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How did you decide to pursue pelvic health physical therapy? What is your background? I hadn’t actually planned to specialize in pelvic health in physical therapy (PT) school or the first years after graduation. My first interest in the area came in PT school when I was assigned the pelvis and pelvic floor for an anatomy project. I was fascinated by the complexity of the region (and still believe a strong understanding of the underlying anatomy is crucial for a pelvic physical therapist). About 15 years ago, Hoag Hospital asked me to create a pelvic health program. They allowed me to pursue a fellowship program with an experienced local therapist, and I was able to take amazing continuing education courses from some of the leaders in the field at that time.
Urinary urgency or urge incontinence happens when the bladder contracts when it is not supposed to and may result in subsequent leakage of urine. This can occur for different reasons. However, it can commonly be due to either overactive or under active pelvic floor muscles. Due to the connection with the pelvic floor muscles, Physical Therapists specializing in Pelvic Floor Dysfunction can help. They can use bladder retraining which is a technique to improve urinary urge incontinence by trying to improve bladder and pelvic floor function. It is best to be evaluated first by a medical professional to find out which category you fall in, as well as to rule out other possible causes.
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!”
The Section on Women's Health Board of Directors would like to announce the resignation of our Treasurer of 5 years, Uchenna Cynthia-Awelle Ossai “UC” PT, DPT, CLT, WCS. UC has been a dynamic and integral member of our board, bringing her “swagger” and intellect to recent growth within our organization and her insightful point of view to issues including Diversity and Inclusion as well as education in the area of LGBTQ health and wellness. We congratulate UC on her service and wish her well as she pursues her professional passions!
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.
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.”
Reflecting back on 2018 and the numerous achievements accomplished this year. A permanent fix to the Medicare therapy cap was achieved after 20 years of temporary exceptions and implementation delays. Other important legislative and regulatory achievements, included enactment of comprehensive opioid legislation that increases awareness and access to nonpharmacological treatment options, enactment of the Sports Medicine Licensure Clarity Act to ensure physical therapists have liability insurance when working with teams across state lines, the elimination of functional limitation reporting, and the expansion of telehealth services in the Veterans Administration and Medicare Advantage. The Physical Therapy Interstate Licensure Compact continued to make progress, with the first licensure privilege being issued and compact legislation enacted in 21 states. These wins help advance the profession of physical therapy. Please join the effort to move physical therapy forward with the start of the 116th US Congress this January and become a grassroots advocate. The 2019 Federal Advocacy Forum will take place Sunday, March 31-Tuesday, April 2 at the JW Marriott near the White House in Washington, DC. Registration and housing will open January 2019 and end March 18, 2019.
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.
Dreams & Aspirations of a Student Physical Therapist Pursuing Pelvic Health Physical Therapy Education I pursued the physical therapy field because I feel a duty to help people live their best life. The more I learn about women’s health the more I’m drawn to helping enhance the human experience of this population by specializing after graduating in 2019 from my Doctor of Physical Therapy program at University of Michigan-Flint (Blo
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/