Kristina Koch, PT, DPT, WCS, CLT is a board-certified clinical specialist in women’s health physical therapy and a certified lymphedema therapist. Kristina has been treating pelvic health conditions in individuals of all ages and genders since 2001 and works in private practice in Colorado Springs, CO. Kristina is a member of the HW faculty with her own course, Pharmacologic Considerations for the Pelvic Health Provider, scheduled next on February 4, 2024.

Why it is Important to Know Pharmacology

All rehab providers need to have a foundational understanding of pharmacology for numerous reasons, all of which contribute to providing safe, effective, and comprehensive care to their patients. In pelvic health, therapists often encounter patients who are taking numerous medications, and it is important for us to understand how these drugs may impact a patient's physical function, exercise tolerance, current complaints, and overall well-being.

Basic pharmacology knowledge includes:

1. Understanding drug classes
2. Pharmacokinetics and pharmacodynamics: how drugs exert their effect on the body and how the body impacts the drug
3. Drug interactions: recognizing potential interactions between medications and how they may affect a patient's response to therapy interventions.
4. Adverse Effects: awareness of possible side effects of medications that could impact a patient's ability to participate in therapy or contribute to their symptoms.

A more comprehensive understanding of pharmacology has clinical relevance on many fronts. The following bullet points highlight how understanding pharmacology has implications for clinical practice.

Assessment:

Pharmacological knowledge allows clinicians to conduct a more comprehensive assessment of their patients. Considering a patient's medication history as part of the overall health profile helps clinicians tailor treatment plans to individual needs and potential limitations.

Safe and Effective Patient Care:

Rehab providers often work with patients who are taking medications for various health conditions. Understanding pharmacology enables therapists to assess potential interactions between drugs and design safe and effective treatment plans.

Optimizing Rehabilitation Strategies:

Medications can impact a patient's response to exercise and rehabilitation. Understanding pharmacology enables rehab providers and therapists to modify treatment plans based on a patient's medication profile, potentially optimizing rehabilitation outcomes.

Pain Management:

Pain is a common reason our patients are seeking physical therapy. Knowledge of medications used for pain management enables therapists to collaborate with healthcare providers to create comprehensive pain management strategies for their patients.

Collaborative Care:

Clinicians often collaborate with physicians, nurses, and other healthcare providers. Knowledge of pharmacology facilitates effective communication, allowing therapists to discuss patient cases, contribute to treatment decisions, and foster a collaborative approach to patient care.

Educating and Empowering Patients:

Pelvic health practitioners and rehab providers play a vital role in educating patients about their health, including medications. Understanding pharmacology allows therapists to explain the purpose of medications, potential side effects, and the importance of compliance, encouraging patient engagement and adherence to treatment plans.

Recognition of Red Flags:

Knowledge of pharmacology enables pelvic health rehab providers to recognize signs and symptoms of adverse drug reactions, identify potential issues early, consult with healthcare providers, and modify treatment plans accordingly.

Informed Decision-Making:

In certain situations, therapists and rehab providers may need to make decisions regarding treatment plans and goals, treatment frequency, or modalities based on a patient's medication profile. A solid understanding of pharmacology contributes to informed decision-making.

Legal and Ethical Considerations:

Pelvic health practitioners need to work within their scope of practice. An understanding of pharmacology helps therapists recognize when it is appropriate to refer patients to other healthcare professionals for medication management.

Monitoring and Reporting:

Monitoring patients for signs of adverse reactions and knowing when to report concerns to other healthcare professionals or federal organizations.

Special Populations:

Pediatrics and geriatrics may require special consideration due to differences in pharmacokinetics and pharmacodynamics. Understanding how medications affect different age groups helps pelvic health therapists and rehab providers adapt our interventions accordingly.

As rehabilitation providers, we invest a substantial amount of time in direct interaction with our patients during their treatment sessions, surpassing the duration they spend with their primary care providers. This prolonged and more frequent engagement, spanning weeks or months, affords our patients an increased opportunity to communicate not only their physical concerns but also their apprehensions regarding medications and potential side effects. This dialogue exceeds what may occur with their physicians or primary care providers. Understanding the impact of medications on a patient is vital for effectively educating them about potential side effects and how these medications may contribute to their complaints, thereby augmenting the overall value of the treatment regimen.

With a solid grasp of pharmacology and insight into medications prescribed for pelvic health, therapists can engage in informed discussions with patients and collaborate effectively with other healthcare providers involved in their care. The capability to explore recent medications, supplements, or alternative approaches that may minimize side effects, mitigate impacts on quality of life, and enhance function. Remaining current on advancements in pharmacology is indispensable for delivering physical therapy interventions that are both effective and grounded in evidence-based practices.

In summary, a strong understanding of pharmacology enhances the overall quality of physical therapy practice. It ensures that physical therapists and rehab providers can provide patient-centered, evidence-based care while collaborating effectively within the broader healthcare team.

Join Kristina in Pharmacologic Considerations for the Pelvic Health Provider on February 4, 2024, to learn about the medications frequently used in pelvic health, their side effects, the clinical impact they may have on your patients, and possible alternatives to consider to improve patient outcomes and quality of life.

Check out the Herman & Wallace YouTube Channel for the full interview with Dr. Yeni

Dr. Oluwayeni Abraham stumbled into the niche field of fertility. She shares, "I had all of these women who would come in with painful periods that would have significant post-surgical problems and would end up having fertility concerns. As I was picking up my visceral mobilization techniques, I started to see that I was able to help women conceive and help women who maybe have experienced reoccurring miscarriages actually carry to term. That's when I said, "I think I'm doing something here that could be something else." That's when I tried to hone in on the specific skills that were influencing and maximizing the results and outcomes. 

In Dr. Yeni's course, Fertility Considerations for the Pelvic Therapist, she shares manual therapy techniques and a lot of data on hormones, the endocrine system, and other pieces of the puzzle. The language in the fertility world is based on these building blocks. Specific fertility-related diagnoses are discussed that help you formulate a pathway in treatment. Another important thing Dr. Yeni teaches is how to collaborate and work with these other providers that are going to be on this journey with your patients.

When working with fertility it's important to ask ourselves how do we bring value to this puzzle? How do we bring value after someone has had multiple failed IVF cycles? We can't just say we're going to do a bunch of manual work. We also have to speak the language and understand the body in its entirety and how it's playing a role in being able to maximize fertility outcomes. 

When asked what sparks her passion and keeps her so excited about working with this population Dr. Yeni stated, "the outcomes! We're still therapists, and we love to see results."

Fertility Considerations for the Pelvic Therapist - Remote Course

• Feb 5, 2022
• Jun 4, 2022
• Aug 13, 2022
• Nov 5, 2022

This course requires each registrant to have a live model. Due to the nature of labs, please be sure your model or partner is not pregnant and does not have an IUD for safety. Additionally, those with hydrosalpinx will not be able to participate in uterine mobility techniques but can still attend the course.

Herman & Wallace has more than 55 different courses with over 200 individual course events scheduled throughout the year to choose from. Our course catalog is growing all the time with new courses, new instructors, more course dates, and even more satellite locations!

In 2022 there are already six BRAND NEW courses available, with more to be planned. H&W is kicking off the new year strong with Dr. Michael Hibner on January 9th with Pudendal Dysfunction: The Physician's Perspective. Kristina Koch is back in 2022 with her newly updated and reformated course, Pharmacologic Considerations for the Pelvic Health Provider which is scheduled for April 10, July 9, and November 19th.

Do you live near Salt Lake City, Utah? Our first live, in-person course since the pandemic will be there on March 12-13, 2022: Dry Needling and Pelvic Health.

• Disclaimer: Due to the nature of this course content, it will be delivered in the traditional "in-person" manner. This means the course instructors will be teaching at a single location, and it will not be possible to join the course remotely via video conference. As with all Herman & Wallace courses, this course content is only intended for practitioners who are licensed appropriately, and for whom dry needling is within their scope of practice. It is the responsibility of every course registrant to check with their state boards to ensure that the content of a Herman & Wallace course that they attend is within their state-specific scope of practice.

Interested in women's health? There are 3 new courses appearing this year: 

• Perinatal Mental Health: The Role of Pelvic Rehab Therapist - February 5, 2022
• Menopause Transitions and Pelvic Rehab - March 5-6, 2022
• Pregnancy and Postpartum Considerations for High-Intensity Athletics - May 21, 2022

Are you thinking about taking a course, but not sure if it is for you? H&W courses are for licensed practitioners interested in the field of pelvic rehabilitation. The most common registrants that we see in our courses include:

• Doctor of Osteopathic Medicine (DO)
• Doctor of Chiropractic (DC)
• Nurse-Midwives (CNM)
• Nurse Practitioners (ARNP)
• Occupational Therapists (OT)
• Occupational Therapists Assistants (OTA)
• Physical Therapists (PT)
• Physical Therapists Assistants (PTA)
• Doctor of Medicine (MD)
• Physicians Assistants (PA)
• Registered Nurses (RN)

H&W courses are classified as Beginner (no prerequisites), Intermediate (one prerequisite), or Advanced (two or more prerequisites). A Beginner course can be taken by a licensed practitioner without prior coursework requisites. Therapists interested in registering for an Intermediate or Advanced course must review the prerequisites on the course description and honestly assess/report their fulfillment of the published prerequisites.

For example, courses that have Pelvic Floor Level 1 as a prerequisite require a working knowledge of performing internal assessments. It is never recommended that a participant skip this introduction without prior training or experience performing an internal exam. Some courses are part of a series and it is not recommended that they be taken out of order. On the Continuing Education Courses page, you can click the Experience Level tab to see courses organized by level of difficulty.

Clinical experience or alternative coursework may be a substitute for the published course requirements, and it is recommended that a therapist considering opting out of a published prereq review the objectives of the required course and assert that said objectives have been met. Review the Course Overview and Objectives on each course page and ask yourself what your treatment goals (in both the long and short term) are and what patient population you are targeting. All courses list the learning objectives, which will give you a lot of information about what you'll be learning at a given course.

If you would like additional guidance on which course offering best fits your goals and target patient population, please contact us! We are here to guide you into an event that best suits your needs.