How I Became A Pelvic Pelvic Floor Physical Therapist

How In The World Did You Get Into This Field?

Is a common question I am asked when I am elbow deep in someone's vag or rectum.  

Just kidding, I'm rarely elbow deep in there--it's only a couple of knuckles.  Sorry if I offended :). But if I offended you with that, you are on the WRONG blog, my friend, so you might as well keep scrolling.  

Back to my "origin story", if you will.  And it's a good one, so I might as well share it.  As Julie Andrews in the sound of music says, let's start at the beginning.  

"I Pee My Pants, Just A Little...But I Don't Think It's Normal..."

It started, as most things do, with a trusted confession, between friends, in college.  

I was sitting at the college coffee shop, studying for midterms, with girlfriends who were on the track team.  I don't know what else we were talking about, but suddenly one of them says "I pee my pants when I race.  Just a little....but it happens every time I race, and I don't think it's normal."  She knew I was in PT school, and even that I was in an elective for women's health, and she then asked me if there was anything she could do to stop it.  

And here's the kicker: besides telling her to "not do kegels", and to "strengthen her hip muscles"...I didn't have much to offer her.  And that felt shitty.  

I felt like I was missing something. 

I really did feel like I was missing something.  Like A HUGE something.  Like we had this whole "evidence-based" protocol for ALL other body parts...then it came to the pelvic floor, and it was like "here's the muscles and nerves", but if you want to learn about them, you have to go to this 5-day additional training to even learn to assess them....so just "don't tell them to do kegels".    (NOTE: This was 25 years ago, so hopefully PT schools do more now).  

I also was puzzled by the fact that tampons hurt...and why was pooping so damn hard sometimes?  And All of this "abdominal bracing doesn't work" and a personal thought that always puzzled me "why are we using surface electrodes on the superficial pelvic floor muscles when there are deeper ones that are SURELY NOT doing the same thing as the superficial muscles??"    Thank the Jesuits (and my ADHD and Anxiety for my inquiring mind.   

Then.  A miracle.  A divine intervention.  

Options for clinical rotations came up, and one, in particular caught my eye: 12-weeks with the University of Michigan: Pelvic Health, that included the 5-day internal pelvic floor training with Herman Wallis Institute at the start of the rotation, so I not only would be 12-weeks with a SUPER experienced pelvic physio, but could also actually do internal work during this 12-week clinical.  I signed up later that day, and it honestly changed the course of my life forever.  

Next Stop: The Most Embarrassing Day Of My Life

I tell my girlfriends "I got you", I'm going to go on this clinical, and learn how to fix your leaks, and my painful tampons.  

Then...I think...wait a minute...to do the 5-day training, I'm going to have to DO THE TRAINING.  And "The Training", for anyone who has ever learned to do anything with the pelvis, involves YOU lending YOUR pelvis to be learned upon.  

Two weeks later (in truth, I have no idea, it might have been 2 months later), here I am, all 24 years old, after a sleepless night, because I'm worried that ONE stranger is about to see my vulva and do an internal pelvic floor muscle exam on me...and two hours later, it's time for the first lab...the external vulvar assessment...I volunteer to be the "patient" first, to just get it over with...and Hollis Herman, the GOAT of Pelvic Floor training, comes over to OUR TABLE (out of a class of 60 people), and says to me "you don't mind being the demo for the class, do you darling?"  

I was the demo vulva for the class of 60.  I was all of 24 years old, and it was seriously my worst nightmare.  But I remember thinking, "remember how vulnerable you feel, because this is probably what your clients might feel like, so you need to do EVERYTHING you can, to make them feel at ease."  And I think it taught me probably more than anything else EVER COULD about being aware of my clients feelings.

There I was, my previous worst case scenario of one stranger seeing my hu-hah BLOWN out of the water, as SIXTY STRANGERS are watching the GOAT Pelvic PT of the universe do an external vulvar assessment on me.  

I learned SO MUCH about empathy, and how to make people comfortable, and about how nervous people are.  

I learned how to assess the pelvic floor.  AND THEN, in the next 12 weeks, I learned how to treat the pelvic floor, and that, is where the magic happened.  

The next 12-weeks, I saw the closest things to miracles happen from PT, that I have ever seen in my life.  

I don't use that word, miracle, lightly.  But I do use it here, and I will continue to use it in my present practice.  It is honestly why I stayed in Pelvic Floor, and never again considered for a moment returning to Ortho in the long run.  

You see, in Orthopedics, you sometimes "have to do the same boring PT exercises for weeks" to get results.  But in Pelvic Floor---when you do the right exercises,  simple, specific exercises, to connect the brain to the body in the right way , you get a HUGE return on investment, and you see HUGE functional improvements in VERY short periods of time.  I saw: 

•  Men, practically skipping out of the clinic, when they no longer had to wear pads to golf again, after just 4 visits.  
• Women, crying tears of joy, who could get through the day without peeing their pants, for the first time in years, after just 6 visits. 
• Moms and their kids, celebrating together, when the children could sleep through the night without wetting the bed, or celebrating that they could go on a sleepover for the first time at 13, which they hadn't been able to do, because of bed-wetting, after just 4 visits. 
• One particular 80-year old couple, who had a particular spring in their step, who was able to use the bedroom for "more than just sleeping" for the first time in a long time, after an unknown number of visits (sorry, I don't remember)
• Another woman, who could now use tampons painfree.
• Another man, and woman, who could poop, painfree. 
• The list goes on. 

And the amazing thing?  Unlike in ortho, when you'd ask, "did you do your exercises", and the patients would be like "umm....well....no....", in pelvic physio, the patients were like "OF COURSE!!", and they'd have all sorts of great questions, and want MORE.  

Interestingly enough, my own pain with tampons, even though I wasn't getting 'actual' Pelvic PT myself during this time...just the carry over relaxation techniques worked!  My own pelvic pain was eliminated during this time!

It was a whole different type of physio.  Physio, as I expected physio would be.  And I loved it.

So, 12-weeks later, I returned to my college, found my girlfriends, and was like, "oh ladies, you have NO idea what we need to do, but it's going to change your life!"   I taught my friends the relaxation techniques.  The internal release techniques, and not only did their leaks stop, but their pain with tampons also went away, and their speed on the track also improved!  Pretty fascinating, huh?  

So that's my origin story, of how I became a Pelvic Floor Physical Therapist.  

It's not as exciting as a Marvel Character's origin story, I suppose, but I love it, because it's mine, and I'm happy to share it with you.  I've shared Pelvic Floored's origin story in the past, and I'll share it again sometime soon.  

What other questions do you have for me?  Comment below, and I'm happy to answer as able!  Be sure to follow me on Instagram, and via my newsletter for other great updates, and thank you so much for being here!!

Until next time,

XOXO

Dr. Kelly 💋

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