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The Therapy Skillset That You May Be Surprised You Need

October 5, 2021 • Pelvic Health • Jennifer Stone

My name is Jenn Stone, and I didn’t want to be a pelvic health physical therapist. Probably similar to many of you, when I was in PT school my eyes were open to all the many amazing ways that PTs can positively impact people with movement disorders and I actually had a hard time narrowing down what area of physical therapy I wanted to pursue. But there was that one…the little I knew (inaccurate, as that turns out – more on that in a moment) told me that I was absolutely certain that I did not ever want to know more about that area of physical therapy. I ended up picking outpatient musculoskeletal care-entering an orthopaedic residency before I had even passed boards and earning my OCS 3 years post graduation. I had found my true love and didn’t think I could possibly be happier than I was helping people with musculoskeletal dysfunction.

Then, my oldest child’s birth forced me to enter the world of pelvic health despite my intentions.

The first thing I discovered was how incredibly lacking the access to physical therapists trained in pelvic health is – I found myself in the position of desperately needing a physical therapist, and the closest one was over 100 miles away. I reluctantly signed up for a pelvic floor course. Honestly not really intending to use it clinically, I mostly wanted to learn enough to rid myself of the intense pain I had been experiencing since his delivery.

I walked out of that course and my husband asked how it went. My response was, “It was surprisingly amazing – and I am honestly really frustrated that I went to a PT school with an excellent MSK curriculum and completed a highly respected orthopaedic residency program, and I have never heard of these muscles! This isn’t a different branch of physical therapy in the sense that pediatrics or treating patients with neurologic dysfunctions is-this is everything I love about musculoskeletal care in a region of the body that I already enjoy treating!” (I already had developed a love for caring for those with low back, SI region, and hip pain, you see.)

Pelvic Health Education

My new pelvic health skill set was incredibly beneficial for some of the patient types that I had really struggled with.

I began to dive deeper into the world of pelvic health. It wasn’t long before I realized how incredibly siloed this area of care was, and how many misconceptions existed around pelvic healthcare. My personal schedule quickly became far too full, with a waitlist far too long, as people began driving distances (sometimes 4-5 hours one way) to seek help. Meanwhile, therapists I interacted with demonstrated fear of even discussing these topics with their patients or me. Honestly, I didn’t blame them-I had been there myself a short time ago, remember.

We quickly built a large pelvic health program in our department (13 therapists within a period of 3 years). I also realized that my new skill set was incredibly beneficial for some of the patient types that I had really struggled with. I am sure most PTs have experienced this as well, but for my entire career there had been these patients who just didn’t quite get better. I am ashamed of this now, but I would smile and laugh knowingly with my colleagues about frequent fliers, people who didn’t do their home exercises, and so on. Come to find out, it was me who was creating these frequent fliers because I was missing 2 major pieces of information to help them: pain science and knowledge about the pelvic floor. Who would have thought that piriformis syndrome and chronic/recurrent posterior pelvic girdle pain would be driven by the pelvic floor as often as they are? Certainly not me, until I started checking.

Another realization: not all patients with pelvic floor dysfunction need internal assessment and treatment!

In fact, there are many, many options to help people that can be performed in an open gym/traditional PT practice setting. Now, please don’t hear me say that an internal exam is never necessary, nor that all patients with pelvic floor dysfunction can get better without intervention on that level-that couldn’t be further from the truth! However, there are so many tools for evaluation and treatment that are well within the typical MSK therapist’s wheelhouse (and comfort zone!) and which can greatly enhance their care for patients for whom the pelvic floor is playing a role in driving their condition.

The final realization that I came to was that many PTs who are wonderful pelvic health specialists would benefit from a deeper understanding of how the pelvic floor fits into the rest of the body-to develop a deeper knowledge and understanding of how to tie it in with the hips, pelvis, and spine. Turns out, treating pelvic health patients orthopedically is highly beneficial!

Thus, the Certificate for Advanced Musculoskeletal Management of the Pelvic Girdle was born. This curriculum has been carefully curated to contain an up to date and evidence based foundation in pain science and musculoskeletal best practices for the pelvic region, while layering on a comprehensive pelvic floor evaluation and treatment toolbox which includes manual therapy, exercise, and patient education/lifestyle coaching options for patients who are experiencing pelvic floor dysfunction. Of course, we will also address how to know that a patient needs more than external intervention.  We hope to serve 2 types of therapist: those who don’t want to do internal work but do want to bring the benefits of pelvic floor incorporation to their patient caseload, and those who are comfortable with internal work, but want to enhance their pain science and orthopaedic toolboxes.

So there you have it: the story of how Jenn Stone accidentally became a pelvic floor specialist, and how the CAMMPG (anyone have a cute nickname idea? Taking suggestions.) was born. I would welcome any opportunity to dialogue with you regarding how this content can help you and your practice, or simply answer any questions you may have.

Want to learn more about how to work external pelvic health treatments into your clinical practice?

The Certification in Advanced Musculoskeletal Management of the Pelvic Girdle can teach you how the pelvic floor fits into the rest of the body-to develop a deeper knowledge and understanding of how to tie it in with the hips, pelvis, and spine.


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Jennifer Stone

Dr. Jennifer Stone graduated from Texas State University in 2009, and completed her transitional DPT through MGHIHP in 2010. She completed an orthopedic residency through Evidence In Motion in 2010 and is a board certified orthopedic clinical specialist through the American Board of Physical Therapists Specialties (ABPTS). She received a pelvic health certification through Herman...

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