ATMS Speaker Q&A

My career started in musculoskeletal and sports physiotherapy, and I was working full-time with sporting teams. The more experienced I became I noticed a subgroup of women who were not responding to treatment as I expected. By delving deeper into their history, I became aware of and increasingly interested in, the impact of the hormonal and reproductive systems on musculoskeletal health. Delving deeper into pelvic health has only increased my passion and curiosity. I couldn’t see myself working in any other field!

My focus has been in two primary areas:

• Working with women with pelvic pain (particularly endometriosis) to manage their neuromuscular hypersensitivity

Using vaginal support pessaries to help women manage pelvic organ prolapse.

Pain Science is revolutionising how physiotherapists work, with most now working under a biopsychosocial framework rather than a purely structural model of injury. Meaning physios are much more aware of how stress, sleep, social and lifestyle factors can impact a patient’s pain.

Another new area that has emerged (since 2012) is pelvic health physiotherapists increasing their scope of practice to fit vaginal support pessaries to help women manage pelvic organ prolapse.

Physiotherapists scope of practice will become both broader and narrower. Physios will have more awareness of a multisystem approach to injury and disease management but with this depth of knowledge we will increase specialisation (like our medical colleagues). This in turn will see different physio specialisations working together as part of a patient’s healthcare team.

The most important step is to listen, validate and work collaboratively with their clients.

Is this problem (e.g. prolapse, dyspareunia, incontinence) common?

Women often think they are the only one suffering from these issues, and they suffer in pain and silence. By using the available research to demonstrate how common pelvic health conditions are, they feel reassured, opening further dialogue within the treatment session and the community at large.

This is tricky, as I have had several inspirational mentors throughout my career. If I had to narrow it down, it would be a tie between my colleagues at Alana Healthcare, Professor Jason Abbott and Dr Erin Nesbitt-Hawes. They are both brilliant surgeons and researchers who always put their patients first. Their level of knowledge, work ethic and desire to improve the lives of others is truly inspiring.