Did you know more than one third of women in the United States suffer from a pelvic floor disorder, which can include urinary incontinence, painful sex, bowel symptoms and pelvic pain? But unfortunately a great number accept their symptoms as a normal consequence of childbirth or aging. Worse yet, some care providers even them shrug off as such. And while pelvic floor disorders are all too common, they are not normal. That's why Jessica McKinney co-instructor of our new Manual Therapy and Pregnancy course, founded Share Mayflowers, a public health and awareness campaign focused primarily on the under-discussed topics of female pelvic and perinatal health.
At CSM this year, the APTA Section on Women’s Health awarded its highest honor, The Elizabeth Noble Award, to NAIOMT faculty member Susan Clinton, PT, DScPT, COMT, OCS, WCS.
Our PT Profile Series exists because we think it's important to hear the varying perspectives of professionals across the physical therapy field. Whether it's a new PT school grad just embarking on their career, a master clinician with decades of experience, or a physio working within an entirely different system across the globe, there's value in every unique voice and set of experiences. And today we welcome Lori Forner, a Canadian physio living and working in Australia, and proud member of the #PelvicMafia.
Where do you practice?
My husband is a business partner out of an amazing private practice physiotherapy clinic the heart of Brisbane City, called Axis Rehabilitation. I am fortunate enough to not only contract out of their rooms, but am also part of the Axis team.
What made you decide to become a physio?
During my undergraduate degree at the University of Guelph, Ontario, Canada, I volunteered and then worked as an exercise physiologist in a private practice physiotherapy company and fell in love with their knowledge whilst they also endeavored to fix all my old gymnastics injuries.
Is there an area you’re particularly drawn to?
Pelvic health, also known as continence and women’s health and of course men are included in that as well. Within the pelvic health field, my major interests are persistent pelvic pain and pelvic floor dysfunction within exercise/sport.
Why was the Pelvic Health Podcast launched?
I have had a podcast addiction for three years and always thought it would be fun to do one in my area of physiotherapy. In particular, I struggled on my own at the beginning of my pelvic health career trying to find information and courses within that field. I thought this would be a great way to help anyone interested in this field, in particular access to free education no matter where you are. And my co-host Antony Lo, The Physio Detective, gave me the push I needed to start one when he was discussing a desire to start one. I loved his holistic background in musculoskeletal therapy, and his love for asking questions no one bothers to ask (or is too scared to). Then my brain and excitement took off.
Also, Antony and I admit that it’s also selfish because our interviews are like mini-courses with just the two of us! ;)
What do you see as the biggest issue facing women when it comes to pelvic health?
I still think there is a lack of knowledge not only with patients/the public, but even with all medical and health professionals, that there is a subgroup of physiotherapists that can help with so many dysfunctions. And many of these issues are not confined to women. I think men, more so, don’t discuss issues down there enough.
What do you see as some of the major differences in Canada and Australia versus the US when it comes to pelvic health?
I find the US is much more vocal about pelvic health physiotherapy. I gained a lot of knowledge following blogs early on by Julie Wiebe, The Pelvic Health and Rehabilitation Center, as well as The Pelvic Guru. And then of course when I found Twitter and Entropy Physiotherapy. Not only was their information extremely well put together and free, but they were happy to discuss topics and ideas through social media.
I also think another big difference is the University and outside Uni education in Pelvic Health. In Australia, we now only have two Universities with tertiary education in Women’s pelvic health -- both of which are not within my reach geographically. That leaves only external education courses, of which there are not many around either. So access to extra information seems a bit harder to come by within Australia itself.
What can physios/PTs (and public in general!) be doing to help shine a spotlight on the importance of pelvic health?
I think the more we talk openly and publicly, the more everyone realizes dysfunctions within and around the pelvis are common, not normal, and there is help.
Do you think it's important for physios/PTs to have mentors?
Yes! In particular in this small field that is ever changing as new research continues to come out. I would not know what I know today without the help of the amazing mentors that have given me their time and energy to teach me. I have had some great mentors, in particular Taryn Hallam here in Australia. Not only has she devoted her time and energy into exceptional evidence-based courses, she also provided so much phone support through my early education years in this field. I am so grateful. And some awesome woman (we won’t tell anyone it was Sandy Hilton) gave me great insight into mentoring and how we should be supporting each other learn because we want to and like to do it, not because we get paid for it. :)
Do you think continuing education makes a difference in physiotherapy/PT? Do you think it can affect their quality of work in the clinic with patients?
Holy moly, yes. The only way I got to this point in my career is through continuing education. I couldn’t even watch the birthing video in University! Besides gaining basic knowledge in areas you are unfamiliar with, this is where I find most of the current evidence or evidence I didn’t know existed, as well as the clinical pearls you learn from those that have been there and done that. This is also where I think the quality of the course comes in. I have been to many courses where you learn information, that if you have the ability to process it all in your head and apply practically in your clinic yourself, great…good on ya. But sometimes, and this has been me many times, the clinical advice and experience brought into the course can just click straight away.
I also think it’s a really great way to network with your colleagues. P.S.…there should always be extra time in courses for chatting with friends !! ;)
What are some changes you’d like to see made in physiotherapy/PT in the next decade? How do you think those changes can be achieved?
Of course I would love to see more and more good quality research come out in all fields of pelvic health. I think the more we find our passion, the more of us are willing to want to find the answers. Once you have that drive, you will generally find your way into research pathways, even if it is a case study of n=1 :)
I think SoMe has already started this trend, but I would like to see even more support between colleagues. I know privately we may be “competing” with one another in a business aspect but I think more good comes out of connecting and supporting, rather than talking down or negatively about others. I am sure this happens in every business, in every company and every field. But it’s a pet peeve of mine I see, and being a people lover and a people pleaser at times, I would love for it to change.
I also want to see even more collaboration with other medical and health professionals. Again, SoMe has helped in a way form connections and discussions with fitness professionals, etc. but I still think physiotherapy, in particular pelvic health, is absent in the minds of many medical professionals. If we continue to talk, promote, lecture, attend, and in particular publish research, I think they will hear us.
Do you have a motto or mantra when it comes to your approach to care?
Head down, bum up. No wait, that’s exercise. I guess I just empathize with my patients (albeit sometimes too much) when I sit and listen to their story the first, and every time, I see them. I can’t help but want to do everything I can to educate them so they feel more empowered and understand what is happening to them and how we may go about reaching their goals.
Let's be honest, in this country, the pelvis isn't every PT's favorite region of the body to address, nor is it the public's favorite area to discuss openly. But it's sure one that needs more attention. That's one of the reasons we've recently introduced a new manual therapy course introducing the skills PTs need to treat pregnant women, in particular. One of the creators and instructors of that course, Susan Clinton was recently interviewed by Antony Lo and Lori Forner on The Pelvic Health Podcast. Take a listen below, and keep an eye out for courses coming up in your region!