The Three Types of Downtraining (And Why They Matter) Artwork

Pelvic PT Rising

Helping pelvic physical therapists improve as clinicians, in their careers or business, and their lives. Hosted by Dr. Nicole Cozean and Jesse Cozean, the founders of PelvicSanity physical therapy and the Pelvic PT Huddle, the podcast explores all aspects of pelvic physical therapy. You'll find the clinical pearls that Dr. Nicole teaches in her continuing education courses, the business and career advice that catapulted PelvicSanity into one of the largest cash-based physical therapy practices in the country, and living life as business owners and pelvic health advocates. And we'll be keeping it 100% real - and having some fun - along the way!

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Pelvic PT Rising

The Three Types of Downtraining (And Why They Matter)

April 14, 2025

🚨 Are you using all three types of downtraining in your practice? 🚨

We often talk about "downtraining" without fully defining what it is—or recognizing that there are actually three distinct types. If you’re not considering all three, you’re missing key ways to help your patients.

We’re bringing back one of our most popular episodes! While I’m out on maternity leave, we’re replaying some of the most impactful conversations we’ve had on the podcast over the years.

In this episode, we break down:
✅ Pelvic Floor – Direct – Hands-on techniques, biofeedback, and other direct interventions.
✅ Pelvic Floor – Indirect – Treating surrounding structures like the hips, glutes, and breath mechanics.
✅ Central Nervous System – Addressing the brain-body connection, pain science, and autonomic regulation.

Each type of downtraining requires different techniques—and knowing which one to prioritize can get your patients better, faster.

If you’ve ever felt like “downtraining” is a vague, overused term, this episode will give you clear, actionable strategies to make it more effective for your patients!

Downtraining Masterclass

If you'd like a deep dive into downtraining, make sure you check out the Downtraining Masterclass! (www.pelvicptrising.com/downtraining).

It's targeted, bite-sized and (at $47 for lifetime access) incredibly affordable. It's information you'll use with your patients every single day!

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!