shutterstock_505081366 (1)

The SoWH Blog

Stay up to date on the latest Section HQ news, patient and practitioner education and member stories!

All Posts

It’s Not Normal : My Drive to Learn More

I’m a wife, a mom of three little boys, and the owner of a private practice caring specifically for Women’s Health. I began my career out of Physical Therapy school in the acute care setting and following the birth of my first child I learned just how important and necessary pelvic health physical therapy (also referred to as pelvic floor physical therapy) is following delivery. At that time, there were no providers within 50 miles of my home, so I sought to change this. I developed and implemented a hospital-based, outpatient pelvic floor program after taking both OB courses through the Section on Women's Health (SoWH) as well as Pelvic Health Physical Therapy Level 1 and Level 2. Unfortunately, the hospital closed with a 30-day notice in January of 2018, prompting me to launch my own practice to continue caring for this patient population. The practice has been open since March of 2018 and has cared for over 150 patients to date.


Where it all began...

Growing up, I loved the sciences and my mother is an RN. I naturally was interested in the medical field, but took to the profession of physical therapy following a shoulder injury in high school. Physical therapy treats a person using a teamwork approach- something that is lacking in many other medical-based fields. By working together with my therapist, we addressed my shoulder pathology as well as what caused the injury to occur in the first place to prevent re-occurrence. This mind-set of teaching others how to fix their ailments really resonated with me and I knew immediately this profession was right for me.


My interest in women's health physical therapy stems from my own needs following the delivery of my first child. Left with a pudendal nerve injury and lack of urinary sensation as well as poor core strength following delivery, I needed help. Unfortunately, at that time, the closest Pelvic Health Physical Therapist (also often referred to as Pelvic Floor Physical Therapist) was nearly an hour away and my OB/GYN told me my symptoms were “normal.” From that point on, I began searching the SoWH’s course catalog and taking courses to further my knowledge in this area. I realized if I was having these problems at 25 years old, others had to be suffering silently as well. It’s now become an absolute passion of mine. Assisting women who are suffering from symptoms that are significantly impacting their quality of life and watching them regain their confidence and happiness is honestly the most rewarding patient population I’ve had the opportunity to care for thus far.


Expanding my practice to meet the growing demand...

I plan to continue my education by completing the Pelvic Health Physical Therapy Level 3 course, I’ll be able to provide comprehensive pelvic floor therapy to my community. As mentioned earlier, there are currently no other pelvic floor providers in my area with significant pelvic floor training. Over a 2-month period of time, I received inquires regarding six male patients seeking pelvic floor therapy with appropriate referrals. I had not even yet completed the training for Pelvic Health Physical Therapy Level 3 and couldn’t prior to the October course due to our third child being due in July 2018. There is a rising demand in pelvic health physical therapy services that I hope to meet in the future.

I plan to expand current services at my practice to include male patients following completion of this course. In addition, the furthering of my education will provide more in-depth clinical training for complex patient presentations as well as neurological patients. Being the only local provider for these services, complex cases are common.

Currently, pelvic health and pregnancy/postpartum physical therapy are extremely underutilized and unknown to most providers including other physical therapists. Following the newly released ACOG guidelines, I have continued to educate to local OB/GYN’s regarding the importance of pelvic health during and following delivery which directly impacts the women’s pelvic health in later years. I often see patients presenting to my office who have seen numerous other providers regarding pelvic-related pain and are frustrated with lack of improvement. Most physicians are extremely open to implementing pelvic floor therapy with their pelvic pain as well as pregnancy/postpartum patients because often times they can offer them no additional options. Local physicians frequently contact me regarding their patients to determine if I can provide any benefit to them. This is how I envision the physical therapy profession as well as the healthcare industry to evolve. The physicians contact me not as a therapist who provides exercises, but as a colleague. Instead of sending patients for surgery, I’m consulted first. Pelvic Floor therapists truly are in a position to be considered the provider of choice for this patient population.

I’ve had to turn away male clients from my practice because I had not completed training to adequately care for them. My plan is to complete further training and education through Section on Women's Health which will allow me to accept all pelvic health patients regardless of gender or complexity and have confidence that I am trained to adequately care for their needs and continue to earn the respect of local physicians in caring for these patients while improving the awareness of pelvic health physical therapy.

Darla Schwab, PT, DPT
Darla Schwab, PT, DPT
Darla Schwab is a Section on Women's Health member based in Louisville, OH. She has recently been selected as the recipient of the Pelvic Health Physical Therapy Level 3 course scholarship the Section on Women's Health has sponsored to recognize PT and PTA members in the field and support their education goals.

Related Posts

A PT Student's Takeaways from 2019 APTA CSM Washington, D.C.

Imagine walking in from the rain and the cold, through a set of double doors and seeing a wave of people coming in and going out; individuals whizzing by you as they make their way to their designated location and having crowds of really smart and cool people all around you. Well, that was my experience on my first day heading into the Walter E. Washington Convention Center in Washington, D.C. for the 2019 Combined Sections Meeting, the nation’s largest physical therapy conference that is held every year. To say that attending this conference and then in some way having a small role in it, was overwhelming, is an understatement.

Key Factors That Limit Access to Physical Therapy Care

Hi, I'm Michelle Little. My parents were born in Colombia, South America and moved to the United States with dreams of a better life. They immigrated from an impoverished area, lacked a college education and with a very basic English vocabulary. Due to this sacrifice, they have always had very manual,  labor-intensive jobs. From a very young age, I knew what pain was because I witnessed my mother icing her hands and feet after a ten-hour shift. I now understand that my mother’s pain was in part caused by the physical requirements for her job and poor occupational accommodations. During all those years, my mother was never told about or referred to physical therapy, so she lived in fear that her body was weak and damaged. In my sophomore year of college, I had a knee injury that led to surgery and post-operative physical therapy. Going through physical therapy made me feel empowered, and I knew I had found my life’s passion. I wanted to educate and empower patients that had orthopedic pain like my mother, and improve the quality of life of my patients and their families.

“Just Relax?” Meeting with Trauma in the Physical Therapy Setting

In his seminal book “The Body Keeps the Score,” trauma expert Dr. Bessel van der Kolk states “the ability to feel relaxed in one’s body requires the emotional experience of safety.”