You Know More Than You Think You Know

Hi, welcome to the Pelby Biz Podcast. Are you a pelvic health PT or ot struggling to start your own practice? This podcast helps pelvic health PTs and OTs get out of debt, gain the income they desire, be able to treat patients without insurance restraints, and learn how to create time freedom for yourself and your family. I'm your host, Dr. Kelly Alhui, founder of Ortho Pelvic Physical Therapy, Pelvic health Business Grower and Pelvi Biz. Over the last two years I went from a solo entrepreneur to a seven person team in counting. I'm here to help provide a clear path to grow your pelvic health business as fast as possible so that you can gain the time freedom, decrease debt, increase income and live the life that you desire. Before we get started today, make sure you click the link in our bio to grab your ticket for pelvi Biz. Now let's get into today's episode.

What's up guys? Welcome to Pelviz Podcast. I'm your host, Dr. Kelly Alhui. Today, this one may strike a nerve with people. Today I'm going to talk about imposter syndrome and how to overcome that and how to progress in the pelvic health world. So, so many people that I've coached so far have kind of gotten into the pelvic health world through the orthopedic realm. Not always, but most have and then have gone into pelvic health. And a lot of times what I'm finding is a lot of people are saying I have imposter syndrome, which basically they feel that they don't know enough. And I'm here to tell you that's not the case. I believe that anyone that has been through PT school can be a pelvic health physical therapist 100%. And I find that it's pretty easy. I have coached lots and lots of pelvic health pts, especially in my clinic. And then just in general, I was always a CI and you know, I've been practicing now for 12 years, so I have done a lot of teaching when it comes to pelvic health. And what I have found is people are like, oh, it's pelvic health. Like somehow it just seems like they feel like they can't use our orthopedic background and that is definitely not the case. And yes, there's different diagnosis and pelvic health, whether or not you're dealing with chronic pain versus a higher level athlete with leakage, it all actually is pretty much the same. And what I mean by that is it's all comes down to function. So all you need. Let me just go back to this. All you need is a level one, like Herman and Wallace class to get started with pelvic health. And the reason why I just say you need that is because they teach you how to perform an internal exam. Other than that, I believe this may be, you know, this may not be your belief, but this is my belief. I believe anyone can do pelvic health if they know how to perform an internal exam. And in, you know, when treating pelvic health patients. Okay. And I do believe that you need to do an internal assessment. That is my belief and I'll tell you the reason why in a minute. But I do believe that. So let's just say I took my Herman and Wallace Level 1 course. They teach you how to do an internal exam. Now, when it comes to pelvic health, if you break down every single condition, prolapse, leakage, pain with intercourse, hernias, tailbone pain, I see endometriosis, all these things, if you really break it all down, it's all about decompressing tissue, lifting the tissue, pressure control, pretty much, that's it.

Decompressing the tissue and pressure control.

It really comes down to that. So if you know how to work on the abdominals, and if you don't know how to work on the abdominals, it's really not that hard. If you know how to do any skin rolling technique, which we all, I think, have learned in school, how to lift the tissue. If you know how to lift tissue, you do that on the abdominal region, you do that on the inner thigh, you do that on the perineal body, maybe on the labias externally, maybe on the external tissue vaginally or around the rectum. And even males, I work on that perineal body for sure. And then also, you know, get in on the surrounding tissues as well. So it's all about decompression. It is. Doesn't take much to learn how to work on the pelvic floor. That's just externally. And I love an. I love external manipulation. I think it's very, very effective. And then if you know how to do the internal exam with your finger, besides lengthening the pelvic floor muscles, you can also evaluate pressure. For every single person that walks into my office, we do, I have them squat with my finger internally standing up. I have them cough, sneeze, laugh with my finger internally as they're standing up, I have them do tasks, functional tasks that actually I can see if they're controlling the pressure because if they have a prolapse, it's a pressure issue. If they have a hernia, it's a pressure issue. If they have leakage, more than likely it's a pressure issue and potentially muscle guarding. If they have tailbone pain, typically a lot of times it's muscle guarding and, or a blunt force or childbirth. Right. What else? Typically it comes down to the muscular skeletal system and pressure. That's. I'm really breaking this down, guys. Very, very basic. So if I pull in my orthopedic background, which the hip is the pelvic floor and the pelvic floor is the hip. That's why we call orthopelvic, because everything that's orthopedic goes into the pelvic floor. We don't just chop the body in half. Then you're actually treating the diagnosis of any pelvic floor issue from a whole holistic, whole body approach rather than just the pelvic floor. So someone just had, let me just say leakage and I'm only working on their pelvic floor and I'm treating nothing else like getting them back to function. I believe we're doing a disservice. So if you are someone thinking I just have an orthopedic background and I just potentially just took a Herman and Wallace level one course, I don't know anything. You actually know so much more than you think. And it's very simple. When we break it down, pressure control issues, which, how do we solve that? It's all about breath, work with movement, breath, work with movement. I'm going to repeat that. Okay. That's how we solve pressure control issues with the correct muscle activation as well. Right. And then how do we solve tightness in a muscle? Well, first there's a couple of phases. You got to lengthen the muscle, then re educate the muscle, then put it in a functional task to then be able to do the thing that you want without it going back into protective, protective mode. Right. So this is kind of the process and I teach my patients that and I teach PTS that or OTs. This to be able to recognize it's really not that much different than a orthopedic exam. The only difference is, I always say is that we can wash both sides of the window, which means I can work externally on their glutes or their perineal body or their adductors. And I can also then work internally and get to those deep external rotators and or the superficial muscles. As well. And, and that's the positive about doing internal work, I believe is that you can again wash both sides of the window. So when it comes to imposter syndrome, there's honestly not too much that you have to know. Except for those things that I just mentioned. That's it. That's literally it. And I believe, and I believe that a lot of times these courses, well, no offense to any of these course people because I do believe that there is a place for them. But I do believe that a lot of times they overcomplicate things in different diagnosis and sometimes they get too technical or try to put probes in or try to use these fancy little tools. Well, these fancy little tools and these probes a, they cost a fair amount of money. Like some of them cost anywhere between $10 a visit to $50 a visit. Who wants to pay that? On top of that, are they going to be jumping around with their daughters on a trampoline and putting a probe in, being like oh my pelvic floor. It's just so fantastic right now. No. So how then can we do function? I was just talking to one of my mastermind students and they were saying that instead of putting a balloon in rectally to feel the pressure and pressure management of that sphincter, well, why don't you just use your finger and re educate your own self to understand like the feeling of it. You're going to get more feedback from your finger and or if you didn't want to put your finger in rectally, why don't you just place it on the sphincter externally and just have people breathe. We do this a lot for pregnancy. Anyone that's pregnant, we have them glove up. I just give them a glove. They put their finger on their X to external sphincter and I have them inhale and I say, do you feel your finger drop down? And they're like oh yeah. Or they're like oh no, I don't feel anything. Okay, now on the exhale, do you feel your finger come back up? Just so you know, that's your pelvic floor dynamically moving. How cool is that? And they're like wow, that's so cool. I'm giving them a tool in their toolbox to empower them to that at anywhere, at any time that they can actually feel their pelvic floor move. If I gave them a probe that I learned in a pelvic floor course or some kind of tool like that, like it doesn't equate to function and So I want people to really understand that, keep things simple. Breath work is key when it comes to pelvic health, AKA the whole system, from the glottis to the diaphragm to the abs to, to like the cervix and, or testicles or whatever else, you know, in males. Okay. But it's a whole pressure system. And if you know how to control that, it comes down to breath work. That's number one then. And I like to do breath work first on the table, and then we'll do it in standing, and then we'll do it more in dynamic movement, like a squat with breath work or deadlift with breath work. So for us, I have my signature method that we use at orthopelvic, and we hit things in three different phases. So my first phase is lengthening. My second phase is strengthening, and then my third phase is return because I return back to the activity that they had difficulty with. And with this method, I've been able to use in every single diagnosis that walks in the door. So over 20 different diagnoses, we typically treat at orthopelvic. And I've been able to use that because I came up with this method that I started to see that these patterns were happening in the pelvic health and orthopedic world. And I'm like, look, let's break it down. Let's make it super, super simple. First one to four sessions. Typically for every diagnosis, you got to lengthen the tissue. So what do I mean by that? You got to decompress the abdominals. So you can use cups, you can use your hands. Any visceral work. If you don't know how to do visceral work, that's okay. Just lift the abdominal tissue. Basically it helps decompress the bladder, it helps with prolapse. So that's what you want to do. And then you want to re educate. So now the muscles lengthen. Now you want to actually make sure that muscle can actually fire and contract when we actually want it to, instead of it just being, being guarded. Then after that, and that's about visit four to visit eight. Okay. And then after that I like to hit it. From visit 8 to 12 is more of the strengthening phase or the return phase, where we're going back and doing the things that they had difficulty with, which means returning back to running without leakage, returning back to jumping without leakage, being able to squat without hip pain, being able to pick up their child and put them in the crib without any low back pain or Any difficulty or maybe bulging of their abdominals, that's the return phase. So we gotta look at this as more dynamic. I think instead of just being like, oh, it's just the pelvic floor, I just gotta hone in on the pelvic floor. And even like my endo patients and I see patients, I again, I treat it with that approach. I've got a lengthen. They may be in the lengthening phase for a longer period of time because maybe this has been a chronic thing. We know typically it takes about 15 years to diagnose endometriosis. So maybe they're in that lengthening phase longer, but they're still in that phase. Then I have to get them back to function because a lot of them want to, you know, kind of curl up in a ball and stay there and not really move. And they're compressing their abdominals. So I got to re educate that. Then I have to get them back to daily life. What can't they do right now and what is this impeding? And then I get them back to that. Okay, so I just wanted to come on and I'm hoping that this kind of helps with the impostor syndrome of I'm not good enough for pelvic health PT or I've only had this one course. You actually only need one course. And I'm not saying only just take that one course and that's it. I'm saying that you can actually just take that like a Herman Wallace Level 1 and get started in the pelvic health world and be very good at that. If you just understand that it's about breath work, which means pressure control and about lengthening muscles to then be able to re educate the muscle to then get them back to function. And you don't need any fancy ultrasound machines or any probes, anything like that. You just can potentially use your hands and or, you know, your breath. I mean, it's huge. So hopefully this helps guys give you a little bit confidence boost that you can do it. Make sure you're using your orthopedic background because it is one whole system. And when you're treating, please do not just break it up into the pelvic floor. Let's keep moving this field forward. Everyone's doing awesome, so let's just keep progressing forward and treat it when from a multifaceted approach. And speaking on that, before I go, one more thing is this is why orthopelvic has created the puzzle piece. Because I do believe a lot of times it's not just strictly the pelvic floor. And these are what a lot of times these courses are not teaching as well because they're strictly just focused on the pelvic floor. You've got to pull in other providers. So maybe that's a guided imagery specialist, maybe that's a naturopath doctor, maybe it's a nutritionist, Maybe it's a psychologist. Maybe it is a sex psychologist. I mean, the realm can be so big and broad. And I believe to truly help with pelvic floor dysfunction or any kind of, you know, pelvic health issue that you probably have to have between two to three providers on your team. But we should actually be the one providing, you know, that team. Like, we should be creating that team for the patients. And that is what we do at Orthopelvic. We create that team because we. We vetted many of the different providers and we know that, okay, if this person has constipation, we need to hit it from a nutritional component, we need to hit it from a supplement component, and then we also need to hit it from a muscular skeletal component and combine with all three of those things that is going to give us the best outcomes. So that's what I want you guys to think about when it comes to, you know, being a pelvic floor, PT and ot and just how that you can continuously progress the patient forward in a multifaceted approach. But also know that you don't need, you know, 20 different Con Ed classes to feel that you are sufficient enough for this pelvic health world and to treat pelvic health patients. Everyone has a pelvic floor, guys, so hopefully you enjoyed that. Let's get over the imposter syndrome and let's treat patients.

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