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Finding the Right Core Physical Therapist

Welcome to the Healthy Core blog, written for the many individuals who wish to be better informed about how to recover from pregnancy, surgery, car accidents, falls, chronic pain or conditions related to the pelvic girdle and spine. I am going to share the wisdom I have gained as a mom of three and as a manual physical therapist of 23 years. Like the countless women that did not receive the timely help they needed, it has taken me years to learn what I am going to share in this blog. I will cover many topics related to the core including exercise, bodily functions (in clinical terms), core dysfunctions and a healthy gut. My background is in orthopedics and sports medicine, before specializing in the pelvis 17 years ago. Although I am a women's health therapist, I consider myself to be a pelvic core physical therapist, treating pelvic floor dysfunctions while addressing the deep core muscles and all 35 muscles that directly attach to the pelvic girdle. The pelvic floor does not work in isolation and is not a dysfunction unique to women, as men have the same muscles and can develop similar symptoms.

Having each of my children was life changing and eye opening. It was difficult for me to find someone to help me recover, even with all the resources I had available working in a large hospital system. How much more difficult is it for someone outside of the medical field to find help? The truth is that there are very few therapists and practitioners who understand and can effectively treat the pelvis, SI (sacroiliac) joints, pelvic floor muscles and the connection with the gut, bladder, bowel and sexual function. My physical therapy education did not provide me with the tools to understand the pelvic floor, let alone pelvic pain. Most of what I have learned was in postgraduate studies and coursework, from yoga and Pilates instructors and from some of the best mentors in the world! I am constantly learning and growing in my treatment approach. I believe this is the attitude you want to look for in a physical therapist. The good news is that more physical therapy programs now include internships for the treatment of pelvic floor dysfunctions and the future looks bright. But until more therapists are trained, finding someone with experience and effective skills can be a daunting task.

There are ideal characteristics you should look for in seeking help from a pelvic core physical therapist. You should continue searching until you find these qualities, even if it means traveling to get the help you need. Do not limit your search to your geographical area, since there might not be a qualified therapist in your area and you will waste time and money and end up with feelings of hopelessness or despair. With this age of technology, you can search just about any topic on the web and find information. But how do you know you are in good hands (pun intended)?

Here are some tips to look for in a good women’s health physical therapist, not necessarily in the order of importance:

  • Has at least two years of experience practicing under a mentor in women's health, has had a fellowship in women's health or is a board-certified women's health specialist (WCS) and/or has a background in orthopedics with extensive postgraduate training in pelvic girdle dysfunctions

  • Has passion and compassion to address your emotional needs

  • Has been recommended from a doctor/ provider or friend who has received treatment

  • Provides education and empowerment to teach you how to manage your condition

  • Addresses the core system and will evaluate and treat you as a whole individual, not a part

  • Teaches you how to lengthen the pelvic floor through Reverse Kegels/ diaphragmatic breathing and does not recommend Kegels as the first line of treatment

  • Does not recommend sit-ups, crunches and impact exercise until the core is restored and is able to modify your current exercise program or help you get started

  • Addresses hip range of motion, spinal mobility and core strength

  • Practices good health habits and yet is realistic and understands the demands of life

  • Continues to advance his/her education and skills

I have many patients contact me before scheduling an appointment at our clinic. My treatment approach is to get patients better in fewer visits and make myself obsolete. In other words, I want my patients to help themselves. In addition to possessing the above qualities, I use visceral mobilization (myofascial release of the fascia surrounding muscles and organs), intravaginal trigger point release and Integrative Dry Needling therapy to maximize the benefits of treatment.

Too often I hear how patients wasted time and money going to a physical therapist who lacked the above qualities. I have had patients who cancel surgery after correcting the biomechanical dysfunctions in the pelvis and retraining the core, in less than five visits to our clinic. I have had patients remark that their gynecologist asked why they had tight pelvic floor muscles. I have had patients tell me their provider told them if they had more partners and more sexual experiences, they would not be so tight! This is ludicrous and absolutely the wrong advice! There is a lack of education even within the medical profession when it comes to pelvic floor dysfunction. Physicians are very skilled at what they are trained in. They want to help, but many do not have the musculoskeletal background to understand and treat myofascial pelvic pain.

On the other hand, I have had interested physicians and practitioners ask to meet me in person so they could better understand my treatment approach before sending a patient to me. It is ideal to have great communication with other health professionals who want to know what I do and who I can ask medical questions and refer patients back to. However, it is not always realistic, given our current healthcare environment. Providers have many challenges today with more regulation and documentation than ever. Time is money and so are more patients! There is more competition to keep patients "in-house", being driven by declining reimbursement, large quotas and financial gain, making the wall higher to climb for those that need help. Providers and hospitals should put "patients first" but unfortunately, this is not the case. This is driving many individuals to seek alternative and holistic practitioners, who offer a cure instead of a quick fix and are not bogged down by the system, for a fraction of the cost.

You deserve to find and receive the help you need, learn how to self-manage your condition and have HOPE for the future! You can achieve a healthy core! To locate a pelvic floor specialist in you area, click here. Type keywords "women's health" and then do your own research to find the most qualified provider for your condition.

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