Updated: Jul 17
Well, do I have a story for you? I'm asked this question at least once a week, "So how did you get into pelvic floor therapy?" Well, it's really funny story. It is a long story starting when I was younger, but I'll share about my first pelvic floor experience as a Student Physical Therapist. As a physical therapy student, you're expected to complete clinical rotations in addition to your graduate school education. Clinical experiences are important as you learn valuable hands on experience from advanced practitioners. Clinicals also help you choose what direction you'd like to continue in once a licensed professional.
Never tell your mentor you would like to learn more about the core
The clinical coordinator and one of my dear professors knew how much I loved working with the core and breathing due to my dance and Pilates background. My professor suggested doing a women's health clinical experience to learn more. Being very naiive, I was thrilled to accept the clinical experience. I thought "hey, what a great way to learn more about the core, advanced breathing techniques. and work with women."
Well, I was so wrong with what I "thought", women's health physical therapy really was!
So off to my clinical, I hopped on the train to Philly and showed up with my expectations. I was seriously nervous as I'm not a city girl at all. So to take the train, walk to the office and meet new people was giving me a panic attack already that day. Right off the bat, my clinical instructor, shared a bit about the practice, and we started treating clients.
The first client was a young female college student who shared very intimate details about the pain she was having with sex! I honestly had never heard of that before, nor ever thought that that was possible. You got to remember I grew up in South Jersey and went to Catholic school my whole life. (lol)
Do NOT pass out during your first pelvic floor clinical
As I stood professionally next to the clinical instructor, she gently palpated the clients perineum. The longer I was observing, the more I started feeling anxiety creep in. Why you ask? One, I had no idea that pelvic floor physical therapy was going to include assessing someone's pelvic floor, let alone looking at one! Two, I had never seen anyone else's vulva before, let alone mine.! Obviously, I knew where my vulva was and what it looked like, but never at that capacity. Only the gynecologist checks "down there".
As we continue to assess the client's perineal region, I could feel my shoulders getting tense, my armpits starting to sweat, and the color drop out of my face. Oh my goodness, I was starting to have a panic attack! As I tried to talk myself off the ledge, and remind myself the perineum is beautifully created. Everyone's looks different. And it's okay, we are professionals. I felt myself starting to freak out even more. Within the next second, my clinical instructor placed her finger in the client's rectum. And that was it! I lost it! I knew if I didn't calm myself down or get out of the room, I was going to pass out right on to the table where our lovely client was so comfortably resting. So I did what any professional would do. I made up a coughing attack. I started coughing, clearing my throat and saying my sinuses were acting up.
I ran out the door and slide down the wall into a fetal position! As I tried to regroup myself, another therapist in the practice came over to me and knew exactly what had happened. She said, "It's okay. There are a lot of things that come up when you start to be a pelvic therapist". And man, was she right? Sitting in a fetal position for a few minutes brought up so many emotions regarding my relationship to my pelvis and gynecological health. In our American society, we learn to be ashamed of the human body or that doctors are the "only ones" who should know about its sacred workings.
Say "vagina" and "penis" out loud everyday
As a baby pelvic therapist, one way I was able to start to work on my confidence and improving my relationship with the pelvic region was to say, "vagina and penis" out loud every day. Yeah, it sounds really funny. But it's not words that we grow up feeling comfortable with. Again in our childhood, anything having to do with the perineum, genitalia, sex, menstrual cycles, erections. pooping is taught to us as dirty or not natural. Well guess what? Its all natural! The body has certain cycles and rhythms that may seem gross, but all cycles have purpose for our health and is normal (most of the time). So in order to help myself get over the giggles and normalize "vagina" or "penis", I would say it out loud in the car on the way to work.
Now, it's 10 years later, I am a Certified Pelvic Rehabilitation Practitioner (PRPC) with a multitude of other education, with over 3000 hours of pelvic floor specific physical therapy. And ironically I own my own pelvic floor physical therapy practice. Emotions still comes up as I listen to my clients stories. I am no longer embarrassed or nervous to assess and treat pelvic floors and cores, but some issues of shame, grief, guilt, sadness, do relect similar emotions I continue to work to heal. My healing is not for my clients to hold, but it's for me to continue to work through. We can only be as good providers as what our experiences teach us.
As the business (and my confidence) grows, I'm no longer afraid of seeing a vulva! (Ha) I know it sounds funny, but my anxiety has brought me through many things. Our anxieties can actually teach us to overcome our fears, guilt, shame or sadness. These lessons are now the goals of my business.
Uphold the sacred female (and male) body and normalize function during every stage of life
Meet people where they are so they know that it's okay to feel uncomfortable to talk about their bodies. It is okay to experience something embarrassing, like leakage, but there is help.
Promote a healthy understanding that our body, mind and spirit all work together to bring us to exactly where we are at just the right time
If I quit that day of clinical, then I would have never opened Breathe Life PT. I would have never known any of you, my amazing friends and clients. So when you ask, "Is this weird I'm talking about this?" Just know I've been there and totally understand. And if you need to, just make a coughing attack! ;-)
In the South Jersey area and want one on one care with Dr. Amanda? Schedule an appointment for your complimentary 15 min phone call to see how pelvic therapy can help you!
Dr. Amanda Heritage, PT, DPT is the owner of Breathe Life Physical Therapy & Wellness, LLC located in Collingswood, NJ. She has been practicing physical therapy for over 10 years with a strong focus on pelvic health. She enjoys encouraging women and men about pelvic therapy as a treatment option for those suffering with pelvic pain, incontinence or constipation.