To assess what the pelvic floor muscles are doing, we have the option to use either/or manual evaluation, as well as real-time ultrasound imaging (if you are seeing Amy Zipp, MS OT/L only for ultrasound imaging). No matter what method we use to do testing of the body's systems, we are always discussing this prior and helping you to understand the testing, to give consent if you feel there is information to be gained to help us understand your specific situation's needs. Pelvic health PTs and OTs use internal digital muscle testing to assess the quality of the contraction of the pelvic floor muscles as well as their tension at rest and movement based testing for assessing if there are any other types of prolapse or scarring that may be impacting your body’s ability to work in a functional range. We will not do an internal pelvic floor assessment without a medical provider consent either prior to the 6 week post-birth check up or during pregnancy without signed provider consent--but we can do MANY things in those cases without that aspect to help things improve that are bothersome. An internal pelvic floor muscle test is not always necessary for all pelvic health issues. With the addition of real time ultrasound to clinical practice, we have the advantage of being able to greater assess externally using imaging & without internal testing but still have more objective information to work on. We are also able to start earlier with rehabilitation than the 6 weeks post-birth time if you choose to do so! It is advisable to get into a recovery routine that is evidence based when you feel ready which for many people who are active is much sooner than that time.

Please arrive to the appointment knowing that you will need to either feed your baby/babies, or use a pump in between applications of therapeutic ultrasound & manual techniques.

In short, there is not a difference. The code for evaluations for submission to your insurance for reimbursement is different for each license, but all of the other possible 10+ treatment codes are the same between the two licenses. In terms of what goals are being addressed or what treatment approaches, the diagnoses we are addressing and symptoms we are treating...this is all the same in this arena. In some other areas of rehabilitation, there are more significant differences between OT & PT for goals and what they are within their scope to address. But in pelvic health, that is not generally the case. Differences between providers most often has much more to do with training background, varied experiences and exposure to a range of conditions, populations and treatment tools/approaches. Please see the TEAM tab at the top for additional information about each clinician.

This is a great question! We are so thankful to have worked with more and more personal trainers who are receiving education to learn about chronic injuries or other female related areas such as pregnancy and how they might impact fitness and health. In some cases a trainer or a coach is an additional member of an interdisciplinary team. Like many professions, there is high-variability in their educational background and experience levels so in general terms, trainers focus on exercises with more basic fitness goals. They cannot evaluate or diagnose for conditions such as a rotator cuff tears, radiating pain, neurological conditions, ulnar nerve impingement, pelvic floor muscle exam or lumbo-pelvic pain. This is really the primary difference. If the evaluation isn’t well-informed, then the approach to goal attainment is going to stall. Knowing what to look & when to refer out are both essential to success. As a general experience level, a trainer would not be able to help with motor coordination retraining to address HOW you are doing exercises. They would not be able to treat you for a medical condition. Also, generally they do not coordinate with other providers who would potentially be helpful for your care, such as post-op surgical protocols, pessary needs during load, referrals for various research based types of injections (ie, PRP, steroids, interventional pain medicine) and following post-procedural protocols. If you have someone you already like to work with, it does not have to mean that you don’t do that fitness aspect any more. The main idea is to get you back to whatever it is you WANT to be doing. We can both work to support you with the best challenges for your improving status. It is common that some healthcare clinicians do not have a strong fitness or training background. That is not the case for Pondera Rehabilitation. We truly 'bridge the gap' between fitness and rehabilitation with both formal training, informal training and actual experience level. We have been involved in training, coaching and education for other fitness and healthcare personnel for many years. We are comfortable designing a cross-training or resistance and conditioning program for a parent who wants to just go to the park & play with their kids without pain, a retiree who wants to travel in their RV smoothly, a high-performing swimmer reaching for reducing their times in the pool, or a fitness-lover who wants to get the most they can out of various workout classes. Additionally, Amy & Kirsten have both worked with a variety of high level athletes ranging from firefighters, collegiate cyclists, semi-pro baseball players, elite runners, to triathletes.

In short, the answer is “NO” you do not need to wait. There are so many things we can do to get you moving towards meeting your goals post-partum, or to address issues that might have arisen during birth, or in the early weeks after delivery. Since we are trained on imaging ultrasound, we are able to use that to help you see what you are doing from a motor control standpoint; that is all done externally. Also, many areas that we are working on in the early phase have to do with helping you to regulate relative intra-abdominal pressure, the abdominal wall and early exercise progressions. We will not do any internal examination until you have been cleared by your birth provider but we often do not need that initially anyway.