At some point during their course of treatment, most of my patients delicately ask a variation of the question, “How did you decide to become a pelvic floor physical therapist?” The questions they really want to ask are, “Why on earth would anyone want to be doing physical therapy in vaginas and rectums? Wouldn’t you rather just fix someone’s sprained ankle?” To be fair, I did not go into physical therapy with the goal of becoming a pelvic floor specialist. I barely knew the specialty or the need existed. I started out wanting to treat patients who suffered a stroke or a traumatic brain injury and in general was very interested in patients with neurological diagnoses. I spent some years working as a physical therapist in Columbia University’s ALS Clinic and rotating through different specialties in New York Presbyterian Hospital at Columbia, gaining a wide variety of experiences.
Then, I got pregnant with my first son. Somewhere around 32 weeks into my pregnancy I began to have shooting pain with every step I took, directly into the front of my pelvis. Wondering if this was what labor felt like, I ended up being directed by my Ob-gyn to visit the emergency department. A young resident, after examining me, suggested that I might have separated my pubic symphysis, and provided me with a prescription for Percocet for pain (during my pregnancy!) and no other advice. I decided to not wade into the world of opioids while pregnant and the severe pain continued and worsened as my pregnancy progressed. No matter who I spoke to about it — my husband, my colleagues, my parents, my brother, my friends, my dog, my doorman, random strangers I accosted on the street – it seemed there were just no options other than suffering through the pregnancy. And that’s what I did, even though I was literally unable to put one foot in front of the other. Eventually and fortunately, I gave birth to a healthy baby boy. Unfortunately, I was unable to get out of bed without excruciating pain.
As the weeks went on, I became more despondent. At lactation support groups, on the streets of NYC, and on magazine covers, mothers with new babies appeared to be recovering much better than I was. I figured I must be doing something wrong and was terrified I would never get better. Somewhere in the postpartum haze, someone mentioned a pelvic floor physical therapist that they thought might help. I told this to my Ob-Gyn at my routine 6-week follow-up appointment and she skeptically provided me a prescription for pelvic floor physical therapy.
I remember sitting in the waiting room of the physical therapy clinic for my initial evaluation among the little old ladies with their walkers and canes. It was the first time I had been a patient seeking rehabilitation since becoming a physical therapist. I was scared, in pain, weak, and hopeless. After talking to the physical therapist and telling her my story, I immediately felt like someone finally understood what I was going through – and even more importantly, had a plan for how to help me. I remember deciding right then that I wanted to do for others what this wonderful woman was doing for me.
“After talking to the physical therapist and telling her my story, I immediately felt like someone finally understood what I was going through – and even more importantly, had a plan for how to help me.”
Over the next six months, I learned a tremendous amount about my pelvic floor and pelvic floor physical therapy. Near me, there weren’t many people practicing this specialty, but there was clearly a need. As I healed, I learned that the treatment for my condition wasn’t even that complicated; it was just a matter of knowing what to do. I will admit that when it came time to consider a second pregnancy I was nervous, knowing that it was likely I would experience the same symptoms as the first time around. But armed with the knowledge that I would be able to recover and also minimize the suffering during my next pregnancy, I eventually carried a second son. It wasn’t easy the second time around, but I didn’t feel as lost as I did the first.
Since then I have taken numerous courses to advance my understanding of pelvic floor rehabilitation, established the pelvic floor physical therapy rehabilitation program at New York Presbyterian Hospital at Columbia University, treated well over a thousand different patients with pelvic floor dysfunction, earned my Pelvic Rehabilitation Practitioner Certification (PRPC) from the Herman and Wallace Pelvic Rehabilitation Institute, and established a private pelvic floor rehabilitation clinic in Westchester, NY. It’s amazing to look back at how my personal journey has informed my career path.
I treat both male and female patients with a variety of symptoms related to pelvic floor dysfunction. These include, but are not limited to, patients with urinary or fecal incontinence, difficulty urinating, urinary frequency, interstitial cystitis, chronic prostatitis, constipation, pelvic pain, painful sex, erectile dysfunction, coccyx (tailbone) pain, hip pain, lower back pain, diastasis recti (separation of abdominal wall muscles), pelvic organ prolapses, rehabilitation needs following colorectal or urogenital (including prostatectomy) cancer treatment, sacroiliac (SI) joint dysfunction, endometriosis, painful bladder syndrome, irritable bowel syndrome, pudendal neuralgia, vaginismus, vulvodynia, and painful C-section or perineal scars.
My training and experience have allowed me to successfully treat many women and men who have had difficulty finding relief. In addition, although it’s certainly not a prerequisite for being a good physical therapist, the fact that I have suffered through significant pelvic floor dysfunction and chronic pain myself has enhanced my expertise and treatment approaches.