There are faculty members who teach courses, and then there are faculty members who help define the standard of education in an entire specialty. Pamela A. Downey, PT, DPT, WCS, BCB-PMD, PRPC, is the latter. A Senior Faculty member at Herman & Wallace since 2006, Dr. Downey has spent nearly two decades shaping how clinicians learn to assess and treat pelvic floor dysfunction, and she shows no signs of slowing down.

We are proud to spotlight one of the longest-serving and most accomplished educators in our institute.

A Clinician and Educator Since 1991

Dr. Downey has been a physical therapist for more than 30 years. She is a Board-Certified Specialist in Pelvic Health Physical Therapy (WCS), Board-Certified in Biofeedback for Pelvic Muscle Dysfunction (BCB-PMD), and a Certified Pelvic Rehabilitation Practitioner (PRPC). She brings more than 25 years of focused experience treating individuals with pelvic pain, including neuralgias of the lumbosacral plexus, voiding and sexual dysfunction, pregnancy-related and postpartum musculoskeletal dysfunction, diastasis recti, sacroiliac joint pain, and dyspareunia.

She is the owner of Partnership in Therapy, a private practice in Coral Gables, Florida, where she provides personalized one-on-one care to patients of all genders, from adolescents to octogenarians. Her mission is to educate and integrate healthy lifestyles for patients on the road to wellness.

From Sarah Lawrence to the University of Miami

Dr. Downey earned her Bachelor of Arts from Sarah Lawrence College and her Master of Science and Doctorate in Physical Therapy from the University of Miami Miller School of Medicine. She currently serves as an Adjunct Professor in the Physical Therapy Program at both the University of Miami Miller School of Medicine and Nova Southeastern University in Fort Lauderdale, Florida.

Her academic career runs alongside her clinical and continuing education work. She is actively involved in the Academy of Pelvic Health of the American Physical Therapy Association, where she has served as Coordinator of Research Submissions for annual meetings and as a manuscript reviewer for the Journal of Women’s Health.

Pilates as a Clinical Tool

One of the hallmarks of Dr. Downey’s practice is her integration of Pilates therapeutic movement into pelvic health rehabilitation. A certified Polestar Pilates Educator since 2000, she has spent more than two decades using Pilates and therapeutic exercise interventions specifically designed for patients with prenatal and postnatal conditions, pelvic floor muscle dysfunction, and lumbo-pelvic pain.

Her Herman & Wallace course, Pilates Therapeutic Exercise for Pelvic Health, introduces clinicians to the Pilates Method with an emphasis on clinical application and patient empowerment. The course covers the original 34 mat exercises and select Reformer activities, giving clinicians tools to move patients beyond passive treatment and into active, neuromuscular integration. For Dr. Downey, the philosophy is simple: patients who understand and feel how their muscles work become active participants in their own healing.

A Published Author and International Speaker

Dr. Downey has lectured nationally and internationally at professional conferences and has authored multiple published research articles. She is the author of a book chapter on chronic pelvic pain in the medical text Women’s Health in Physical Therapy, contributing to the academic body of knowledge that informs how clinicians approach complex pelvic pain cases.

Her expertise is sought beyond the continuing education classroom. Most recently, Dr. Downey was invited to present at a virtual pop-up session co-hosted by the International Pelvic Pain Society (IPPS) and the APTA Academy of Pelvic Health. Her presentation, “What About Ken? Sexual Dysfunction and Pain in Younger Men,” addressed the musculoskeletal side of sexual pain and dysfunction in younger males and the positive outcomes that can be achieved through collaborative, multidisciplinary care. It is a topic that remains underrepresented in pelvic health education, and Dr. Downey’s willingness to bring it to the forefront reflects her commitment to advancing the field for all patient populations.

Senior Faculty at Herman & Wallace

Dr. Downey has been teaching with Herman & Wallace since 2006, making her one of the institute’s longest-serving faculty members. She teaches across the Pelvic Floor Series as well as her own Pilates course, bringing a combination of clinical depth, movement expertise, and patient-centered philosophy to every course she leads.

Her role as Senior Faculty reflects not just longevity, but the sustained impact she has had on the quality and direction of pelvic health education at Herman & Wallace. Clinicians who train under Dr. Downey consistently describe her as thorough, passionate, and deeply invested in helping them translate what they learn in the classroom into meaningful results for their patients.

About Dr. Downey

Pamela A. Downey, PT, DPT, WCS, BCB-PMD, PRPC (she/her) is a Board-Certified Specialist in Pelvic Health Physical Therapy, Board-Certified in Biofeedback for Pelvic Muscle Dysfunction, and a Certified Pelvic Rehabilitation Practitioner. She is the owner of Partnership in Therapy in Coral Gables, Florida, and an Adjunct Professor at the University of Miami Miller School of Medicine and Nova Southeastern University. A Polestar Pilates Educator since 2000, she has more than 25 years of experience treating pelvic pain, voiding and sexual dysfunction, and pregnancy-related musculoskeletal conditions. She has been Senior Faculty at Herman & Wallace since 2006 and is the author of a book chapter on chronic pelvic pain in Women’s Health in Physical Therapy.

Learn From Dr. Downey

Whether you are looking to build your foundation in pelvic health or integrate Pilates into your clinical practice, Dr. Downey’s courses offer the depth, clinical precision, and hands-on learning that define the Herman & Wallace experience.

May 30-31, 2026: Pilates Therapeutic Exercise for Pelvic Health 

Pelvic Floor Series (Levels 1, 2A, and 2B)

Multiple dates and locations available | Satellite, In-Person, and Self-Hosted formats

Your patients deserve comprehensive care, and you deserve the knowledge to deliver it. View upcoming course dates and register at hermanwallace.com. Courses fill quickly, so register early to secure your spot.

From Home Care to Pelvic Health: A Journey Guided by Faith, Mentorship, and Resilience

Sometimes the most meaningful career paths aren’t the ones we plan. For Herman & Wallace faculty member Carole High Gross, PT, MS, DPT, PRPC, the road to becoming a leader in pelvic health rehabilitation was shaped by unexpected challenges, pivotal relationships, and a willingness to trust the journey even when the destination wasn’t yet visible.

We recently sat down with Carole to talk about her career, her calling, and the work that drives her. What unfolded was one of the most compelling stories of resilience and purpose we’ve heard.

A Career Built on Breadth

Carole’s career in physical therapy spans more than three decades. After earning her Master of Science in Physical Therapy from Thomas Jefferson University in 1992, she worked across nearly every clinical setting imaginable: pediatrics, aquatics, outpatient orthopedics, inpatient rehab, contract work, and home care, which she loved most. She built a deep clinical foundation long before pelvic health was on her radar.

Then life intervened.

Carole was diagnosed with breast cancer, followed by a rare chronic leukemia called hairy cell leukemia. She also lives with CIDP, a neurological condition that significantly impacted her mobility. At one point, she was using a walker, a wheelchair, and a scooter for community outings. Clinical work, at least the way she’d always done it, was no longer an option.

But Carole’s response was characteristically forward-looking: her brain was still working, so she went back for her doctorate.

Getting Back Into the Swing of Things

When Carole enrolled in her Doctor of Physical Therapy program at Arcadia University, the same institution where she’d started her undergraduate education years earlier (she lovingly calls them her “bookend university”), the transition wasn’t easy. She recalls sitting on her bed, textbooks in hand, wondering why she was putting herself through it.

But she found a way to reframe the challenge. She hadn’t forgotten how to learn. She’d simply had a very long summer. That simple mindset shift became a guiding mantra. Every time Carole faces a challenge in her health, her career, or her education, she reminds herself that she’s just getting back into the swing of things.

Walking Through the Door

As Carole neared the end of her DPT, she knew she couldn’t return to home care. She felt pulled toward something but didn’t know what it was. She describes it as trusting a GPS where someone else can see the full route, but she can only see the next turn on the screen.

Then, in a matter of days, a series of small, seemingly random events changed the trajectory of her career.

A friend convinced her to stop by a retirement party. There, she bumped into Kathy Sumner, a PT she’d worked with 20 years earlier. Kathy invited Carole to visit a pelvic health clinic she ran with Janet Drake Whalen, who Carole now works alongside as a Lead Teaching Assistant at Herman & Wallace.

When Carole walked through the clinic door, the feeling was immediate and unmistakable. She was home.

Kathy and Janet became Carole’s mentors. Weekends of hands-on training. Patients brought in for teaching opportunities. Encouragement to pursue coursework. The small-room private practice setting turned out to be the perfect environment for someone navigating mobility challenges, a place where Carole could not only survive, but thrive.

The timing was ideal. Her DPT program required a semester-long research project on a topic of interest, and Carole channeled everything into developing her Belly After Baby program for postpartum women, with Kathy and Janet guiding her every step of the way.

Eating Disorders and Pelvic Health: A Critical Connection

Today, Carole is a Pelvic Clinical Rehabilitation Specialist at Jefferson Health Lehigh Valley in Pennsylvania, where she treats patients of all genders with pelvic, bowel, bladder, and abdominal concerns. She holds her Pelvic Rehabilitation Practitioner Certification (PRPC) and serves as both an instructor and Lead Teaching Assistant at Herman & Wallace.

Her course, Eating Disorders and Pelvic Health Rehabilitation: The Role of a Rehab Professional, fills a critical gap in pelvic health education. Individuals with eating disorders frequently present with the exact symptoms pelvic rehab professionals treat every day: constipation, bloating, abdominal pain, pelvic organ prolapse, urinary dysfunction, and pelvic pain. Yet the connection between eating disorders and pelvic health is often overlooked.

As Carole explains, pelvic health providers aren’t going to diagnose or treat eating disorders, but they absolutely can and should be asking the right questions. They can observe, support, refer, and provide manual and educational tools that make a real difference in someone’s recovery journey. Sometimes, a pelvic health clinician is the first provider to notice the signs and gently guide someone toward help.

The course has received outstanding reviews, with clinicians praising its depth and Carole’s ability to connect the bigger picture, the multidisciplinary web of providers that supports individuals with eating disorders, with the specific, actionable skills pelvic health professionals can bring to the table.

Research at the International Level

Beyond Herman & Wallace, Carole serves on the Pelvic Workgroup of the International Consortium on the Ehlers-Danlos Syndromes and Hypermobility Spectrum Disorders, facilitated by the Ehlers-Danlos Society. In 2024, the workgroup published a landmark paper in PLOS ONE, a multidisciplinary, multinational effort co-creating evidence-based clinical guidelines for the management of pregnancy, birth, and postpartum recovery in individuals with hypermobile Ehlers-Danlos syndrome (hEDS) and hypermobility spectrum disorders (HSD).

The workgroup is currently finalizing a paper focused on pelvic health concerns in individuals with hEDS and HSD, with additional publications expected through 2026 and into 2027, including updates to diagnostic criteria and guidance across multiple clinical domains.

Carole is passionate about the screening role pelvic health professionals can play for hypermobility. As she describes it, asking just a few simple questions about a history of joint subluxations, dislocations, or being “super bendy” can start to connect dots that no one else has connected. Many individuals with hypermobility present with pelvic dysfunction, GI issues, chronic pain, skin changes, and temperature sensitivities. Pelvic health clinicians may be the first to notice that these seemingly unrelated issues share a common thread.

A Philosophy of Mentorship

One theme that runs through every chapter of Carole’s story is mentorship. She was mentored into pelvic health by Kathy and Janet. She was encouraged to take that first Pelvic Floor Level 1 course by people who believed in her when she wasn’t sure she believed in herself. And now, she pays it forward: mentoring new clinicians, serving as boots on the ground at satellite courses, and fostering the collaborative, family-like learning environment that she believes is the heart of what Herman & Wallace does best.

Her advice to clinicians who feel overwhelmed by the breadth of pelvic health education?

“Keep your focus on the step you’re on. Don’t look up at the full staircase. There’s no timeline. One course, one skill, one patient at a time, and before you know it, you’ll have built something incredible underneath you.”

About Carole

Carole High Gross, PT, MS, DPT, PRPC (she/her) earned her Doctorate of Physical Therapy from Arcadia University in 2015 and her Master of Science in Physical Therapy from Thomas Jefferson University in 1992. She works as a Pelvic Clinical Rehabilitation Specialist at Jefferson Health Lehigh Valley and serves as a Lead Teaching Assistant and instructor at Herman & Wallace, where she created and teaches Eating Disorders and Pelvic Health Rehabilitation: The Role of a Rehab Professional. Carole is a member of the Pelvic Workgroup of the Ehlers-Danlos International Consortium and has a special interest in working with individuals living with eating disorders and hypermobility throughout the pregnancy and postpartum journey. She is a dedicated mentor for growing pelvic professionals and focuses on team building and program development.

Learn From Carole

Ready to explore the intersection of eating disorders and pelvic health rehabilitation? Carole’s course is designed to expand your clinical lens, build your confidence in screening and observation, and equip you with practical tools to support individuals with eating disorders on their recovery journey.

Eating Disorders and Pelvic Health Rehabilitation: The Role of a Rehab Professional

Remote Course | October 4–5, 2025 | Live via Zoom

Your patients deserve comprehensive care, and you deserve the knowledge to deliver it. Register today at hermanwallace.com. Spots are limited.

I recently evaluated a 75 y.o patient who presented with significant urinary urgency and frequency, voiding approximately every hour. She reported disrupted sleep due to nocturia, stating, “I can’t sleep at night because I keep getting up to go to the bathroom. They gave me medication to help me sleep, but it doesn’t work.”

Over the course of the visit, it became clear that she was also experiencing chronic anxiety. Anxiety permeated multiple aspects of her daily life, she worried about day-to-day events as well as events in the future. She reported that her urinary symptoms worsened during periods of heightened anxiety, and she had difficulty relaxing both her body and mind.

My initial clinical focus was nervous system regulation. I guided her to sit back comfortably and take several gentle breaths, emphasizing a prolonged exhalation with an audible sigh. She was instructed to consciously release tension throughout her body while maintaining attention on her breath. After only a few breaths, she smiled and reported that she already felt calmer.

In addition to a home program that included diaphragmatic breathing, self–abdominal massage, and pelvic girdle mobility exercises, I introduced two Acupressure points for nervous system self-regulation: Conception Vessel 17 (CV17) and Yintang (EX-HN 3).

CV17, located at the center of the chest, is traditionally associated with emotional regulation and calming of the heart-mind connection. Yintang, located between the eyebrows, is described in Traditional Chinese Medicine (TCM) as having a mentally stabilizing and calming effect.¹

At her subsequent visit, the patient reported feeling calmer overall and noted that she was able to use the Acupressure points independently to regulate her anxiety. Over the course of several visits, an integrative plan addressing hip mobility, bladder training, behavioral modification and nervous system regulation resulted in measurable improvement. Her daytime voiding interval increased to approximately 2.5 hours, and nocturnal voiding frequency also decreased.

Acupressure as an Evidence-Informed Integrative practice

Acupressure, rooted in Traditional Chinese Medicine, is increasingly recognized as an evidence-informed, integrative, and trauma-informed intervention. Integrative health and medicine approaches intentionally combine conventional physical therapy interventions with holistic strategies that address the whole person - physically, mentally, emotionally, and spiritually (Justice et al).

The use of Acupressure for anxiety is well established in integrative medicine. Acupoints such as Yin Tang (EX-HN3), Shenmen (HT7), Neiguan (P6), Hegu (LI4), Taichong (LV3), Jianjing (GB21), Zu San Li (ST36) and Sanyinjiao (SP6) are some of the most frequently used points to treat anxiety2. Yintang (EX-HN 3), in particular, has demonstrated anxiolytic effects and has also been associated with improvements in depressive symptoms.³

Beyond mental health applications, Acupressure has also been used as an effective non-pharmacological therapy for the management of a host of conditions such as insomnia, chronic pelvic pain, dysmenorrhea, infertility, constipation, digestive disorders and urinary dysfunctions. Emerging research suggests that Acupressure influences neural networks across multiple systems, supporting emotional regulation and multisystem healing

Physiologically, Acupressure has been shown to improve heart rate variability and reduce sympathetic nervous system activity. This downregulation is associated with decreased release of stress hormones such as epinephrine and cortisol, facilitating the relaxation response and correlating with reductions in anxiety and pain.

Why Acupressure Matters in Pelvic Health Rehabilitation

The pelvic floor is highly responsive to stress, anxiety, and unresolved trauma, often demonstrating increased tone or guarding in response to perceived threat. This can contribute to pelvic pain, urinary dysfunction, dyspareunia, constipation, and other pelvic health conditions.

These presentations are not purely musculoskeletal, they frequently reflect underlying nervous system dysregulation. Incorporating Acupressure into pelvic health rehabilitation can meaningfully support patients by:

· Calming hyperactive pelvic and autonomic nerves

· Improving circulation and tissue mobility in the pelvic region

· Releasing stored muscular tension and trauma

· Supporting emotional grounding, safety, and resilience

Acupressure can be particularly beneficial during or after pregnancy, childbirth, surgery, or emotionally traumatic experiences, offering a gentle, patient-empowering approach to healing.

Acupressure as a Hands-On Self-Regulation Tool

Acupressure involves the application of gentle, intentional pressure to specific points along the body’s meridian system. These points correspond with key organ systems, including the nervous, digestive, and reproductive systems and can influence both physical and emotional health.

Clinical benefits of acupressure include:

· Vagal nerve modulation and stress reduction

· Decreased muscle tension and chronic pain

· Enhanced emotional regulation and trauma support

· Promotion of relaxation and improved sleep

Integrating acupressure into pelvic health physical therapy supports whole-person healing, restoring not only movement and function, but also a sense of safety, stability, and emotional balance.

Commonly Used Acupressure Points for Anxiety, Pain, and Pelvic Health

· CV 17 (Conception Vessel 17) – Located at the center of the chest Main point for Emotional healing

· Yintang (EX-HN 3) – Located between the eyebrows Mentally stabilizing effect, calming point

· H 7 ( Heart 7) – Located on the ulnar side of the hand, in the joint space) Helps with Insomnia, reduces anxiety

· P 6 (Pericardium 6) – Inner forearm Calms the heart, reduces anxiety and nausea

· Sp 6 (Spleen 6) – Above the inner ankle Regulates reproductive health

· CV 6 (Conception Vessel) – Below the navel Supports core energy, fatigue and abdominal tension

These points can be gently stimulated during therapy or taught as part of a home program, offering patients the tools for emotional self-regulation. To explore these concepts further, please join us for the upcoming remote course Acupressure for Optimal Pelvic Health scheduled for Feb 7th & 8th . This course introduces participants to foundational principles of Traditional Chinese Medicine, Acupuncture, and Acupressure, with a focused exploration of the Bladder, Kidney, Stomach, and Spleen meridians.

Participants will also learn additional nervous system–regulating points for managing anxiety, pain, and related symptoms, as well as two comprehensive acupressure-based home and wellness programs. The course further integrates Yin yoga as a complementary practice, offering an evidence-informed perspective on how Yin postures associated with specific meridians may influence neurodynamic pathways and support multidimensional healing.

References

1. Chen SR, Hou WH, Lai JN, Kwong JSW, Lin PC. Effects of Acupressure on Anxiety: A Systematic Review and Meta-Analysis. J Integr Complement Med. 2022;28(1):25-35. doi:10.1089/jicm.2020.0256

2. Yang J, Do A, Mallory MJ, Wahner-Roedler DL, Chon TY, Bauer BA. Acupressure: An Effective and Feasible Alternative Treatment for Anxiety During the COVID-19 Pandemic. Glob Adv Health Med. 2021;10:21649561211058076. Published 2021 Dec 12. doi:10.1177/21649561211058076

3. Kwon CY, Lee B. Acupuncture or Acupressure on Yintang (EX-HN 3) for Anxiety: A Preliminary Review. Med Acupunct. 2018;30(2):73-79. doi:10.1089/acu.2017.1268

4. Justice C, Sullivan MB, Van Demark CB, Davis CM, Erb M. Guiding Principles for the Practice of Integrative Physical Therapy. Phys Ther. 2023;103(12):pzad138. doi:10.1093/ptj/pzad138

5. Monson E, Arney D, Benham B, et al. Beyond Pills: Acupressure Impact on Self-Rated Pain and Anxiety Scores. J Altern Complement Med. 2019;25(5):517-521.

6. Abaraogu UO, Igwe SE, Tabansi-Ochiogu CS. Effectiveness of SP6 (Sanyinjiao) acupressure for relief of primary dysmenorrhea symptoms: A systematic review with meta- and sensitivity analyses. Complement Ther Clin Pract. 2016;25:92-105

7. He Y, Guo X, May BH, et al. Clinical Evidence for Association of Acupuncture and Acupressure With Improved Cancer Pain: A Systematic Review and Meta-Analysis. JAMA Oncol. 2020;6(2):271-278. doi:10.1001/jamaoncol.2019.5233

8. Hasanin ME, Elsayed SH, Taha MM. Effect of Acupressure on Anxiety and Pain Levels in Primiparous Women During Normal Labor: A Randomized Controlled Trial. J Integr Complement Med. 2024;30(7):654-661. doi:10.1089/jicm.2023.0072