Behind the Scenes of Pelvic Pearls

We are living in a very challenging time, one that has impacted every aspect of our lives and families, with much unknown still ahead. Many important services have been curtailed due to social distancing, including the work I do as a pelvic floor physical therapist. My daily schedule and ability to work with patients has changed significantly since March, yet I have tried to find the silver lining of this situation and utilize the extra time that I have been granted in a productive manner. While it is extremely tempting to binge watch Netflix, it is much more meaningful to spend time on professional projects that I have dreamed about but never had the opportunity to explore.

One of those projects is creating informational videos to educate the public about pelvic floor physical therapy. As a passionate pelvic floor physical therapist, I am grateful for the opportunity to share valuable knowledge and spread awareness of this extremely important specialty, especially considering that many people are needlessly suffering in silence. I enjoy giving lectures, blogging, and even answering questions that arise conversationally from curious friends. Knowledge is powerful, and the more that people know about their pelvic health, the better equipped they will be to address any issues that arise. That is why educating my patients about their conditions and instructing them on self care skills is one of my favorite parts of my job. I enjoy helping people understand the biology and physiology underlying their experiences, and I have found that it empowers them to take a more active role in their healing process.

Considering my thirst for both learning and dispensing knowledge, I have decided to shift gears and use the extra time to educate a larger audience. It is with great excitement and humility that I announce the recent launch of Pelvic Pearls. Pelvic Pearls is a YouTube channel which offers pearls of wisdom about pelvic floor physical therapy in short videos. Topics addressed include bladder dysfunction, bowel dysfunction, sexual dysfunction, pelvic pain, and prenatal and postpartum issues. This series is intended to educate and offer practical tips to listeners as well as explain how pelvic floor physical therapy can help address these conditions.

I am very grateful to my friend and colleague, Dr. Ivy Branin, for patiently teaching me how to create these videos, and I would also like to thank my roommates for allowing me to turn our apartment into a recording studio. I am also grateful to them for tolerating the constant sounds of “pastel slide short” introductory music that has been echoing through the rooms of our apartment incessantly. (One of them jokingly suggested that instead of a swear jar, our apartment should have a Pelvic Pearl music jar. Anyone who accidentally plays the song out loud owes money to the jar to be used by the other roommates as they please. #guilty)

Please subscribe today to access each and every Pelvic Pearl as they are posted. If there is a topic that interests you which has not been covered, please contact us and inform us what you would like us to address. We are here to help you in any way that we can during these trying times. Until we have the opportunity to meet and share knowledge in person, we look forward to continuing to do so with you virtually via Pelvic Pearls.

Missed Opportunity to Educate

Misinformation can be dangerous. With all due respect to author Dr. Jen Gunter, I found her most recent piece in The New York Times (link to article) lacking and misleading. In her recent article, “Is Incontinence Inevitable?” (1/14/20), she completely missed the opportunity to promote the benefits of pelvic floor physical therapy when it was handed to her on a silver platter.

The following questions was posed to her by a reader: “Dr. Gunter, I am a postmenopausal 63-year-old woman. I am wondering if the fate of all women my age and older is to wear pads for leakage. I understand your specialty is gynecology and not urology but thought you could weigh in on any advances in this area as the two specialties are related.”

Dr. Gunter proceeded to explain the difference between stress and urge incontinence and to cite several commonly known statistics about incontinence. She then offered several tips to her readers, the second of which was to limit fluid intake. According to her, the notion of drinking eight cups of water per day “is a myth.” I have found this to be completely not true. Anecdotally, patients who drink greater quantities of non-irritating, flat water fare better than patients who drink smaller quantities of poor-quality irritants (ex. caffeine, carbonated beverages, and artificial sweeteners). The solution isn’t to restrict fluids; it is to drink larger amounts of high-quality fluids to allow the bladder to fill and empty in a healthier manner.

She then encouraged readers to participate in Kegel exercises, both endurance and quick flicks exercises. The problem with this is that approximately 50% of people who attempt to perform Kegel exercises do not perform them properly and engage in substitution patterns. In other words, people use the wrong muscles, such as the buttocks or inner thigh muscles, rather than the pelvic floor muscles. The best way for people to learn how to correctly engage the pelvic floor muscles is with a physical therapist who can introduce the learner to the muscles by touching them through internal manual cuing.

While Dr. Gunter answered the question correctly, that incontinence is NOT inevitable, she neglected to mention a very important piece to the puzzle in addressing the issue. The fact that the words “physical therapy” did not appear once in the article was, in my opinion, an oversight on Dr. Gunter’s part. Pelvic floor physical therapy has helped many women improve their continence in a safe, conservative, and evidence-based manner. If you or anyone that you know stands to benefit from our services, please contact us at Revitalize Physical Therapy. It would be an honor and privilege to help you!