Today we are honored to present our featured Certified Pelvic Rehabilitation Practitioner Jessica Dorrington, PT, MPT, OCS, PRPC, CMPT, CSCS! Jessica was kind enough to answer a few questions about her role in pelvic rehab.

Describe your clinical practice:
Our clinic practice is an outpatient orthopedic private practice. We are committed to making individual results accessible through compassionate therapeutic care. Our practice spans treating men, women and children through a realm of urologic, gynecologic, obstetric, and colorectal conditions- as well as orthopedic conditions.

How did you get involved in the pelvic rehabilitation field?
Initially, I was an outpatient orthopedic physical therapist. Within the first few months of my career, the clinic I was working at needed someone to just “teach Kegel exercises”. When I realized the impact that you could have on someone’s life, I was immediately drawn to the pelvic rehabilitation field. I saw getting someone even 75 percent improvement was a whole different success than getting a shoulder patient 75 percent better that could now throw their ball to their dog. It was restoring relationships, saving marriages, and giving women the freedom to go do things they could not do before.

Congratulations to Dr. Sarah Capodagli, DPT, our featured practitioner of the week! Dr. Capodagli owns and operates CorrEra Physical Therapy, and she is in the process of expanding her practice in Buffalo, NY. We were curious to hear more from her about running a practice in Buffalo, and Sarah was kind enough to write in. Thanks, Sarah!

Although Buffalo is considered the second largest city in the state of New York, we often operate like a small town. We value community and for just about any business, the best marketing tool is word of mouth. If you need a new roof, new car, or a good doctor, well, ask around and I guarantee that you will find someone who “knows a guy,” to help or advise. I cannot speak for every city, though when I think of Buffalo, NY, I think of family. When you see your family in need, you help.

A few years ago I was working in a large oncology hospital and one of my primary roles was running the pelvic floor rehabilitation program for men living with or being treated for prostate cancer. I loved this work; however, I saw greater need in our community for not only the proper conservative care and treatment, but also for the information about pelvic health to be shared more publicly with men and women. Although opening my own clinic in a suburb of this “City of Good Neighbors” was not always the plan, when given the opportunity to grow into my own practice by a chiropractor friend, I jumped at the chance and have never looked back. It was a big jump, but for me, the fear of regret in never trying was so much worse than the fear of failure.

The following comes to us from Felicia Mohr, DPT, a guest contributor to the Pelvic Rehab Report.

Vaginal mesh kits were used frequently early in the millennium as they led to high initial anatomic success rates with peak use between 2008 and 2010. Objectively they seemed to help elevate women’s pelvic organs to appropriate anatomical locations. Unfortunately there has been a high rate (10% according to a review of current literature on PubMed^{Barski 2015}) of mesh erosion causing recurrent prolapse and/or stress urinary incontinence. Also there are cases when the mesh product perforates surrounding organs causing numerous dangerous complications. The rate of mesh-related complications according to current research is 15-25%. As a result, the FDA has reclassified the risk of synthetic mesh into a higher risk category so that the public has an increased awareness of the risk involved in these types of surgeries.

A systematic review and meta-analysis, published in 2015, reviewed the risk factors for mesh erosion following female pelvic floor reconstructive surgery ^{(Deng, et al)}. They concluded the following factors increase risk of mesh erosion: younger age, more childbirths, premenopausal states, diabetes, smoking, concomitant hysterectomy, and surgery performed by a junior surgeon. Moreover, concomitant POP surgery and preservation of the uterus may be the potential protective factors for mesh erosion.

The following is a guest post from Nancy Fish, LCSW, MPH who will be presenting at the Alliance for Pelvic Pain Retreat on May 20-22 in Ellenville, NY. Check out this flier to learn more about the retreat.

Gaining a Sense of Hope and Empowerment

Nancy Fish, LCSW, MPH (co-author, with Deborah Coady,M.D. of Healing Painful Sex)
About the Alliance For Pelvic Pain Retreat, May 20-22, 2016, Ellenville, NY

When thinking about registering for the Alliance for Pelvic Pain Patient Retreat, I imagine you are asking yourself “Why would a person suffering from pelvic pain, with more medical appointments than is humanly possible to handle, add another item on an already overwhelming “to do” list?” It would be completely understandable if that is your initial reaction. So why is this retreat a must in your path to physical and emotional healing? There are so many reasons why this retreat can be a life-altering event but I’ll just name a few compelling ones. As a psychotherapist who specializes in pelvic pain (I am also a pelvic pain patient) the primary challenges I hear from most of my clients are:

There's a lot going on in the world of pelvic rehab, and continuing education is no exception! This March, Herman & Wallace is hosting NINE courses around the country. It's a lot to keep up with, so we thought you might appreciate a brief overview of what's coming up next!

Where's this pain coming from?

Pelvic pain can have many sources, and Elizabeth Hampton wants to help you quickly get to the source. Finding the Driver in Pelvic Pain empowers you to play detective in order to help even the most complex patients. Don't miss out on Finding the Driver in Pelvic Pain in San Diego, CA on March 4-6, 2016

What goes in eventually comes out

How important is a good diet? For most of us eating healthy is important, and for many pelvic rehab patients it is a necessity. That's why Megan Pribyl wrote her "Nutrition Perspectives for the Pelvic Rehab Therapist" course. This beginner level course is intended to expand the your knowledge of the metabolic underpinnings for local to systemically complex disorders. Don't miss out on Nutrition Perspectives for the Pelvic Rehab Therapist - Kansas City, MO - March 5-6, 2016!

Kelley Thibault PT, NCS is an outpatient rehabilitation pro, having more than two decades of experience in that setting. She is a recent convert to Pelvic Rehabilitation, however, and she's jumped in head first! Her practice has shifted in that direction and she has four Herman & Wallace courses under her belt in just the last two years. We reached out to see what lessons she could share with us, and she was kind enough to give us her time today. Welcome to the field, Kelley!

Tell us a bit about your clinical experience:
I have been a physical therapist for 22 years and spent much of my career working in a hospital based outpatient clinic treating primarily neurologic diagnoses. I have worked in a transdisciplinary neurologic program for much of this time. I received my NCS from the APTA in 2004 and recertified in 2014. Over my career I have had an interest in Women’s Health Physical Therapy and attended a course with Holly Herman in the early 1990’s. I began treating more Women’s Health clients about 2 years ago to cover a maternity leave. 75% of my practice now is Women's and Men’s Health. I attended the pelvic floor level 1, 2A, 2B and 3 courses over the past year and have found them to be invaluable!!! I also have taken many of the pelvic courses on MedBridge.

What/who inspired you to become involved in pelvic rehabilitation?
I find it most rewarding to work with women who are postmenopausal and are experiencing dyspareunia and stress and/ or urge incontinence. I find with some education and behavioral modifications these clients can experience gains after the first visit. I also have enjoyed working with the chronic pelvic pain clients who require internal pelvic floor and myofascial work and seeing them return to function with less pain and more confidence.

This week we end with a fantastic interview with our featured pelvic rehab practitioner. Nancy Suarez, MS, PT, BCB-PMD, PRPC just joined the ranks of the elite Certified Pelvic Rehabilitation Practitioners! Check out our interview below:

Describe your clinical practice:
I work in a private practice specializing in women’s and men’s pelvic floor disorders including bowel and bladder issues, prolapse and sexual dysfunction, prenatal and postpartum rehabilitation, pre and postprostatectomy care, and lumbopelvic pain.

How did you get involved in the pelvic rehabilitation field?
As a physical therapist who regularly took continuing education courses following PT school, I happened to be looking for a course that might give me more knowledge to help some of my geriatric patients improve their urinary incontinence. I took my first Pelvic Floor course given by Hollis Herman and Kathe Wallace in 2000, and immediately began to make a difference in many of my patient’s lives.

Happy Tuesday! Today we are fortunate enough to hear from Stefanie Foster, who just earned her designation as a Certified Pelvic Rehabilitation Practitioner! Thank you for your time, Stefanie, and congratulations!

Describe your clinical practice:
I have a private practice specializing in pelvic health and related orthopedic conditions. My clinical practice is infused with my training in yoga, pelvic rehab, women’s functional nutrition, orthopedic manual physical therapy, and movement system impairment syndromes.

How did you get involved in the pelvic rehabilitation field?
I first became curious about the pelvic floor muscles as a consequence of treating orthopedic conditions. No matter what you’re working with in that setting– back pain, hip pain, even shoulder or foot, central stability or the core is of utmost importance. I started to wonder what was going on with the respiratory diaphragm and pelvic floor when we were doing all this abdominal bracing that was (and still is in some circles) all the rage. I arranged a clinical in-service with Susan Steffes to come give us a little overview and talk about how to screen for when someone needed to see a pelvic PT. After that little hour, my interest was piqued and I knew I had to learn more…hence my first H&W class.

Today we get to hear from Sherine Aubert, PT, DPT, PRPC who just earned her certification! Sherine was kind enough to share her story about discovering pelvic rehabilitation.

Tell us a bit about your clinical practice
Men and women across the life span with urogynecological, colorectal, orthopedic, as well as pre and post-surgical cases including sexual reassignment surgeries make up the majority of the population I treat. Most patients are working towards improving their bedroom and bathroom issues including prolapse, urinary frequency, urinary urgency, incontinence, pelvic pain, coccydynia, voiding dysfunctions, interstitial cystitis, vaginismus and dyspareunia. Educating and setting male patients up with pre surgical prostatectomy pelvic floor muscle strengthening programs and as well as improving outcomes of patients who have undergone sexual reassignment surgeries.

How did you get involved in the pelvic rehabilitation field?
I have always had such respect and fascination with the pelvic floor muscles. They are underestimated and overlooked in many physical therapy settings and I feel passionate about changing this! I have made it my goal to educate and empower individuals while making a comfortable environment to ask questions to further understand their anatomy, function and optimize their health.

This week we are proud to feature Christy Ciesla, PT, DPT, PRPC! She just earned her Pelvic Rehabilitation Practitioner Certification, and was kind enough to share some of her thoughts with the Pelvic Rehab Report. You can read the interview below. Congratulations to Christy and all the other PRPC practitioners!

Tell us about your clinical practice:
I am currently coordinating a Women and Men’s Health program at the Miriam Hospital (The Men’s Health Center and The Women’s Medicine Collaborative) in Rhode Island. We are fortunate to be a team of 5 skilled pelvic therapists and to work with the some of the best physicians and surgeons in New England. We work with so many different patients. I am currently most excited about our involvement in a tremendous Cancer Survivorship Program offered here at the Women’s Medicine Collaborative.