Lee Sowada, PT, DPT, PRPC is a newly minted Certified Pelvic Rehabilitation Practitioner (PRPC) who treats patients in rural Wyoming. Within her community, she relishes the chance to bring pelvic rehab to a more rural environment and provide care that many people in the community didn't know existed. Dr. Sowada was kind enough to share her story with us. Thanks, Lee, and congratulations on earning your certification!

How did you get involved in the pelvic rehabilitation field?
I fell into pelvic health rehab by accident as a student when I was placed in a “Women’s Health” rotation at the last minute. Initially I was disappointed as this was my last clinical rotation and among the longest. However, I fell in love with this line of work almost right away. It was evident from the start that pelvic rehab makes an enormous impact on a person’s life in a way that most outpatient rehab doesn’t. The impairments were private and sometimes embarrassing and they often resulted in social isolation and loneliness with the inability to share it and the assumption that nothing could be done. It was so rewarding to provide support, information and much needed treatment. After that, I never looked back.

What patient population do you find most rewarding in treating and why?
While I’m continually fascinated and challenged by nearly all pelvic rehabilitation, I really love treating pelvic pain. I love the problem solving and detective work with a required knowledge of urology, gynecology and gastro-intestinal health (along with the musculoskeletal system). I always look at the body as a whole and study functional alignment, myofascial restriction, strength and tone asymmetries, and try to connect the patient with the other appropriate health care providers. I work in a rural area with little access to pelvic health and these patients are always so grateful for any help.

What has been your favorite Herman & Wallace course?
I really enjoyed the Capstone course. I was blown away by all the great minds attending and teaching the course. The discussions were extremely beneficial and the material addressed many of the questions that had developed, including thorough education regarding diet, hormones, inflammation and chronic disease processes. It was very helpful and I left all the more inspired to treat complicated patients.

What motivated you to earn PRPC?
I was motivated to earn the Pelvic Rehabilitation Practitioner Certification (PRPC) for a few reasons. First, there were details about the anatomy, physiology and pharmacology that I had to research, even after thousands of patient care hours. I wanted those details to be very accessible to me in treatments. I found that studying always improved my patient care. I was able to deliver information about current research that I’d forgotten along the way. Secondly, I wanted to be the clear choice for my referral sources. I was proud of my knowledge base and experience but, to many of them, nothing separated me from other PTs who dabbled in pelvic health. I wanted my commitment to this line of work to be obvious.

Interested in becoming a certified pelvic rehabilitation practitioner? The next testing window is May 1 - May 15, 2017. Learn more at https://www.hermanwallace.com/pelvic-rehabilitation-practitioner-certification.

On November 15th, 2016 a new class of Pelvic Rehabilitation Practitioner Certification was crowned! Today we get to celebrate with Andrea Wood, PT, DPT, PRPC from New York. Andrea was kind enough to share some of her thoughts on pelvic rehabilitation and what certification means to her. Thank you Andrea, and congratulations on earning your PRPC credential!

Describe your clinical practice:
I work in an orthopedic clinical practice that has one on one care which I think is valuable. I joined my practice to help offer another view that included pelvic floor knowledge to various patient cases. My coworkers and I collaborate a lot because we both may see things differently, and exchanging ideas is always invaluable for optimal patient outcomes. I really believe the best health care practitioners can admit when they don’t know everything and seek out other viewpoints to learn.
 
How did you get involved in the pelvic rehabilitation field?
I actually had no idea I originally wanted to do pelvic floor rehab. I was lucky to fall into it right out of graduate school up in Boston at a wonderful place called Marathon Physical Therapy. I found it fascinating how important it was to consider in a lot of patients, especially those presenting with hip, back, or pelvic pain. Two years into working, I found out I had mild congenital hip dysplasia in my left hip and underwent a periacetabular osteotomy to correct it. Going through the rehab on the other side as a patient and having to experience what it means to practice a lot of the principles I teach patients made me excited to continue to help people overcome obstacles. I’m a better physical therapist now because of my personal history. It taught me to always give patients the means to keep moving within their means and not provide only passive treatments. My two physical therapists that helped me through that became my biggest role models on how to approach complicated patient problems.
 
What patient population do you find most rewarding in treating and why?
I find it most rewarding to work with pelvic pain patients. I like to think of them as a puzzle. With those patients, I’m an orthopedic physical therapist first, because of how much influence other parts of the body can have on the pelvis. I also am a big advocate of collaborative health care with those patients, and when you bring a team of different views together (i.e. medical doctor, physical therapy, nutritionist, and psychologist to name a few) I find I learn something new each time.
 
If you could get a message out to physical therapists about pelvic rehabilitation what would it be?
It is not just about 3 layers of muscles in your pelvic floor and Kegels. Your pelvis is a center of your body with various biomechanical, vascular, and neurological influences. For example, erectile dysfunction in males can be influenced by pelvic floor muscle dysfunction, cardiovascular health, and psychological or neurological conditions. A woman with painful intercourse could have various contributing factors ranging from a back or hip problem to a dermatological skin issue. I think physical therapists not properly educated on pelvic floor rehab oversimplify it unknowingly.
 
 
What has been your favorite Herman & Wallace Course and why?
My favorite Herman & Wallace course was the Pudendal Neuralgia and Nerve Entrapment. That course opened my eyes up to pain science and how much we really don’t know about pain as a medical community.
 
What lesson have you learned from a Herman & Wallace instructor that has stayed with you?
That the amount of pain a patient may have does not always signify the amount of damage that is present. When patients realize this, they feel a lot more hopeful and in control.
 
What do you find is the most useful resource for your practice?
I love learning from other physical therapy blogs. Blog About Pelvic Pain by Sara Saunder and Julie Weibe’s blogs are two of my favorites to follow. I lend the book Pelvic Pain Explained to a lot of my patients.
 
What motivated you to earn PRPC?
I like to challenge myself, and I felt it was a good test to access areas I need improvement in and should study more or seek out further continuing education.
 
What makes you the proudest to have earned PRPC?
I’m proud to have earned the PRPC because I earned something that I am passionate about. Some people don’t get that blessing.
 
What advice would you give to physical therapists interested in earning PRPC?
Just being passionate and asking a lot of questions about what I don’t know in clinical practice provided me with best tools to prepare for the exam.
 
What is in store for you in the future?
Continuing to learn as much as I can. I plan on seeking out some continuing education in areas of physical therapy like neurology or cardiovascular issues that can all still influence the pelvic floor. I think its important to be a well rounded physical therapist.

Danielle is among the latest class of Certified Pelvic Rehabilitation Practitioners! Her experience treating patients and owning Core 3 Physical Therapy prepared her to pass the exam in flying colors. Read her bio here and check out our interview below. Congratulations, Danielle!

What/who inspired you to become involved in pelvic rehabilitation?
A patient was the first one to inspire me to improve my knowledge and treatment abilities in pelvic rehabilitation. I was working with a postpartum patient, while carrying my first child, and she felt that my guidance had been so helpful in her care that it made me interested learning more about the pelvic floor. Most of my fellow colleagues could discuss my orthopedic questions but I didn’t have any mentors that could offer advice in more advanced pelvic floor cases so I started attending the Herman and Wallace classes. They have been an invaluable at improving my ability to care for patients with pelvic pain which has even improved my treatment of orthopedic patients with low back pain and sacroiliac dysfunction.

What patient population do you find most rewarding in treating and why?
I enjoy working with chronic pelvic pain patients because it's rewarding to be able to bring relief to someone who has been living with pain, limited quality of life or even social anxiety and has not received any benefit with other treatment options. Being able to help this patient population understand the pelvic floor muscles and function as well as providing justification to why they are in pain and then help them progress through various treatment approaches makes my job rewarding.

If you could get a message out to physical therapists about pelvic rehabilitation what would it be?
PT's are uniquely trained to provided internal pelvic floor muscle release. This is something that no other health care professional is licensed or has the schedule/time to perform. This technique can provide relief and feedback to your patients that is possible in no other way. If you do not want to address this region or feel comfortable providing this treatment, find a therapist local to you who has experience with pelvic floor and refer when appropriate. Additionally, we as physical therapists are often the first line of defense in recognizing and educating patients about the ability to address a wide variety of symptoms that they believe is "just a normal part of life". Asking the in-depth questions and providing a multimodal approach to their symptoms is not only a boon to the patient but to our profession.

What lesson have you learned from a Herman & Wallace instructor that has stayed with you?
"Your most valuable tool is your finger." It is rare to treat an orthopedic patient without incorporating any hands on approach and the same holds true for the pelvic floor. With an internal exam you can make your most accurate assessment while providing valuable feedback to the patient.

What makes you the most proud to have earned PRPC?
I think it has helped me gain respect with my fellow health care professionals for my expertise in the area of pelvic floor treatment. It has broadened my knowledge base and provided me a strong guide for furthering my ability to treat patients with pelvic pain and dysfunction.

What is in store for you in the future?
I would like to become involved in research to further evidence based evaluation and treatment of pelvic conditions. I hope to facilitate the effectiveness and value in pelvic floor rehabilitation via physical therapy.

What role do you see pelvic health playing in general well-being?
It should become a staple for all pelvic floor surgeries just like a physical therapy is the staple post total knee surgery. Currently in my region I find it very underutilized despite the research behind our treatment. This is largely due to the general population not being aware of the treatment benefits physical therapy can play in pelvic dysfunction. European countries make it a standard of care in this area and I hope we progress to adopt a similar view of treatment.

Congratulations to Jane Blair Johe, PT, PRPC on becoming one of the newest Certified Pelvic Rehabilitation Practitioners! Read our interview with Blair below.

Tell us about your clinical practice
I work in a free standing outpatient PT center of a large 4 hospital affiliation. 70% lymphedema 30% pelvic floor rehab.

How did you get involved in the pelvic rehabilitation field?
I was already the lymphedema PT (LANA cert.) when I moved to WV. The women's health PT was moving to another state and asked me to please pick up her bladder incontinence patients.

What patient population do you find most rewarding in treating and why?
I do like pelvic pain clients as I can work with other PT’s on staff to problem solve . Both patients and their doctors are so grateful.

If you could get a message out to physical therapists about pelvic rehabilitation what would it be?
That you cannot ignore a very important group of muscles (PF) whether you are treating backs, hips etc. or pain and weakness or balance issues…. it plays such a vital role in wellbeing. Any of these clients should be questioned about bowel and bladder issues.

What has been your favorite Herman & Wallace Course and why?
I took my first course from them in September and was so impressed (compared to other courses)

What lesson have you learned from a Herman & Wallace instructor that has stayed with you?
the PT pelvic floor assessment. Correct postures , breathing and “safe” effort of bowel movements.

What do you find is the most useful resource for your practice?
MedBridge Courses

What motivated you to earn PRPC?
If I only had one pelvic floor referral, I would like to give the best service possible to that client. My referring MD’s are very happy too.

What makes you the most proud to have earned PRPC?
I thought it was a many faceted subject and combined many aspects of my 45 years of physical therapy practice. It made me feel that I do know my profession that I love.

What advice would you give to physical therapists interested in earning PRPC?
Have a broad back ground in multiple areas of PT then I highly recommend Herman and Wallace courses as the best path.

What is in store for you in the future?
A urologist in town contacted me today to set up referring for pre surgery PT (prostate surgery).

Kelley Thibault PT, NCS is an outpatient rehabilitation pro, having more than two decades of experience in that setting. She is a recent convert to Pelvic Rehabilitation, however, and she's jumped in head first! Her practice has shifted in that direction and she has four Herman & Wallace courses under her belt in just the last two years. We reached out to see what lessons she could share with us, and she was kind enough to give us her time today. Welcome to the field, Kelley!

Tell us a bit about your clinical experience:
I have been a physical therapist for 22 years and spent much of my career working in a hospital based outpatient clinic treating primarily neurologic diagnoses. I have worked in a transdisciplinary neurologic program for much of this time. I received my NCS from the APTA in 2004 and recertified in 2014. Over my career I have had an interest in Women’s Health Physical Therapy and attended a course with Holly Herman in the early 1990’s. I began treating more Women’s Health clients about 2 years ago to cover a maternity leave. 75% of my practice now is Women's and Men’s Health. I attended the pelvic floor level 1, 2A, 2B and 3 courses over the past year and have found them to be invaluable!!! I also have taken many of the pelvic courses on MedBridge.

What/who inspired you to become involved in pelvic rehabilitation?
I find it most rewarding to work with women who are postmenopausal and are experiencing dyspareunia and stress and/ or urge incontinence. I find with some education and behavioral modifications these clients can experience gains after the first visit. I also have enjoyed working with the chronic pelvic pain clients who require internal pelvic floor and myofascial work and seeing them return to function with less pain and more confidence.

What has been your favorite Herman & Wallace Course and why?
Pelvic floor rehabilitation works!!! There is so much that can be preventative as well as rehabilitative. I look forward to learning more and more!!! I think my favorite course thus far has been 2A mainly due to the fact that was the last course in the series that I took this past December 2015. The information on constipation and fecal incontinence as well as male pelvic anatomy, physiology and treatment was the piece I so felt I was missing in helping my clients.

What lesson have you learned from a Herman & Wallace instructor that has stayed with you?
I have found the “clinical pearls” given in each course to be invaluable!!! I have reviewed my manuals several times and will continue to do so.

What is in store for you in the future?
I hope to obtain my PRPC or WCS in the next several years and plan to continue to attend courses to improve my practice. I have been able to use my knowledge of pelvic health and treatment with my neurologic clients as well.

This week we end with a fantastic interview with our featured pelvic rehab practitioner. Nancy Suarez, MS, PT, BCB-PMD, PRPC just joined the ranks of the elite Certified Pelvic Rehabilitation Practitioners! Check out our interview below:

Describe your clinical practice:
I work in a private practice specializing in women’s and men’s pelvic floor disorders including bowel and bladder issues, prolapse and sexual dysfunction, prenatal and postpartum rehabilitation, pre and postprostatectomy care, and lumbopelvic pain.

How did you get involved in the pelvic rehabilitation field?
As a physical therapist who regularly took continuing education courses following PT school, I happened to be looking for a course that might give me more knowledge to help some of my geriatric patients improve their urinary incontinence. I took my first Pelvic Floor course given by Hollis Herman and Kathe Wallace in 2000, and immediately began to make a difference in many of my patient’s lives.

What/who inspired you to become involved in pelvic rehabilitation?

Really it was my patients that inspired me to become involved in pelvic floor rehabilitation; I knew embarassingly little about it on my own until my first course! I was very fortunate to have been given the opportunity to join a pelvic floor specialty practice a few years after that first course, and there I honed my skills and began adding more pelvic floor courses to improve my practice.

What patient population do you find most rewarding in treating and why?

It is honestly difficult for me to choose one type of patient that I find MOST rewarding; it is such a privilege to see patients getting better when they may have thought there was no hope. I do find that I love helping middle aged and older women learn about their pelvic floor and learn how to overcome their incontinence, prolapse and pain.

Today we get to hear from Sherine Aubert, PT, DPT, PRPC who just earned her certification! Sherine was kind enough to share her story about discovering pelvic rehabilitation.

Tell us a bit about your clinical practice
Men and women across the life span with urogynecological, colorectal, orthopedic, as well as pre and post-surgical cases including sexual reassignment surgeries make up the majority of the population I treat. Most patients are working towards improving their bedroom and bathroom issues including prolapse, urinary frequency, urinary urgency, incontinence, pelvic pain, coccydynia, voiding dysfunctions, interstitial cystitis, vaginismus and dyspareunia. Educating and setting male patients up with pre surgical prostatectomy pelvic floor muscle strengthening programs and as well as improving outcomes of patients who have undergone sexual reassignment surgeries.

How did you get involved in the pelvic rehabilitation field?
I have always had such respect and fascination with the pelvic floor muscles. They are underestimated and overlooked in many physical therapy settings and I feel passionate about changing this! I have made it my goal to educate and empower individuals while making a comfortable environment to ask questions to further understand their anatomy, function and optimize their health.

What/who inspired you to become involved in pelvic rehabilitation?
I have been very lucky to have many wonderful influences in my academic and professional career. The two pelvic floor “geniuses” who have always had time to discuss new treatments, brainstorm, and optimize my skill set would be Dr. Chris Eddow PT, DPT, OCS, WCS, CHT and Dr. Jamie Taylor PT, DPT. Thanks for always pushing me to the next level ladies, I look forward to advancing the pelvic floor world with you gals!

What do you find is the most useful resource for your practice?
During every initial evaluation I use a pelvic model to show all the pelvic floor muscles, organs and connective tissue with an overview of anatomy and function. I find patients are very appreciative of the explanation and find extreme value in understanding their own anatomy. Every time I show the model, I feel like I am sharing the world’s best secret about their bodies!

What motivated you to earn PRPC?
I appreciated the fact that "PRPC" included men and women's knowledge base.

We're excited to have the chance to interview Lisa Odabachian, MPT, BSN, RN, PRPC, this week's featured Certified Pelvic Rehabilitation Practitioner! Lisa earned her certification in May of 2015 and she was kind enough to share her thoughts with us. Thank you for your contributions to the field of pelvic rehab, Lisa, and congratulations on your certification!

What motivated you to earn PRPC?
For patients and referring providers to have confidence that I have expertise in treating pelvic floor dysfunctions.

What makes you the most proud to have earned PRPC?
That I have evolved into a practitioner that can make a difference in this patient population’s quality of life.

What advice would you give to physical therapists interested in earning PRPC?
Take as many courses with hands on lab work that you can so you can treat with a broad base of knowledge to get the best outcome for your patients!

Tell us a little about your clinical practice:
I am a full-time clinician at a well-known and well-respected hospital-based outpatient women's clinic. I have been at the Beaumont's Women's Urology Center, a multidisciplinary clinic focusing exclusively on women's health, for the past 5 years. incontinence, pelvic organ prolapse, urinary urgency and frequency, chronic pelvic pain conditions (painful intercourse, interstitial cystitis, vulvodynia, abdominal pain), post-surgical pain and weakness, colo-rectal dysfunctions (fecal incontinence, constipation, rectal pain). I have been in clinical practice treating women and men with pelvic dysfunctions for over 14 years at Beaumont Hospital. Prior to that I was a clinical nurse treating patients in a variety of settings. I am currently an ABPTS candidate to sit for the 2016 WCS specialist certification examination in Women's Health physical therapy.

How did you get involved in the pelvic rehabilitation field?
Through the years of being a nurse, family member and friend I have heard many stories from women and men who have had symptoms that were unsuccessfully or only partially helped with medications and/or surgical interventions. When I learned that there were specially trained physical therapists who treat bladder, bowel and sexual problems by providing the patients self-help education and rehabilitation techniques to help resolve these issues, I became charged up to get my master’s in physical therapy so I could then specialize in treating pelvic floor dysfunctions.

What/who inspired you to become involved in pelvic rehabilitation?
When I learned that there were specially trained physical therapists who treat bladder, bowel and sexual problems by providing the patients self-help education and rehabilitation techniques to help resolve these issues, I became charged up to get my master’s in physical therapy so I could then specialize in treating pelvic floor dysfunctions.

What patient population do you find most rewarding in treating and why?
The patients who are motivated in helping themselves by being compliant in their rehabilitation by doing their home exercise program and asking questions are the patients who typically have the best outcomes.

If you could get a message out to physical therapists about pelvic rehabilitation what would it be?
There are so many women and men who could benefit from a skilled pelvic floor physical therapist. Many patients with pelvic floor dysfunction have difficulty being appropriately evaluated and referred to pelvic floor physical therapy, and then if that occurs they often have to travel long distances to find a proficient provider.

What has been your favorite Herman & Wallace Course and why?
I have learned so much from each and every course I have taken. My first course was in Akron Ohio in May 2001 with Holly Herman and Kathe Wallace, so of course that is my most memorable course because it was like opening a Pandora’s Box, in a good way! It all made sense!

What lesson have you learned from a Herman & Wallace instructor that has stayed with you?
Perform a good orthopedic evaluation first

What do you find is the most useful resource for your practice?
I often refer to course/lab course notes.

What is in store for you in the future?
My application has been approved to sit for the 2016 specialist certification examination in Women’s Health in physical therapy to obtain WCS credentials through the APTA.

What role do you see pelvic health playing in general well-being?
It’s huge! When people have bladder, bowel and/or sexual dysfunction, their relationships, social, career, education, emotional, recreational and/or psychological, etc. well-being is affected to varying degrees. People often do not even know they have pelvic floor muscles until there is pain or a functional impairment.

This week we get to feature Katie Tredo, DPT, PRPC, one of the first people to earn her Pelvic Rehabilitation Practitioner Certification! Katie co-owned a private practice in Maryland, and has recently relocated to the Milwaukee area to practice her trade. She was kind of enough to offer her insights with the Pelvic Rehab Report today.

Hi Katie! Tell us a little bit about your clinical practice
I recently joined the staff at Health In Balance Physical Therapy in Mequon, WI. Our team is made up of experienced physical therapists with a variety of interests and specialties. Along with two of my coworkers, my practice is focused on treating men, women, and children with pelvic dysfunctions. I think a practice with such a skilled and diverse set of physical therapists allows us to better serve our patients.

What patient population do you find most rewarding in treating and why?
I find treating patients with pelvic dysfunctions, especially pelvic pain, to be extremely rewarding. Pain, incontinence, and other pelvic dysfunctions can leave patients feeling very isolated and hopeless. Watching my patients open up about their issues then progress toward their goals, returning to their previous activities and relationships without pain or dysfunction is amazing. There are so many quality of life issues that go along with pelvic dysfunctions and I am honored to be a part of each of my patient’s journey to recovery.

If you could get a message out to physical therapists about pelvic rehabilitation what would it be?
I would encourage physical therapists to get comfortable asking about bowel, bladder, and sexual dysfunction on their initial intake forms. Many people will not think to report these issues without being asked and a pelvic dysfunction can be a major component of a hip or back issue. If your patient reports a pelvic dysfunction, be comfortable acknowledging it and make an appropriate referral for them. I enjoy working closely with and sharing patients with other physical therapists so that we can maximize our patients’ recovery.

What role do you see pelvic health playing in general well being?
In the past discussing pelvic dysfunctions was considered embarrassing or taboo. In the past few years, I have seen more and more of my patients educating themselves, discussing their issues with other men or women, and finding themselves the help they need. Many patients are going into their referring physicians and requesting to receive help instead of waiting for their doctor’s suggestion. Patients are becoming more empowered over their own care. I see pelvic health becoming more and more of a focus in people’s lives and that fewer patients will be content living with their dysfunction.

Earlier this week a blog post asked the question "Do male therapists belong in pelvic rehab?" With increased frequency, male therapists are participating in pelvic rehab coursework and practices. Some of the male therapists are even attending coursework as students. I asked Justin Stambaugh, a student from Duke University (who very much impressed me with his command of the material, and his calm, curious, and competent demeanor), a few questions about his path into pelvic rehab. Below are his responses.

Holly: How did your path lead towards pelvic rehab in general?

Justin: Pelvic rehab really necessitates an openness and sense of comfort regarding issues that can be seen as very personal, private, and even taboo. I was drawn to pelvic rehab because I am the type of person who doesn’t believe that individuals should have to suffer in silence because of fear or embarrassment of addressing their issues. I want people to know that they can and should seek treatment for their pelvic health issues, and that physical therapy can be a valuable resource in this regard.

I also value the complexity of pelvic rehab. In addition to the clinical aspect of care there is also the psychosocial element that adds to the scope and depth of treatment. I appreciate that pelvic rehab requires the clinician to continuously evaluate and adapt their approach in order to be proficient.

Additionally I find that often times many physicians, patients, and other physical therapists don’t realize the extent of what we are capable of treating, and how great of an impact we can have on someone’s life. I get excited about educating and promoting this side of the profession.

Holly: What is your viewpoint on how you will be perceived as a male therapist in treating pelvic rehab with a female patient?

Justin: As a male therapist in the pelvic rehab setting I understand that there are some female patients who will be hesitant to work with me solely because of my gender. I think this is an unfortunate fact, however it simply requires me to be a bit more industrious as a practitioner. Patients who may initially be uncomfortable with me due to my gender are really just asking me to prove to them that I know what I’m doing and that I am trustworthy. It is completely understandable that I need to win their trust before moving forward with any type of treatment. I respect my patients and ultimately just want what’s best for them. We can work together on achieving this goal, and find the correct path that suits each patient’s needs based on their comfort level. Often times I think of the phrase “to a man with a hammer, everything looks like a nail”. Although I am capable of performing an internal pelvic floor exam and subsequent treatment, there are also external approaches that may work just as well for an apprehensive patient depending on their presentation. This may also help gain their trust in order to implement more effective care in future sessions.

Holly: How do you think your generation differs from those before you in addressing the entire issue of gender?

Justin: I would like to think that my generation is more open regarding issues of sex and gender. However I think there are still many hurdles left to climb in this regard. I feel that socially my generation is part of an evolution in tolerance and empathy towards diversity with respect to issues such as gender, gender identity, sexual orientation etc. All of these qualities define some part of all of us and are constantly being communicated and evaluated. If we look back through history we see the dynamics of social inequality based on gender. Today we continue to see broad discussions regarding sex and gender. I feel that each generation continues to grow from these conversations and socially we persist in advancing our understanding and comfort regarding this topic.

Holly: Where do you see us (on the continuum) as a profession in normalizing the experience of having treatment directed to the pelvis by any gendered therapist to any gendered patient?

Justin: It would be my hope that in the future more institutions will instruct pelvic health with patient models that allow students to interact and conduct treatment based therapies in a clinical manner. I feel that in order to alleviate some of the gender based fears and apprehension regarding pelvic rehab from a professional perspective, all students should get to experience this aspect of physical therapy before deciding if its for them. I do feel it’s unfortunate that there are not more males who are interested in pelvic rehab. Oftentimes people are afraid of what they don’t know. It seems that perhaps pelvic rehab has remained somewhat enigmatic in that many individuals don’t get to experience this type of patient care, and therefore never approach it. It is such a great benefit to be able to work with this population of patients. I feel that the more exposure and normalization pelvic rehab gets to the patient population as well as to the professionals in the field of physical therapy the more we will see an increase in gender representation within the profession.

If the work of pelvic rehab is in the hands of students like Justin, we have so much to look forward to in our field. Thank you to Justin for being willing to articulate his thoughts and experience so that we can continue to explore issues of gender in pelvic rehabilitation.