Today we are happy to celebrate Aline Flores, PT, PRPC! Aline is one of the newly minted Certified Pelvic Rehabilitation Practitioners, having passed the exam last month. Here's what she had to say about her career in pelvic rehab. Congratulations, Aline!
Tell us about your clinical practice
This year I opened Natura Physical Therapy, a small private practice specializing in pelvic pain and breast cancer rehabilitation. Manual therapy is a big part of our approach to patient care. I often utilize myofascial release, connective tissue manipulation, trigger point therapy, and manual lymphatic drainage during treat sessions and prescribe 2-3 specific exercises for patients to complete at home. I also provide education on the neurological/physiological/emotional response to pain and teach techniques for patients to be able to modulate this response, including breathing exercises and down training techniques. The majority of my patients are high stressed, overwhelmed and extremely hard on themselves. Helping patients become more compassionate towards themselves is a huge accomplishment.
How did you get involved in pelvic rehabilitation?
I was immediately interested in women’s health when I graduated from physical therapy school in 1997. I sought out a part time position to work/train with a therapist who was treating women with urinary incontinence. At that time I was only treating 1-2 pelvic patients a week primarily using biofeedback and muscle re-education. A year later I was hired by a hospital that was just starting a pelvic health program. Over the years I have been able to help this program grow from very basic pelvic health rehabilitation to treating much more complex pelvic health issues of like vulvodynia, pudendal neuralgia, and interstitial cystitis.
What/who inspired you to become involved in pelvic rehabilitation?
There have been so many women in pelvic rehabilitation that have inspired me and continue to inspire me. Elizabeth Nobel and Holly Herman were definitely early inspirations for me, as therapists in the founding of pelvic rehabilitation. I am always impressed the therapists who are currently making a huge impact with educating the medical community on the value of physical therapy in pelvic health issues. But, my biggest inspiration comes from my patients. Every day I learn something new from one of my patients. Whether it is a better understanding of their experience, or something that has worked, or doesn’t work for them, I am continually improving as a therapist by listening to my patients.
What patient population do you find most rewarding in treating and why?
I really enjoy working with patients with complex pelvic pain. These can be the most challenging patients to work with, but they are also the most rewarding. They keep me thinking critically. Usually these patients have a physical and an emotional component, but often have been told or assume that their symptoms are “all in their head”. It is very rewarding when I can explain the connection between the body, the nervous system and emotion, and the patient, finally feels understood. It is truly an honor to be able to work with these patients as they progress from a very difficult experience to a much more empowered state, where they have better understanding and control of their symptoms.
If you could get a message out to physical therapists about pelvic rehabilitation what would it be?
Pelvic physical therapy is much more than just “Kegels”. Issues involving bowel, bladder and sexual functioning are important activities of daily living that can have a significant musculoskeletal cause. Every physical therapist should have a basic understanding of pelvic floor muscle functioning, even if they don’t directly treat these conditions. The best pelvic rehabilitation therapists are good orthopedic therapists first.
What motivated you to earn PRPC?
Taking the PRPC exam was a challenge to myself to critically think about my knowledge base and how I practice. Although, I try to stay up to date on the most current research on a regular basis, preparing for the exam, encouraged me to be more though and consistent with my review.
What is in store for you in the future?
I hope to keep learning every day. I also plan being more involved in teaching physical therapists interested in pelvic health.
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