How I Went from Ortho to Pelvic Floor PT

Sarah Clampett, PT, DPT, is Head of Clinical Operations at Origin, a leading provider of pelvic floor and whole-body physical therapy with a special focus on pregnancy and postpartum. After studying Kinesiology and Psychology at the University of California, Sarah stayed on to earn her Doctorate of Physical Therapy. As a clinical leader at Origin, she’s as passionate about helping PTs love the work they do as she is helping patients feel good in their bodies.

Shortly after I started physical therapy school, I realized that being a physical therapist is a fantastic conversation starter. People’s eyes tend to light up when they hear I’m a PT because almost everyone has had an experience with physical therapy — and even if they haven’t, they’ve had an injury. They want to tell me about the physical therapy they did in high school for their scoliosis or that time they tore their ACL skiing. They even seek advice for that pesky low back pain that hasn’t fully resolved since throwing their back out six months ago. 

I love to hear people’s stories and genuinely enjoy engaging in casual conversations about injuries. When I’m done explaining that core strength is important when dealing with back pain, I go on to say that while I started my career in ortho, I’m now a pelvic floor PT. That’s when one of two things happens: 1) They stare at me blankly, then quickly change the subject, or 2) Their eyes light up even brighter and they start asking questions. That’s when the conversation gets really fun. “What exactly do you do?” “What do you treat?” and “How did you get into that?”

Where My Passion for Ortho Started
I decided to go to PT school for a couple of reasons. I’ve always loved sports and consider sports a large part of my upbringing. (Fun fact: I only listened to AM sports radio until I was about 13). And, like many PTs, I discovered physical therapy as a patient. In my case, it was after injuring myself in high school playing volleyball.

I loved going to PT, not only because I was getting better — I loved seeing all the other patients getting better around me. It was a very sports-oriented PT clinic and my first and only experience with PT, so when I declared Kinesiology as my major and started my pre-PT coursework in college, I had my heart set on being a sports/ortho PT. It felt like the perfect fit at the time. I was a student athletic trainer for 2.5 years in college to learn as much as I could about the sports rehab world before heading into PT school.

Fast forward to my final semester and clinical rotation at PT school: I was at an ortho clinic with a large population of athletes. I loved it. After I graduated, I was hired as a PT at that same clinic and started my career as a working PT. I began working a few days a week to build my caseload with the plan to transition to full-time as my schedule filled. That clinic happened to also own a women’s health clinic that treated primarily prenatal and postpartum patients. A few weeks after starting, I was asked if I wanted to work additional days by filling in at the women’s health clinic. As a new grad who needed to pay rent, I said yes because more days meant more money. It was supposed to be temporary.

My Journey to Becoming a Pelvic Floor PT
As soon as I walked into the women’s health clinic, something clicked. I fell in love with the patient population and helping them feel better. I remember early on, a patient with such severe pelvic pain that they could barely walk to the bathroom. At their next visit, they said they could walk without pain again. The ability to help people going through pregnancy and postpartum felt especially meaningful. I spent a year and a half working in both clinics and then transitioned to treating women’s health full time.

After working in women’s health for a couple of years, I eventually got tired of referring my patients with pelvic floor conditions to colleagues who treated pelvic floor and decided it was time to start treating it myself. To be honest, I was hesitant at first and definitely nervous about taking my first course. But as soon as I started treating the pelvic floor, something clicked again.

Even more so than in the past, I connected deeply with my patients and their goals. Giving someone the confidence to leave the house without wearing a maxi-pad or carrying extra underwear because they’re no longer worried about leaking was amazing. So many people suffer in silence from pelvic floor disorders and are resolved to just live with them. I’m lucky enough to provide a safe space to talk about it and assure them that it can get better. How cool is that?  

Advice for an Ortho PT Curious About Pelvic floor
Take a course! Just because you take the course does not mean you are committing to a career change. Even if you decide it’s not the right time to switch or you didn’t enjoy it as much as you thought you would, you’ll still learn valuable information that you can immediately incorporate into your practice. That overworked, stressed patient with lingering hip pain might need pelvic floor lengthening to get that last bit of pain to resolve.

Most ortho PTs who make the shift are nervous they won’t be able to use their ortho skills when treating the pelvic floor, and that simply isn’t true. My time in ortho has definitely shaped the pelvic floor PT I am today.

In ortho, you treat the whole body. If your foot hurts, you look at the knee, the hip, the low back, and how everything works together to figure out what’s causing the foot pain. Pelvic floor PT is no different. You must look at the whole body and figure out how all the parts are working together to get the results you need. I continue to use many of the same exercises now that I used back when I was working as an ortho PT.

Lastly, the pelvic floor is a group of muscles. If it’s weak, it needs to strengthen. If it’s overactive, it needs to lengthen. If it’s uncoordinated, it needs to be retrained. Yes, treating pelvic floor dysfunction requires special training, but at the end of the day, muscles are muscles.