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Evidence Informed or Out of Date? | When the research matters

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Physical therapy but make it FASHION

I know what you’re thinking…

“Excuse me, Carrie. You’ve misplaced your metaphor.”

I promise I haven’t! Just hear me out…

We all know how the high fashion that walks down the Paris runways eventually trickles down to the clearance rack at TJMAXX. (I know you remember Meryl Streep’s rant in The Devil Wears Prada.)

It may take months and months, but the cute prairie dress (because THOSE are apparently in again)  we picked up at Target was a hit on the runway SEASONS ago.

Well, that is the SAME cycle of how physical therapy research and practices make their way to the treatment room. 

Most people don’t realize how long it takes to compile research, publish it, then get it to the masses. 

By the time something is in a textbook, it’s probably tragically out of date. 

Clinicians really need researchers to suss out the questions we have. And at the same time, researchers really need us to communicate what we are seeing day to day to make their research relevant. 

Moral of the story, when you hear someone say, “Well, research says this.”, you really need to see how old said research is. 

Beyond that, clinicians are the ones with a voice. It’s up to us to help promote the researchers and their work. Help them find as many subjects as possible. 

It’s a collaborative effort. 

I would love to hear from you. If you’re a mom do you just assume your clinician is up to date on the research? If you’re a Pro, is it important to you to stay up to date on the research? What does “evidence informed” mean to you?

Prolapse, Hormones & Urogynecology Dr. Jocelyn Fitzgerald

Prolapse, Hormones & Urogynecology Dr. Jocelyn Fitzgerald

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Today I speak with Dr. Jocelyn Fitzgerald, Assistant Professor Urogynecology and Pelvic Reconstructive Surgery, University of Pittsburgh. Recently, she had a tweet go viral talking about what a terrible job we do about educating women about their bodies and we unpack that in our conversation. We have a candid conversation about prolapse and why so many professionals think women shouldn’t be education about the possibilities BEFORE they are pregnant. Jocelyn talks about how patients can find the right type of provider to care for the symptoms they are experiencing. So much has changed over the years with how women get care for prolapse. We talk about those changes and current options that exist.  

Jocelyn is committed to equity in women’s health and supports the Magee Women’s Research Institute. If you’d like to donate to women’s health and know that the funds are going directly into the hands of real scientists on a singular mission of bringing women’s health to where men’s health has been for 100 years, the Magee Women’s Research Institute is doing just that. 

We  talk about:

-educating women about their bodies

-stages of pelvic floor prolapse

-the role age plays in experiencing prolapse

-the brain’s interpretation of pain and sensation

-when pessaries can help 

-tailoring care for each patient

-outreach

Time Stamps

1:00 education decreases anxiety 

4:00 common types of prolapse and the spectrum

9:30 how people experience prolapse differently

15:28 navigating options for care and pessaries 

22:00 how options have changed

28:45 advice for women in postpartum 

CONNECT WITH CARRIE

IG: https://www.instagram.com/carriepagliano/

Website: https://carriepagliano.com

CONNECT WITH JOCELYN

IG: https://www.instagram.com/jjfitzgeraldmd/

Twitter: https://twitter.com/jfitzgeraldMD

Website: https://www.obgyn.pitt.edu/people/jocelyn-fitzgerald-md

Magee: https://mageewomens.org/support/ways-to-give

The Active Mom Postpartum Podcast is A Real Moms’ Guide to Postpartum for active moms & the postpartum professionals who help them in their journey.

This show has been a long time in the making!

You can expect conversation with moms and postpartum professionals from all aspects of the industry.

If you’re like me, you don’t have a lot of free time (heck, you’re probably listening at 1.5x speed), so theses interviews will be quick hits to get your the pertinent information FAST!

If you love what you hear, share the podcast with a friend and leave us a 5 start rating and review. It helps us become more visible in the search algorithm! (Helps us get seen by more moms that need to hear these stories!!!!)

Watch Episode on YouTube:

Listen on Buzzsprout:

postpartum body changes prolapse words matter

Words Matter! | Let’s talk about postpartum body changes

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“Damaged”

“Broken”

“Oh, no!”

And my personal favorite…

“I’ve never seen anything THAT bad.”

Words matter! 

Especially in the context of postpartum issues, specifically prolapse. 

I was talking to a client who had surgical intervention and she was told by the doctor that things were “damaged”.

Now THAT’S a heavy word choice.

Damaged to me means broken, things won’t get better. That makes me SCARED (which I can tell you can actually make symptoms worse, if your problem is overactivity)

IT DRIVES ME NUTS!

Providers, we really need to watch what we are saying to patients because we are scaring them! 

Imagine, if you think you are damaged beyond repair, are you going to hold out hope for a return to normalcy? NOPE. 

We are just making an already hard thing even harder for moms. 

A lightbulb can be broken. 

Your can can be broken. 

A mom CANNOT be broken!

We need to be cognizant of the words we are using when we are talking to moms about the changes that have happened with their postpartum bodies. 

Share with me, what experiences have you had with these situations?

Postpartum Pelvic Floor PT with Dr. Sara Tanza, PT

Postpartum Pelvic Floor PT with Dr. Sara Tanza, PT

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Today I speak with Dr. Sara Tanza, a physical therapist who runs her own practice “Pelvic Potential”, in Aptos, California. After suffering a running injury while competing on the Triathlon Team at University of California, Santa Barbara, she saw first hand how physical therapy helped get her back into racing again sparked her interest in this career path.

Dr. Tanza switched out of the hospital setting to work in outpatient physical therapy.  Soon after, Dr. Tanza began to dive deeper into the world of Pelvic Floor physical therapy, realizing very quickly that it was a much needed tool for an underserved population.

Dr. Sara and I share the sentiment that the functional aspect of pelvic floor physical therapy is the where the power lies. We really have a great conversation. You don’t want to miss this interview!

We  talk about:

-finding her way to pelvic floor physical therapy

-the collision of pelvic floor health and athletics

-expectations in childbirth

-symptoms occurring later in postpartum

-using symptoms as a warning light

-dispelling shame around the pelvic floor

-how things will change in the future

Time Stamps

1:00 introduction

7:05 common challenges to moms returning to athletics

10:15 expectations in childbirth

19:15 finding other issues through pelvic floor issues 

28:00 changes in treatment

34:30 the future of pelvic floor PT

CONNECT WITH CARRIE

IG: https://www.instagram.com/carriepagliano/

Website: https://carriepagliano.com

CONNECT WITH SARA

IG: https://www.instagram.com/pelvicpotential/

Website: https://pelvicpotential.com/

The Active Mom Postpartum Podcast is A Real Moms’ Guide to Postpartum for active moms & the postpartum professionals who help them in their journey.

This show has been a long time in the making!

You can expect conversation with moms and postpartum professionals from all aspects of the industry.

If you’re like me, you don’t have a lot of free time (heck, you’re probably listening at 1.5x speed), so theses interviews will be quick hits to get your the pertinent information FAST!

If you love what you hear, share the podcast with a friend and leave us a 5 start rating and review. It helps us become more visible in the search algorithm! (Helps us get seen by more moms that need to hear these stories!!!!)

Watch Episode on YouTube:

https://youtu.be/oTPhR1ALg6o

Listen on Buzzsprout:

is there perfect running form

Should we stop trying to have “perfect form”?

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Can “perfect” running form cause leakage?

Does that question even make sense?!?

Well, hear me out and then decide. 

I was talking to a mom about her experience with a physical therapist she went to see for some hip pain. Her kids are older, so she’s definitely not in the “near postpartum” window. She never experienced any pelvic floor issues, until she tried to follow a running form cue from this physical therapist. 

She tried to “fix” her form and now she has leakage when she runs!

Thankfully, that PT sent her to see me. (See? You ALWAYS need to have a referral system in place when it’s out of your scope!)

I talked to her about her symptoms and when she experienced them, and we were able to determine that trying to change her running form caused her to create more downward pressure. 

We are seeing some new research about professionals being unable to reliably identify which runners are efficient and which aren’t. If we, as professionals, aren’t able to pick out which runners are efficient, should we really be telling people they are running wrong?

If we are trying to change a mom’s running form to be more “efficient”, and in doing so cause them to experience pelvic floor symptoms, is it even worth it?

Has this happened to you, as a provider or a client?

Do you think there is a right way to run or specific cueing?

Do we know as much as we think we do? Do we understand the impact on other symptoms?

pelvic organ prolapse

Does Prolapse Need to be Terrifying?

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It’s talked about the least and feared the most…

PROLAPSE.

When I have conversations with moms about prolapse, the word I hear most frequently is “fear”.

The first time I learned about prolapse was in my very first pelvic health class and the idea that organs could just exit your body…well… my mental image went to that scene in the movie Alien (you know the one). 

Then, SURPRISE! 

After I had my children, I experienced prolapse and prolapse symptoms (even though I had two c-sections and you’re “not supposed to” have prolapse with c-sections. 🙄)

But we don’t talk about it because we’re afraid of it. So, the mystery surrounding prolapse only exacerbates the fear. 

It’s a vicious cycle.  

We were taught as providers that if strengthening exercises didn’t work, then the only way to fix a prolapse was surgery. 

But it’s way more complex than that! 

I’ll be talking more about it here soon. I would love for other providers to share their stories with me.

Tell me about your introduction to prolapse. 

Did you experience it yourself?

How do you address it now?

And moms, what was your experience of care and did it work?

How we perceive prolapse probably plays heavily into our prognosis. 

the secret youre missing

The Key to Postpartum Success

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It’s the time of the year when I really start thinking about transitions and the overwhelm that comes with them.

Summer is ending. New school schedules. Moves to new parts of the country. New jobs. 

It’s bananas, right? It can be so difficult to stick with a routine or a habit through a transitional phase. 

But the secret is consistency and showing up however you can. It doesn’t have to be perfect. You just have to keep showing up.

Sure, there is some trial and error involved (you won’t know it doesn’t work until it doesn’t work). 

Yeah, it’s a little boring sometimes, but it works. It’s allowed me to get in strength training a few days a week. It’s allowed me to get in my Sunday Runday. 

If you need help walking through that, or your current provider just hands you a list of exercises to do and expects you to magically figure out how and when to do them, reach out to me!

This is something I do with my clients to MAKE SURE they have all the tools necessary for success. We sit down and map out every single exercise and when it’s going to happen. We program EXACTLY what they need, no more no less.



supermom or meh

Are Moms Superhuman?

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Well, this was unexpected.

An article just came out in Sport Medicine, where the author investigated the idea of mom athletes not being superhuman…just regular human. 

I asked all of you over on Instagram whether you agreed or not and 75% said “superhuman” and 25% of you said “meh”.

I needed to hear more from the “mehs”.

A lot of you spoke to the double-edged sword that comes with being a “supermom”. 

And I get it. I remember those days of The Hustle being glorified. 

Do ALL of the things. For EVERYONE. All at ONCE!

But I think the tide is finally shifting. We finally have examples of female athletes returning to their sports after having a child, and returning at an incredibly high level. 

And while we ‘re cheering on these mama athletes, all of us know deep down inside what a shit show it has to be for these moms learning how to mom while having to perform at a high level. 

Just because you think I’m supermom, don’t add more to my plate. 

CAn we live in a world where we value our mothers and their performance in other areas, while also NOT expecting them to be perfect all the time?

That’s the challenge. 

And there’s no roadmap. 

WHen you’re trying to navigate life as a new mom, with a new roll, and a new body, you deserve the support to get back to a semblance of yourself without the unattainable expectations of the term “superhuman”,

I would love to hear from you. How do YOU navigate being that ideal with the realities of being a new mom? Especially, if you’re in the first 5 months where you’re still in the weeds. HIT REPLY to this email and let me know!



game changer or deal breaker

Embarrassing Pelvic Floor Moments

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Pee gushing into your sock as you frantically chase your 2 year old across the playground…

With your newborn strapped to your chest & your pooch in hot pursuit?

We’ve all been there!
​​What did it take for you to finally ask for help because you were peeing your pants. Or you felt like your uterus was falling out? Or that your abs were split wide open?

At some point, we all get fed up. 
At the beginning of the pandemic, I was feeling all of the stress and all I wanted to do was go for a run to relieve some of that stress. I got about 200 meters down the road and I had to stop and ask myself if the stress relief was worth the symptoms I was experiencing. 

  • Public bone pain. 
  • ​Urgency with urination. 
  • ​Super tight pelvic floor. 

​
​All of the greatest hits. 

It would have been really easy for me to say “Screw this, I’m out.” But because of my profession, I knew the why behind my symptoms. I knew I needed to get back to my relaxation exercises.

But not everyone is a pelvic floor physical therapist, so not everyone has the luxury of being able to troubleshoot the why behind their symptoms. 

I’ve had so many women come to me with stories of running across the playground with their children and peeing themselves. Or having to know where all the nice bathrooms are along the turnpike. 

What was it for you? What was your worst mom moment? What made you  FINALLY decide to ask for help?


pelvic prolapse confusion

The RIGHT Information from the RIGHT Provider

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This information given to you by your provider is incredibly confusing. 

Let’s back up the truck a minute. 

I was talking to a client who had just had prolapse surgery. And it sounds like she got the same advice she would have gotten if she were postpartum and had prolapse. 

Vague and confusing. Leave her frozen, because she doesn’t want to mess up anything. 

Here is what we know for sure: at 6 weeks, we generally have about 75% soft tissue healing. But what does that actually mean?

Do I…

Go for a swim?

Take a walk?

Light exercise?

None of that is helpful because each of those things can be wildly different for different people.

They are all context dependent. An easy run will be very different if you’re dealing with a former collegiate runner than it will be if you’re talking to someone who hasn’t ran in 10 months. 

As clients, we expect our providers to give us instructions because they are the medical experts! But quatifying “go for an easy run” is NOT their area of expertise. We think they have the exact criteria, but they don’t. This is where you need to seek advice from someone who understands dosing of exercise, progression of exercise, what other issues may be playing into the why behind their symptoms. 

That’s the stuff that’s incredibly important but it’s not your OBGYNs job! That’s my job! 

If you have questions that aren’t being answered by your OBGYN, that’s your cue to find someone who is knowledgeable about the sport you want to return to. 

The confusion comes because you’re asking someone who isn’t an expert in this area. There isn’t a lot of research, just clinical guidance

You have to find a rehabilitation provider who understands the whole picture AND the sport you want to return to.

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