The hip flexor muscles include the Iliopsoas group (Psoas Major, Psoas Minor, and Iliacus), Rectus Femoris, Pectineus, Gracillis, Tensor Fascia Latae, and Sartorius. When the hip flexors are tight it can cause tension on the pelvic floor. This can pull on the lower back and pelvis as well as change the orientation of the hip socket, lead to knee pain, foot pain, bladder leakage, prolapse, and so much more. The ramifications of iliacus and iliopsoas dysfunctions are discussed in Ramona Horton's visceral course series:

• Mobilization of the Visceral Fascia: The Gastrointestinal System
• Mobilization of the Visceral Fascia - The Urinary System
• Mobilization of the Visceral Fascia - The Reproductive System

You can also learn about this in a contemporary and evidence-based model with Steve Dischiavi in his Sacroiliac Joint Current Concepts and Athletes & Pelvic Rehabilitation remote courses.

A common issue with the iliacus and hip flexors is that they can shorten over time due to a lack of stretching or a sedentary lifestyle. When this happens, the muscle adapts by becoming short, dense, and inflexible and can have trouble returning to its previous resting length. A muscle that resides in this chronic contraction can become ischemic, develop trigger points, and distort movement in the body.

The following is our interview with Mahmoud Shalaby, PT, MS, DPT, PRPC. Mahmoud recently passed the Pelvic Rehabilitation Practitioner Certification (PRPC) exam. He practices at PT of The City in Brooklyn, NY, and is a Teaching Assistant for local New York satellite courses with H&W. Mahmoud was kind enough to share some thoughts about his career with us. Thank you, Mahmoud - and congratulations on receiving your PRPC!

In 2016, I was offered the chance to shadow a senior PT who specialized in pelvic rehab. This specialty was mysterious for me. I didn't think that there was much we could offer to patients with pelvic issues like incontinence, prolapse, IC, and such until I started to treat them. Once I commenced learning more, it never ends.

There is always more to discover and I've always been impressed with the role of physical therapists in assessing and treating pelvic issues. I continue to be very excited to learn more and to develop my experience while further participating in studies to improve my skills and tools in improving people's quality of life.

How do healthcare practitioners improve patient satisfaction? Patient satisfaction is a cognitive evaluation of an emotional reaction to their health-care experience. According to multiple studies, the most significant predictor of patient satisfaction is the quality of their conversations with their medical practitioners.

Patients care about:

• Being listened to
• Being treated courteously and respectfully
• Being involved in decisions about their healthcare
• Receiving clear explanations about their medical status and treatment

This is good news because they are all factors that you can control. Practitioners who take the time to communicate clearly, listen intently, understand each patient as an individual, and respond compassionately can improve their patients’ satisfaction and treatment outcomes. As Lauren Mansell stated in an interview with H&W, you have to “know what questions to ask patients for treatment. Our patients often feel alone, are frustrated with medical treatments, and feel like no one can address their symptoms.”

This blog contains an interview with Alyson N Lowrey, PT, DPT, OCS. Alyson treats the pelvic floor patient population through an orthopedic approach, working closely with pelvic floor specialists. Alyson’s clinical interests include evaluation/treatment of chronic pain, lumbar and cervical spine disorders, foot and ankle disorders, pelvic pain, and clinical instruction. Alyson is the co-instructor for the new H&W course, Pain Science for the Chronic Pelvic Pain Population - Remote Course scheduled for July 17-18, 2021.

Q: Who are you? Describe your clinical practice.

A: I work in an outpatient hospital-based clinic where I am able to provide true 1:1 care to patients of all ages and orthopedic conditions. Since pelvic floor therapy came to our clinic, I have developed strong clinical and personal relationships with pelvic floor therapists. We have been able to successfully combine our respective expertise into a wholistic approach for improving patient’s functional outcomes. My knowledge and relationships with pelvic floor therapy have allowed me as an ortho clinician to recognize when a patient’s dysfunction may have a pelvic floor component and refer appropriately. I am also in a unique opportunity where my pelvic floor colleagues will co-treat or transition care of a patient to me to continue to improve their overall function by providing functional strengthening and neuromuscular re-education to the pelvic floor musculature and other supportive muscular systems. This relationship also allows us to treat comorbid orthopedic conditions and pelvic dysfunctions such as low back pain or SIJ dysfunction as well.

Herman & Wallace currently has satellite courses, remote courses, and online courses offered through our partner, Medbridge. These online courses provide education and patient engagement tools for pelvic floor dysfunction. H&W faculty have put together a collection of online continuing education courses with our partners at MedBridge. These convenient learning resources and can be purchased individually or as part of an annual subscription

The truth is that we all have hectic busy schedules that can make setting aside time for a live course can be difficult. Annual subscribers get access to all 800+ courses on the Medbridge site, their Home Exercise Program, and Patient Engagement platforms! As a Herman & Wallace referral, you are eligible for a discounted subscription with access to all of the content at MedBridge with promo code HWoverview.

Heather Rader, PT, DPT, PRPC, BCB-PMD recorded a new series for Medbridge last summer. Her courses explore:

The following is our interview with Jazma Dobbins PT, DPT, PRPC, CAPP-Pelvic. Jazma recently passed the Pelvic Rehabilitation Practitioner Certification (PRPC) exam. She practices in at TherapySouth in Gadsen, AL and is a Teaching Assistant for local Alabama satellite courses with H&W. Jazma was kind enough to share some thoughts about her career with us. Thank you, Jazma - and congratulations on receiving your PRPC!

Q: How did you get involved in the pelvic rehabilitation field?