Combining Pelvic Health Therapy, Doula Services, and Childbirth Education

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More about my guest:
Courtney Trocinski
Since her doctoral capstone at a birth center in graduate school, Courtney found her lifelong passion and career in the birth world. As a doctor of occupational therapy specializing in pelvic health, she works primarily in fertility, prenatal and postpartum care. Courtney co-founded her practice, OWN Your Pelvic Health, in Denver, in 2021, where she manages a small team focused on women's health. Her co-founder focuses on pediatric pelvic health. They offer pelvic floor therapy, birth and postpartum doula services, personal training, childbirth education, and they also regularly host various workshops and support groups for expecting and new parents. OWN Your Pelvic Health is also home to a fabulous lactation consultant and massage therapist. When she's not treating clients, attending births, or teaching childbirth education, Courtney loves to spend time outside with her husband, taking advantage of everything Colorado has to offer.

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Transcript

Lindsey Vestal My guest today is Courtney Trocinski. Since getting her doctoral capstone at a birth center in graduate school, Courtney found her lifelong passion and career in the birth world as a doctor of occupational therapy specializing in Pelvic health. She works primarily in fertility, prenatal and postpartum care. Courtney co-founded her practice own Your Pelvic health in Denver in 2021, where she manages a small team focused on women's health. Her co-founder focuses on pediatric pelvic health. They offer pelvic floor therapy, birth and postpartum, Doula services, personal training, childbirth, education. And they regularly host various workshops and support groups for expecting and new parents. Own Your Pelvic health is also home to a fabulous lactation consultant and massage therapist. When Courtney is not treating clients, attending births or teaching childbirth education, she loves to spend time outside with her husband, taking advantage of everything Colorado has to offer. I can't wait for you to hear our conversation today. New and seasoned OTAs are finding their calling in Pelvic health. After all, what's more adult than sex, peeing and poop? But here's the question What does it take to become a successful, fulfilled and thriving OT 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 OTAs. We are out of the box, Otis. We are Pelvic health Otis. I'm your host Lindsey Vestal and welcome to the OTAs and Pelvic health Podcast. Courtney, thank you so much for being a guest on the Fellow for podcast. I've have been looking so forward to this conversation together. 

Courtney Trocinski Yeah, Thank you so much for having me. I'm excited to chat. 

Lindsey Vestal I am so curious. Since stepping away from conventional hair health care model. What specific challenges have you encountered? And more importantly, how do you think they've shaped your practice? 

Courtney Trocinski Great question. I think there's definitely the element of owning my own practice that is a challenge in and of itself. And I would say also the just the expectation that people have of health care in the United States and that what we can offer is so much better and helping people see that value. And so I think the biggest thing is in stepping away from like working in a hospital system, working in an inpatient rehab setting or with an insurance based practice, that what we do in that in a cash based practice out of network and kind of however we want to treat is so different and so much more valuable. I find a higher quality of care. I think one of the biggest challenges in helping people see that difference and kind of expressing that value because I do feel like we as a culture, as a society, don't value health care a ton and don't value preventative and proactive health care. And that's a lot of what we do in our practice. So I'd say that's definitely a challenge of just helping people understand how much better it can be and that they're worthy of that care. 

Lindsey Vestal What? I 100% agree with you. I get that. Have you found anything, you know, in your years of practicing that has helped answer that question? Like, how are you help? How are you able to bridge that gap to help them understand? And I know it's different case by case, but is there anyone, anything listen, anyone who could be listening to our chat today. Is there anything that you feel compelled to share that has been working for you guys? 

Courtney Trocinski I feel like we found it's more more of a word by mouth. And when people see that the change. So, like, people don't know what they don't know until they're in it. So when I think of like, we work with people throughout their fertility pre-natal postpartum journey, and that's one of our highest percentage of the population that we see. And so, like a lot of people don't know when the the value that preventative public health care can have for postpartum recovery. So when their friends say, hey, you should do this even if you're feeling great, and then they come and do that and and like word of mouth just slowly that kind of trickles through the neighborhood and the greater Denver area, I feel like that's probably been the most impactful. Because otherwise, you know, if someone's feeling fine throughout their pregnancy, they're not going to understand the value that we can bring when they don't know what's coming. 

Lindsey Vestal I 100% love that. And I'm curious if you do anything when you discharge a client to kind of let them know, hey, there's so much value in this kind of preventative work we've done together. And I'm not so sure that the word is really out there, you know, because the thing is, we sometimes make expect our clients to make that assumption that that they went through it so everyone else understands it. Do you guys have any sort of like practice in, you know, in your own practice that lets clients know, hey, I would love it if you shared your experience with others? 

Courtney Trocinski Yeah. Yeah, absolutely. And I think I found that I don't necessarily even have to tell them because it's been so life changing for them that they then go and share with all of their friends and their sister and sister in law and whoever their hairdresser. I've had a lot of people come from the same hairdresser who had a really significant experience. And so everyone is, you know, people talk about things and when they're getting their drugs. So I find that, you know, just through the word of mouth and in different pockets of community, people have just shared because it's made pretty significant differences in their journey. 

Lindsey Vestal That's awesome. And you're in a great area. Denver is just I think, so fantastic and so ripe for for the type of health care you guys are providing. 

Courtney Trocinski Absolutely. 

Lindsey Vestal Are there any other health care professionals that you guys frequently collaborate with to support your clients holistically? 

Courtney Trocinski Yes, we feel strongly about a whole team approach and that, you know, we can't do everything and be everyone. So there is a pretty close group of, I would say like chiropractor, lactation consultant, acupuncture, as does midwives. We have a group of people that, you know, we send referrals back and forth pretty consistently and kind of collaborate on their care. So I'd say daily mental health. I didn't mention that's a huge one, but daily we're kind of sending sending emails and phone calls back and forth about collaborating about different clients. 

Lindsey Vestal How did you get that network to begin with? 

Courtney Trocinski Just a lot of years of, you know, coffee dates and emails back and forth and finding finding our village of people that kind of had a similar approach and fit our vibe, if you will, a gist of how we treat and what's important to us in chronic care. And I also like we would trade services. So like I would receive an acupuncture visit and they would receive pelvic floor therapy for me. So that I also felt really confident about the type of care that I was sending my client to because I had experienced that. 

Lindsey Vestal I've done. I did the exact same thing in New York City when I had my private practice. Is there anything in that journey of kind of creating, like I call it like a high vibe tribe, like, you know, people that like, as you said, like really share your values. Was there any experience that comes to mind where it was a learning lesson for you? So I'm really just trying to think about the hotties listening to our chat today that, you know, are in the throes of it and are trying to get to where you guys are now. Any like learning lessons or takeaway points that come to mind for you that you would want them to know in that journey of getting that high vibe? Tribe? 

Courtney Trocinski I would say the biggest thing is that it's it's it takes quantity to find the quality. So I, I would say when we were first starting that whole first year, I, I met with hundreds of people truly to kind of find who I vibed with best. And there are plenty of people who. We don't refer to each other and I haven't spoken with them in years. And there's other people who have become good friends and we refer back and forth frequently. So I would say finding like prioritizing the time of those coffee dates or the walks or whatever it is, and finding the people that are quality time and it can take a lot of time and effort and it's unpaid effort, but it's really important. And I personally just have enjoyed that a lot of like the networking and meeting with people who have a similar interest in providing really quality health care. 

Lindsey Vestal I think that that's such a crucial part of it and it really does. I find that it gives back to us as well, because sometimes we're learning about new techniques, new strategies that we can share with our clients to also let them know we've met with these practitioners like they are coming to us from firsthand knowledge and experience, especially in the case where you trade its services. And I think that that's such an underestimate it, you know, experience that you can share as a practice. Are you guys still finding new practitioners? Are you still trying to make connections in the network or are you have you see do you guys think you've done enough and you're sort of existing on those relationships that you've already formed? 

Courtney Trocinski I have found that that is the one thing that stayed consistent over the years, even as we've grown that I'm still constantly meeting with people. And it's been one of the things that I need to almost cut back on because it may is not the most important thing I need to be doing in the week, but I enjoy it the most. And so I pretty regularly have at least two, you know, coffee dates on my schedule in the week to meet new people. And whether it's someone that I just realized has a yoga studio down the street, even though we've been here for two years, or if it's somebody that's reached out to us because they're interested in what we're doing. So I think it's definitely stayed consistent over the years, and I imagine it will continue to as more and more people are finding that this is where quality care is. 

Lindsey Vestal Honestly, Courtney, I'm so relieved to hear you say that because my husband, Doug Vestal helps O.T. start their private pay practices. And one of the things that he is constantly sharing through his mentorship is exactly what you said. Like it is not a one and done. It is one of those things that even practice owners who have been in business ten plus 15 years are still investing in the community. Not only are there always new businesses opening up that we can collaborate with, but referral sources come from all over the place. And I remember I was so nervous when the one practitioner who probably gave me 55 or 65% of my referrals stopped sending to me because they merged practices with another another practitioner and just kind of took a pause on our furloughs as they took a moratorium of their own business and suddenly my schedule was cut by 50, 60%. And I was so scared. And I just remember thinking just how important it was to really diversify referral streams and to just constantly be giving back in that way through workshops, coffee dates, etc.. So I'd love to hear that because I know you guys are thriving in Denver and just doing amazing things for your community. So I'm so glad to hear and to get that feedback from you. I also read a couple of articles because you guys have some great press out there. And one of the things that was really mentioned was your focus on integrating the mind body practice into your sessions. Would you tell us a little bit about that? 

Courtney Trocinski Yeah, I feel like coming into the Pelvic health worlds, you know, five or so years ago, it seems like, you know, knowing the history of public health and the history of attempted seems like kind of there are theories and our approaches are really focusing so much more on the nervous system. And so a lot of the coursework that I'm taking and what I'm finding in my own practice is that we really need a nervous system first approach. And I know, you know, as as TI is very looking at the whole body and that's what we learn in school. And so I find that it's just second nature and how we treat, but. I would say like tangibly impact us. A lot of it looks like, you know, really getting into details with the client of what's truly going on. And I realized early on when I wasn't asking the right questions, I was missing pretty big pieces of of of the client's puzzle. So like early postpartum, of course, sleep and mental health play a massive role in lactation and how feeding is going play a really huge role. And if we're not asking the right specific questions, it's pretty easy for someone to gloss over, I'm doing okay. Yep, I have a therapist. This is all going well. And you know, if there's tension being held in their body or there's trauma from birth or early postpartum, that's not being addressed. Nothing that we do in a session is going to really stick or make a difference. And so firstly, I would say it's really getting at that like the right questions. It's a really I think that's one of the hardest skills that I've learned and like teaching other physicians of like asking those right questions. And then otherwise it's a lot of, you know, manual techniques and exercises and, you know, everything that we do that kind of altogether addresses that nervous system first. My. 

Lindsey Vestal Gosh, you know, you're speaking my language. I always say that when working with the pelvic floor, we're working with the nervous system. And so, yes, I love I love how you said nervous system. First you gave us an example, especially because you do work so much with the pre and postnatal population. You give us an example of like sleep and lactation. Are there any other questions that that come to mind to you as being really pivotal to ask our clients? 

Courtney Trocinski Yes. I also think just it's it really comes down to the details and like what happened that day or that week, like if a symptom is coming up, like, you know, they might say, Yeah, yeah, I drink water every day or yeah, three meals a day and think, okay, what was this morning. Tell me about this morning? And it's like, actually I didn't eat breakfast. I forgot my water bottle. It's like, is this a normal day or is this just today? And so I feel like no matter what the topic is, you know, bladder, bowel, pain, sex, getting into the details of of what specifically is going on in that moment rather than just how's about this week now constipation. Great because a lot of times we miss what's most important. 

Lindsey Vestal I have some super exciting news for you. O.T. Pioneers ensured a pelvic floor therapy is opening for enrollment January 13th through the 17th, 2025. This is your chance to dive into a 100% online course with lifetime access. You'll get five group mentoring calls with me and two free months inside our off social media private community Pelvic TPP's United. Plus, we're hosting an optional in-person lab in Cleveland on February 21st and 22nd. Please come join over 1500 other hotties who have already taken the leap. I can't wait to see you inside Oti Pioneers Enrollment January 13th through 17th 2025. Yeah. That's amazing. I just love the gritty approach. So I would love to hear Courtney just like a meaningful client experience or, you know, case study of sorts that really had a lasting impact on you that that has informed sort of the confidence that you're that you're sharing with us today regarding how you approach your work. 

Courtney Trocinski Yeah. I would say I think of so many people, but what comes to mind is people that I have seen over the course of many years, and because I do work primarily with pre-natal postpartum population, I think of a couple of clients in particular that I maybe was not part of their first pregnancy journey or their first birth journey and was a little bit traumatic or didn't go according to their their plan or their wishes or what they hoped it would be. And so we found each other postpartum and have worked through symptoms and life, and they've kind of stayed on as maintenance clients where we see each other monthly. It just, you know, something pops up with the shoulder or neck, you know, we treat the whole body so well, I'll treat whatever is going on. And then they get pregnant again. And they asked me to be there July. They asked me to be part of their pregnancy journey for that second, second pregnancy and second birth. And it's a different kind of redeeming experience. And I think that there's so much power in that knowing that that first experience, they didn't have the education, they didn't have their their own confidence in their body and everything that we have learned together. And then once they do that second pregnancy, the birth, the postpartum journey all go so much more smoothly. And I've seen it enough times that it's it's too much to be coincidence. And so I, I believe pretty strongly in what we do because I've seen the difference that it makes on that second time around. 

Lindsey Vestal Yeah, that is so beautiful and so true. It's it's incredible. I would love to hear a little bit about how you handle, let's say, like emotionally intense cases, especially when a client of yours had some sort of traumatic birth. 

Courtney Trocinski Yeah, I would say that's that's been one of the hardest things for me. I mean, just working in a health care and, you know, a profession where we care so deeply. And I, you know, I felt this even when I didn't have this practice. I worked in a hospital. I would take things home with me and think about these people beyond. But I'm sure they thought about me. But I think birth in particular is so it can be so happy and there's so many factors. And I, I think part of what helps me is also being in birth rooms, like having experienced births as a Dula, I have I've seen a lot of different types of births. I've seen how things can go. I've seen what what can happen. And so I think when I meet somebody that's had a traumatic experience, I also have a little bit of a framework for it. Like I've seen some of those things happen and I've seen certain ways that people are treated her talked to and how there can be kind of a loss of control in that birth space, no matter the setting, no matter the provider. And then it's also individual. So I think it it helps to kind of have that experience of seeing things that happen and also working through that on my own of like I've had some secondary birth trauma, like recognizing that, working through that with my own therapist and then being able to hold that space for somebody who has had the traumatic experience and being able to offer them the support that they need at that time. But it's definitely always it's always tricky, it's always heavy. And I think the other thing I found that's helpful is kind of frame framing my day in a way that I know if if there's going to be a particularly heavy session to like maybe give myself an hour afterwards that I'm not going directly into the next session or to plan it on a day that I know I'm going to have some time because I personally also need a little more time to just kind of process a more emotionally charged session. 

Lindsey Vestal 100%. And that reminds me because I know you guys offer do services, right? And so remind me the size of your team and how many of you guys are still actively providing those services. 

Courtney Trocinski Yeah. So there are four, four of us births to us and then to postpartum to us. And so we part of my reason in kind of bringing a couple of people on as their their contractors, they have their own businesses. We just also work as a team with. I was finding that, you know, being a does kind of independent isolating work and I was wanting more of that support where I would attend, you know, a really wonderful birth or really challenging birth. And I wanted to talk to somebody about it besides my therapist. And my husband can only tell them so many birth stories. So having a team has been really helpful that just process all those details, like from the support person perspective and what we can do better. So we kind of just take on clients as they come and we serve as each other's backups. 

Lindsey Vestal You guys have a formal process for supporting each other through those birth experiences? 

Courtney Trocinski Yes, so I'm working on it. We just kind of formed this team earlier this summer and as we're getting everything together, figuring out a way to like meet pretty regularly, to be able to talk through tough cases and also do a little bit of form of like continuing education and making sure that we're providing the best care possible. So right now it looks like kind of monthly sessions. 

Lindsey Vestal I love that. I love that. You know, I, I haven't met many practice owners who offer this component. You know, I know you guys do like personal training, childbirth, education, the dual services and everything. And I, I just it, it feels like a one stop shop in many ways. And so I just wanted to stop and give you such acknowledgment because it's just I would have loved that when I was pregnant. 

Courtney Trocinski Yeah, I appreciate that. And that that's kind of been my goal of of bringing people together to support. Families through what is a really can be a really intense and challenging time of life if you don't have that support. And I've seen the difference when people have the support versus not having it and just knowing that even if your lactation journey is going really smoothly, we have someone here just to check in, answer your questions. Something comes up. Things were going well and then they're not great. She's here. She can help you. And having everyone in one space and having vetted all of the people that I know, they're providing the best possible care so that, you know, this neighborhood has the best support that we can offer. 

Lindsey Vestal It's amazing. And you guys are all on the same page, too. Like, I remember going to childbirth education well over 13 years ago now. And, you know, there was nothing about the pelvic floor mentioned. And I think, you know, even my Julia, like, I absolutely adore her, but I know that there wasn't a lot of conversations around pelvic floor care. And and so it sounds like the team you assembled is also on the same page, which means everybody's kind of listening proactively for for the signs and signals when maybe we come back to the team and share a story or an experience. And honestly, I think that that is like so worth its weight in goal to have that. 

Courtney Trocinski Yeah, absolutely. I'm part of it transparently starting, you know, in my mid-twenties was building the team that I would want for myself because I was working with people that I realized didn't have that. And I know, you know, if I someday choose to have children down that down the road that I have this team that I have the support that, you know, I feel like is the best support that we can offer in Denver. So it's also a little bit selfish. Creating the team for myself. 

Lindsey Vestal And that's what's selfish about it. I think it's it's a service that has been inviting so many, so many. Courtney, can you share anything regarding maybe this is sometimes hard to take this moratorium, but can you share maybe how your approach to Pelvic health has evolved over time? 

Courtney Trocinski Yes, I would say probably the biggest thing is getting out of my head and trusting what I'm hearing and seeing, which I think just takes time. As a clinician in general, and I say this still as a very new therapist that I've learned a lot, so I can only imagine what the next, you know, ten, 15, 20 years might hold. But I think I've learned to trust what what I'm hearing the person in front of me say, trust my hands with what I'm feeling. And rather, I think I, I started out wanting to like over plan sessions and make sure that somebody was getting the most value out of it that I could possibly give them. And I was over educating and giving them way too much and they were not on the same page at all. And I think since stepping back and giving people a really bite sized education, really bite sized things to do at home that fit into their life and in the session, really trusting that what I'm seeing and hearing is most important and following that intuition rather than, you know what, whatever. I'm imagining this these muscles and this pelvis is doing. It's more it doesn't necessarily. Matter if that makes sense. 

Lindsey Vestal Percent It makes sense. And what really resonated with me as you were speaking was this idea of over planning. You know, like I, as you know, I support practitioners getting into Pelvic health through pioneers. And I think this idea of wanting to over plan, feeling like it's our obligation, like we're doing right by the client when we over plan and we may not even identify it as over planning, but it definitely is. And the thing is, I really find that when we do that, we've kind of come in with a program. And sometimes that program isn't going to serve our client in that moment because of some new development. Because sometimes when we're present, we're hearing that they're actually needing something else than what we planned for them that day. And so being flexible with a loose structure of how you'll take the session, but then being able to pivot based on the fact that maybe they did break down and let you sleep hasn't been going well. And so guess what? That day you're probably going to be talking about sleep hygiene and some other nourishing supportive practices versus getting in that internal exam. And I and so I really appreciate you saying that because I think that it gives ourselves a little bit more grace and be reminding ourselves of that overwhelm that you talked about. You mentioned bite size, education, bite size, things. You know, and I know pioneers we talk a lot about just like having them leave with three areas of focus, you know, just three things. And sometimes that might even be too much. And that helps our brain start to recognize when we might be crossing that line with our genuine enthusiasm of literally wanting to impart our all of our knowledge into them in session one, which is like such, such a strong need that I think we have. And so I love that advice. I think that is is so spot on. And so I really appreciate you bringing that up. 

Courtney Trocinski Yes, It's really taken time to step back and not tell them everything I know about you. That's awesome, Courtney. 

Lindsey Vestal Well, I have one last question for you, which is, what advice do you have for anyone entering Pelvic health or Dula work? Outside of all the nuggets and words of wisdom you've already shared with us? 

Courtney Trocinski I think I would say the biggest is to not be afraid to just start because I think a specialty like this can feel really intimidating. But I have found that even when you're really new, even when you have so, so much left to learn, you're still going to provide better care than they're going to probably get anywhere else. So just having the confidence to know that what you know is enough at that time and you can learn from the people in front of you where like I think I found that I was seeing a lot of training on postpartum clients. That was my biggest interest. And then I was finding like, okay, now I need to learn more about prolapse. Now I need to learn a little bit more about Diocese's and letting my clients kind of lead me as far as what specifically I needed to learn more. Was it the manual techniques, practice, exercise, kind of letting that guide my choice of continuing education because it's so overwhelming and there's so much to learn. So I think just stepping back and starting with what we know is enough and then going from there. 

Lindsey Vestal 100% agree with you. And so I also think that once you have that foundational knowledge and you're with your client and I always say that our clients teach us the most that that we can, we then start to realize exactly as you said, what skills we need to add on. So I don't need to come to that first session with all those skills. I'm going to be guided. I think a lot of times by the the work that we're doing in the room and by the clientele that's reaching us to know what we need to do next. Because as you said, we don't know what we don't know. And until we really get in there and figure out who I really want to be for my movement options and how I'm prescribing exercises, you know, actually, I want to learn more about this from manipulation or any of those skills that we can grow into. So I really appreciate you bringing that up, because I think that also brings my listeners a tremendous amount of relief knowing that they don't have to walk in the expert the day that they start treating Pelvic health clients. 

Courtney Trocinski Yeah, and I think it's pretty tricky until you actually do it and realize that we know so much more than we think we know. And also, I look back to several years ago and think, wow, I really I really started when I didn't know what to do and it was okay. And those people still got better. And I'm a better therapist now. And we learn from that. 

Lindsey Vestal If we don't start like we're the world's best kept secret, you know, like, we. 

Courtney Trocinski Just got to that. We got to get out there. 

Lindsey Vestal Courtney, it has been so much fun talking with you today. I really appreciate you spending this time with us and sharing sharing those like your personal and professional philosophy. You guys are doing amazing things and just so grateful for you to be a part. Part of our community. 

Courtney Trocinski Thank you so much. That means so much. And I'm really excited to just have the chance to talk with you. 

Lindsey Vestal Thanks for listening to another episode of Ateez and Pelvic health. If you haven't already, hop on to Facebook and join my group Otis for Pelvic health, where we have thousands of Otis 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 Otis and Pelvic health podcast.