Hypermobility and Pelvic Health: A Journey of Resilience, Awareness, and Transformation

Resources mentioned in this episode:

• Doug Vestal's Private Pay MBA course   (that Nicole took to help her start her business)
• Spider hypermobility test
• Disjointed: Navigating the Diagnosis and Management of Hypermobile Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders 
• The Trifecta Passport: Tools for Mast Cell Activation Syndrome, Postural Orthostatic Tachycardia Syndrome and Ehlers-Danlos Syndrome
• Saving My Sister: How I Created Meaning from Addiction and Loss by Nicole Davis Woodruff
• POTs Providers Course by OT Emily Rich
• Hypermobility Solutions by PT Kathy Walker

More about my guest:
Nicole Woodruff, OTD, OTR/L, PCES, GTS, RYT, is an occupational therapist, author, and owner of Intuitive Therapies & Pelvic Health in Tampa, Florida. With over 12 years of experience across various settings, Nicole now specializes in treating pelvic floor dysfunction, hypermobility, and chronic conditions. She takes a holistic and trauma-informed approach to care, combining lifestyle medicine, manual therapy techniques, and movement-based practices to help clients achieve their goals. Drawing from her personal journey with hypermobile Ehlers-Danlos Syndrome (hEDS) and Postural Orthostatic Tachycardia Syndrome (POTS), Nicole combines professional expertise with lived experience to offer a unique and empathetic approach to care. She is passionate about empowering clients to improve their quality of life and dedicated to raising awareness about the intersection of pelvic health, hypermobility, and other chronic conditions through education, advocacy, and patient-centered care. Outside of the clinic, Nicole is married to her husband, Cort, and a boy mom to two little ones. She enjoys spending time with family while exploring new places, practicing yoga, and going to concerts.
How you can connect with Nicole:
Instagram / Tiktok handle: @nicolepelvicot

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Transcript

Lindsey Vestal My guest today is Nicole Woodruff, who is an occupational therapist, author and owner of Intuitive Therapies and Pelvic health in Tampa, Florida, with over 12 years of experience across various settings. Nicole now specializes in treating pelvic floor dysfunction, hypermobility and chronic conditions. She has this unique blend of holistic and trauma informed approach to care, combining lifestyle, medicine, manual therapy techniques and movement based practices to help her clients achieve their goals. Drawing from her personal journey with hyper mobile air close download syndrome and postural orthostatic tachycardia syndrome. She combines professional expertise with lived experience. Outside of the clinic. Nicole is married to her husband, Court and boy mom to two little ones. She enjoys spending time with her family while exploring new places, practicing yoga and going to concerts. I cannot wait for us to chat today. New and seasoned oats 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 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 Otis=OTs. We are out of the box OTAs. We are Pelvic health OTAs. I'm your host Lindsey Vestal and welcome to the OTAs and Pelvic health Podcast. Nicole, thank you so much for being a guest on the Hot Pelvic health podcast. I have to tell you, I am really excited about our conversation today. 

Nicole Woodruff Thank you so much, Lindsay, for having me. I'm really just honored and so excited to be here. 

Nicole Woodruff I want to do a quick teaser here and mention that the topic today all about Hypermobility and supporting our Pelvic health clients. Nicole will be joining us at the fourth annual Oats and Pelvic health Summit, happening this September 2025 to talk about this very topic. So how lucky are we? 

Nicole Woodruff Yeah, I am so excited to share all the things and I'm really looking forward to the summit. I was sad that I couldn't be there last year, so. 

Nicole Woodruff We're so glad to have you. And this is just something that we should be talking more and more about. And, you know, because I'm not sure we really understand all of the nuances of this topic. And so I'm really glad that we're we're going to dive into this today. And I know that that you're going to be able to go into some much more depth at the summit. So I'm very much looking forward to that. You have some things I want to kick it off with. Would you mind sharing with us a little bit about your own experiences with Hypermobility personally? 

Nicole Woodruff Yes. So I have been hyper mobile like my whole life. Right? But I never really understood the implications of that until, honestly, almost two years ago. So I was diagnosed with hyper mobile ehlers-danlos syndrome in September of 2023. And I got to give a shout out to you, honestly, because you had my and I'm sorry, I cannot think of her name right now on your podcast talking about Hypermobility. Libby Hensley Yes, yes. You had her on your podcast in the in that summer. I think it might have been like July or something. And I was resonating with so much of what she was saying. And I thought to myself like, all right, I'm not because I have been searching and reading about it over the last few years, but I didn't really connect all the dots until that podcast. And I thought to myself, okay, I'm going to find a specialist and I'm going to look into this now after all these years of having unexplained issues. So a little background is when I was in my early 20s, I was working as an O. T, and I would come home every day from work and I would be exhausted. And I had so much pain and I didn't understand any of it. There was really no explanation. And when I was 25, I was given the label of having fibromyalgia, and I basically just masked my pain and I just kind of went through life and pretended that it wasn't there and did a lot of things to try to help. But I never really understood it until, again, just a few years ago. But I had always been hyper mobile. I loved doing yoga. I was a gymnast when I was a young girl, and I just never knew how that that all could be connected. But when Libby was talking about pots was when I was like mind blown because I really, truly thought that pot's was a more symptomatic condition in the sense of like, having more cardiac episodes and having things happen that like, you're passing out and you're really having like just a lot of severe issues from a cardiac perspective. And that was not what I was living, but I was really resonating with her talking about the brain fog and fatigue and just feeling, you know, a lot of these other symptoms in relation to like orthostatic hypotension and feeling dizzy at times. And so I honestly don't know if I would have pursued the Hypermobility diagnosis if I didn't understand the connection with Pots and just how much that was affecting my brain on a day to day basis and my ability to show up as a as a healer for other people and really care for others, when I truly felt like I was not in a good place myself. So that that diagnosis and that experience of learning more about my body and myself really just like. Opened up my eyes to just so much of the that the connection between these diagnoses and how they're related to so many other diagnoses that are misunderstood as well, and especially with pelvic health and pelvic floor clients. And so I just kept, you know, learning more on my own as my personal journey. And then I started to notice patterns in my clients as I continued to do, you know, work as a O.T. and Pelvic health and I'll get into more later. But it just was so fascinating to be able to connect the dots and then use my own personal experience to influence my my work as an empty Wow. 

Nicole Woodruff I love how this has come full circle. I just briefly looked up while you were talking and Libby's episode, which was episode number 58, came out in July 2023. So within two short months, three short months of hearing that podcast, you went you were so proactive that you then went and sought out a diagnosis and then I'm sure have been on a long journey to continue to support yourself with that. But I cannot tell you a happy that makes me that that you were able to, as a healer, as a human being, that I just respect so much, like to be able to connect those dots for yourself to now finally have like a full understanding of what your day in and day out experiences have been, which can feel sort of like nebulous and not connected. As you said, you were given that diagnosis of hyper malaria, which we know is just kind of a catchall for we don't know what's going on with you. I am just I didn't know this, Nicole, And I'm so, so honored and so happy that that that episode is able to help you and also want to applaud your action of then pursuing it and, and really, you know, being able to put those pieces together for yourself. Absolutely awesome. I'd love to know a little bit more about what inspired you to specialize in Pelvic health and how have your own personal experiences with Hypermobility and Pelvic health really kind of influenced your career? 

Nicole Woodruff Yes, and I'm so excited to answer this question because this is real. You really get the full background of how I got into Pelvic health and all the things, but essentially so in 2019, I, I moved to Florida with my husband and we didn't have kids yet at the time. And I had just ended five years of working in home health and I just felt just so burned out. Honestly, by Oti, I was like, I don't know if I can do this anymore. I really don't. And so we moved here and I took a little bit of a break from work. But eventually I was like, okay, I really want to get back to something. So I ended up working part time at an assisted living facility, and during that process, within four months, I felt it again. I'm like, I'm burnout. Like, I really don't know how I can see this going forward. So at the end of 2019 and then starting into 2020, I enrolled in a yoga teacher training. Like, I just want to do something different. And I was writing a book, so I decided to take a break from O.T. and at the time I became pregnant with my first year. So I was pregnant. We all know what happened in 2020, so the pandemic happened and so I ended up finishing that yoga teacher training on Zoom and, you know, writing my book. I had my my son in August of 2020. And after that, I ended up with so many pelvic floor problems that looking back on now that I know all I know, I really did have like underlying pelvic floor dysfunction. Like my whole life I had like urgent continence in college and I would always have that urgency, feeling and history of ovarian cysts and all these things I just didn't necessarily know were connected. But it really hit me like a ton of bricks. When I was postpartum, I had a terrible second degree tear that wasn't classified as terrible because it wasn't quite third or fourth, but it was really bad. And it took me forever to heal. I mean, 11 weeks long, I was still bleeding and postpartum and I was really going through it. And I just thought at the time because again, I wasn't pelvic health trained or anything, but this was just normal for women to be suffering like this and that you will just get better. But it really didn't get better for a long time. And because of that I was suffering with postpartum depression. I really didn't realize how much my being neurodivergent and ADHD affected me and postpartum with the hormone dip, and I was really struggling. Eventually I started pelvic floor therapy and I had a pelvic floor therapist come to my home, which was lovely for probably like it was definitely over six months, maybe even close to a year. I saw her and it was life changing. You know, here I was doing yoga for so many years. I was breathing wrong. I. Is doing all the things wrong. You know, and I learned how to, you know, engage with my core and connect with my pelvic floor. And, well, I ended up with prolapse. I guess I didn't mention that. But while the prolapse did not necessarily go away, I learned how to manage it and I was having less symptoms and I was feeling a lot better. So in 2021, I actually did a pre-natal yoga teacher training because I felt really inspired by my own journey and I was already teaching yoga. And during that they talked about the pelvic floor so much and I thought, my gosh, like this. I think I what if I can do this? And so I started to look up like, can Otis, you know, take these courses to specialize in Pelvic health. And I had reached out to my PC and she recommended Herman Wallace. And I found a course that was in August of that year. So four months after the prenatal training, I took my first level one pelvic floor course. And from there I really didn't have like a direction of exactly what I was going to do. But I started doing some home visits like in my community, and I was teaching yoga and I taught some workshops and I was just really loving, like all things related to women's health and pelvic floor health. But I was taking my business really slow because I ended up pregnant with my second child shortly after that. So and I really didn't want to make anything too extensive until I had my second kids. So in that time postpartum, I in my after my next son, I had a much different experience. I had a lot of birth and a much more redemptive postpartum experience, but I still had pelvic floor issues. Again, I'm realizing these are more chronic things I'm going to have to manage throughout my life. But in that postpartum period, about five months and I decided to go work for another clinician at a private cash based practice. And I did that for 18 months until June of 2020, for this year and this past year where I decided to open my own practice. So it was a big decision and I was really scared. But essentially 18 months into, again, working for another person, while the experience was amazing and I cannot think that experience enough for getting me to where I'm at now because I got the reps. And that's how I say like, I really got to see so many different clients, so many different diagnoses and got the experience I needed to feel confident to then now build a business. I felt overwhelmed trying to do both at the same time. So after that I just started to notice that I just couldn't. Like again, I was feeling really tired. At the end of the day, it was burning out, honestly. And I noticed a trend in several of my clients who were having pelvic issues, whether that's urinary or pelvic pain or. Digestive problems like different pelvic health concerns that we're not necessarily getting better with, like the traditional approaches that we take. And I'm starting to connect the dots for a lot of them that, hey, you might you might be hyper mobile or there might be more going on here. And I thought to myself, you know what? If I could specialize in helping people that are kind of like me that did not really understand their bodies until later in life, who are on this type of mobility spectrum, who have more of these chronic, complicated conditions, know that they're not alone. And there is people that understand and there's a lot of things we can do to help, but it may not be the most straightforward path to get there because there's a lot of other things to consider. And I think that's really what I wanted to set out to do. And with opening my practice, I kind of went all in with that. With that in mind and got people there finding me. So it's working and I'm really excited to be where I'm at now in my office. 

Nicole Woodruff So thank you so much for sharing all of that with us. It's quite a journey and I think that so many of the reflections and observations that you have made are part of what's making you such a spectacular clinician because of what you said, this evolution of discovering, discovering your body, understanding your body, connecting the dots as you get older is it is a real gift. And while some of us maybe wish we we knew that gifts sooner, I always believe it happens when when it needs to. And so I really appreciate that. And I also have to commend you because I happen to know that you are such an action taker. I know that you worked with Doug Vestal, my husband, with Private Pemba, with starting your own practice, and he, like you're one of your one of his rock star students because of your ability to take action. And I feel like that was also evident at the start of our conversation when you told me you listened to that podcast episode in July and in September had a diagnosis. And so I just personally feel that taking action and responding to information that the universe gives you is really key to to getting through confusion, cutting through that that mess and making clarity of what was next. And I think all of that set you up for working for someone else. But then to be able to open up your own private practice. So I really want to call it out and just tell you how much I admire that. Also. Nicole, tell us tell us the name of your book. 

Nicole Woodruff Yes, my books name is Saving My Sister, and it is a memoir I published in May of 2022. And it is about my journey of loving my older sister, Amanda, who died from an opioid overdose in 2019. So before she died, we had talked about writing a book together. And so when I kind of had this like crossroads and, you know, we moved from Tennessee to Florida, and I had quit my job and I just went for it. I was like, Well, I think it's probably time. And, you know, we talked about writing that book, so I found a way to make that happen. And yeah, it was a labor of love for a few years, but I published in 22 and yeah, stories out there. 

Nicole Woodruff So if you don't mind, I'll link to that in the show notes for anyone that would be interested in reading that. So I appreciate that. Sounds beautiful. We could have a whole nother episode just on that. I will keep us. I will keep us focused here. I'd love to talk now a little bit about the misconceptions that you commonly encounter around Hypermobility and Pelvic health and how you address them. Yeah, so it's kind of honestly. 

Nicole Woodruff It's a little bit of twofold. I think one big thing about Hypermobility in itself is that it's really rare and that's the thing that I think is a big misconception because it's really not all that rare. And I wish that more people with pelvic health concerns understood that it could be linked back to being hyper mobile. So that is a big thing because I have been able to connect the dots for some people and then point them in the direction of getting a diagnosis. And once people have that understanding, it really does make a big difference and piecing things together throughout your life. And also just knowing that like it's okay, like if you're going to need to maybe work at this intermittently throughout your life, like it's going to change, like symptoms can improve and then they can they can fluctuate, right? So you might have flare ups and then you'll have periods where things are great and then you might have a dip again where something happens and then you're symptomatic. But that's kind of par for the course with a chronic condition. And I think understanding that like provides just a level of acceptance instead of like feeling shame or, you know, what did I do wrong or what overanalyzing your symptoms and your activities. Like, what could I have done? Caused this and what was this and what was that? And just understanding that sometimes things flare. You know, and your connective tissue is not the same as someone else's. And so your muscles are hypertonic for that reason. And it just explaining how all those things are connected and stress can increase the muscle hyperactivity, you know, all of the things. So I think having that understanding is really important. And then another misconception I feel like I find in people who are hyper mobile is just like almost people think that we're like really fragile or like that. We're really bendy and like, gosh, we better watch out. And that's that's not that is not what I buy now. I see people that are hyper mobile all the time and some of the stiffest people ever. You won't believe just how tight and stiff and immobile as they age hyper mobile people are. Because with all that overactive and joint joint laxity and like the. Overactive is the word I'm using. Because if you think about how the joints are just constantly moving on themselves, right, because the connective tissue is not supporting it, you are at a higher risk of having earlier onset of arthritis and earlier onset of like digital degeneration and things like that because the joints are not supported in the way that they need to be. And so with that friction of bone on bone, you're going to have more of those like bone sparing and things happening and then muscles are going to be tighter trying to stabilize. So we might be really, really, really bendy when we're young. But you grow up and you are so stiff by your mid-thirties and I'm telling people that you could be hyper mobile and they're looking at me thinking there's no way because I'm way too stiff. But I'm like, But were you always this dead? So that is just another big thing. We're not as fragile as people think that we are. 

Nicole Woodruff So that is so interesting. And, you know, the bite and test, right, is is that test of hypermobility. I actually teach it in what Pioneers is kind of a screening love for our clients. Do you think if someone did the bite like, let's say, Nicole, you did the buy and test today, would we classify you as hyper mobile? 

Nicole Woodruff Yes, I'm still very hyper mobile, you know, in my mid 30s, but they're like in 5 to 10 years by the time I'm 35 now, by the time I'm 45, I don't I honestly don't know what I score on it. And it's I don't know. But there are some people who are very borderline on the bite. And I love that you teach that in those pioneers because we do need some basic generalized screening tools that are quick and easy to do. We need that. But there are some other ones that are even more involved and talk about more about like the comorbidities and stuff that you'll see, which I like a little bit more. Just because the buy in does miss other joints that are often more hyper mobile. Like for a lot of people, you know, the hip, the shoulder are very hyper mobile and the bite in tends to look more at the a lot of the hand, like there's four points just for the hand. And then so there's six points total from the upper extremity and then only three that have to do with the lower extremity and one is the spine. So it's, it's not quite, it's not the best screen tool, but it's all we really have right now. And I'm hoping it's going to be more research and more validated tools in the future. But yeah, not every does not catch everybody. And I have had clients come through who really are not a positive on the buy in, but they still got a diagnosis because they had an informed physician who knows other ways and other things to look for outside of that scale. But there are a lot of people that are missed by rheumatologists and even neurologists that are not as an understanding of hypermobility that will not diagnose people because their buy in is not a positive score. 

Nicole Woodruff So this actually leads us really naturally to the question I wanted to ask you next, which is are there specific assessment tools or techniques that you rely on when working with your hyper mobile clients? 

Nicole Woodruff Yeah. So there is one called the Spider. So the spider is great. It's really it looks like multi systemic symptoms and it has like 31 questions. So it's a really thorough, but it looks across like different domains, including neuromuscular pain fatigue. Just autonomic or parts would fall into that. Right. Gastrointestinal issues, urogenital and then anxiety and depression. So it looks like a lot more than just a quick hypermobility screening. So I really do like this and being able to add this as like a screening tool for clients who come in or say you do a buy in and you're not sure, then this could be a good follow up for somebody to do like in between sessions to then bring back, or you can send it to them via email or your patient portal to have them fill out and then you can get a better understanding of how all these things are connected. Because really I wanted to make sure I said this in the podcast is that there is so many of these. Random, you know, chronic ailments. I want to say like ailments or things that we have that we carry with us throughout our lives. That took one off. You wouldn't think that they're connected, but when you see multiple of them together, they are very connected. And so, for example, I had a client tell me last week that she has chronic like she has very low blood pressure always, and she has chronic migraines and chronic GI issues. And so hearing those things like me years ago, I would probably wouldn't have thought, you know, then I wouldn't have thought any of that was connected. But now, knowing all that I know, like these things are all very connected. And so then I screened her using the Biton scale, and she was an eight out of nine. And I said, I mean, I'm not I'm not a doctor Who diagnosis, but knowing all of this, if you took this to a physician who is aware and informed, I think you there's a high likelihood you could be diagnosed because of how all of these things are related. And she was really mind blown. And then, you know, in the meantime, she told me, well, my sister, I think my sister has pots. And so just kind of seeing how it's a genetic condition and how there's other people in the family who have similar things. You know, I think she was kind of mind blown to and really starting to understand and connect the dots herself. 

Nicole Woodruff I will definitely link to the spider in the show notes, and it looks like they're doing something in the adolescent realm too, which is kind of exciting because if we can get the diagnoses so much earlier, think about all of the prevention and just body literacy we can build in to to these students to protect themselves, especially our gymnasts, especially our, you know, been, you know, the ones that are doing, you know, in the front row in the yoga class outperforming everyone, you know. So that's that's really cool. Thank you so much for sharing that with us. How do you address overlapping symptoms? So I'm thinking about things like fatigue, like chronic pain that can accompany hypermobility. 

Nicole Woodruff Yeah. So it really is a holistic approach where we're looking at everything and no session will ever look the same and no person will ever look the same as the next. So it really just depends on what, you know, what the person's dealing with. I like to say that, you know, when I talk to clients on the phone, like doing discovery calls, there's kind of like three umbrellas of interventions and kind of helping people with. And the first one would be like lifestyle modifications and almost lifestyle approaches. So that's all that education and that's working through habits and routines and that's looking at nutrition and all the things that can help you feel better or worse on a day to day basis. And then there's pain management, and that can look like working on manual techniques in office or, you know, teaching people how to manage on their own. That's really a big part of it. I don't want people like I can help people feel better with manual therapy. It's a gift that I was given. Thankfully, my hands can handle it. But it's not the that's not the be all end all. That's not that's not the plan forever. Right? So we're going to help these the nervous system come down. We're going to help these hypotonic muscles come down, whether that's in the hips and then the back and the abdomen in the pelvic floor. And then we're going to teach you ways to manage it and do it on your own. And then that third umbrella is kind of like the exercise component. So working on the stabilization, working on strengthening, working on down training or up training as we need to so that the pain is more manageable and there's more support. And I am totally open to referring out if I think that they need to have a party involved as well or other movement professionals too, because sometimes trying to honestly, I'm, I'm really being honest with myself because I'm trying to do a lot for these people because there is so much going on. It can be a lot trying to manage all of that. And so in one session, we it may only be so we talking about lifestyle things and then we may only have time for a few, like a manual technique or two and maybe one exercise. It's not we can't do a ton in every session because there is so many things to go through. So I really try to help clients recognize like this is this is a journey. We're going to be here for a little while because you didn't get here overnight. This is taken years to get to the point of understanding your body and learning how to recognize it. And although my specialty is pelvic, I don't only treat pelvic here in office because I you know, I'm specializing in the chronic illness and, you know, coaching kind of through that lifestyle stuff as well. So it really just depends on what the person needs. But those are my those are my main things I'm working on here. 

Nicole Woodruff That's absolutely phenomenal. Your clients are just are so lucky to have such a comprehensive approach. And I love that you're true to style, really addressing sort of all of those overlapping things that we know we know are ultimately going to help their clients with their pelvic floor issues. It's it's really this supported, holistic, robust biopsychosocial approach that enables us to treat everything that's impacting and affecting their quality of life. I also really love that you're doing that expectation setting, you know, letting them know this. You didn't get here overnight. We're not going to we're not going to evolve from this overnight. I, I really do think that's such an important gift and conversation to have with our clients. There was also something else you had said that I was really impressed with in terms of. I love that you don't put all the pressure on yourself to give all the things. So actually, this is your second time doing this, Nicole, where you've led me to my next question. Meaning you're not shy about referring out and recognizing like, there is so much to cover. And so there may be other specialists that could take a slice of of that area, take a piece of that area and go, okay, like, for instance, I may be going to talk therapy in addition to seeing Nicole, or I might be meeting with a nutritionist because we just can't get to all of those things in our hour long session together. Right. And so I think that taking that burden from ourselves to have to do everything and to be the expert in all the arenas is also a really great way to not burn out because I think there's a lot of excellent therapist who do put that pressure on themselves and as a result, find burnout. So finally, getting to my question, which is what role do you think interdisciplinary teams play in your approach and how does collaboration with other other professionals end up really benefiting your clients? 

Nicole Woodruff Yeah. It's so important. More than any other diagnosis, I think that we see in Pelvic health. Like if you're on the Hypermobility spectrum, if you're somebody with chronic multiple chronic conditions, you need to be seeing a multiple multidisciplinary team. So there is there's no other way around it. I refer out to all sorts of, you know, specialists. Other therapist Functional medicine is a huge one. I always refer out to functional medicine because there is so much hidden stuff in food, right? Not just I don't even mean headed ingredients, I just mean like, symptom wise, like contributing factors that people just do not connect the dots on. And I can tell them, you know, till I'm blue in the face and sometimes just hearing it from another specialist who really that's their main focus. It helps people see it. And then also seeing, of course, like lab work reflecting either food sensitivities or inflammation markers or all that stuff. So it's so helpful to have a really trusted functional medicine partner. So I'm continuing to build my referral sources for that. I have a few already that I just, I love, but you just need to have more that are accessible to depending on the client. And then I've been building my referral sources for physicians who can diagnose. So because that's so important. There are people now that are finding me that say I really resonate with what you're sharing. I think I have this too, but I don't know how to get diagnosed or I don't know how to even I don't even know where to begin. And then I love when they do, because if they get that diagnosis and now they're like, okay, well, this makes sense, but what the heck do I do with all of this? I can be either their advocate and their partner in that, helping them understand everything that the physician just told them in like a 30 minute, or if they get that long with the doctor to diagnose them. So because oftentimes they're given a lot of options or a lot of recommendations and sometimes they're starting multiple medications at once and they're like, I don't even know. This is so scary. I don't even know what any of this means. And honestly, like, I felt that way, too, when I was diagnosed, I felt so like, why do we what do I do with all this? And I was kind of looking for somebody like me at the time to help me kind of implement this and make sense of it within my life. So it really does feel like full circle to be, you know, almost a year and a half ish from my diagnosis and understand that, okay, I got through it. And, you know, because I'm an O.T. and I do have good health literacy, I could figure it out. But now I can help other people do the same. So and then other multidisciplinary team members I would recommend is definitely like mental health therapists, because living with a chronic illness is hard and there are going to be days you don't feel good. And sometimes, even though, like I said, physical therapists for helping with more of that movement aspects because I really just can't do it all. So we really do. It really does take a whole team and we need all of the professionals on board that we can. 

Nicole Woodruff So absolutely, that's that's fantastic. I think that is just so incredible, such an incredible source of wisdom and encouragement that you bring in those team members for for your clients. Are there any resources, Nicole, that come to mind, books, support groups, anything like that that you would recommend either to professionals such as Otis and Pelvic health or even clients that come to mind? 

Nicole Woodruff Yes. So for Otis in particular, there are two courses that I took as I was opening my office or as I had already opened, but I was like, okay, I need to learn more outside of what I know as a patient. And that is the Pots provider pots, Providers Course by Emily Rich. She is an O.T. and she is. wow. The course is amazing and it's all online. It's really accessible. And she walks you through like basically all the background information and then from evaluation through treatment interventions and discharge and all the things for parts patients. Now it's definitely very geared towards pot. So if you're open to like and one to learn more about pots, that is a great course to take. And then for Hypermobility there is a Hypermobility Hypermobility Solutions course that the physiotherapist is out of Canada and her name is Cathy Walker and she is on Instagram and she is a wealth of knowledge in regards to exercise, prescription and nervous system regulation techniques and all these things that you can do with hyper mobile clients. So those were two great online courses that I. That have been very helpful. And it's especially like an intervention strategies, making sure like I have a big toolbox of things to work with clients on. And then as far as understanding these conditions for patients or for therapists or whoever, just wants to get more knowledge on these, I there's a book called Disjointed and it's it's a pretty popular one. A lot of patients know about this and they should anyway. But it's help it's written by many different physicians all these different specialty realms that kind of treat hyper mobile clients. And then there's another one by I think her name is Amber Walker, and that's called the Trifecta Passport. And it talks about she's a physical therapist and she wrote about a lot of holistic interventions and things for Tots, AEDs and Mass Cell Activation syndrome. That's a really good book, too. There's so many good treatment ideas, just things that you can try as a patient or therapist to bring up to clients. And then Facebook groups are great too, because there are a lot of resources in Facebook groups. I definitely and then a lot of those and the Ehlers-danlos Society website. So much information on there too. Or died by diagnosis and how to find a provider. That's how I found my provider. I went on to the Aids Society website and they have a provider directory. So if you're looking for diagnosis or looking where to send clients to find a diagnosis, that is a great, great place to find an informed provider. 

Nicole Woodruff Those were those are amazing resources. I will I will link to the two courses and the two books in the shownotes so that our listeners can find them more easily, but absolutely fantastic. Yeah. My last question for you is, are there any, you know, I guess research topics or like emerging trends that are coming out and hypermobility and pelvic health that kind of have your attention or that you're excited about? 

Nicole Woodruff Yeah, I mean, it's from like the Hypermobility standpoint itself. There has been some intriguing research in the last year looking for a genetic marker for identifying the hyper hyper mobility type of Aids in people. So I'm I'm hopeful that we'll get more information on that in the years to come. It looks like we're getting closer. That is the only there's 13 types of Aids and that is the only type that does not have a genetic marker. And that's why that's would be important because it really is like a rule out diagnosis. And I think if we had more awareness and an easier way to test that, maybe more people could get the diagnosis sooner. But as far as Pelvic health, I did see that Dr. Jill Krafft, who was actually a local Bulbar pain specialist here in Tampa, she did a study with some of her colleagues this last year looking at the presence of pelvic pain and the I can't find the right words, the presence of pelvic pain with. Hyper like co-occurring hypermobility. And so she would have, you know, clients come in presenting with pelvic pain these different symptoms. And then they screened so many patients across, you know, for a period of time and they found a correlation between hypermobility and pelvic pain. And so I really think that's a place that we really need to have more research. And I'm hoping that will continue in the years to come. I did for my I did my I went back for my first professional doctorate this last year. And so I did a small case study research on its role in treating these conditions. And so I hope to be able to share more of that in the in the next year, finding somewhere to hopefully publish and present or share this research. It was a small sample. It was a case study, but it was still relevant and it was directly related to clients with pelvic health issues and my basically my approach treating them as a public health. Okay. So you're. 

Nicole Woodruff Amazing. My gosh. Hopefully you can talk a little bit about that at our summit in September of 2025. Also encourage you to submit to not only our National IATA Association, but even in the state of Florida, like I bet the state association would be would be so pleased to have you. And again, once more and more people see this research is happening and needs to happen. The more we're going to get funded, the more that's going to come out. You know, and so I always encourage folks to be as loud as they can in their states because that's really often the easiest place. Often there's not travel associated with it, especially if they have a virtual component. We kind of get our feet wet, so to speak, and then it's just easier to keep on on talking about it. Nicole, this has been this has been such a pleasure. I am really so appreciative of you sharing your journey with us and your vulnerability as well as just your passion and the clarity that you have regarding really serving other clients that are in such a similar, similar place as you and also not rags. It's not this is exclusively what you're seeing in your practice, but my goodness, is it so clear that you are so incredibly meant to be in this space? So thanks for all that you do for our community. I can't wait to meet you in person in September, and I look forward to seeing your career grow. 

Nicole Woodruff Thank you so much, Lindsay. I really appreciate all of that. This really has been a pleasure to share and to talk with you. And yeah, I just really my goal to just raise awareness about Hypermobility and Pelvic health and really just be an advocate for all the people out there that are experiencing, you know, the symptoms that I just did not understand for so many years. So I really appreciate the opportunity to share today. Thank you. 

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