"What Brings You In?" What a Pelvic Health Eval Looks Like

• Save the date: 3rd Annual OTs in Pelvic Health Summit is happening August 17-18, 2024!
• Learn more about the first ever Trauma-Informed Pelvic Health Certification
• Pelvic OTPs United -- Lindsey's new off-line community!
• Get Lindsey's 9 page OTs Map to the World of Pelvic Health.
• Meet Lindsey on the OTs for Pelvic Health Facebook Group!
• Check Out More OT Pelvic Health Content here.
• Find Lindsey on IG! @functionalpelvis

More about our 4 amazing panelists:


Jessica Hammond
Jessica became interested in acute OT post childbirth after being an acute care OT for 15 years and seeing a need and perfect fit for OT after having her 3 children. Her manger asked at a staff meeting if anyone wanted to be trained to treat men’s pelvic health and bowel dysfunction and she volunteered! She also started an acute post-partum program and is now a full time Outpatient pelvic health OT.  It’s been an exciting ride and she continues to be amazed how much more there is to learn on this wild adventure. She thrives on changing lives!

How to find her on social: Facebook: Jessica Lynne   /    IG: @Jessica.Alger.Hammond

Jessica Dobson
She is Minnesota girl working and living in the south with two small children and husband. She is a certified reiki and yoga instructor, viscerally trained, functional medicine informed practitioner, pelvic health therapist specializing in digestive health, and a self described health and wellness cheerleader! She is very passionate about guiding and educating patients on their own bodies and nutrition influences digestive in pelvic health. She is currently working on writing a book to inform clients and therapists on the relationship of pelvic health and nutrition! Music and dance is her love language.

How to find her on social: IG: pelvicyogiOT

Meghan Kasper
Meghan is an Occupational Therapist specializing in pelvic health, a massage therapist, and a myofascial release practitioner. She holds certifications through Restore Your Core and The Body Ready Method, and is in the process of finishing her PCES and Birth Healing Certificate. She has a private practice in North

____________________________________________________________________________________________
Pelvic OTPs United - Lindsey's off-line interactive community for $39 a month!
Inside Pelvic OTPs United you'll find:​

• Weekly group mentoring calls with Lindsey. She's doing this exclusively inside this community. These aren't your boring old Zoom calls where she is a talking head. We interact, we coach, we learn from each other.
  ​
• Highly curated forums. The worst is when you post a question on FB just to have it drowned out with 10 other questions that follow it. So, she's got dedicated forums on different populations, different diagnosis, different topics (including business). Hop it, post your specific question, and get the expert advice you need.

More info here. Lindsey would love support you in this quiet corner off social media!

Transcript

Lindsey Vestal I've got something kind of special lined up for today's OTs and Pelvic health podcast. I have invited a panel of four different occupational therapy practitioners to join me to share the secret sauce behind their pelvic health evaluations. So I bet we are all so curious about what each of us do when we welcome our new clients in the door for their evaluation. So I sit down today with Meghan Kasper, Jessica Dobson, Jessica Hammond and Janelle Golan, and together we dive deeply into what each of us do. So I'm going to share a little bit about the background of each of them now to kind of frame the conversation. So Meghan Kasper is not specializing in Pelvic health. She's a massage therapist and a myofascial release practitioner. She holds certifications through your StoryCorps and the Body Ready method and is in the process of finishing her PCOS and Birth Healing certificate. She's a private practice in North Andover, Massachusetts, treating women's pelvic health with a focus on prenatal and postpartum population. Next up, our second panelist, Jessica Hammond, became interested in acute post childbirth after being in acute care O.T. for 15 years and seeing a need and perfect fit for O.T.. After she had her three children, her manager asked at a staff meeting if anyone wanted to be trained to treat men's pelvic health and bowel dysfunction, and she volunteered. She also started an acute postpartum program and is now a full time outpatient pelvic O.T.. Jessica Dobson is a Minnesota girl working and living in the South with two small children and husband. She's a certified Reiki and yoga instructor, viscerally trained functional medicine, informed practitioner and pelvic health therapist specializing in digestive health. She is self-described health and wellness cheerleader. She is very passionate about guiding and educating clients on their own bodies and nutritional influences on digestion in Pelvic health. Last up is Janelle Golan, who's a coffee drinker, a piano player, a reader, a lover of dogs and guinea pigs and a pusher of boundaries. She's also a wife and mother to two kids who are growing up so fast. She's an O.T. who supports women to connect to their body so they can navigate mothering transitions with confidence and vitality. She has an integrated focus on pelvic health mental health and menstrual cycles, and she supports right of passage and the ways feminine transitions impact performance roles, relationship and joy. She's based in Melbourne, Australia. All right. Let's roll up our sleeves and get into the conversation now. 

Intro New and seasoned OTs are finding their calling in Pelvic health. After all, what's more ADL than sex, peeing and poop? But here's the question. What does it take to become a successful, fulfilled and thriving O.T. in Pelvic health? How do you go from beginner to seasons and everything in between? Those are the questions and this podcast will give you the answers. We are inspired, OTs. We are out of the box, OTs. We are Pelvic health OTs. I'm your host, Lindsey Vestal and welcome to the OTs and Pelvic health Podcast. 

Lindsey Vestal I am so honored to welcome Janelle Golden, Jessica Dobson, Jessica Hammond and Meghan Kasper to our podcast today. Getting a better understanding of someone's Pelvic health evaluation process. It's a little bit like getting to look behind the bathroom mirror and see what cosmetics or makeup someone uses. We have such an innate curiosity about these things and I think we are so eager to learn what we do in that first session and how we do it. So thank you so much to all three of you for raising your hand on my Facebook community and volunteering to give us some insight into your process. We'd also love to get a sense of who you serve and what setting you're in so that as we start to hear about your evaluation process so that we have a better understanding of your framework as we start to learn more about the evaluation. So kind of think about it like a snapshot into the process. So let's start with you, Jessica Dobson. What communities do you serve? You know, broadly speaking, let's think maybe like 70% of your clientele. Who do you serve and what setting are you in? 

Jessica Dobson Yeah. Thank you so much for letting me be honest with you guys. I'm so excited to be here. Okay. So my clientele has really shift since I started working there. Is that saying that you kind of bring the people to that your best serving? Right. So over the past year, I've been on a process of learning more about digestive health, constipation and bowel dysfunction. And that's really what I'm seeing right now. So I would say about 70% are coming from gastroenterologist with diagnosis of bowel dysfunction, pelvic floor, muscle disinter, g.I. Constipation. I treat all diagnosis is i treat men and women. I treat postpartum pregnancy. So I do see it all. However, I do feel like I'm seeing more digestive issues. Constipation. I work in an outpatient clinic privately owned by an occupational therapist, which is amazing. I can't tell you how big of a shift that's been for me to learn more as a public health practitioner, to work with a boss that just gets it. So that's pretty much my clientele. We do outpatient services. 

Lindsey Vestal Beautiful. What a gift. Owned by an OT. I love that. Jessica Hammond. Let's hear from you. 

Jessica Hammond Hello. And again, thank you for having me here. I'm excited to be here as well. My clientele is, I would say, kind of similar to Jessica. And this is typically colorectal type patients, bowel dysfunction. My main referral source here is colorectal surgery. They they see us as being their helpers in helping these people that, you know, they've tried all the beds, they've done the surgery. They can't really figure out what's going on with some of these folks. So that's kind of what I'm seeing the most of. But similar to Jessica Dobson, I'm also seeing pregnancy and postpartum. I also see a lot of urology patients. So I'm seeing men post prostatectomy and men with bowel and urinary incontinence. That's probably at least 50%. So I have a pretty good split of men and women and a decent amount of post-pregnancy, postpartum women as well. But because of the area I work in, I work in a kind of predominantly elderly population. So I think I also have a high percentage of 70 plus year old people on my on my caseload as well. So I have pretty much a mix. 

Lindsey Vestal And what setting are you in? 

Jessica Hammond Hospital based. Hospital based outpatient for now. But I was in acute. 

Lindsey Vestal You were in acute. I love that. It sounds like it sounds like there's not a whole lot of boredom in your day. It sounds like an incredible variety. 

Jessica Hammond It is quite. 

Lindsey Vestal Awesome. Meghan Kasper, let's hear from you. 

Meghan Kasper So I work in private practice. I predominantly treat prenatal and postpartum women helping prenatal women that have any sort of pain, but I also do a lot of preventative work for them so that they can prepare for birth and have a better postpartum recovery. I also see postpartum and I would say I have speckled in. Are just other women's health issues. Women that have pain with sex and digestive issues post menopause, perimenopause. So I really I see across the board all different age groups. But for the most part, I'd say 90% pre-natal postpartum, which I love. 

Lindsey Vestal Yeah, absolutely. We share that in common. My private practice, I could say, probably comprise the same. Amazing. Janelle, let's hear from you. 

Janelle Golan Yeah. Thanks for having me, Lindsay. I'm in private practice as well. And very similar to Meghan. It is predominantly prenatal and postpartum moms looking for this preparation support and then that recovery afterwards. I do also see some people at that preconception phase or even women who have no intention of falling pregnant but realize it's something going on in their body, something happening within menstrual cycles. And I've been blessed to see a number of women even in their 67 years. I think I've had an 80 year old that are realizing that this thing sitting in their body, maybe they're having some symptoms, maybe they just realize this stuff going on, that it's time to tend to in that phase of life. So quite a broad spectrum that I'm predominantly for. 

Lindsey Vestal Well, the mom of a completely volunteer activity. You all raised your hands. And I have to say this is an incredible breadth and width of expertise and specialty. So let's pull up our sleeves and get into the nitty gritty now. I'm going to break up the evaluation process into a little bit of bite sized chunks so that we can try to tease out the process a little bit. And so let's start and maybe we'll kind of continue in this order. So, Jessica Dobson, you're up first. I'd love to know how to clients find you and your practice most of the time. 

Jessica Dobson Okay. So most of the time it's coming from a doctor's referral. However, I've become kind of the gut person in our area, so I'm getting a lot of self referrals, recommendations from other clients to their family members or other people in the community. I do get the doctors kind of just send me people with not a lot of information nowadays. They're like, Just go see Jessica and I'll help you figure this out. 

Lindsey Vestal Got it. And I know you do. Awesome. Jessica Hammond, what about you? 

Jessica Hammond Same. Same. And being in the hospital system, I kind of have a built in referral source. So we have script pads that say, and we took them to all the doctor's offices, and the doctors will just, you know, check the script and give the patient the paper and say, Call, call Jess and she'll take care of you. And that's how they end up here as well. 

Lindsey Vestal I love that. Meg, you're up. 

Meghan Kasper My primary referral source most recently, which I'm super happy about, is word of mouth, actually. And I'd say the rest of it is probably from Facebook moms groups, which is another form of word of mouth. I did have a pretty regular physician referral, but he has since retired from obstetrics, which I miss. And occasionally I get referrals from local offices. But I would say most part it's word of mouth and social media. 

Lindsey Vestal Fantastic. Janelle, we'd love to hear from you in Australia. 

Janelle Golan Yeah, I do get a few referrals from some independent midwives and doulas, birth workers, but similar to making a large proportion of people find me through social media or might be word of mouth from someone else who has seen me. They just looking for that slightly different perspective that I offer lots of word of mouth and just finding me on social media saying a real or something like that and going that resonates. 

Lindsey Vestal Beautiful. I love that. So let's move on to the paperwork aspect of the evaluation. We're just going to spend a brief moment here. Jessica Dobson, how do clients get their paperwork and do you have a process for when and how they get it back to you? 

Jessica Dobson Yes. So we do email. We offer both. So we do have a large elder community that we serve in our area. So we offer to fill it out when they come to their appointment or ahead of time online and will evaluate the situation when they come. If they haven't filled finish out their paperwork, I'll just have them skip it and do it at the end of the evaluation. 

Lindsey Vestal Okay. So no formal requirement there from your practice aside that they have to turn it in before they see you or anything. 

Jessica Dobson It's preferred. I do have a long wait list. So typically people are on board and have things ready ahead of time. But you can never know for sure if there are someone who can't read. I mean, that's happened in my practice or has difficulty with some sort of vision issue or their handwriting for other ailments they may be dealing with. So I'm prepared for there to be nothing and go from there. 

Lindsey Vestal Yeah, that flexibility is key, isn't it? That's wonderful. Jessica Hammond. 

Jessica Hammond Yes. So for the paperwork, I usually on the intake form requests an email address and or if they don't have one, then I request their home address and I'll print out the papers and mail it to them in the snail mail. But typically, most people are cool with me sending it via email, but I don't require them to email it back. I just have them fill it out, print it and bring it with them to their place. 

Lindsey Vestal Okay, excellent. Meg, what about you? 

Meghan Kasper So I require consent. So I have a few moms that are super busy that don't get to all the questions, but I will not treat them and especially in private practice, until they've consented. I felt more covered when I was an outpatient. They always had to sign consent to treat and not necessarily fill out their paperwork and outpatient as well. But when I book somebody into my EMR, I send that paperwork to them and I require to be finished within 24 hours of seeing me. So I have time on a good day to read it before they get there. 

Lindsey Vestal And what happens if they don't turn that paperwork in before that 24 hour mark? 

Meghan Kasper That's okay. I will send a reminder that morning and say, hey, just you know, I can't treat you until the consent forms. And if they say, I don't have time, I'll say, okay, you can. It's only happened a few times. I'll I'll let them skip the paperwork portion because I've already had a pretty good conversation with them already on the telephone. But I do need that consent form. And if they'll have to pull it up on their phone in my office and sign that consent before I will work with them. 

Lindsey Vestal What's the process like for you, Janelle? 

Janelle Golan Yeah, I guess a lot of people contact me and book a discovery call online and so they tend to be a little bit more technology savvy from the get go. And that's how they connecting with me. But once I put that first appointment, I've got an electronic form that's connected with my client management software and that goes out to them and they generally complete that and send that back. I don't make people have to do that If they haven't completed that when they arrive at the appointment, then I go through a consent process as part of the actual appointments there. But sometimes whether they filled it in or not, it can be an interesting reflection on what's actually going on for them and how overwhelmed they might be feeling or how uncertain about what is going on in their body. So almost the completion of the form is part of the assessment to begin with. But I do have that process if I haven't filled it in. And I think that's a really big thing that I've noticed as I've matured as a practitioner in this space, that initially that first client that you say, I want everything about that when I need all the details and so I can go and research and see what ideas. Whereas I think you get a bit more comfortable someone walking in and you say, Hey, why are you here? And feeling confident that you can step in and support that without having all that space. So I think that's something that I've been reflecting on as people talk as well. 

Lindsey Vestal I love that, first of all. So O.T. to consider the paperwork as part of the assessment process. I just love that. And also, you're right, I, I almost thought about putting like a panel together of like a nice mixture of new and seasoned practitioners, just kind of, you know, compare and contrast that little bit of seasonality and how we grow and not that it's reflective of everybody's process, but it is really beautiful. Janelle, you and I have had these conversations in the past together, just like how we grow and progress and how we assess priorities based on that intake process. So I love that. Thank you. And actually, let's take a quick second and maybe just share how long we have been in Pelvic health just to give that frame. Jessica, let me bring it back to you on that one. 

Jessica Dobson Yeah. So I've been in public health for just about three years. 

Lindsey Vestal Okay. Perfect. Jessica Hammond 

Jessica Hammond About two officially. Perfect. I love it, Meg. 

Meghan Kasper About four and a half. 

Lindsey Vestal And Janelle. 

Janelle Golan Officially six and dabbling a few bits and pieces before that. 

Lindsey Vestal Perfect. Perfect. Now, all four of you, anything else that you would like to share about this part of the process before we move on to the next question? So basically, is there anything else you would like our listeners to know about the process before you actually meet the client? 

Meghan Kasper Yeah. I would like to add for any of the people that are interested in private practice, I definitely feel like my discovery call is how I get clients. There is a connection developed in that call. I give them a good, you know, a lot of time to share with me what's been going on with their experiences and they feel heard. And then I really tailor how I can support them to their specific issue. And, you know, we've had this conversation before. I'm sharing my pricing and I've already explained at this point that I'm not going to see you, you know, two times a week for 12 weeks, that this is going to be really a once or twice a month thing. And I have more buy in for private practice and private pay at this point through sort of doing a little bit of that intake and the discovery call. 

Lindsey Vestal Yeah. Excellent. Thank you for bringing that up. 

Jessica Dobson Yeah, I would. I'd like to jump in to share some success with people. Something that you might be able to utilize as well. So when I came in, we got busy really quick and we were having a hard time with referrals showing up for their evaluations. And we started kind of an assessment trying to figure out why that was happening. And it came to just a lot of fear and misunderstanding of what they were coming for. So I created a video very short one minute or long where I talk about what Pelvic health is. I show them my face. I show them the treatment room. We talk about what symptoms that we might treat different diagnosis says. And then also I explain it's a conversation. This is a collaborative effort. We're going to figure out what's best suited for you. It looks different for every client, but your first visit. We're going to talk. We're going to figure some things out. So I want patients to know that I might not get hands on with them. Here's the safe space you're going to be in. Come and chat with me. You're welcome in my doors and we'll figure it out together. And that has drastically changed. Our referrals will show up for their evaluations. 

Lindsey Vestal How incredible. I love that. Jessica, did you come up with that? Yes. Yeah. Yeah. I'm not surprised. I love that. What a beautiful way to frame the experience and to just already feel that client centeredness and client collaboration. But bringing them into that experience before they ever walk in the door. Brilliant. Anything else? Before we move on to the next question, before we get to that client facing part. 

Janelle Golan I'd love to highlight that the intake form can be a real opportunity to showcase the O.T. mindset that we're going to be bringing to that appointment. The intake form that I use is the exact same Whether someone is saying me for a public health concern or a mental health concern or anything in between, So my intake form doesn't ask Are you leaking? Do you experience heaviness? All those kinds of pelvic health questions? I'm asking questions. How are you engaging in your day to day life and where are you finding rest? Where are you finding joy and does it feel that life is meaningful and what is getting in the way of that? And so immediately when people walk in the door, I really love those questions because you're not just saying me as a novice. You're seeing how this is actually showing up in the full breadth of my life. And a lot of the people that I'm seeing are those that have felt very reduced to their pelvis if they have sought support previously. And it's like, Hey, I can actually see this whole picture that you're really interested in. So depending on what your location of practice and those sorts of things, that can be constraints around that. But I think take the opportunity. How can your intake form actually be exploring that breadth of what we actually consider as occupational therapists and what we think is really important and what matters to us, which is what matters to our clients. And really it's about the pelvic floor or whatever it is itself. It's about all these other things that sit around in that context, so we can highlight that and get them in that mindset before they walk in the door with an intake. 

Lindsey Vestal I have to admit that I think getting them into the or sharing our viewpoint, our unique stance is 99% of it before they ever walk in our door, whether it's to that discovery call that Meg mentioned, Janelle, your paperwork process, all of us, your videos address Dobson I mean it's it's it's all about that pre framing. And I learned that very quickly in my private practice in New York City. When I first got started, I wasn't doing much screening. I was just so excited to to get a client in the door and to actually open my business. And very quickly, over time, I started to realize that that pre framing enables us to have that sweet spot. So we're not professionals like salmon swimming upstream. We're actually attracting the client that not only brightens us and gets our energy really high and our satisfaction so incredibly innate, but it also is that match. And I think I love all of this that you're sharing because you found unique ways to really attract and bring in those clients that you are really best intended to serve. So thank you for that. So I'm curious, what assessments do you guys. 

Jessica Dobson It depends on the person. We do typically provide an impact questionnaire. So that is going to be in the short form utilized questions talking about bowel or bladder or pelvis pain and how it relates to their life and occupations. So for instance, one of the questions says, does this particular issue impact your ability to do household chores? So the patient would answer somewhat moderately, quite a bit or not at all. And then there is a calculation that's involved that gives you some more information. And we do that test again at discharged or if we're doing a progress report to see how they view their progress. And the last question on that questionnaire asked about mental health and if this particular issue causes frustration and they separate frustration and mental health being anxiety and depression apart. And that has been the most interesting thing to me because so many people don't think it's causing mental health issues for them or causing anxiety or depression, but they're certainly frustrated. So it's that is one I standardize use with almost everyone. So I have something if I'm utilizing insurance, I want to provide some information. But other assessments, it just depends on the time and what's appropriate for that patient. 

Meghan Kasper So I have in my intake and in the Edinburg postnatal depression scale just so that in the short one it's only about four questions. They rate their level of anxiety over things and I like to use that to, you know, have a sense of if I need to refer them out for a little bit more mental health support. And then I also use the PDI 20. I will say that when I started my practice, I had grand plans of tracking my outcomes and giving the PTI 20 upon discharge. But in private practice with moms that it just didn't happen. I never often knew when somebody last session was going to be, and I don't formally discharge because they don't have to. And I thought that I would track these things, but I became too busy to do that. So I do use them as part of my intake process, but I don't use them at the end. 

Janelle Golan Yeah, I really resonate with what you said there, Meghan, that you don't always know when that last session might be and you might think the person is planning to come back and it doesn't eventuate for whatever reason. Maybe it's because they feeling fabulous in their body and able to do everything that they're needing and wanting to do. So it can be tricky to know where that endpoint is with some of these private pay people. But probably the column is an assessment that I tend to bring in. Sometimes it's the formal one. Maybe it's a little bit more informal, just looking at what actual activities and various parts of their life is being impacted and something specific that they want to do. I've got a client at the moment where assessments about being able to double carry her to children without getting heaviness or columns are really lovely way to be tracking a goal around that, how she's feeling about it and how she's actually doing. There's a few really, I guess, nonpublic health specific assessments that I can be bringing in as well, that things like the Intersection awareness assessment can be an interesting one to do. The sensory profile might be something that comes off again, might be formal or informal. The other one that I sometimes use is that maternal wellness and quality of life, occupational inventory. And that's I'm still trying to track exactly where that one is landing up with a formal assessment. But some of the questions within that, looking at various mothering roles and overlaying how public health might be showing up, there can be a really useful way to see exactly how how what's happening in their post and happening in their body might be playing out in ways that they hadn't actually realized. And perhaps that generates a goal goal as well. That would be the things that I add.

Lindsey Vestal Janelle, you kind of cued me up for a future podcast. I've already got scheduled with Sarah Sadar to talk about sensory and how she uses sensory processing and things with her Pelvic health clients. So thank you for mentioning that and the interests of awareness and all of those other sort of out of the box ones that I think are so applicable to Pelvic health. 

Meghan Kasper Lindsay, can I chime in for a second? Since the summit actually not too long ago, I have given the adult sensory profile to a couple of clients with the intention of especially people with nervous system and pain issues. How can I use the sensory profile to help create more calm in my treatment room? So thanks for mentioning that now. 

Lindsey Vestal Yeah. Fantastic. I love when we get together. It's exactly the purpose of this happened at the summit. It's happening now. We're just getting to learn and expand what we know as possible and what we can do in our treatment room. So this is what it's all about. I love it. So we're going to now transition a little bit. Jessica Dobson, can you please walk us through, let's say, the first half of your session and you know where I'm going with this? We're going to break it up to the second half and the next question. So kind of in your mind, kind of mentally divided and just like walk us through the client experience the first half of your IV all together. 

Jessica Dobson Yes, I have to say. And in order to talk about my client's experience in evaluation, I have to also bring my presentation in how I'm doing before I step into a room. So I'm very aware of how my nervous system is regulated, getting away, cultural biases or things that I may have thought about. I typically don't any more look at the diagnosis or much about the patient before they walk in, because I've learned that I do better as my authentic self when I'm going in almost blind. This is where I get a little hippie and weird. But I love. I've read about this in different cultures, but we, you know, as pelvic floor therapists, we really kind of accept other people's energy. Not always on purpose, right? So I love to have my hair up. There is some cultures that talk about shamans that put caps on their heads or have their hair is in bonds to weed out negative energy or to not accept someone else's energy into your space. So that's what I do to prepare myself. I wear my hair up, I take a deep breath, and then I go in and I try to be as calm as I can be to provide that safe space. I first am going to look at that client I'm going to be looking at for their body postures, how their arms are, they folding their arms, is their head down. That's going to indicate to me that they're uncomfortable. They probably don't know why they're here or understand their diagnosis. So that's going to change my presentation and how the rest of our evaluation proceeds. So I talk first. I have them get as comfortable as they can be. They say, Here's some pillows, lay down if you want. Sit back, make yourself comfortable. I ask them. The first question I typically ask is What brings you in? What things are you dealing with at home that brought you to this space? Not what's your diagnosis or those kind of questions. I want to know what's troubling them. And then if they're able to verbalize that, then I sit and I wait, write down whatever I need to from what they're talking about. But I allow them space. And sometimes I let the awkward silence silence happen because they realize, she's waiting for more and they'll start pulling more out of their, you know, their problems or their symptoms. And they're starting to talk about things they we're not planning to talk about. And then if they're having trouble verbalizing, I might explain pelvic health So I might say, hey, so pelvic health pelvic floor therapy. Your doctor may have referred you for these symptoms and then talk about how the bladder, the bowel, the sexual organs are all related in the pelvis to give them an idea of, okay, this is the things you can talk to me about and honestly, that that's where it starts and we go from there. So I'm going to ask more questions based on what they're telling me, and then I'm going to go through bowel habits, bladder habits, sexual organ relations, What's happening to each part of that body? I want to know, you know, how many times are going to the bathroom, what their water intake is. If they take supplements for digestive health, I'll ask a few questions related to their home life. Do they live with family? Do they have a support system? I really base my questions on what I'm hearing and what I'm feeling and what intuitive, what I call intuitive. You know, interviewing is just being there and knowing where the conversation needs to go. 

Lindsey Vestal It's it's there. It's a secret power in there, isn't there, to be silent. Think the average physician interrupts their client after 11 seconds. So our clients are not used to silence. They're not used to someone really holding that therapeutic space for them. And so that was brilliant. Jessica, thank you. Thank you for sharing that. Jessica Hammond, let's hear from you. 

Jessica Hammond So usually when they start, I go out to the waiting room and I greet them and usually I know which person it is. So I say, Hi, I'm Jessica. Come on back with me. I'm going to be working with you and helping you with this. And I usually show them with the bathrooms first because everybody usually kind of wants to know their way around. So I kind of show them the bathroom and then I lead them to the room. And then I always say, this is going to be the room we're going to be working in, and you'll always be with me and you'll always be in this room because they're always going to be with me and they're always going to be in this room so that they feel safe. And then when we walk into the room, I usually offer them to either sit in the chair or sit on the table, whichever they want. And then I usually say, and if you want to switch or if you want to stand up or if you want to move, it's fine. Just kind of make yourself cozy. And then I kind of just give them a minute and I say, you know, I have to go get something. And I usually walk out and I usually offer them a glass of water if they want one, just so they can kind of like get themselves situated so they can kind of look around and check things out without me sitting right there and watching them. And I, you know, I'll go out and get myself a drink or, you know, get get a pen or pick something up from a desk or just give myself a minute to kind of gather myself before I come back in. And then I come back in and I'll sit down on my stool and I'll look at them and just say, So what brings you here today? You know, what are you doing here? So tell me a little bit about why you're here. And then they then they usually go on and lots of times they don't really understand why they're coming. Like, I don't understand how this therapy is going to help me with my constipation. Like, or how is this going to help me with this pain I've got in my book? Because, you know, I don't really understand how it's going to work or they think I'm going to give them a pill that's going to make their urinary incontinence better. So I have to explain a little bit about what Pelvic health is and how it how it works and how it relates to their body. And I have lots of models, so whatever model applies to them, I usually pull out and I usually explain where the muscles are and have them touch it and feel it and explain how the muscles move with the breath. And usually I usually start with it kind of explaining how it relates to breath, because almost every person I talk to, I talk to about breath and the muscles and the nervous system and all of that type of stuff. So that's usually where we go and then it kind of goes from there to like, yeah, you know, you talking about the nervous system, I, you know, that really resonates with me because and then they go off on the whole story about how it all started when their mom passed away or their dog died or, you know, it usually like clicked something like, yeah, like this all started. And that's another question I ask is when did this start? Like, when did you start having this happen? And usually sometimes like the lights go on, like the light bulb clicks like, yeah, that's it. I remember that. Yeah. This all kind of started because nobody ever asked them that before or sat and listen to their story and ask questions about when it started or when they remember it starting and they're like, that's a good question. I guess it started. And then they start, you know, thinking about it and processing it. And that's usually where I go and then it goes from there. 

Lindsey Vestal It is very obvious how clearly you put yourself in your client's shoes. That beginning part that you explained to me about giving them, first of all, saying, You'll always be with me and you'll always be in this room to you, then leaving and giving them a chance to be curious and not feel so watched as they look around your room. So I have to admit that everything from getting my haircut to, I don't know, getting my nails done, I'm always thinking about the experience and like how it could be done in a more optimal way or pure compliment. Like, wow, I would have never thought to to have done it that way. And so I think all of these non-related experiences of life really do inform how we can make. A client feel more comfortable in that very special pelvic health session? Awesome. Meg, I'd love to hear from you. What's the first half of your evaluation look like? 

Meghan Kasper So in order to get my discovery call, I have really outlined and talked about how often pelvic floor dysfunction is not necessarily because of the pelvic floor. And I've talked about how we're going to do a whole body assessment. And I've talked about breath and I've talked about posture. So they show up in my room, you know, having had a pretty good conversation with me and understanding what to expect. And they filled out my paperwork. And Janelle, I just have to say, I'm going to go I have some more holistic questions in my intake. But you know what? The rest and the joy question like I'm so inspired by. So thank you so much for sharing that. And then I basically say to them, you know, I know you've taken the time to fill out the intake form, which I have read, and I'm we're going to talk about. And I know that we spoken on the phone, but I want to start all over and just have like a conversation here again. And it doesn't mean I spend 30 minutes talking about the same stuff, but it's always been amazing to me and all types of practice. What comes out in that moment that might be different than the phone call and the intake form And I, you know, go through the pelvic floor spiel and I tell them sort of what to expect that day. Now that is with somebody who has a pretty standard issue. I very often get phone calls from moms and postpartum women who are in acute pain, and that evaluation is very different. And that's a conversation for another day. But that's very like, let's go quickly through these couple of things and then you're getting an emergency treatment session. And like Jessica, I love the hair back idea. That is not an option for me because my hair down is my thing. But I do have a spiritual practice of clearing and protection as well, which has been a game changer for me in public health for being able to, you know, the sacred spaces we're working on and the nurturing that we're giving to not to not pick up stuff and also to make sure that I'm showing up in the room without ego, without agenda and really being present with that that new person in a clear space. And so thanks for bringing that up. I think that is an important doesn't matter how you do it. My protection is I put a bubble around myself that's penetrated all by good things. 

Lindsey Vestal So I really appreciate that. I think all four of you really touched on this 1 in 1 way or another, which is the importance of having a a ritual of sorts. And I think anyone listening to to our conversation today, if they whether it's hooky dippie or it's very practical, having something to clear so that you can show up fresh and so that when you go home, at the end of the day, you're you are showing up for the other loved ones in your life is very important. And it's a fast track to burn out. And so even if you're new in your practice and you haven't felt that yet, it's it's a great gift to receive to realize that the importance of taking a moment to do that. And Meg, I love how you have really continued to highlight for us the importance of that discovery call in your practice to set that tone for that therapeutic relationship. So that's just that's just fantastic. Janelle, what is your about like? 

Janelle Golan Yeah, I resonate so much with what everyone else has said, so I'll just add a few few additional things in there. Certainly that preparation beforehand and checking what's happening with my own energy, what's sitting in my pelvic bowl and what do I need to do to reset before I see someone resonates a lot? And your comments about using rituals with that that I work from a home based clinic space and so me and my cocker spaniel meet people at the front door. And so 50 of my clients listen this I'm not psychoanalyzing here, but just seeing how people show up and how they interact with the dog and how how are they walking through that space. It can say so much about what's going on on in their body. So that's always interesting to notice. I've got some bolsters on the floor, so someone's not feeling uncomfortable in that position. We're usually on the floor and I always just ask them, What have you had to juggle to get here this morning? So working with moms, often it's the childcare drop off at the school or the doing this and grabbing that from the supermarket. So what did you have to juggle? And let's really honor and acknowledge that. And then what do we need to do to pause? What would help you with it? Hands on the chest and a deep breath. Is it looking around the room and just orientate orientate into this space where you're at? Do you actually need to do a little bit of a stretch while we're here on the food? We need to do some child's pose together or just being curious what would feel good for them? And sometimes that mom, look, I had one yesterday. We just sat there probably for 3 or 4 minutes. And this is. Close. We just breathe together and just let us sink into her body. Before we before we got started. So all of my assessments, there are an hour and a half. So my practice is so much about time and space, and that allows me to have that settling time without feeling like it's impacting on what I can do in the sessions. So once we've settled. Usually my next question, if it's the first time I've seen them, it would be How did you feel about completing the intake form, recognizing I've got some of those really broad brush questions and that can be interesting to notice what has come out for that client, what things they really pick up on. I've noticed. I don't have a lot of that in my life or I've realized that this is actually going on as well and is probably impacting my pelvic health. So it's always interesting to check in on the experience of answering those questions. And I'm also checking in as well. Like were there any triggers that came up with that as it touched on something that felt a little bit uncomfortable for them just seeing how they blended with that? And then another question I love using is what's feeling present for you right now? So that might be in that first session or it might be that they've come back for a repeat session. We had an intention of what we might do, but just checking in. What feels present for you right now? What are you noticing? How's that sitting in your body? How do we want to use that to guide what actually happens next? 

Lindsey Vestal That's really beautiful, Janelle. I love so much about what you shared. But I have to say, between the cocker spaniel and the question of what you know, what is feeling present for you right now? It's a tossup because I just think both are invaluable. That's awesome. Before I ask you all the second half of your of your email quick interlude question, which is if you do internal work, how do you introduce the internal exam? 

Jessica Dobson Jessica Dobson I do internal work. I don't always and it's presented. I talk about it most often on the first evaluation as an option. I introduce it as these are some treatment techniques. We can do all of these. We can do none of these. We can do what you want. But I provide the information because so many people are aware of internal work now, and I want them to know that this is a place where it's possible, if that's your journey. But it doesn't have to be. 

Jessica Hammond Similarly, I, I will mention it just kind of bring it up like this is a way we can check your pelvic muscles and kind of get an idea of what's going on. But it doesn't. We don't have to do this. It's kind of an option if you want to think about it, we can always do it Next visit. I usually don't push the issue, but I Samus just stops and I kind of want them to know that we do that It does happen that we do do it here because, you know, some people are coming and they are expecting that to happen on the Ebell and I don't want them to feel like, well, you know, she doesn't do that, so we'll go somewhere else or, you know, I'm not getting what I need out of this, this visit. So. 

Lindsey Vestal Okay. Excellent. Meg, what about you? 

Meghan Kasper I love it. You guys touched upon like some people have no clue it's going to happen and some people have expectation that it's going to happen. So I address it in my discovery call, actually, when I'm just talking about all of the things I'm looking at and how it impacts the pelvic floor. And I'm saying no internal assessment is an option. It's something I almost never do. On the first day I said I said something that feels super clinically important and then that's a conversation we can have or it's something that you really feel like somebody has a really bad pain with sex. That might be something that's really important to have on the first day. And so I always say if it feels like an important option for you to do more quickly, certainly, you know, will it'll be a conversation, but I'm talking about that on the Discovery call. 

Lindsey Vestal All right. Janelle. 

Janelle Golan Yeah, very, very similar. It's always good for people to know that it's an option. I would very rarely do it in the first session unless someone's come to me specifically asking for support through through that internal work. I also don't do internal work until that pelvis is balanced. So I'm tabling shortly on that one. I've found such a difference, even if they've come specifically for a session that we focus on the internal work, I will always just checking what's happening around the place. Can we get that moving? Can we make sure that sitting in an optimal place because that's going to make a huge difference with what we actually feel and what we discover from that internal perspective. I was so heavily influenced by some of that Wheel of Consent and Betty Martin work looking at what is that potential power imbalance with internal work. So when I'm talking about it, I'm always really saying this is an option. I'm not going to tell you that it's a good idea to do it now. I'm never going to tell you what is right for your body, but it might come up at the end of the session. I might go, okay, we're exploring these ligaments. We found there was a bit of restriction here. This is something we could do next session and I'm going to let you ask me for that. If it is something that feels right for you or if we're in a session, I'll say to them, I'm noticing this about your body. We could do internal work and see what's happening around those uterine ligaments or round the cervix, or we could explore that through your belly coming in more abdominal Lee What would feel right for your body? So I always try to avoid that. Would you like to do internal work now? I feel like it's such a loaded question and there's such a potential for that power imbalance, the person going in. Yes. So it's always thinking about how do I actually frame that and how can I set it up so that it is always an option? And ideally, that person actually saying, hey, last week or last month when I saw you, you talked about this, I'd really like to do that today. So I guess that's probably another question in my initial part of the assessment. Is there anything specific that you really want to happen in this session today? And that can be an option to say, Hey, I'd really like to explore that internal work or anything else that that I've put on the table as an as an option. But that's a really big consideration that I that I have when I'm offering that. 

Lindsey Vestal Yeah, I think you've highlighted a really important part, Janelle, which is, which is a little bit of a power dynamic there. And this is something I'm incredibly passionate about. And if anyone is interested in hearing sort of how I do it and like the menu of I call it like a menu of options and I never do it on the first session either. But it's I think it's episode 33 and it's how to talk about the internal exam with your clients, where I kind of go into the way I present those three options to optimize their choice. It's a choice for them if they want it or not, and if they feel like they have to. Like I had so many type-A New Yorkers be like, I'm here because I went to a physical therapist to who couldn't do it. You can't. So let's do it now, you know? And it's like, let's take a step back for a second, you know, And I want to meet them where they are, but I also want them to see to see. We talk about the full picture and the benefits and how we can do it. And I think the other thing I'm really passionate about is presenting all the options. So there's not the the gold standard is not the internal exam. We can do it so many other ways and we present it equally and then say which one of these are you open to today? I'm really passionate about that. Awesome. Quick. Yeah, please. 

Janelle Golan I think the other the other thing I want to add to the internal work is I also talk to clients about the fact that because they've asked for that or said yes, at this point they can change that to a no at any time. So again, honoring that. I've got a lot of time and spaciousness in my sessions that when I stop the internal work, I always commence just with my finger resting on the outside and we just slow down and we just breathe together and we check like, how is your body feeling about that? And usually they'll go, actually I'm just I'm noticing something a bit in my chest. And I wouldn't have noticed that if we'd actually hadn't slowed down or been given that opportunity or we just noticed what's coming up in the body and we see what the body needs. And then after a little while, they'll settle on the go. Okay, no, actually I'm ready now and then will very slowly go in and I'll just sit there and we'll go, what's happening in your body? So bringing in some of that interception awareness, maybe some emotion is coming up. And we sit, we sit and at any point it's I can I can leave your body straight away. We can pause or we can keep going. So making it clear that just because I've said yes at the start doesn't mean that they have to keep saying yes. I've had a few sessions where it's like, Do you need me to leave your body? I feel like you're really not present with what we're doing here. And sometimes we have said, okay, now it's not right. Right now. Maybe we've done a pause and we've come back once I felt more settled. Or maybe they just realize it's not right for that time and place. But I think that is so important as well. It's not just a consent at the start, it's consent that continues the entire way through that process. 

Lindsey Vestal Why is so important? Janell, thank you so much for bringing that up. So we're now going to officially segway to the second part of the evaluation. Jessica Dobson, what's that part like for you? 

Jessica Dobson So the second part, we're usually still talking, getting more information and building that rapport as best we can. I will do education. Of course. I bring out the models of the pelvis. We talk about different things that might be going on. I'm constantly in my head just these red flags are going off and they're conversations, things that I want to segue way to or things that I'm going to bring up in the educational portion. So the second half of my evaluation may include some type of assessment. I might use biofeedback, I might do an internal assessment. However, like everyone else is saying, that's typically almost never done on the first evaluation. But I'm going to leave the client with something, whether it be a piece of education, or I might look at their pelvis alignment and just kind of see some postural things, something they can leave and feel, wow, I might get something out of this. And it just it can be small at first, like maybe a lot of you resonate. But I would overeducated. I could educate all day long about all the things and it's too much. So I want one thing that they're going to leave that evaluation with or if they got nothing else, they have this education about bladder retraining or I help them align their pelvis a little bit and be aware of their posture. 

Lindsey Vestal Jessica, thank you so much. Jessica. Jessica H. Was the second half of your rebound like. 

Jessica Hammond So the second half is similar to just the and so we do a lot of education. And it kind of like as we're going through the intake forms, I always review the intake forms for them and we kind of go over like, you know, what their water intake, it's like what their fiber intake is like what their bowel habits are like. There's still consistency and we go through all of that. And as we're going through that, I'm kind of like thinking, better educate on this. And I'm maybe jotting down a note, but like just stops and said, I'm kind of in my two years of experience learning that I have a tendency to overwhelm people with tons of information on the first, first visit. So I'm trying to scale it down. So I'm now the queen of Post-it notes. So I usually try to fit something to take with them, and I write it on a Post-it note. And every session I'm usually writing a couple takeaways from the session on a Post-it note, and I give it to them and they take it with them and it helps them remember kind of what the highlight of the session was that they need to kind of remember or keep in mind, you know, maybe it's sit with your feet flat on the when you're sitting on the toilet, make sure your feet are flat or maybe it's sit for an extra minute or maybe it's try pelvic tilts or double voiding or maybe it's just drink more water, you know, whatever it is, or drink less coffee. And so I try to give them like a little a little sticky note to take with them every time when they leave. And that's kind of been my my calling card lately. 

Lindsey Vestal Yeah, I think it was Michelle Lyons who was on my podcast who said, you know, I kind of a hack is like to say, what would you share with with your best friend about today's session? And what you get back tells you, tells you volumes, you know, and maybe that's the thing that you can add to the Post-it note. 

Jessica Hammond Jessica Yeah, there you go. It's a good idea. 

Lindsey Vestal Meg, what about you with your second half of your email? Like. 

Meghan Kasper You know, like all things Pelvic health It depends. But typically I am also giving a lot of overwhelming education, but I'm letting the client know that I am giving them an overwhelming amount of education. And I'm saying, Listen, you might get a little glassy eyed. I really want to dive into the nitty gritty of some really not fun stuff like anatomy and pressure systems. Because if I suspect that there's their issue is because of any pelvic floor tension, I'm explaining to them that we're going to look at all the reasons that pelvic floor might have tension. Maybe it's breathing patterns, maybe it's postural patterns, maybe it's our movement strategies, maybe it's our nervous system. And so I'm really like getting into all of that. And I'm giving a basic explanation of the pressure system and how our upper body and lower body impact our pelvic floor. And I'm letting them know to just stay present with me because I'm going to give them all this information and equally as overwhelming email later. And I also am letting them know that I'm going to give you some very simple homework. And I want you to understand, I want that simple homework to be relevant. And this education about the why to me is been super important. So and if I do feel like I have overwhelming them, I will check in or I. Pull back or maybe I'll just do breathing or just do posture instead of all of it. And so then I'm doing a pretty thorough postural assessment and breathing assessment. If there is time, I will do a core assessment, a Dra assessment, and of course, strategy assessment. And if the person's issues are not really pressure related, I might skip that core stuff and go. I'm also Janelle, a practitioner of Lynch royalties. And so if I have somebody that's coming in for CPD, I'm skipping a lot of that stuff and really focusing on bony alignment and what muscles might be working and what muscles are not working so that we can pull that pelvic X more into alignment. So sometimes people are leaving with breathing and posture homeworks. Sometimes they're just leaving with one thing, sometimes they get it and they're hungry. And I might be dipping into my second session with them. Well. So but I really just really want them to understand. My biggest takeaway for them is how you breathe throughout the day and how your posture is not. That has to be perfect all day, but if you're tuning into it in moments throughout your functional activities, and if you are sort of paying attention to what your core strategy is, that that is instrumental in Pelvic health healing. 

Lindsey Vestal Fantastic. I love that. Janelle, what about you? 

Janelle Golan At the core of the work that I do is this idea of getting out of your head and coming home to your body. So once I'm moving into that more, more hands on assessment, I'm really focusing on supporting that person to increase their awareness of what's happening in their body. So usually I start off just with some general listening with my hands just to see how the energy sitting in their body, like you say, rotational pull, is they swaying? Do they actually notice what is coming up in their bodies, their standing there? I love to do an assessment where they're sitting on the table in my hands. I bring them underneath onto the seat, bones. And just sitting with that and saying, what am I noticing? And talking to them about what I notice and then being curious about what they notice. And as we just sit there with that, noticing that they sink more into their body and then go, I'm actually feeling a pulse there, or I'm feeling that tingle down my toe. And so constantly that that conversation about I'm noticing this, what are you noticing in your body? So again, it depends. But often I am coming to the pelvis saying and being curious about how is it moving and how is it not moving where restrictions there. Can the person actually notice that one side of their pelvis is completely jacked up and blocked off and not able to move, whereas the other ones moving well and then just being led by that? What is going to bring more movement into this space, whether that self through through the ribs, through the spine, maybe it's down through the legs. What is going to do that? And sometimes we might feel something go, yes, and I can feel there's a restriction there. We'll work with that. But I think there's also a beautiful part of the assessment that can be so intuitive. Sometimes I'll be working with someone will be like, Why is this getting stuck or why are they not syncing in to what's happening here? And I'll just get this lever, get a look at the lipo. It's the ribs. And I think when we talk about evaluation, we can be so stuck in this idea of we follow this checklist and this is what happens next. And I love how I think particularly is, okay, we can bring that intuition in and get curious about all kinds of things. I know Ramona Haught and she talks about who are the cousins. It's not just who are the neighbors, who are the cousins. And we could have some theory behind that intuition. But just going with that and leaning into it. And when we create that time and space, it's amazing how often a client will say, I don't know if this is relevant. That's the cure for psych. It's extremely, extremely relevant. But I'm noticing this or I've just started thinking about that. And I think having that real fluidity through our assessment. And for me, I tend to come back to the pelvis is that anchor to assess what is changed, what is what is shifted as well as that current awareness of what is happening in their body. That's another sort of informal measure that I'm tracking against. They are. But just that real fluidity of that and the the randomness that can be so relevant in that assessment that I think that feels really relevant to highlight. 

Lindsey Vestal my goodness. I have like 22 more questions for every single one of you because I just want to know so much more. It's like I just found your lotion in the bathroom cabinet and I want to know what face wash you use. You know, like, I'm just like, so intrigued. But I think we're going to for the sake of time and with just like three questions, speed round style. So we'll just continue in the order. Jessica do you, Jessica age, Meg and Janelle. And the first question is how often do you see clients? And on average, I know this is such a hard question, but on average, how many sessions do you see them for? 

Jessica Dobson I see patients once a week, and that's because of my availability and it works for us. And I see them for any rounds of four sessions to a year and some so completely spectrum. 

Jessica Hammond Same here. About once a week, usually about, I would say on average, probably six weeks. Some I've been seeing for almost a year, but I would say average, probably like six weeks. 

Meghan Kasper Atypical. Typically see my clients twice a month, some pain patients or more three times a month. Occasionally I will do once a week if that's appropriate for the client. And sometimes I just do once a month. And the average postpartum issue is usually the turnaround is 3 to 6 visits. And then some of my for more chronic pain, people just really like to come in for the manual work as long as they can. But on average, I say it's about 3 to 6 visits.

Janelle Golan I have a lot of variability as well. I have some clients who I see just for once and they get what they need from that. And I, I can think of one person I've been saying on and off for five years now is they need. But I actually use that frequency of visits as part of that process of the person tuning into them. So, so often the goal, when do I need to come back? And I'll go, You're going to ask your body, When do you need to come back? Do you does your body feel like it quite quickly wants to keep following on and continuing to get support for what's happening and what's shifting for you? Or does your body actually need a reasonable amount of time? Is it a month that it needs to sit with that and integrate? Do you need to notice your body throughout your whole menstrual cycle before you come back? So from a business perspective, it can prove more challenging, but I actually use that. When do you need to come back? We're going to ask your body and I won't send them an email. Just checking in, saying how they feeling and might ask some questions that help guide that process. That's actually the person in my body that says when I need to come back. 

Lindsey Vestal That's beautiful. All right. Second speed round question. Same order, please. What surprised you the most about being a pelvic floor therapist? 

Jessica Dobson It would be this fun. I love it. And it's. It's the best thing ever. Yeah. 

Jessica Hammond Yeah, I would say the reward of it. I was not expecting it to feel so good to help people in this realm, but I would say that would be it for me to like the reward. 

Meghan Kasper I would say the reward is is the best benefit for me. But the surprise for me was what an art it is. No two pelvic floor therapists do things the same way, and even therapists that I resonate with in my area that we treat the same way we've taken the same courses. We and I've had a lot of clients that have hopped around to us just hearing their experience with with people's approach, not know one's better than the other, but there's just such an art to to how we take all of this education and this Oti approach and, and put it on our table. 

Janelle Golan I think, like others have seen how much fun it can be and what an amazing scope of practice to work within our profession on. But there's also something there about the connection that we get to build with our clients in this space and the real honor of sharing with them around topics and experiences that are deeply personal and how how beautiful it is with those connections that we make and the difference that Pelvic health makes to people and their occupational performance and the things that they want him to do. 

Lindsey Vestal The last question I have for our speed round is like, what lights you up in a session? What is your favorite aspect of the novel process with a client? 

Jessica Dobson The change, the change you see in that client's face when they know that you're going to be helping them. The smile. They leave that room knowing they're not alone and they have someone on their side. 

Jessica Hammond Yeah, I think I think that's a big one for me too. Like, just that connection, like building that connection. And finally, somebody understands and listen to me for the first time. 

Meghan Kasper I really love the moments. People have an awareness and when they start to become more literate about about their body and and understand their body more and and to actually get vocabulary for things that they've been feeling that they haven't had words for. 

Janelle Golan Again, I think it's those connections and seeing the look on people's faces when they can view their body and their experience in a different light and start noticing different things to what they noticed before, to have a shift in their awareness and a sense that they are actually broken, they just stuck in some way and that there is enormous capacity within their body to actually experience themselves and show up in the world differently despite what they might have been told or the message that they've received from other places. They aren't broken and there is enormous capacity, particularly in the female body. She is an incredible work of art. So I love I love sharing that with my clients. 

Lindsey Vestal Fantastic. I am beyond grateful for all of you sharing sharing this time with us and really, you know, helping us to reflect more on our own processes and to just celebrate yours. So thank you for your time today. It's such a pleasure. 

Outro Thanks for listening to another episode of OTs and Pelvic health. If you haven't already, hop onto Facebook and join my group OTs for Pelvic health, where we have thousands of OTs at all stages of their pelvic health career journey. This is such an incredibly supportive community where I go live each and every week. If you love this episode, please take a screenshot of this episode on your phone and posted to IG Facebook or wherever you post your stuff and be sure to tag me and let me know why you like this episode. This will help me to create in the future what you want to hear more of. Thanks again for listening to the OTs and Pelvic health podcast.