A Student Physical Therapist’s Written Experience of Observing a Pelvic Health PT

Written by Katelyn Hickey, SPT

Given the current state of the COVID-19 pandemic, many student observation opportunities are on hold. Here is my written experience from shadowing two pelvic health physical therapists (PTs) for one month while in undergrad.

Given the current pandemic, student observations are hardly taking place, if it all. I recently was thinking back on my experiences while in my first couple years of college shadowing different physical therapists in different settings. 

Personally, I believe observing is one of the most important things you can do to prepare for graduate school. It is the perfect opportunity to get a feel for what it would be like to actually work in various settings. 

In case you are wondering where to start, you can look into local clinics and hospitals. When I was looking to shadow a pelvic PT, I called around my town, but unfortunately, I was led to multiple dead ends. The way I ended up finding someone to observe was through the “PT Locator” provided by APTA Pelvic Health. All you have to do is type in your zip code and choose the mile radius you’re willing to travel, and it will provide the names and locations of pelvic health physical therapists near you. 

The PT I observed happened to work at an ATI Physical Therapy clinic located in a hospital. She also worked out of a women’s health center a couple days of the week. I previously had not known pelvic PTs could practice at clinics alongside OB-GYNs, but I learned it was a very beneficial way to practice. Many of the patients were referred by their OB-GYN who worked in the same office. It made interdisciplinary team work much more efficient, and it was often beneficial for the patient in regard to coverage through their insurance. 

One of my favorite parts of observing a pelvic PT was learning something new with every patient. Even when the reason for the visit was something I recognized or knew about from prior cases, each patient’s story was unique, and therefore, so was their treatment. For the sake of not being able to observe in the current state of the world, here are some of the patient cases I saw:

• Post-partum mom seeking treatment after receiving an episiotomy during birth: An episiotomy is a procedure that can happen during labor and delivery to assist the doctor in delivering the baby. It is a vertical incision made in hopes of easier delivery. There is research supporting the end of episiotomies, and they are done less than they were twenty years ago, although they are still performed by some doctors. The resulting scar tissue can often become painful in lots of people and inhibit them from performing ADLs like using tampons, having sex, or even sitting without pain.
• Transgender woman seeking treatment for pelvic pain and post-surgery maintenance: pelvic PT an essential part of care for transgender community. After surgery, it is essential to emphasize patient education and the important of adherence to their home exercise program.
• Older aged woman seeking treatment for dyspareunia and pelvic pain following chemo and radiation for cancer: Chemotherapy and radiation can cause severe pelvic pain in some people, especially for those living with vaginal, breast, cervical, or ovarian cancers. 
• Young woman seeking treatment for dyspareunia and pelvic pain: This was one of the most common cases I saw. These visits required a lot of education regarding the prevalence of dyspareunia in young women and the hopeful prognosis. They were the type of interactions that made me realize that pelvic PTs don’t only provide a physical aspect of treatment but are used as emotional and mental support as well. Many people struggled with shame or embarrassment because of the problems they were facing, and patient education was something that really helped with those instances.
• Pediatric patient seeking treatment for chronic UTIs: This was one of the most surprising cases I saw. It never crossed my mind that patients in the pediatric population would need pelvic floor physical therapy, but pelvic physical therapy is for everyone, because everyone has a pelvic floor.
• Middle-aged man seeking treatment for sexual dysfunction: I only saw one male patient during my time observing, but it was a valuable experience because it reinforced the idea of the field being called “pelvic health” rather than “women’s health”. It is important to be as inclusive as possible in order to create a shame-free and welcoming environment. 

These are just some of the cases I observed in my month-long experience shadowing two pelvic PTs. I was overwhelmed by the amount of information I learned and the impact I saw being made on these patients lives. Although reading about different patient cases is always a great learning opportunity, I highly encourage anyone who is even slightly curious about pelvic PT to find an opportunity to observe, even if it just for one day, as soon as it is available again. You would be surprised by how much you can learn in just eight hours of being a shadow.

About the Author

Katelyn Hickey, SPT is a first year physical therapy student at Carroll University in Waukesha, Wisconsin. She is a certified personal trainer and completed her Women’s Fitness Specialization certificate through NASM (National Academy of Sports Medicine) which she uses while working within the perinatal population at a local gym.