“You must’ve been a strange kid.” That was my patient’s comment as I held a plastic model of a pelvis and paused for a moment as I was explaining pelvic anatomy and what I’d be checking during her exam.
“Why would you say that?” I asked, truly bewildered.
“Because you do this for a living,” she said.
I remember my next thought – a sarcastic comment I kept to myself – but I don’t remember what I said. Maybe I laughed awkwardly, or changed the subject. I don’t know.
It’s not strange to be a pelvic health physical therapist or to want to be one! What’s strange, or maybe just unfortunate, is to ignore parts of our bodies because it’s socially taboo to discuss them. I’ve met adult women who don’t know their clitoris from their urethra and adult men who don’t know that they too have a pelvic floor.
The blogger as an 8-year-old, eating her sister’s birthday cake – yum!
Physical therapy graduate programs are beginning to add pelvic health into their curricula, but barely. My program had a guest lecturer on the subject, but if I remember correctly, it was one lecture out of 3 years of school.
My first introduction to pelvic health physical therapy was at the clinic I ultimately would fall in love with – Back in Motion Physical Therapy. I was fortunate to be placed at Back in Motion for both part-time and full-time clinical experiences during grad school. Once I graduated and passed my national board certification exam, I started working at the clinic. In 2018, Back in Motion moved pelvic health to our sister practice, Physical Therapy Your Way Advanced and Specialty Care.
It makes perfect sense to have therapists trained in rehabilitation (and prehabilitation) of the pelvic floor! The pelvic floor is responsible for so many important life functions: bowel and bladder control, core stability, organ support, fluid movement, sexual function. If something goes wrong with an area of the body that’s so vital, why wouldn’t we rehab it? Or, even better, why wouldn’t we get routine pelvic health checkups to help prevent anything from going wrong?
I’m not going to argue that traditional orthopedic physical therapy isn’t important. It is. But think about this . . . If someone twists his ankle and tears a ligament playing basketball, we rehab that ankle. If someone tears her pelvic floor delivering a 10-pound baby, we should rehab that too. The pelvic floor is made up of muscles, nerves, connective tissues, all the structures physical therapists work on. We shouldn’t ignore the pelvic floor just because the body parts there are private.
The main nerve to skeletal muscle in the pelvic floor is called the pudendal nerve. The name comes from the Latin “pudenda,” which translates roughly to “shameful.” Really? We need to stop perpetuating the idea that there’s anything shameful about the pelvic floor, or about our bowel, bladder, or sexual functions. And, I’d argue, there’s nothing weird about specializing in helping people maintain continence, decrease pain, or improve sexual function. In fact, it’s really quite rewarding.
I love what I do. The human body is endlessly fascinating. I’m continually studying anatomy and physiology, listening to pelvic health podcasts, attending webinars, going to in-person continuing education courses and seminars, and practicing therapy techniques. I’ll talk about sexual function just as readily and easily as I’ll talk about shoulder function. It’s not shameful. It’s important. If that makes me strange, then I guess I’m strange.
The blogger now, Dr. Brauna Carl, PT, DPT.
