Episode 1637 - I did NOT want to be a pelvic PT

Dr. Christina Prevett // #ICEPelvic // www.ptonice.com

In today's episode of the PT on ICE Daily Show, #ICEPelvic division leader Christina Prevett discusses her journey to becoming a pelvic floor PT.

Take a listen to learn how to better serve this population of patients & athletes or check out the full show notes on our blog at www.ptonice.com/blog.

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EPISODE TRANSCRIPTION

INTRODUCTION Hey everyone, this is Alan. Chief Operating Officer here at ICE. Before we get started with today's episode, I want to talk to you about VersaLifts. Today's episode is brought to you by VersaLifts. Best known for their heel lift shoe inserts, VersaLifts has been a leading innovator in bringing simple but highly effective rehab tools to the market. If you have clients with stiff ankles, Achilles tendinopathy, or basic skeletal structure limitations keeping them from squatting with proper form and good depth, a little heel lift can make a huge difference. VersaLifts heel lifts are available in three different sizes and all of them add an additional half inch of drop to any training shoe, helping athletes squat deeper with better form. Visit www.vlifts.com/icephysio or click the link in today's show notes to get your VersaLifts today. CHRISTINA PREVETT Everyone and welcome to the PT on ICE daily show My name is Christina Prevett and I am one of the lead faculty within our pelvic health division Today I want to talk a little bit about kind of my journey in to pelvic PT and the reason why I want to do that is because when I first started in pelvic I was actually really adamant that I was never going to be a pelvic PT. It was not something that I wanted. It was not something that I wanted to do. And I want to talk to you a little bit about why I think that's important and where we have seen a shift in pelvic PT that I think is super beneficial. So you all haven't seen me on the podcast now for a while. You know that my start and my love is working in geriatrics, right? My PhD was in geriatrics. My business model was very focused on, with Stavoff, on healthy aging. I did a lot of bridge programming between one-on-one rehab and group fitness wellness for individuals with complexities with the idea of removing barriers to exercise, and optimizing as many facilitators as possible in kind of a medically supervised but not medically necessary type of way. And part of my PhD was really trying to get into this health and wellness space. And you know that fits the bias at ICE really beautifully because we truly believe in preventative healthcare versus our sick care system that we currently have. And part of that was to do a scoping review around where physical therapists could be involved in health and wellness. And I meant that as a primary and secondary prevention aim. So not once disease has already been established, but what to think about this bridge, identifying risk factors to potential issues, or to really think about population level health. And of course, there was a lot of things in the literature that lit up around, you know, chronic Z self-management and working and isolating at risk factors like blood pressure. But one of the other things that came up and came up really strongly in the evidence base was around perinatal care. And so a lot of people go into pelvic PT around their own experiences, and that was actually not the case for me. And so I had applied for a city grant. I was like, well, if this is where we are going and we want to take a lifespan approach, then let's try and get involved in exercise in the perinatal space. And so we applied for a grant, we were able to get grant funding, and we started a program called Strong Like Mom. it was a new area for me you know i did my research on like exercise this is a lot of postpartum exercise in canada we have a year of maternity leave so a lot of moms in the first year would bring their babies in it was really great i was kind of in a period of my life where my husband and i were talking about having kids so i got exposure to other moms and their experiences i got to talk through different pelvic health complaints. And from an external perspective, I was able to help manage a lot of those conditions. But I was not internally trained. And this was back 2018, 2019. And I was still adamant that I was not going to be internally trained. And here's why. I had this belief that I had to be a Volvo Cupcake type of person. And this is absolutely no, no negativity at those who go into pelvic and love it so much that they buy a costume where their head is the clitoris. Like we need those people because they reach individuals in such a unique way. But that was the way that I had interpreted going into pelvic. So I had my exercise class. I was talking about pelvic health issues. But I really truly thought that as soon as I became a pelvic PT, all I did was internal assessments. I stayed in the room with people in supine and I stopped getting an orthopedic caseload because everybody that I talked to, their entire caseload turned into pelvic. And I loved working with older adults. I loved working orthopedically. I saw a lot of people with complexities and multimorbidity. I loved that part of my job. And I did not want that to go away from me. And so in 2018, so I must've started this program in 2017. So we're talking some years now. In 2018, I was a national level weightlifter and I got pregnant with my daughter. And we got pregnant faster than we thought we were going to, which is such a blessing. But I was prepping for a weightlifting meet, trying to qualify for nationals again for 2019. And I already had the meat. I was like well into my prep. And so I was like, you know, I'm not worried about weight. I'm well off my weight category. I'm still gonna compete. And I remember the first time I went to snatch heavy and I made contact at my hip, I started to cry. And I knew that exercise was not bad. I had well gone into the literature with me being a PhD student around exercise and pregnancy, but the visceral, fear response and the thought that everything in my brain had said, I need to protect was real. And I was lucky. We had a referral network with individuals. We were working in a research program with a high-risk fetal medicine physician and obstetrician. And we were doing referrals back and forth for individuals with cardiovascular risk. That's a whole other conversation for another day. But in that moment, I reached out to him and I said, Hey, like I'm a weightlifter. And I sent him a video of a snatch. I was like, I'm prepping for a meet. What are your thoughts?" And his messaging was so clear. He said, that baby's so small, it is back in your pelvis, and your body is used to this. It's okay, you are going to be fine. And my fear melted. It melted. And I will never, never not be grateful for that interaction. And in that moment, I recognized one, how much fear we can have around pregnancy because it's so protected. But number two, how much that fear can be melted away by somebody in the obstetrical space that you trust, that allows that fear to extinguish. And so, This was all kind of happening. Again, I wasn't doing internal PT, but I started to feel this like gut pull to this space. But I still had this like interaction where I just did not want to do only internal assessments. This is kind of the origin story of pelvic. And so I was still not coming to terms with this, but I really wanted to start bridging towards this fitness. I had been doing Strong Like Mom for a couple of years. I was a national-level weightlifter on Instagram and social media. I was getting comments about my body prolapsing and all these things that were so fear-focused, and it started to just gut me that it was so fear-invoking. and I was going and I was interacting with other pelvic BTs, they were the ones who were making me afraid because they were the ones telling me that I was going to prolapse. They were the ones who were saying, and this is not against them because that is truly what we believed and what we were taught in our training. We have come so far to move away from that narrative, but that was where the narrative was in 2018. My staff member who was an internal trained PT and I went to fitness athlete and being in this space, we kind of took over a little bit, sorry guys. In this live course, talking about things like diastasis recti and talking about how to load the core and it very naturally for me became this teaching moment. And this was in 2018, 2019. And in that moment, because Alan was there, he was like, this needs to happen. This needs to happen. And even then. When I st