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Pelvic health physical therapy can be a difficult topic for many people to discuss. It can be embarrassing, confusing, and even painful. Society tends to discourage discussion of these topics, causing confusion and lack of awareness regarding what is or is not normal. The reality is that pelvic floor dysfunction is common and there is something we can do about it. As one of my professors once pointed out, “There is an entire aisle dedicated to adult pads and diapers in every Target, someone is buying them!”
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.
My initial interest in women's health was sparked by a conversation with a professor during my 1st year of DPT school. I was subsequently surprised and pleased to discover the APTA specialty Section on Women's Health. Researching the field provided insight into issues of pelvic floor pain and lymphedema and networking with clinicians in the field provided me with concrete examples of how physical therapy can positively impact the quality of life in this under-served population.
Key Highlights For the first time, USA Weightlifting is actively getting involved in educating their coaches and lifters about pelvic health. On Thursday, December 6, Tamra Wroblesky gave an hour and a half interactive seminar to coaches and lifters about pelvic health, pressure regulation, hip and thoracic mobility, bowel and bladder regulation, all to improve performance under the bar. This will be an uphill battle as there is poor awareness and education about pelvic health. They have hired Tamra for their 2 international female camps (Barbados and Ohio) in 2019 due to the popularity of the first camp in Las Vegas last year. Check out Tamra's original Team USA article, Supercharge Your Pelvis, which has gained momentum in the weightlifting community and her latest report below!
Meet Alexis Smith PT, DPT My entire childhood, I dreamed of becoming a Veterinarian. I was a very good student in high school, and graduated Valedictorian of my small class. I then attended a prestigious liberal arts college for undergraduate, and had a difficult time making high science grades. I worked part-time as a student athletic trainer, played basketball for the college team, and studied constantly. Unfortunately, my rural high school had not prepared me for the science classes I would need to qualify for the Veterinary school program I applied to. After graduating, I started to re-evaluate my career options, and realizing how much I enjoyed my college job in the athletic training room, I started working as a technician in an outpatient PT clinic. I took the science courses again, made a 4.0 the second time, and eventually was accepted to my dream Veterinary program as well as a DPT program. I decided to become a physical therapist and have not regretted that decision. Through PT school, I enjoyed my classes and clinical rotations, but did not feel as though I had found my niche. I finally took the women's health class in my third year and a fire was sparked. I was able to shadow a specialist in pelvic health soon after and realized I had found my calling. I am very passionate about women's health and so enjoy my work as a Pelvic Health PT.
Two SoWH members are travelling to Argentina this weekend as presenters at the World Professional Association of Transgender Healthcare (WPATH) International symposium (Nov 3-6, 2018). Sandra Gallagher PT, WCS and Caitlin Smigelski DPT from Portland, Oregon will be presenting with an Oregon Health and Sciences University (OHSU) team. The topic is Physical Therapy for People Undergoing Gender Affirming Vaginoplasty. The Transgender Health Program at OHSU has embraced physical therapy (PT) as an important aspect of transgender care. At the outset of the program, the surgeon preforming vaginoplasties wanted PT involved preoperatively to improve knowledge about dilation. Intentionally including PT in the treatment plan has expanded to teaching pre-operative stretching, proper pelvic floor exercises, general conditioning and screening for and resolving bowel and bladder disorders and post-op follow-up. An important part of the program has been teaching people positioning for dilation. Most people undergoing surgery learned from those before them about dilation, word of mouth or YouTube videos. Some positioning commonly used for dilation can actually make dilation more difficult and affect tissue healing. Applying biomechanical and anatomical advice to correct positioning can make dilation easier and more successful for patient. The involvement of PT has been well received by the trans community and both Sandra and Caitlin are excited to be sharing this information on an international stage with the goal of improving care for transgender people everywhere by involving PT with vaginoplasty. Physical therapy also has a role with other gender affirming surgeries and non-surgical conditions that affect people who are transgender or gender nonbinary. We look forward in a future blog post from Sandi and Caitlin about their experiences networking, presenting and connecting at the WPATH Symposium 2018. About WPATH The World Professional Association for Transgender Health (WPATH), formerly known as the (Harry Benjamin International Gender Dysphoria Association (HBIGDA), is a 501(c)(3) non-profit, interdisciplinary professional and educational organization devoted to transgender health. Our professional, supporting, and student members engage in clinical and academic research to develop evidence-based medicine and strive to promote a high quality of care for transsexual, transgender, and gender-nonconforming individuals internationally. We are funded primarily through the support of our membership, and through donations and grants sponsored by non-commercial sources. https://www.wpath.org/
I have just completed my 6 week clinical experience in the Women's Rehab and Men's Health with UPMC Center for Rehab Services. Unfortunately, according to company policy, I was not permitted to perform internal examinations and based on my school policy for clinical sites, I was not eligible to complete a longer clinical that includes internal pelvic floor examination. I began to seek education and training on my own.
My interest in women’s health physical therapy first began when I was working as a rehab technician in a clinic with two pelvic floor therapists. My personal interest was piqued after my own experiences before, during, and after childbirth. Interested to learn more once I began physical therapy school, I spent time during my winter break in 2017 to shadow a women’s health specialist. I was delighted to observe how large of an impact patient education could make for the pelvic health patient population.
My name is Anietie Ukpe-Wallace and I am currently in my final year of the University of St. Augustine’s FLEX DPT program. Before I even considered physical therapy (PT) school, I taught yoga for several years and have always had an interest in the pelvic floor and how those set of muscles could impact a person’s ability to move through a pose or limit the amount of movement in their hips or back. The muscles that cannot be visibly seen externally held a lot of mystery to me. Having gone through my own trials with my own pelvic floor from miscarriages to surgery and pregnancy to birth, this region of the body continued to be a mystery even then despite all of that “stuff” that I had happening down there. Sad to say, PT school did not discuss much on the pelvic floor other than a short lecture on pregnancy and when I discovered that I could become a physical therapist with a specialty in the pelvic floor, my interest was piqued, and I began to investigate how to go about that path. During my time in PT school, I have been lucky enough to have two professors with whom I was able to discuss my interest and desires about pursuing this specialty. In addition to offering me resources to learn more about it and advising me to start seeking out courses, they also offered me encouragement to pursue this field since it was still growing and there is a high demand for this specialty.
I first learned about physical therapy when I was dancing with a ballet company as a teenager in San Diego. I gained more exposure to the field when I went to college and minored in dance at Duke University. I worked closely with a Physical Therapist to create a pre-physical therapy association for Duke undergraduates. Many of my dance colleagues, however, sustained chronic foot and ankle injuries, and were subsequently sidelined for months at a time. Similar to the Section on Women's Health’s tight-knit community of hard working professionals, the ballet community in general is also a group of close and accomplished women (and men!), and unfortunately, injuries are part of the landscape due to the intense nature of training. I met two Physical Therapists during my dance training who educated me about conditioning and rehabilitating my body. I admired these women who understood the rehabilitative needs within the dance community, and went above and beyond their clinician duties to encourage me, teach me how to condition properly, and inspire holistic wellness in an otherwise intense climate. Despite my commitment to dance, I also loved the sciences—physiology and anatomy were my favorite courses—and I also loved talking to people about their lifestyle needs. Physical therapy has been the perfect way to marry my interests in anatomy and physiology, interacting with people, solving problems and keeping both myself and my patients active!