OTs In Pelvic Health
Welcome to the OTs In Pelvic Health Podcast! This show is for occupational therapists who want to become, thrive and excel as pelvic health OTs. Learn from Lindsey Vestal, a Pelvic Health OT for over 10 years and founder the first NYC pelvic health OT practice - The Functional Pelvis. Inside each episode, Lindsey shares what it takes to succeed as a pelvic health OT. From lessons learned, to overcoming imposter syndrome, to continuing education, to treatment ideas, to different populations, to getting your first job, to opening your own practice, Lindsey brings you into the exciting world of OTs in Pelvic Health and the secrets to becoming one.
OTs In Pelvic Health
How COTAs Can Specialize in Pelvic Health
- Learn more about Level 1 Functional Pelvic Health Practitioner program
- Get certified in pelvic health from the OT lens here
- Grab your free AOTA approved Pelvic Health CEU course here.
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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!
Lindsey Vestal
Perfect. Weslina, thank you so much for being a guest on the OTs for Pelvic Health podcast today to talk about something that is incredibly important that I know minimum, I have asked you about so many times the last couple of years that we've known each other, which is all about whether or not COTAs can be pelvic floor specialists. So thank you for coming on and dispelling in this once and for all.
Weslina Maxey
You're so welcome. Thank you for having me. I am looking forward to this discussion and yes, COTAS can be pelvic floor specialists.
Lindsey Vestal
What? Say that loud and clear one more time for everybody with doubts or questions or concerns.
Weslina Maxey
Yes, COTAS belong in this field just as much as OTRs. COTAS can specialize in the pelvic floor.
Lindsey Vestal
Weslina, talk us through a little bit about your journey and how you know this. How did you start off? What was that like and where are you now?
Weslina Maxey
Yeah, I'd love to. In 2018, I became a COTA, In 2024 I became an OTR so In that time, I bridged over and opened up my business in 2022.
Weslina Maxey
So that kind of kind of give you a outlook of that. I was a COTA in my business as a pelvic floor specialist for about a year and a half, a little bit over a year and a half before I became an OTR. So I was able to open up my business, create the LLC, see clients in my COTA - on my COTA license.
Lindsey Vestal
So wait, you just said two things, which are probably some of the most common questions we get. Number one, you worked in pelvic floor therapy as a COTA. And number two, you actually started a business doing it as well.
Weslina Maxey
Right. Yes. and Yes. So, that's a very common question. So I'm glad you're asking it because yes, you can open up your business and be the head person of the business as a COTA.
Weslina Maxey
I did during the time of before I bridged to be an OTR. I hired an OT as a 10/99 employee That way they could sign off on my documentation and my you know assessment outcomes, things like that.
Lindsey Vestal
And that, I guess, is probably why many people aren't sure they can do this, right? Because they're thinking, oh do I have to get signed off? What if there's an OTR that isn't at my facility?
Lindsey Vestal
It sounds like you were able to do all of that virtually.
Weslina Maxey
Yes. Yes, I was. So we would meet either, you know, for one business-wise and then for two client-wise of like bi-weekly or even weekly at first, just, you know, make sure we have our...
Weslina Maxey
T's and O's crossed or whatever the saying is. And then from there, as you know, we got to know each other and she got to know how competent I was in my pelvic floor, in the pelvic floor world, then we were able to kind of space that out a little bit for meetups via Zoom, which is what you we usually use with Zoom.
Lindsey Vestal
Does she have a background in pelvic health? Is that a requirement?
Weslina Maxey
He does not. So that is not a requirement. It's same idea as if, say, a COTA went to go specialize in strokes or hand therapy. You can still do that work as long as you show that you're competent in that and that your OTR knows like, hey, yeah, I trust this person. They do have competency in this field and they are, you know, they trust you so that It's same same idea with pelvic floor work. Like, are you competent? that Do know you know what you're doing? Do you know what you're saying?
Weslina Maxey
Do you know what you're educating on? And if you do, then that OT should have no problem signing off on your documentation and what you're doing with your clients or patients.
Lindsey Vestal
This is so liberating to so many people listening. We know that there's more pelvic floor clients out there that need our help. And I personally believe that the more OT practitioners that are available to serve them, like the world's in a better place. So this is really freeing and liberating to hear you say all this.
Lindsey Vestal
Especially though that the OTR doesn't have to be in pelvic floor therapy like that just opens up so much more. Do you have any advice for anyone listening on how to find that OTR that they could work with to sign off on their notes if they want to get started right away.
Weslina Maxey
I think, you know, it goes with conversation of just talking about it, saying, hey, I'm interested in this. And maybe somebody, you know, next to you has somebody else that's like, hey, you know, like, I think this person would be interested in even just learning more about pelvic floor, right? Because they once they want to sign off on you, they do probably want to know more about it, right? Just like any OT, we want to forever learn, right?
Weslina Maxey
So I will say like you can educate them on, okay, this is what the, the improvements are. These are what the assessments are, things like that. And another thing that I hear a lot is can you do internal work?
Weslina Maxey
And yes, you can as a COTA. You just have to have that competency, the course behind you to show that, hey, I learned how to do this. I know what I'm doing. i know what I'm educating my client about.
Weslina Maxey
And then you go from there.
Lindsey Vestal
speaking of which, of competency piece, if we have a COTA listening to this call, or even an OTR, who's interested in pursuing pelvic floor therapy, I know you got trained through me, you took OT Pioneers, you also took a level one for your introductory courses.
Lindsey Vestal
Do you have a recommendation for someone listening to this call to get started with one course over the other now that you've had, now that you've experienced both?
Weslina Maxey
I would say like if you're just dipping your toes in into it, then ot Pioneers is a perfect course for that. That's exactly what I took at the very beginning. By the end of that month, before I even like ended the course, I signed up for my LLC.
Weslina Maxey
So it was definitely a great roundabout course to make sure that you are totally into it before going into like, say your level 1 total course where, you know, it's a, it's a big commitment for the level one and it's a lot more information and things.
Weslina Maxey
So yes, the OT Pioneers is definitely a dip your foot in get the information that you need, make sure that you, that's what you want to do. And then you can go into it after you've taken that course and then later on, you know, take more after that.
Weslina Maxey
So that's a good way to start.
Lindsey Vestal
100% and just a quick note because it is important to me if folks ever feel like they want to take more and learn more because the level 1 course does include a lab it does include a second level course that deals with the colorectal area I always give bridge tuition credit to students so if they've taken ot pioneers and they jump into level one they get that financial credit.
Lindsey Vestal
Towards the level one program. So I just want to make sure folks know that because I think it's important to kind of see the trajectory to a no do I know I want to do pelvic floor therapy and if I do, how far do I want to take this in a really financially responsible way.
Lindsey Vestal
So thank you that makes a lot of sense.
Lindsey Vestal
I completely agree with you. One of the questions is I hear you talking about it because I think you did this in such a creative way, you know meaning that you started your business. like you You're just a very driven person who, when they know they want something, you go for it.
Lindsey Vestal
It's one of the things I admire so much about you. But I bet we have some people listening to our conversation right now that wonder if they have to start their own business to work in the pelvic health world. What would you say to that question?
Weslina Maxey
I’d say, no, you do not. I love owning my own business, but if I could go back, I might have started, you know, a little bit here and there in the settings that I was already working at when I was a COTA.
Weslina Maxey
but so glad I did because I don't regret it at all, but, just, but knowing that, like that, that's something I did not know when I first started looking into pelvic floor therapy. and I was like, okay, I'll just open my own business. It's fine.
Weslina Maxey
Whatever her worked out. But, I do still PRN at a hospital every now and in acute care. like once a month. So i bring my pelvic health education there too. So, cause we have so many that have incontinence. We have so many that have constipation that have prostate issues or back pain, hip pain, hip surgeries, abdominal surgeries, back surgeries, all the things.
Weslina Maxey
So you can bring that education. into play, into those acute care settings, into inpatient settings, into skilled nursing facility settings. And again, your OT that's ahead of you signing off on your documentation doesn't necessarily have to be specialized in pelvic floor. They just need to know that you're competent in what you're educating your client or your patient in.
Weslina Maxey
So say you're going in and you're going to see someone with a hip surgery. So you're educating them on how it affects the pelvic floor. How, okay, are we connected to the pelvic floor? So that way we can prevent incontinence from happening because that tends to happen a lot after a hip surgery because we lose the coordination of those muscles or the weakness of those muscles happens.
Weslina Maxey
So we want to work on that hip strength, even though we have that restriction right now. And how can we do that in that setting and then as they move into inpatient rehab, how can we bring it into that setting as well? And then from there going home, home health, skilled nursing facility, whatever it may be, how can we continue on that trajectory so we can prevent symptoms from happening pelvic health wise? And then if there are symptoms that are already rising, then how can we eliminate those
Weslina Maxey
So we don't just say, oh yeah, I had a hip surgery when I was 50 and I've had incontinence since then.
Lindsey Vestal
I love that. I so appreciate the way you laid that out because at the end of the day, we do know that everyone with a pelvis could really benefit from pelvic floor therapy throughout their lifespan. And you just like in the course of just a minute or less really walked us through how if someone is curious about pelvic floor therapy, like does realize there's so much there, they can take a step back, look at their current setting. Like you've just walked us through and go, there's a place for me here. It doesn't mean we have to do it full time. It definitely doesn't mean we have to do internal work.
Lindsey Vestal
In fact, in my course is the only course that teaches you a menu of options that starts with a person fully clothed. And yes, the one of the options is where your clothes are off and you can do an internal exam.
Lindsey Vestal
But one of the things that I think I'm so passionate about is that we don't have to do the internal exam. In fact, I question I pause and ask us to consider whether or not it actually is appropriate. We've been sold that it's the gold standard, but it may not always be the thing that our clients need. And so for anyone listening to this episode, right, they're curious. And I think along with all the questions you've answered so beautifully, it's also reiterating, take advantage of the setting that you're in, start to maybe take some of the things you learned in OT Pioneer's
Lindsey Vestal
Use it in the current setting and you don't have to be an outpatient. You don't have to start your own business and you don't have to do internal exams. And you still can provide so much quality of life to your clients.
Lindsey Vestal
Just knowing that those three things that maybe we commonly associate with pelvic floor therapy are simply not what we always have to do.
Weslina Maxey
Exactly. Yeah. And I will say, like I said, I peer in at an acute care hospital and I have actually created a handout. I'm going to be doing it in service soon for all of them. I have created a handout over what the pelvic floor OT or PT, whoever's seeing them, you know, how they can bring in education of the pelvic floor.
Weslina Maxey
How can we do that when we're transferring? You know, how can we do that when we're sitting on the bedside commode positioning breath wise and then an educational handout for the patient? So like, how do we start bringing in pelvic floor?
Weslina Maxey
into our everyday life and how can we educate our patients to do this as well? Because like you said, everybody with a pelvis can benefit from pelvic floor therapy. So why are we not talking about the pelvic floor muscles when we are working on all the other muscles and the movements during their stay? For example, if someone has a stroke, well, if they are left-sided affected, then their left side of their pelvic floor is affected as well.
Weslina Maxey
So why are we not, you know educating them on, hey, you might have lack of sensation there. You might have, you know, pen tingling feeling around that area.
Weslina Maxey
things like that, just like on the fingertips, on the feet, things like that. It's the same idea, but we don't talk about it because it's so taboo. However, we'll go bring them to the bathroom and help them wipe their butt, but we won't talk about the muscles that we're doing that with. Like, it makes no sense. Like you always say, toileting is an ADL, sex, pee, poop, like all of it.
Weslina Maxey
It's something we need to be talking about and we need to be talking about in any setting, every setting, and with every discipline.
Lindsey Vestal
I couldn't have said it any better myself, Weslina.
Lindsey Vestal
That was beautiful. Beautifully said. Thank you so much for being a model of all of these things. I mean, even you just talking now about this handout you've created, you're continually educating everyone around you, your fellow rehab professionals, allied professionals, your clients, and no matter what setting you're in, in your own business, acute care. I mean,
Lindsey Vestal
You have just such a passion for this work. Thank you for being the trailblazer that you are. Is there anything else that you would want anyone listening to this episode to know or consider?
Weslina Maxey
I would love to say that you can also do like community workshops to get the pelvic health education out there to your community, to for people to know what pelvic floor therapy is and what pelvic health is, and then how can they start taking care of it? So, you know, they can can prevent them from going to the hospital because they fell because they had urge incontinence.
Weslina Maxey
All of those things. And you can do that without a business. You can just start doing community workshops, right?And then the other part of that is if you open up a business, you don't necessarily have to be under your OT license. So say you want to open up a business and you want to be more of a pelvic health educator or a pelvic health like wellness certification specialist type deal.
Weslina Maxey
So that is a way you can do it without having to have an OTR ahead of you. And you can just have your own business not have to worry about that. However, you wouldn't be able to do manual work, internal work because you're not under your OT license. You would just be under this wellness background.
Weslina Maxey
With an OT background, obviously. But that is another realm that you can look into. But if you wanted to go other route with your OT license behind you, then you'd have to have, you know, the OT and everything like that.
Lindsey Vestal
Amazing. Thank you so much for highlighting those things. There's just so many ways to do this. And so I think to me, the call to action after listening to you is if you think pelvic floor therapy is for you, if you think you can add something to your current practice setting into your client's quality of life, like go for it. It is truly to me the most fulfilling specialty there can be. And we just need more of us out there doing it.
Lindsey Vestal
So thank you so much for showing us that, for helping others listen to this and know, like if the calling is there, go for it because there's no, to me, there's no going back once you do.
Weslina Maxey
Right, yeah. It's an awesome specialty. And like you said, yeah, you don't go back because it's such an important muscle it connects and affects everything in the body.
Lindsey Vestal
Thank you so much, Weslina, for being such an incredible member of our community and for all that you do in your own community for pelvic health clients. You're amazing. Thank you for your time today.
Weslina Maxey
Thank you so much.
