little more work from here. The APTA’s directory does provide a space for the PT to put more practice information, etc–so you get a little more information there.

Ask a friend…or the mafia: 

Social media is amazing and has truly revolutionized healthcare. Now, patients are really able to have experts at their fingertips with facebook, twitter, linkedin etc. Asking for a personal recommendation can be a great way to find a skilled PT. Patient groups online are also great resources for finding someone skilled in your particular need.

The #pelvicmafia is a twitter community of pelvic PTs who are truly doing great things to advance patient care, share research, and improve practice patterns across the board. Feel free to ask us for a recommendation by tweeting #pelvicmafia after your question. If we know of someone skilled living near you, we will be more than happy to share!

Also, know that most pelvic PTs are happy to help you if you ask! I have gotten several random phone calls from patients living in different areas, and I am always happy to give a recommendation if I have one! Find a reputable clinic anywhere in the US, and most PTs will be happy to do the same!

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Finding the right PT for you: 

Once you locate a PT, you’ll want to reach out and talk with her to make sure she is a good fit for you. First, what’s in a name? There are a few specializations/credentials you may need to be aware of.  Let’s go through the basics:

  • Entry-level degree- BS, MSPT, or DPT: The first few letters behind the PT’s name basically just give you some information on when that person received his or her initial degree. A while back, becoming a physical therapist just required a bachelor’s degree (4 years of study)–then it became a master’s degree (6 years of study)–then became a doctorate (7 years of study) ~ 10 years ago. That being said, many people who originally had a BS or MS have gone on to receive additional education to attain a transitional doctorate degree.
  • WCS (Women’s Health), OCS (Orthopedic), SCS (Sports), etc. Clinical Specialists: These letters will be behind someone’s name who has either 1) completed a residency in that specialty and passed a written examination or 2) had 2000 hours of experience within that specialty, completed a case study reviewed by a board, and passed a written examination. The current field of women’s health includes not just pelvic floor disorders in women and children, but also includes evaluation and treatment of breast cancer related musculoskeletal dysfunction, lymphedema, osteoporosis, fibromyalgia as well as female athletes. The WCS has been around for about 8 years (my educated guess).
  • BCIA-PMDB: This is a certification for using EMG biofeedback for pelvic floor muscle disorders through the biofeedback certification international alliance. Becoming certified requires 28 hours of education, a 4 hour personal training session and 12 hours of mentoring time reviewing 30 cases with a mentor. This also requires passing a certification exam. This has been around for a longer period of time in terms of the Pelvic specific certifications.
  • PRPC: This refers to the Pelvic Rehabilitation Practitioner Certification through Herman & Wallace. This test is offered to other health care practitioners as well, but of note requires  2000 hours of patient care and a written exam to attain. This certification is specifically focused on treating pelvic floor disorders and has only been around for about 1 year.
  • Other letters: I could spend quite a chunk of time defining all of the letters out there and still probably would miss quite a few!! Fellowships, certification programs, and even some continuing education courses will assign letters that a person can put after his or her name. I recommend looking at those letters, then typing them into google and finding out what they mean and whether they apply to you.

After you have decoded the PT’s name, ask about any continuing education the PT has had after graduation. This will give you insight into how that person has chosen to advance his or her education. In my mind, this is one of the most important pieces for many reasons.

  • Most entry-level programs have minimum to no training included on evaluating and treating pelvic floor dysfunction. I graduated from Duke University which has more training than most–but even that only included a few lectures and a short elective course. That being said, most Pelvic PTs end up being trained while on internship, residency or after graduating from school via continuing education courses.
  • The largest continuing education training programs are the APTA Section on Women’s Health (SOWH) and Herman & Wallace Pelvic Rehabilitation Institute. I am involved with both, have taken courses through both, and think both are wonderful programs! Both include training for internal examinations and treatments which is so important and both have plenty of lab assistants to help make sure participants know what they are doing. I lab assist for H&W and I am on the Educational Review Committee for SOWH. SOWH also has a certification option called “CAPP” for both Pelvic and Obstetrics to indicate a person has gone through the series of courses and passed a reviewed case study. Note: Although not all pelvic floor dysfunctions require internal vaginal or rectal treatment, I do believe that having formal training in this is important for a PT who is specifically treating pelvic floor disorders.
  • Internships: Some students who are interested in pursuing pelvic health or women’s health will choose to do internships working with clinicians in those fields. I did this as a student and worked with Darla Cathcart, PT, DPT, WCS in Shreveport, LA for 5 months (She’s awesome!) . I have taken 2 students from Duke University myself. These internships are a great way to learn and give you information that the person you are seeing has had one-on-one training.
  • Residencies: These are 1-year programs focused on treating women’s health physical therapy. There are less than 10 of these in the country, so if your PT has done a residency, it shows a strong commitment to education, in my opinion.
  • Other Continuing Education: I really think this is so important so cannot emphasize this enough. There are so many options for education including courses, conferences and national meetings. Feel free to ask the PT to see his or her resume or CV to see which courses have been attended and how they fit with what you need.

Hopefully this information helps you shop around and find a PT who fits what you need! Please do not feel lost or hopeless if you cannot find a pelvic PT who lives close by– the unfortunate thing is that there are way more people who need pelvic PTs then there are currently PTs to treat them! In the field of physical therapy, it is one of the “newer” specialties, so we definitely have room to grow! If you find a PT who may not have the training you desired– don’t fret! All of us had to begin somewhere, and there is so much to be said for a passionate, dedicated person who desires to learn! I have known PTs with less than 1 year of pelvic experience who I would easily refer to because of their passion and dedication alone!

Learning Summary: Becoming the Best Event- Interview with Jessica Drummond

As you may know, part of my goal in writing this blog was to have a forum to process things I learn, and of course, to allow you to benefit from my nerdiness in learning. This week, many of my physical therapy colleagues from across the nation are traveling to Indianapolis for the American Physical Therapy Association’s Combined Section Meetings—basically a week of excellent presenters, networking, and seeing old friends. Of course, my heart is SO sad that I won’t be there this year—so I just had to find a way to learn on my own!

Thankfully, Jessica Drummond clued me in on Twitter to the Becoming the Best Event– a week long summit of (FREE) interviews with top holistic health professionals in the country! I read the bios, and I was in. I have been following Jessica for years (Didn’t know you had a stalker, did you Jess?:) ) and I have truly enjoyed learning from her. Jessica is a physical therapist and the CEO and founder of the Integrative Pelvic Health Institute. She has created a unique model of treating the whole person—managing the hormonal and dietary aspects as well as the physical—and she is pretty awesome at doing it! I was fortunate to collaborate with her this past year in caring for a wonderful woman who was experiencing sexual pain, and I can say from my experience that Jessica really did make a difference in her life!

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So, here is a summary of what I took from Jessica’s Interview:

  • In treating women, Health Care Providers (HCPs) must work to normalize women’s health issues. We should all ask about a woman’s menstrual cycle and reproductive history the same way we ask about diet, bowel movements and sleep habits. For some reason, women are taught from an early age that our normal cycle is something to hide and be embarrassed about. However, it is so important and can be one of the only clues to us that something is off! Did you know that an abnormal menstrual cycle could even be an indicator of Celiac’s Disease? I didn’t, until today.
  • Just like we individualize nutrition based on the person, exercise and fitness recommendations should be individualized based on the person. Jessica said this awesome statement during our interview, and I absolutely agree: “I actually don’t think there is any specific form of exercise that is bad—it’s the way, the intensity and your body’s readiness for it.” 
  • What about high impact activities (running, jumping, gymnastics)? Not “bad” either but can put women at risk for problems if they do not understand how to adequately use their pelvic floor muscles.  Increasing pressure on the pelvic floor without adequate timed recruitment can lead to problems like incontinence/prolapse. Jessica recommends that all athletic women should be mindful of their pelvic floors (not always Kegels!) and all HCPs working in wellness should ask questions and encourage seeking help when needed.
  • Women often ignore the benefits of our hormonal cycles—we are always encouraged to hide it from the time we are 12 years old! Estrogen and testosterone are at its highest right before ovulation (2nd week in the cycle). Women actually have more energy at this time, and will burn more fat when exercising these days! We can capitalize on that by eating a higher fat meal a few hours before we exercise to encourage our bodies to burn more fat. So, at mid-cycle- we should eat less sugar, healthy protein and good fats to encourage our body to utilize the natural hormonal environment. In the second half of the cycle, the body actually prefers using protein as energy! If a woman has a big fitness event at the end of the cycle- she may need to eat more often and will probably need more support since hormone levels are at their lowest. And what about running with gels and gus? Jessica actually says that doing this does not encourage our body to use the right fuels but rather pushes a simple sugar energy.
  • Women exercising intensely daily without modulating for hormonal cycle can end up being a negative thing—this does not necessarily allow for adrenal recovery and can negatively impact the system. Estrogen can become lower and this will put someone at risk for cardiovascular dysfunction (and poor bone health too!- JR add)
  • What about for pregnant women? There are some specific things that can be done to tweek a fitness program and get maximum benefits. First, it is important to recognize that the uterine environment is a very important environment to build. That environment can pre- program the genetic expression of the fetal genes. Weight issues, DM, PCOS, Metabolic issues can impact the environment. Clean eating (low sugar) with regular, healthy eating. Insulin sensitivity decreasing as pregnancy progresses can lead to big blood sugar swings which are also not ideal for womb environment. Eating healthy foods at regular intervals can help- focusing on eating nutrient dense foods, healthy fats and minimal sugars. Exercising (even just walking 30 minutes per day) can also help to control blood sugar and promote healthy blood sugar for the baby. Of note, pregnant women should be careful of actively detoxing during pregnancy and while nursing. Stored toxins are “hidden” from the baby and trying to “release” them can actually transmit those things to baby. That being said, a more intense detox before pregnancy can actually be a good thing.
  •  Hormones are of course significantly impacted during menopause. Did you know we can help prepare for menopause? Jessica recommends women focusing on building strong adrenal function during their 30s and 40s, emphasizing addressing stress, nutrient density, and controlling blood sugar. Doing this can impact the entire hormonal environment and create better health for women as they age. During menopause, women lose the estrogen support from ovaries–but having healthy adrenal glands can help a woman make enough estrogen to minimize menopause symptoms (including hot flashes, discomfort and brain fog!)
  • And lastly, what about us health care professionals? How do we avoid adrenal burn-out? It is essential for us to create a fairly strict list of priorities focusing on our vision for our life: What do you want life and work to be like? What must your health be to support this life? Jessica encourages prioritizing self-care and in an oh so inspiration way, encouraged us to “Be an inspiration for patients rather than being the person resposible for ‘fixing them.'” She also encouraged eliminating the guilt we often feel from being unable to cure everyone. She said, “You are not everyone’s healer.” We cannot heal everyone, but there are specific people out there who need our specific skill sets. Our goal should be to provide the knowledge, wisdom and skills patients need to allow themselves to heal. When they see us as an inspiration, they will take the responsibility to own their healing, wellness and healthcare. And this is a total mindset shift! We don’t have to feel guilty when we cannot help someone! And this frees us to really be what we need to be for the people who need us.

Thanks so much Jess for all of this great information! Please check out Jessica’s website for more information about her and the awesome work she is doing! If you would like more information on the Becoming the Best Event, please feel free to check it out here! You can access all of the interviews for free for 24 hours after they air, or you can pay $97 to access them whenever you would like!

Hope you enjoyed this summary! Please let me know any thoughts/comments you have below! ~ Jessica

Throw-back Thursday: When “Kegels” are not appropriate for Urinary Incontinence

For the next few weeks, I plan to re-blog/update every Thursday a previous post originally written by me when working in Greenville, SC for the Proaxis Pelvic PT blog (http://proaxispelvicpt.wordpress.com), in hopes of building a comprehensive library of posts at jessicarealept.com. Selfishly- I like having them all in one place since I often refer patients who come to see me in Atlanta for pelvic PT to my old posts to read as “homework.” 

That being said, today’s post is one published a while back here, originally titled, “Yes, you have incontinence. No, I do not necessarily want you to do Kegel exercises.” It has been modified/updated for you today 🙂 Enjoy! 

~ Jessica 

Recently, I was fortunate to evaluate a nice middle-aged woman referred to me by her urogynecologist for urinary incontinence. When we first sat down, she looked at me and said, “I’m not sure why I am here. My doctor specifically told me that I have a strong pelvic floor. I really don’t think you can help me.” I smiled. I hear this same thought process on a weekly basis (See my previous article on common misconceptions of pelvic physical therapy) You see, at some point the world became convinced that from a musculoskeletal perspective, stress urinary leakage is always due to a weak muscle. And the best way to fix a failed muscle is to strengthen, strengthen, strengthen. But, if that’s the case, then why do I have so many patients walking into my office telling me that they have done “Kegel” exercises and still leak? Why would a patient like the one above have a “strong” pelvic floor that cannot hold back urine? Why is urinary leakage associated with low back pain and pelvic pain- disorders that we know can often include tight and irritated pelvic floor muscles?

Now, as a caveat to this article, let me say now that it is sometimes totally appropriate for a person to start a pelvic floor strengthening program. In fact, the person with a truly weak, overstretched, poorly-timing pelvic floor will likely be prescribed a strengthening program. With that being said, the truth is that the majority of patients referred to my clinic for evaluation of urinary incontinence are not issued a traditional kegel exercise program. My colleagues and I actually tend to be surprised when we evaluate a new patient who truly needs to start a true “strengthening” program for their pelvic floor at the first visit. The reason behind this is that Stress incontinence is not simply a failed muscle, but a failed system.

The urethra is supported within the continence system by fascia, ligaments, as well as muscular structures. When a downward force is applied to this system as occurs with coughing, sneezing, lifting, bending, etc, these structures function in a coordinated way to compress the urethra and prevent urine from leaking. In fact, Hodges et. al. in 2007 examined musculoskeletal activation occurring when a person performed an arm movement and found that the pelvic floor muscles pre-activated to prepare the body for movement. This helps to demonstrate that our pelvic floor muscles function as a member of the anticipatory core team. This team requires optimal and coordinated function of the diaphragm, the deep abdominal muscles, the deep low back muscles as well as the pelvic floor muscles. My awesome colleague, Julie Wiebe demonstrates that relationship very well in the video below (Note: Julie has an AWESOME blog/website- read more of her stuff here):

When any of these structures are not functioning well, leakage can occur. Now, the tricky part here is that optimal functioning requires both strength, flexibility and proper timing. A tight irritated muscle then becomes equally as dysfunctional as a weak over-stretched muscle. And, a strong, flexible muscle that doesn’t have the right timing contributes to a very dysfunctional system.

So, treatment for incontinence then must include retraining and reconditioning the system to ensure its proper functioning—which for me includes a bit of detective work to truly identify the faulty components. And, when it comes down to it, typically does not include doing 100 kegel exercises a day. More often, it includes learning to relax the pelvic floor and teach the pelvic floor to be a working team member– learning to coordinate the pelvic floor with the diaphragm, eliminating trigger points and restrictions which may be inhibiting this function, and then retraining the motor control of the lumbopelvic girdle as a system.

So, for now, take a deep breath and relax. We’ll save Kegels for another day.

For more information, check out the following:

I hope you enjoyed this throw-back- please feel free to share any thoughts or questions below!

~ Jessica

Partners in Health: Building a Strong Patient-Provider Relationship

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In my mind, one of the most important aspects of patient care is building a strong patient-provider relationship. I find that treatment outcomes truly depend on the patient being able to trust the provider and the provider truly listening to the patient. For many patients, seeking treatment can be intimidating and produce fear—of the unknown, of what the diagnosis could be, etc! This fear can lead to patients feeling a need to hold back thoughts or beliefs and can ultimately create barriers in treatment which leads to frustration by both the provider and the patient. Providers, on the other hand, can often contribute to fear or stall progress without intending to by not individualizing treatment and partnering with patients.

So—this post is for all of us! These are a few of my thoughts—both advice for the patient and for the provider on how to better build a partnership in healthcare. But more importantly, I want to hear from you. So, read on, and comment at the end so we can all learn to work together better and improve the way we deliver and receive healthcare.

For the patient:

  1. Remember that you have control: I have had several instances where a patient will say “yes” to a prescribed medication or will feel pressured into having a surgery that he or she really did not feel comfortable in having. If a physician, PT or other healthcare provider recommends a treatment that you are uncomfortable with, don’t be afraid to speak up and say so! Remember that we as providers want to help you get better as quickly as we can. If you are unhappy with the treatment plan, that won’t happen!
  2. Don’t be afraid to speak up: Many times, we as providers forget that not everyone has the same background knowledge we do when it comes to the human body. If you are being told something you don’t fully understand, speak up! I always thank my patients when they ask me questions because helping you understand and feel understood is such a key piece of my practice. Often times, those questions help me personalize treatment approaches and often I find we end up in a better place by those conversations we have. Along with that, don’t be afraid to question the treatment approach your PT/provider is recommending. Did you read a blog or article which recommended something different? Did your friend hear of a new treatment approach? Share those thoughts and ideas! I love to have those conversations with my patients because often times there are specific reasons why I recommended what I did and having that conversation helps both of us to be on the same TEAM. Occasionally patients may suggest new treatment approaches I am not as familiar with—and that’s great! That gives me an opportunity to learn and work together with my patient to determine how we should proceed.
  3. Make sure your goals are being addressed: If your goal is to be able to walk around the house, make sure your provider knows that! Sometimes there can be a mis-match between what your provider thinks your goal is and what your goal actually So, speak up! Let us know what you hope to get back to so we can work together to help you move!
  4. Be open to new ideas: When it comes down to it, we (the providers) do genuinely care about you and want you to get better as quickly as you can! Sometimes your provider may suggest something that seems “weird” or “unconventional,” but listen to what they have to say! I have had many patients who initially were hesitant about a treatment I recommended then later were SO glad they chose to give it a try!

For the provider:

  1. Listen to your patient!: When I was in PT school, I remember having a professor say to me, “If you listen to the patient, they will tell you what is wrong with them!” Seems so simple, but often our minds jump to immediately categorizing the patient and planning ahead to our next steps. So, let’s all stop, take a breath, and give our patients a chance to tell us what they need to tell us.
  2. There is no “I” in TEAM: To truly help a patient achieve optimal results, we have to partner with our patients and develop a treatment plan that is unique to them and their goals and values. For example, if I think my patient would benefit from doing a yoga/pilates routine but my patient hates that type of exercise, our plan is ultimately not going to be successful. However, that patient may love to swim and lift weights, so we could develop a program that might achieve the same goal in a method the patient will enjoy.
  3. Don’t be afraid of “not knowing”: Sometimes we become anxious if we do not know the answer to a question a patient asks or if we reach a point where we are not really sure how to proceed to help the patient achieve the results that patient is hoping for. I am often shocked how admitting I do not know but will work to learn actually builds a stronger patient relationship! Trust is not only in being able to help, but also in knowing when you need to seek answers from elsewhere. So, be vulnerable. Admit you do not know. Seek additional consultations or refer out if you need to! In the end, the patient is the one who will benefit from your humility.
  4. Watch your language!: No, I do not mean avoid cursing with your patients (that’s a no-brainer!), but be careful with what you say and how you explain things. My sister went to physical therapy and was told, “Your rib on one side is ‘out of place’.” She totally freaked out—not knowing what that meant, she worried something was structurally wrong with her body. She was scared, and guess what? Her pain actually got worse that week. Recent studies have shown that our words do not always mean the same thing to us as they mean to our patients. Check out this awesome blog post by Matthew Low which summarizes several studies on the subject. Pay attention to what you say and make sure your words promote healing and health—not fear!

Let’s partner together and work toward better health! These are just my thoughts…. So, what do you think?

Patients- What would you like your health care providers to know to better help you in your recovery? Have you had any bad experiences with providers you would like us to learn from?

Providers- What would you like patients to know when coming to see you? What can we all do to work together better?

Cheers!

~ Jessica

Interview on PT for Urinary Incontinence in Greenville News

A few months ago, I had the opportunity to be interviewed for a story in the Greenville News on Urinary Incontinence.

Many women (and men too!) don’t realize that there are effective non-surgical options for UI. My hope is that articles like this can help spread awareness and encourage people to be proactive in seeking out help! Women’s Health and Pelvic Floor Physical Therapy can make a huge difference for people struggling with these problems!!

Enjoy the article here! Will be added to our News page for future viewing!

Happy Thursday!