New article

Thank you Christine! I don't claim to understand all the terms, but I was comforted to read your letter and I feel I do have a much better understanding of what is going on in my body. Before reading your letter, I was talking on the phone to my sister-in-law who had an unsuccessful surgery for prolapse in December. She unexpectedly had to have two operations the same day--the second to undo the first. Her surgeon told her it had never happened to him before. Then later on he told her he talked to a surgeon friend who has had this happen more than once but can't figure out why. Maybe they should read your letter??? Anyway, I am going to share your information with my naturopathic doctor and the woman who does my acupunture. Both will be very open to what you have to say. Again, thank you, Christine!

Hi, Christine...

As one of the 'resident' PT's on the board, I read your letter to the APTA in earnest. You are bringing so much awareness to the profession, as I can attest to the abysmal amount of information we learned about pelvic structure and function in school. As I've mentioned before, women's health PT was a quickie weekend elective at my school (and I didn't take it). I have a close friend who did, though...and I will ask her if she still has her course notes in it as I would love to see what kind of information was disseminated, especially knowing what I know now and what I've experienced.

I think as part of your letter you might try to find out, on average, how much time schools are spending on women's health and what specifically is taught. I will also look through my Advance for PT's magazine that has listings of courses offered nationwide...I can tell you for the most part that there are very few specialized advanced courses offered for pelvic rehab. In any case, if I do find one and it is convenient for me to take (easier said than done with a 4 month old right now)...I would be VERY happy to take it and to report back to you in regards to what is taught.

Overall, the concept that women's spines are very different from men's spines and the issues that we face as the baby carriers and birthers of the species would be a huge paradigm shift in the profession of physical therapy.

You might also want to be a bit more specific in terms of suggesting how these concepts might be integrated into physical therapy education. I honestly think that since low back pain is associated with pelvic organ prolapse, that the basic orthopedic therapy course that we take would be incomplete without at least some mention of this. We need to get this information out of the electives and into the overall PT education.

I will re-read the letter and see if I come up with any other ideas. Thanks so much for working so hard at this, you have such a talent for taking this (complicated) information and making it easier to grasp.

Peace,
Michele

I think your letter is wonderful. You do make the anatomy and its function so clear as you point out, one by one, the flaws in the belief system that is currently in place. I agree with Michele, I don't see why the orthopedic coursework cannot include this information. the female spine is not the same as the male spine, and I think that treating them the same does gross disservice to women. Not only does this relate to back pain, but any dysfunction that can be traced back to the spine (pain in weightbearing joints, and even shoulder, neck and head pain).
Its been a while since I went to school, and I, like Michele, worked in pediatrics so my orthopedic knowlege is rusty to say the least. I am also not up on current curricula in PT schools. I wonder if they have included any womens health or reproductive physiology courses. this topic would obviously be right at home there too. now wouldn't THAT be something, PT's spreading the word that women's bodies are capable of gentle birthing? but I digress.
Michele - if you sign up for a pelvic floor course in NY let me know. we can go together.

Wonderful letter Christine, very clear and succinct for all! I will be interested to hear the response!
Michelle.

yes...how amazing would it be if PT ends up being the profession that champions gentle, natural birth!

that may not be too far from becoming reality...if we can get some good, evidence based studies out there regarding the long term outcome of instrumental vs. natural deliveries from the pelvic floor rehab. perspective, we might just get the tide to turn in obstetrics.

i didn't realize you were from ny, i am also but hubby and i moved to san diego 3 years ago. i would love to take a course in ny with you, as i have lots of friends and family there and we are planning to go back to visit some time in early summer (after i've fully recovered from this surgery and have a few months of conditioning under my belt...i'm quite weak right now). certainly would be something to keep in mind for planning our trip back east, i'll check the latest advance to see if there are any courses coming up any time soon.

peace,
michele

As usual silly me cannot find the letter :(

Helpppppppp

Hi Christine,
this new site is great, and the links to medical articles are really interesting, only I have been missing the "search" options the other site provided, it was so useful, I wonder if yr computer programmers are planning to add it to this site too.
Thanks fr your devotion to us all.

Ornella

PDF files just freeze my computer so I still cannot see it :( Sorry

Sue

and was very very impressed. I certainly will share it with my pt and accupuncturist.

Now, I have a question for you based on something in the article and it has to do with the potential cause of my prolapse. I told you I had a vacuum extraction 1st birth with significant blood loss and blood transfusion. My second and third births were at home with no complications. I had periods of stress incontinence a couple of years after the first birth, which seemed to be resolved by doing kegels. After the second (or was it third?) birth, I noticed that when I got my monthly cycle back, I had a lot of discomfort for a day on the first day of my cycle. I said it felt like "my pelvic floor was falling out". After the first day, though, no problems. About 5 or 6 months post partum after the third birth is when I noticed the prolapse, although I didn't have a word for it at the time. This was really really different than the previous symptoms of stress incontinence or on the first day of my cycle. But here's the thing: the third birth was really fast. I went from 2 cm dialated to birth in 1.5 hours, and he was born in water with 2 pushes. He didn't even crown, but shot out of me. I didn't even feel it -- just pushed and there his head was between my legs. So, as to the cause of the prolapse, was it the instrumental birth 7 years prior, the precipitous birth 10 mos. ago, or perhaps a combination of both? Not that it matters, I guess, but just pondering. If it was the instrumental birth, why didn't I experience prolapse sooner? Also, do subsequent vaginal deliveries worsen prolapse? They may have seemed to in my case. Would welcome your thoughts, Christine, and others.