By Stephanie Prendergast, Cofounder, PHRC Los Angeles
January is often the time to reflect on the past year and set goals for the future. So, in that spirit, we thought it would be fun to dedicate this post to a few top Pelvic Health and Rehabilitation Center events of 2017….and a peak forward to 2018. In no particular order, here’s what happened and what’s going on.
#1 New Faces at PHRC
Katie Hunter, DPT joined PHRC LA team in January.
Sigourney Cross, DPT joined PHRC Berkeley in September.
Cheri Jones joined PHRC Berkeley in September.
Natalie Christopherson, DPT joined PHRC SF in December.
#2 Blogging: As the Pelvis Turns….
In 2013, Liz and I revamped the Pelvic Health and Rehabilitation Center blog, As The Pelvis Turns. Our goal was to publish reliable, evidence-based information about pelvic floor disorders for our patients and colleagues. As PHRC grew, As the Pelvis Turns grew with us and became a team effort. All of the physical therapists of PHRC and several of our colleagues contribute to our weekly blog. Since its beginning, we have published 249 blog posts. By the end of 2017, our As The Pelvis Turns blogs collectively averaged 26,000 reads per week!!
We knew there was a need for reliable information about pelvic health but we never imagined our little blog would generate so much interest. We are grateful to our readers for their thoughtful comments, questions, and suggestions. Please keep them coming and thank-you for your support!
Here’s a look at a few of our top posts in 2017, also in no particular order:
- Posture and the Pelvis Part One and Posture and the Pelvis Part Deux by Britt Van Hees (Blog of the Quarter winners)
- Foul! What the media got wrong about women’s health! by Rachel Gelman (Blog of the Quarter winner)
- Diaphragmatic breathing, pelvic pain, peeing and pooping by Nicole Davis
- Beating the odds: how one woman overcame a traumatic birth and had a successful second birth by Malinda Marshall
- Love and Vaginismus: Mary’s story of personal growth by Melinda Fontaine
- Male pelvic pain and chronic nonbacterial prostatitis: a story of hope and determination by Shannon Pacella
- I insist! My pain is coming from my Tarlov Cyst! by Liz Akincilar
- Beating Interstitial Cystitis by me
- Endometriosis: Beyond the lesions by Jandra Mueller
- Understanding pelvic floor movement by Katie Hunter
We often struggle to cover complex topics in the length of one post. Therefore, in 2017 we introduced a series of posts on a related topic. June is Men’s Health Month, we focused five posts on men’s pelvic health and backed up our blogs with posts on Facebook, Twitter, and Instagram.
Peripartum pelvic health care is significantly lacking in the US. To raise awareness we constructed a 12- post series covering the physical and emotional challenges women face, from the time they try to conceive through the toddler years.
Finally, and still running, each physical therapist from PHRC is reporting on a lecture from the Third World Congress on Abdominal and Pelvic Pain (#WCAPP17).
#3 Speaking of #WCAPP17….
People who know PHRC know we are long-term supporters of the International Pelvic Pain Society. I served on the IPPS Board of Directors since 2003 and was the first physical therapist to be President of the society in 2013. This year the IPPS hosted the 3rd World Congress on Abdominal and Pelvic Pain, bringing the conference to the United States for the first time. I was honored to serve as Scientific Program Chairman along with current IPPS President Amy Stein and Vice-President Erin Carey, MD.
#WCAPP17 was the most successful conference the IPPS has hosted to date! Pelvic health professionals traveled from 26 countries, 30 exhibitors participated, and 89 researchers submitted abstracts. There is always so much to learn and the conference was a wonderful opportunity for the PHRC clinical staff to spend time together in-person as we absorbed the latest research on management of pelvic pain. At PHRC we strive to be the best providers we can be. Attending conferences is on way to do this but we don’t stop there.
#4 Expanding our Knowledge
Pelvic floor physical therapists need to have knowledge of every system in the body, medications, medical interventions and surgeries, pain science, and of course, anatomy, physiology, and function. We need to read, collaborate, discuss, practice, and repeat.
Every week we take turns presenting a journal article in our weekly staff meetings. We also use this time to present inservices to each other from courses, present case studies, discuss difficult case studies, and bring in medical specialists to help us learn their area of expertise. Last year Dr. Joshua Gonzalez, urologist and sexual medicine specialist, Dr Leo Treyzon, GI and functional medicine expert, Erica Marchand, PhD, sex therapist, and Jessica Newman, clinical pain psychologist shared their knowledge with us.
Interdisciplinary collaboration is the key to clinical success but it is also fantastic that we can learn from each other within PHRC, as we did this year with inservices from PHRC’s Britt Van Hees, who also had a major achievement in 2017.
#5 Britt Van Hees completes the Institute of Physical Art training and passed the certification exam with high honors!
Congratulations to Britt for passing with honors, we knew she would, and for sharing her knowledge about proper posture and coccyx assessments with us. Following Britt’s lead, each of the physical therapists at PHRC presented two inservices over the course of 2017.
In addition to cultivating our clinical skills, the entire PHRC team is committed to raising awareness about pelvic floor disorders and the role pelvic floor physical therapy plays in managing them.
#5 Spreading the word
Rachel Gelman, Director of PHRC SF, spent a decent amount of time in 2017 contributing to professional blogs, podcasts, and media articles. I contributed to a handful myself, and as a result we created a podcast and press section on our website.
In our respective cities, Liz, Malinda, Melinda, Rachel, Britt and I gave local lectures to medical providers, birth professionals, college students, and the general community. On the road, I gave two lectures at the World Congress of Endometriosis in Vancouver, Canada.
#6 PHRC finally joined Instagram and Pinterest! Please follow us!
#7 May was dedicated Pelvic Pain Awareness Month
In 2017 PHRC supported the International Pelvic Pain Society’s decision to dedicate the month of May Pelvic Pain Awareness Month. Stay tuned to our social media channels this May as we help support the cause and raise awareness.
#8 PHRC contributed to the development of the film Tightly Wound, by Shelby Hadden
In 2018 PHRC is teaming up with Heather Jeffcoat of Femina Physical Therapy and Shelby to premiere the movie in Los Angeles!
#9 A Clinician’s Guide to Vulvodynia
This year, Elsevier dedicated an entire issue of OBGYN Clinics of North America to Vulvodynia. The publication has 13 chapters on the topic, I was honored to author one of them: Pelvic Floor Physical Therapy for Vulvodynia: a Clinician’s Guide. Thank-you to Elsevier and to the National Vulvodynia Association for publishing the article in their newsletter. And finally….
#10 Pelvic Pain Explained is now available in paperback! Check it out, share it with people who need to learn more about pelvic pain, and please review us on Amazon!
2017 was a great year, and it was the first year since 2010 that we did not open a new clinic or move an existing clinic to a larger space. Whew! Apparently one year off was enough….
We are thrilled to announce that Melinda Fontaine, Director of PHRC Berkeley, is teaming up with Innovative Wellness on the other side of the Caldecott Tunnel! Coming March of 2017, we will be open and accepting new patients in Walnut Creek, California. We thank Melinda for spearheading this project!
2018 is off to a busy start and we are currently hiring physical therapists to join our team in Berkeley, San Francisco, and Los Gatos, California and in Lexington, Massachusetts! For more information and to apply please check out the Employment Opportunities section of our website.
We are excited for 2018, Happy New Year everyone!
FAQ
What are pelvic floor muscles?
The pelvic floor muscles are a group of muscles that run from the coccyx to the pubic bone. They are part of the core, helping to support our entire body as well as providing support for the bowel, bladder and uterus. These muscles help us maintain bowel and bladder control and are involved in sexual pleasure and orgasm. The technical name of the pelvic floor muscles is the Levator Ani muscle group. The pudendal nerve, the levator ani nerve, and branches from the S2 – S4 nerve roots innervate the pelvic floor muscles. They are under voluntary and autonomic control, which is a unique feature only they possess compared to other muscle groups.
What is pelvic floor physical therapy?
Pelvic floor physical therapy is a specialized area of physical therapy. Currently, physical therapists need advanced post-graduate education to be able to help people with pelvic floor dysfunction because pelvic floor disorders are not yet being taught in standard physical therapy curricula. The Pelvic Health and Rehabilitation Center provides extensive training for our staff because we recognize the limitations of physical therapy education in this unique area.
What happens at pelvic floor therapy?
During an evaluation for pelvic floor dysfunction the physical therapist will take a detailed history. Following the history the physical therapist will leave the room to allow the patient to change and drape themselves. The physical therapist will return to the room and using gloved hands will perform an external and internal manual assessment of the pelvic floor and girdle muscles. The physical therapist will once again leave the room and allow the patient to dress. Following the manual examination there may also be an examination of strength, motor control, and overall biomechanics and neuromuscular control. The physical therapist will then communicate the findings to the patient and together with their patient they establish an assessment, short term and long term goals and a treatment plan. Typically people with pelvic floor dysfunction are seen one time per week for one hour for varying amounts of time based on the severity and chronicity of the disease. A home exercise program will be established and the physical therapist will help coordinate other providers on the treatment team. Typically patients are seen for 3 months to a year.
What is pudendal neuralgia and how is it treated?
Pudendal Neuralgia is a clinical diagnosis that means pain in the sensory distribution of the pudendal nerve. The pudendal nerve is a mixed nerve that exits the S2 – S4 sacral nerve roots, we have a right and left pudendal nerve and each side has three main trunks: the dorsal branch, the perineal branch, and the inferior rectal branch. The branches supply sensation to the clitoris/penis, labia/scrotum, perineum, anus, the distal ⅓ of the urethra and rectum, and the vulva and vestibule. The nerve branches also control the pelvic floor muscles. The pudendal nerve follows a tortuous path through the pelvic floor and girdle, leaving it vulnerable to compression and tension injuries at various points along its path.
Pudendal Neuralgia occurs when the nerve is unable to slide, glide and move normally and as a result, people experience pain in some or all of the above-mentioned areas. Pelvic floor physical therapy plays a crucial role in identifying the mechanical impairments that are affecting the nerve. The physical therapy treatment plan is designed to restore normal neural function. Patients with pudendal neuralgia require pelvic floor physical therapy and may also benefit from medical management that includes pharmaceuticals and procedures such as pudendal nerve blocks or botox injections.
What is interstitial cystitis and how is it treated?
Interstitial Cystitis is a clinical diagnosis characterized by irritative bladder symptoms such as urinary urgency, frequency, and hesitancy in the absence of infection. Research has shown the majority of patients who meet the clinical definition have pelvic floor dysfunction and myalgia. Therefore, the American Urologic Association recommends pelvic floor physical therapy as first-line treatment for Interstitial Cystitis. Patients will benefit from pelvic floor physical therapy and may also benefit from pharmacologic management or medical procedures such as bladder instillations.
Who is the Pelvic Health and Rehabilitation Team?
The Pelvic Health and Rehabilitation Center was founded by Elizabeth Akincilar and Stephanie Prendergast in 2006, they have been treating people with pelvic floor disorders since 2001. They were trained and mentored by a medical doctor and quickly became experts in treating pelvic floor disorders. They began creating courses and sharing their knowledge around the world. They expanded to 11 locations in the United States and developed a residency style training program for their employees with ongoing weekly mentoring. The physical therapists who work at PHRC have undergone more training than the majority of pelvic floor physical therapists and as a result offer efficient and high quality care.
How many years of experience do we have?
Stephanie and Liz have 24 years of experience and help each and every team member become an expert in the field through their training and mentoring program.
Why PHRC versus anyone else?
PHRC is unique because of the specific focus on pelvic floor disorders and the leadership at our company. We are constantly lecturing, teaching, and staying ahead of the curve with our connections to medical experts and emerging experts. As a result, we are able to efficiently and effectively help our patients restore their pelvic health.
Do we treat men for pelvic floor therapy?
The Pelvic Health and Rehabilitation Center is unique in that the Cofounders have always treated people of all genders and therefore have trained the team members and staff the same way. Many pelvic floor physical therapists focus solely on people with vulvas, this is not the case here.
Do I need pelvic floor therapy forever?
The majority of people with pelvic floor dysfunction will undergo pelvic floor physical therapy for a set amount of time based on their goals. Every 6 -8 weeks goals will be re-established based on the physical improvements and remaining physical impairments. Most patients will achieve their goals in 3 – 6 months. If there are complicating medical or untreated comorbidities some patients will be in therapy longer.
Comments
Have found your emails and articles so helpful and informative. Have had pelvic pain for several years now. Was diagnosed with Pudendal Neuralgia. Received pelvic floor physical therapy for several months and was just about to start botox injections in pelvic floor muscles when my big, strong husband fell and broke his hip. Just about the time I was to start the injections again he fell and broke his other hip. So needless to say the pain goes on. Your emails have been a blessing. Thank you for your dedication.
Dear Stephanie & colleagues, thank you for all your hard work and contributions to our community and body of knowledge.
I loved your new book and read it in one weekend. Thanks for making it available on Kindle! I’v recommended it to several patients & colleagues.
Your blogs & lectures have been a great resource in preparing for the WCS board exam.
Best wishes on the opening of Walnut Creek!