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Herman & Wallace Blog

Interview with Tony Rodriguez, COTA

The following is our interview with Jose Antonio (Tony) Rodriguez Jr, COTA. Tony practices in Laredo, TX where he is also studying Athletic Training at the Texas A & M University. He recently attended Pelvic Floor Level 1 and plans to continue pursuing pelvic rehabilitation with Herman & Wallace. He was kind enoguh to share some thoughts about his experiences with us. Thank you, Tony!

Tell us a bit about yourself!

I am a COTA in Laredo where I was born and raised. My goal is to provide pelvic floor therapy to my community. I have been in school for quite some time. I have associate's degrees as a paramedic and occupational therapy assistant. I studied nursing briefly (finished my junior year). My bachelors is in psychology. I’m currently studying athletic training in Texas A & M International University in Laredo. My ultimate academic goal is acquiring my doctorate in physical therapy.Tony with instructors Dustienne Miller and Heather Rader

What/who inspired you to become involved in pelvic rehabilitation?
I first came across pelvic floor when reading the description of a CE course where it mentions its relation to SI joint dysfunction so I figured I could use this as a trouble shooting tool for those athletes that had recurrent low back pain or suspected SI problems. I figured at the very least I would know when I was confronted with something that I needed to refer. Little did I know how important of a “puzzle piece” this type of knowledge would become in helping me see a more complete picture of the human body. I was often confronted with athletes that would have recurring lower back pain, hip pain, glute tightness, sciatic nerve pain, adductor tightness or pain, and felt I was missing something to be able to help them. Even with a basic understanding of pelvic floor rehab I was able to help athletes with the previously mentioned complaints. As my understanding grew, I felt it was necessary I take these Herman & Wallace courses so that I could actually treat my patients in a holistic manner.

What is your clinical environment like, and how can you implement pelvic rehab into your practice?
My clinical environment varies between outpatient pediatrics, outpatient geriatrics, and D2 university athletics. I use my pelvic rehabilitation tool box at the university. Mostly I am still learning but I try to screen for and educate my athletes on the important role the pelvic floor muscles play in every activity they carry through out the day. I try to convey the importance not just in sports but also in activities of daily living such as any difficulty with going to the bathroom to pain during sex. I figure the more young people I educate about pelvic floor therapy the better they’ll be to make an informed decision today or later on in life.

Do you feel your background and training as a COTA brings anything unique to your pelvic rehab patients?
I could probably say that my COTA training makes it easier to pick up on some of the behaviors people might be relying on to carry out their day while dealing with pelvic floor issues. They may or may not be aware they have a pelvic floor dysfunction but simply think that’s just how they are. Behaviors such as avoiding social events because such activities don’t fit well with their voiding schedule.

How does your background as a COTA influence your approach to patient care?
My approach as a COTA would force me to see a balance in life. I would have to ask myself all the ways pelvic floor dysfunction may affect my client's daily activities from the basics like voiding, resting, sleep, to enjoying their leisure activities. A person cannot rest adequately if they’re in pain. He or she cannot enjoy social activities being worried of an urge.

What patients or conditions are you hoping to start treating as you continue learning pelvic rehab?
I wish to continue learning and exposing myself to different areas pelvic floor rehabilitation may take me. I wish to look at this therapy through a wide lens. This way I can learn, help many, and keep myself a well-rounded therapist. If in the future I feel more drawn to a specific area I wish to pull from all the different areas I should have learned by then.

What role do you see pelvic health playing in general well-being?
I often tell my athletes that there is probably not a single gross motor movement that doesn’t cross the pelvic region directly or through fascia connection. It is simply how we are built. To try and pretend or ignore the importance of the pelvic floor is just leaving our patients out of the appropriate care they need. And now that I know about the role pelvic floor muscles have in our body it would be unethical not to advocate for my patients’ COMPLETE well-being, pelvic floor muscles included.

What's next for you and your practice?
My short-term goal is acquiring my athletic training state license. After that continue with the last four or five prerequisite classes I need to apply to a DPT program. The DPT is my ultimate goal within the next five or six years.

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An Interview with Featured Practitioner Adina Leifer, PT, DPT, PRPC

Adina Leifer, PT, DPT, PRPC recently passed the Pelvic Rehabilitation Practitioner Certification exam and was kind enough to discuss her career with us. Adina Leifer, PT, DPT, PRPC practices at ABLe Pelvic Physical Therapy in Atlanta, GA. Thank you for the interview, Dr. Leifer, and congratulations on earning your certification!

Adina Leifer, PT, DPT, PRPCHow did you get involved in the pelvic rehabilitation field?
After graduating from Touro College, and receiving my Doctorate of Physical Therapy. I began to work in an outpatient sports rehab setting. While looking for continuing education courses, I happened upon Herman and Wallace through the Touro College website. They were hosting PF1 at their New York City campus. I knew nothing about pelvic health and rehabilitation at that time. Holly Herman and Tracy Sher taught that first class, after 3 days of class, I was hooked. I knew that pelvic health and wellness was my calling. It has been 9 years since I took that first course and I could not be happier.

What patient population do you find most rewarding in treating and why?
Not sure I can pick one diagnosis or patient population as my favorite. I feel that with each patient that comes to see me, they have either lost ability or do not have normal function of their bladder, bowel or sexual functioning. When I can treat them successfully and educate patients in proper strength and mobility of their pelvic muscles. When I can provide them with the tools so that they can function in their lives, there is nothing more rewarding then that.

Describe your clinical practice:
I currently have my own outpatient practice in Atlanta, GA. I treat adult men and women with any and all pelvic muscle dysfunction and diagnoses.

What has been your favorite Herman & Wallace Course and why?
My favorite course from Herman & Wallace was the capstone course given by Nari Clemons and Jennafer Vande Vegte. I felt this course was informative with practical hands on information for everyday patient treatment. As well as, really helping me to prepare for the PRPC exam.

What motivated you to earn PRPC?
Having practiced for over 9 years and taken many courses through Herman & Wallace, I felt my knowledge and experience made me a specialist. As I was building my own practice, I felt that I wanted the credentials and letters after my name to prove that I was truly a specialist in this field.

What advice would you give to physical therapists interested in earning PRPC?
Go for it! Study the coursework and anatomy. Trust in the knowledge that you have and take the test! You will be very happy that you did.

Certified Pelvic Rehabilitation Practitioners have experience treating a wide variety of pelvic floor dysfunction conditions in men and women throughout the lifecycle. Each certified practitioner has passed a comprehensive exam, and has directly treated pelvic patients for more than 2,000 hours. To learn more about the Pelvic Rehabilitation Practitioner Certification, visit our certification page.

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Trauma Awareness in Pelvic Health

In July of this year, I was invited to present in Christchurch, New Zealand as part of a teaching tour that took in Singapore, Australia and Tasmania. The topic of my class was female pelvic pain, so we discussed Endometriosis, Vulvodynia, Sexual Health and many other sub-topics but we had several discussions about the effects of trauma on pelvic pain. For those who have visited Christchurch, it is a beautiful city but it is still reeling from a series of massive earthquakes, that started in September 2010. The most devastating was in February 2011, when 185 people were killed and 6600 people were injured. Everywhere you go in Christchurch, there are reminders – from the constant buzz of ongoing construction, to structures that are waiting demolition, like the beautiful old cathedral that was beside our hotel. Usually, when I teach, we do some ‘housekeeping’ announcements about fire drills and exits; in Christchurch it was ‘In the event of an earthquake…’. I wondered how the near constant reminders were affecting the inhabitants, so I read of how ‘…people called living with continual shaking, damaged infrastructure, insurance battles and unrelenting psychological stress ‘the new normal’. There are several ongoing research studies, looking at the effects of this trauma and how it is still having an effect on the people of Christchurch.

If you’ve attended Pelvic Floor Level 1 with Herman & Wallace, you’ll remember we quote a study from Van der Welde about the effects of perceived danger on muscle activity in the upper trapezius and pelvic floor muscles. We also discuss the work of Levine, of ‘Waking the Tiger’ fame, who explores the somatic effects of trauma in our bodies – and how trauma, much like pain, is whatever we say it is.

I became intrigued with the topic, so I was delighted to hear that Lauren Mansell has created a course to deal exactly with this topic. I was even more delighted when she sat down for a chat with me to explore the nuances of trauma awareness, boundary setting and self-care for therapists, especially pelvic therapists, who work with those who have experienced trauma of any kind.

I hope you find this conversation as interesting as I did! Here is our conversation:


1. ‘Vaginismus, a Component of a General Defensive Reaction. An Investigation of Pelvic Floor Muscle Activity during Exposure to Emotion-Inducing Film Excerpts in Women with and without Vaginismus’ van der Velde, J & Laan, Ellen & Everaerd, W. (2001)
2. ‘Waking The Tiger’ by Peter A. Levine (1997)

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An Interview with Lee Sowada, PT, DPT, PRPC

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.

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An Interview with Certified Practitioner Andrea Wood, PT, DPT, PRPC

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.

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Upcoming Continuing Education Courses

Oct 25, 2019 - Oct 27, 2019
Location: Core 3 Physical Therapy

Nov 1, 2019 - Nov 3, 2019
Location: Adena Rehabilitation and Wellness Center

Nov 1, 2019 - Nov 3, 2019
Location: Asante Rogue Valley Medical Center

Nov 1, 2019 - Nov 3, 2019
Location: Cancer Treatment Centers of America - Chicago, IL

Nov 1, 2019 - Nov 3, 2019
Location: Upper Chesapeake Health

Nov 2, 2019 - Nov 3, 2019
Location: University Hospitals

Nov 2, 2019 - Nov 3, 2019
Location: Griffin Hospital

Nov 3, 2019 - Nov 5, 2019
Location: Touro College: Bayshore

Nov 8, 2019 - Nov 10, 2019
Location: Washington Regional Medical Center

Nov 9, 2019 - Nov 11, 2019
Location: Comprehensive Therapy Services

Nov 9, 2019 - Nov 10, 2019
Location: Summa Health Center

Nov 9, 2019 - Nov 10, 2019
Location: STI PT and Rehab

Nov 9, 2019 - Nov 10, 2019
Location: Providence Holy Cross Medical Center of Mission Hills

Nov 15, 2019 - Nov 17, 2019
Location: Banner Physical Therapy and Rehabilitation

Nov 15, 2019 - Nov 17, 2019
Location: Ability Rehabilitation

Nov 15, 2019 - Nov 17, 2019
Location: Huntington Hospital

Nov 16, 2019 - Nov 17, 2019
Location: Princeton Healthcare System

Dec 6, 2019 - Dec 7, 2019
Location: Swedish Covenant Hospital

Dec 6, 2019 - Dec 8, 2019
Location: Swedish Covenant Hospital

Dec 6, 2019 - Dec 8, 2019
Location: Franklin Pierce University

Dec 6, 2019 - Dec 8, 2019
Location: Florida Hospital - Wesley Chapel

Jan 10, 2020 - Jan 12, 2020
Location: Dominican Hospital - Physical Therapy

Jan 17, 2020 - Jan 19, 2020
Location: Spooner Physical Therapy

Jan 17, 2020 - Jan 19, 2020
Location: Banner Physical Therapy and Rehabilitation

Jan 17, 2020 - Jan 19, 2020
Location: Our Lady of the Lake Children's Hospital

Jan 24, 2020 - Jan 26, 2020
Location: Nova Southeastern University

Jan 24, 2020 - Jan 26, 2020
Location: UCLA Health

Feb 1, 2020 - Feb 2, 2020
Location: Evergreen Hospital Medical Center

Feb 1, 2020 - Feb 2, 2020
Location: Ochsner Health System

Feb 7, 2020 - Feb 9, 2020
Location: FunctionSmart Physical Therapy