I just attended my first pelvic floor course! What do I do now?

You palpated your first pelvic floor, dropped your drawers for science (maybe even learned a thing or two about your own yoni) and experienced light bulb moments like you wouldn't believe! Pelvic floor empowering! Afterwards, pelvic meets practical. Maybe your were returning to a practice whose program was set up. Was your first client a straight-forward stress urinary incontinence case or were they rife with complexity really putting your clinical reasoning and prioritization to the test! Or maybe, you returned with a complete sense of overwhelm, feeling alone and wondering how your were going to get that first patient in the door.

Treating a new, very specific, uniquely vulnerable population, behind closed doors 1: poses a challenge for everyone! As Dustienne Miller, PT, WCS, CYT, whom I taught Pelvic Floor 1 last weekend with would say...Keep It Simple Sexy! 

Here are some helpful tips...

Determine your target market:

Define where you want to start. What are you good at? What are you interested in? Where do you think you can make the biggest impact? Expand from there. 

Finding focus can help you build proficiency and attract clients in a specific area. Are you daring enough to get out of your comfort zone and try a group presentation? Scheduling educational events will create urgency to help you hit the books; self-study will reinforce your learning as well as capitalize on your course investments with referrals. If you can teach it, you know it! Create value in your content providing clinical pearls for medical practitioners and connecting the dots for potential clients. 

Example: Sue is a manually based ortho therapist interested in postnatal care who wants to ensure safe progression back to sport.  She makes a list of the OBGYNs, moms groups and gyms in her area and offers a 15-30 minute presentation with them. For the docs, she brings Diane Lee's new book to perous and demonstrates how to assess for diastasis recti and what this could mean for load transfer. For her community presentations Sue develops a handout highlighting key concepts for safe progression back to sport in post-natal women.  She inserts a section on 'signs it is time to seek attention' and a little snip-it on the potential interventions she can offer with her contact information at the bottom.  

Find support:

Tap into your tribe both local and afar. The world of pelvic health can be a very supportive and inspiring place with incredible networking opportunities. Here are some wonderful ways to tap in and contribute.

Get local:

Find out who the other pelvic practitioners are in your area and what their niche is. Ask if there are any monthly networking events. If not, maybe you would like to host a wine night and journal review on a topic you are interested in! Point: there is little room for competition when there is an abundance of need. I don't advise 'doing it all' and it's a whole lot more fun when you're not working alone.

In my little beautiful mountain town of Asheville, NC (pop. 90k) I think there are more pelvic health specialists and lymphedema therapists than all of Atlanta! And they are star studded too! But, I promote Heather Reiche Edwards monthly 'Vino & Vulvas' nights because it is a valuable event to my community and she understands transgender issues better than anybody. I know that Susie Gronski, author of 'Pelvic Pain: The Ultimate Cock Block' is right down the road if I need some men's health help. I refer many in-network patients to our local hospital outpatient rehab center and they know I provide affordable out of network care for clients with high deductables or who lost therapy benefits this October when Blue Cross Blue Shield and Mission hospital could not come to a reimbursement agreement. It takes a team and we all offer something different.

Go Global:

I'm a fan of Facebook groups...BIG fan. Talented and smart therapists from all over the globe pose complex cases and questions that others help fill in the blanks on both for patient care and business. Some of my favs:

Professional organizations

  • Join your accredited body's section organizations like the American Physical Therapy Association's (APTA) Section on Women's Health
  • International Organization of Physical Therapists in Women's Health (IOPTWH)



Create Systems:

Systems stream-line communication and improve organization and efficiency in your practice. First, understand that pelvic health is a unique population which will require some variability from standard procedure in terms of care. Your initial point of order might require a discussion with your boss. Topics may include:

  • why you need 45 mins to 1 hour for evaluation in this population
  • legal consultation regarding consent forms
  • updating your procedure manual
  • ordering supplies to get started (note: CMT Medical is incredibly helpful for this and their prescription program offers discounts).
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Next, intake paper work and outcome measures are going to be different; make sure your front desk knows what forms to give your patient when they come in the door. Create an evaluation form pertinent to women's health so that your subjective interview is streamlined and your evaluation and documentation flow. Provide handouts. Remember how much understanding it has taken you to put together the anatomy of the pelvic floor, pathophysiology behind dysfunction & treatment rationale. Now, consider the overwhelm of your patients and need to have this simplified. We want to set them up for efficient, effective therapy which will require patient buy-in to reinforce home programs and educational carry-over between appointments. 

After I teach Pelvic Floor 1 I always wish my participants Godspeed in the clinic and hope they do this area of specialty proud. In an effort to streamline these processes and smooth fears and clinical reasoning I wrote Your Core PT's "The Bladder Book;" a collection of patient handouts for the pelvic floor therapist. This practical clinical tool will be available November 1st 2017. You can find details pertaining to 'The Bladder Book' content and sign-up for the Newsletter to get the early-bird discount at the Your Core PT website. 

Please feel free to comment below about your favorite pelvic resources! And cheers to strength in collaboration!

Author: Susannah Haarmann, PT, WCS, CLT