From Orthopeadics to Pelvic Floor – My Journey

When I first decided I wanted to be a physio I, like most young physios, had my sights set on working with athletes. In my first job as an orthopeadic physio the owner of the clinic asked me if I would be willing or interested in learning to be a pelvic floor therapist. My initial thought was “No way!” the last thing I wanted to do was spend my days talking about people’s private parts! Fast forward 10+ years and my favorite thing to see on my day sheet is a new assessment for “pelvis” or “urinary incontinence”. So how did that change happen?

Pelvic floor dysfunction is as prevalent as low back pain, a condition we are all familiar with and comfortable talking about. As an orthopeadic physio I spent my days helping people deal with low back pain. I had obtained some of the highest possible training in orthopeadics and yet I would still find there were some patients I just couldn’t seem to get that lingering low back pain to change. Then it happened I came across a study linking low back pain and pelvic floor dysfunction. That article opened my eyes to a whole muscle group that I had for years been essentially ignoring. I had never before considered that my patients pelvic floor may be playing into their low back pain. I would commonly asses adjacent parts and consider how they may be affecting the low back. The hips, tight hamstrings, weak abdominals were all common factors I considered in conjunction with someone’s low back pain. In fact I once treated one person’s big toe to help his low back pain. I was looking everywhere for the other factors that may be causing my patients low back pain but I wasn’t looking at the amazing group if muscles that were right there at the base of it all, the pelvic floor!

I spent the next few years reading, learning, taking courses to understand more about how the pelvic floor works and what role I might play in helping my patients. I had just finished one of Julie Wiebe’s courses when I had a new patient come in for her low back. She had waited 3 weeks to get in to see me about her back. It had been a

chronic thing coming and going for years always when she started a new exercise program. She had seen physio’s in the past and no one had helped but she had been told by a few people to come see me, that I would help her. Pressures on, problem was her pain had resolved by the time she got in to see me. I went through my normal assessment and really came up with nothing, yikes! So I asked a question I had never been asking my patients. “Do you have any problems with urinary leakage?” Her answer, now not surprising, was yes! I treated her with her pelvic floor as the route cause of her low back pain. My treatment plan, her exercises were totally different from my typical approach to low back pain. It’s been more than 3 years now and I have seen her for other issues but never again for her back. She has been pain free and leak free! She was “fixed” and I was hooked, I had found a new passion, I wanted to be a pelvic floor therapist!