A “Pelvic Floor Therapist”… ? What?
Written by Lora Ann Mize, PT, DPT, WCS
To become a pelvic health physical therapist, it takes a journey. Some journeys are long and winding, and some occur in a blink of an eye. I want to share and explore a little of my journey to becoming a pelvic floor physical therapist and possibly shed some light on the process for those who are potentially making the decision to pursue pelvic health PT.
Everything happens for a reason…right? I was an athlete growing up and was an active gymnastics coach while I was in graduate school for physical therapy. Sports medicine was my focus…give me a knee, shoulder, ankle…(anything but a vagina). I wanted nothing to do with “down there.” I didn’t even like to talk to my gymnasts about shaving or wearing shorts in front of the male coaches. I just couldn’t do it! It was too hard for me!
In my 3rd year of PT school, I was whacked in the face with my new reality. We were pregnant with our 2nd child…and this time, the back pain was horrendous…like, step off a curb and fall to the ground horrendous. My OB-Gyn told me, “That’s what happens when you are pregnant.” None of my professors wanted to touch me because I was…(cue the suspenseful music here) PREGNANT!!!! I was miserable, trying to function on my clinical rotations and not doing such a great job.
During my 36th week of pregnancy, several of my classmates and I took a weekend course about women’s health from a therapist we had heard speak at the National Student Conclave. After using me as an example in lab and treating me with manual therapy techniques…my life was changed…literally! I felt better in those last few weeks than I had in the earlier stages of my pregnancy, when you’re supposed to be glowing (when you aren’t throwing up). I was HOOKED! I vowed to never again allow a pregnant woman to have that kind of back pain and be told or think it is normal! My career focus changed in a wink…but what about the pelvic floor?
After this brief introduction course to women’s health, I quickly enrolled in the OB course through the Section on Women’s Health. A couple months later, I RELUCTANTLY signed up for the Pelvic course too. Believe me, I was none too happy about it, but I knew in listening to our instructor, this was necessary to have a complete treatment picture for our patients is a HUGE area where physical therapists can make an amazing impact on the lives of women and men. Reluctant is probably too nice of a word for how I felt…TERRIFIED is more like it…but I knew it was necessary, so I pressed on, almost kicking and screaming.
When I went to the first Pelvic course, I concocted a plan to “keep me from being a participant in labs.” I thought I would just lie and tell the instructors, “Oh shucks, it seems like I am on my menstrual cycle this weekend and just won’t be able to be the patient during labs. Darn the luck…” I had it all planned out in my mind…then the instructor, in the first 5 minutes of the course, told us about these menstrual cups we could insert if we were on our cycle so we could still participate… There went my plan. I’m glad I didn’t lie, looking back at it, but really, that gives an accurate picture of how I felt. I can’t imagine the look on my face…
I know that look. I see it in many faces of those who enter on day 1 into Pelvic Health Level 1 course with the Section on Women’s Health. I understand the terror and fear brought about by having a pelvic floor examination and performing a pelvic floor examination all in the same day. I can say, this fear melts away and everything changes. By the end of the course, I was surprisingly comfortable with the entire process. In fact, I found myself looking around and thought, “Why am I even wearing pants? Why is anyone in the room wearing pants? We could all save some time and just not wear pants”…but I digress.
Something shifted in me during that long weekend in Pelvic Health Level 1. I became more comfortable with my own body and with examining others. I became comfortable with knowing the vulva and vagina; they are anatomical structures that need examination, just like the shoulder or the knee. If the physical therapist (musculoskeletal specialist) feels uncomfortable with examining those “taboo” structures, who will help those patients? And there are plenty of patients with pelvic floor dysfunction who need us, believe me. Incontinence, pelvic organ prolapse, pain with intercourse, pelvic pain, chronic low back pain, SIJ pain, constipation, abdominal pain…they NEED us and they exist in the millions. We can change their lives!!
I can’t really tell you why this shift and change in career path happened to me, except that I know it happened for a reason. Because I had so much difficulty talking about sexuality in the past, I now have a better understanding for those who also struggle with those intimate discussions. It made me a better therapist. Because I have felt excruciating pelvic pain during pregnancy, there is a different level of empathy and desire to help those patients in the same condition. My past struggles have become a strength to my practice!
My favorite thing about being a pelvic floor therapist is the life-altering benefits we can have on our patients. What we do SAVES people. I don’t mean saves them to return to their sport (not that that’s not important, because it is). Our services save sexual relationships from complete avoidance due to pain. We save the patient from complete embarrassment and home confinement due to urinary or fecal incontinence, and the list goes on and on. The amount of gratitude and blessing I have received from patients, as their pelvic floor PT, is immeasurable. It has filled my professional cup to the brink. I can think of no greater way to impact my world than this…to change lives for the better.
If you are considering taking a pelvic health course but are just too unsure to take the first step, I hope you will consider it. I hope you will take that leap of faith and go for it. I can tell you that this field is not for everyone, but if your heart is tugging you and you just can’t seem to understand why this is appealing…go for it…dive right in! You’ll be forever glad you did and you will embark on an amazing journey with this patient population. The journey will not leave you the same person…
Dr. Lori Mize is a board certified specialist in women’s health and pelvic floor physical therapy. She has worked as a clinician devoted to women’s health and pelvic rehabilitation for the last 10 years. She is an instructor for the American Physical Therapy Association’s (APTA) Section on Women’s Health, teaching in the area of pelvic health and currently serves on the Board of Directors as the Director of Education for the Section on Women’s Health. She has served on the Section’s Pelvic Health Committee where she authors course materials. She is currently in full time academics at Lynchburg College Doctorate of Physical Therapy Program as an Assistant Professor and has also served as an adjunct instructor for the University of Central Arkansas for 8 years.