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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/
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.
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!
As an introverted, first year student from University of Maryland Baltimore, with a broken phone, I made the trip to Portland to attend my first APTA conference, the National Student Conclave (NSC), in search of other passionate students.
On August 9th, I gave my "Supercharge Your Pelvis" talk to the inaugural All Women's Weightlifting Camp in Las Vegas. I was invited by USA Weightlifting to come and speak about pelvic health and physical therapy targeted towards female weightlifters. This opportunity came about due to my close workings with a female weightlifting patient for the past 3 years who my business sponsored to go to University Nationals in 2017 where she won 6 gold medals. Through her, I met her Mike McKenna, her weightlifting coach based out of York, PA. I began traveling there on weekends to give my pelvic health seminars and do individual assessments. I noticed how much my knowledge could help both men and women, not just with pelvic pain and incontinence, but with low back, hip, groin, knee, and leg pain. We also worked on proper hip and thoracic mobility programs for the weightlifter, nervous system warm-ups, and proper muscle activation during the squat, clean and jerk, and the snatch.
The pelvic floor consists of muscle fibers and connective tissue located in the base of the pelvis. It is important in supporting the pelvic organs, maintaining continence, and sexual function. These muscles can become overactive, tight, or have spasm in them which can lead to dysfunction and/or pain. Overactive muscles restrict normal blood flow, resulting in a buildup of waste products. This can lead to further irritation, pain, and increased muscle tension. When someone develops pelvic floor pain, this can cause more involuntary tightening or guarding of these muscles, leading to more pain and dysfunction. Relaxation of these muscles can interrupt the pain cycle and promote healing.