#63 - Pelvic Floor Health and Dysfunction in Men, Part 2

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Hi guys, Welcome to another episode
of The Factor podcast. I'm your host,
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Jessica Riddle. If this is your
first time tuning in, welcome and
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thank you for listening. Today.
I am recording back at our headquarters in
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Houston, Texas. As many of
you may have heard on our last episode,
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we were in Japan and visited Tokyo, Osaka, and Kyoto for a
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number of weeks. It was an
incredible experience, and while I'm sad to
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say that it's come to an end, I was very excited to get back
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home and back to work. Our
team has so many exciting things in the
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works for twenty twenty four that they've
certainly kept me busy. Now, in
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today's episode, we're going to pick
back up with Part two of our series
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titled Let's Hear It for the Boys
Pelvic floor dysfunction Diagnosis and Treatment Options for
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men with Britney Saidbrook, a fellowship
trained orthopedic manual physical therapist. Please note
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that in this episode, as in
part one, when we refer to men
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and women, we are referring to
cis gender men and women. Now today
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we will dive deeper into the important
role of proper breathing mechanics and correcting pelvic
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floor dysfunction. We will also touch
on the impact these conditions can have on
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the mental health of your patients and
cover best practices for collaborating with other healthcare
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providers. So pull up a chair, open the notes app on your phone,
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and get ready. Today's episode is
full of great information that you can
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implement into practice immediately. Let's get
started. So the next thing that we're
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going to look at now that we
have covered a little bit of the anatomy
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of the pelvic floor, we've talked
about the local structures of the pelvic floor
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and then global structures of the pelvic
floor that or that can impact the pelvic
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floor or what are some of the
common pelvic floor diagnoses and so some of
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the most common pelot floor diagnoses that
we see and men are listed here for
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you. Urinary and continence. Yes, this is a thing men can suffer
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from. Urinary and continence. The
second thing is constipation. Constipation is one
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of the major factors actually two urinary
and continence. And so if a patient
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is suffering from constipation and they are
able to list that on their medical intake
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form, that is definitely something a
question that I would lead with. Next
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is asking them if they've ever had
any issues with loss of bladder. With
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the rectum just being exterior to the
bladder, that can create issues. Too
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much content into the rectum can push
antier onto the bladder, and also inter
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abdominal pressure can create a little bit
of leakage. So that's a question that
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I would ask. The one that's
the probably the most common I think that
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is out there, and just like
in general in terms of the world,
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is a rectile dysfunction. So we
often see a rectile dysfunction and that can
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be just with pelvic floor muscles being
too tight. Is that creates issues with
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the muscles and can create those problems
also prostate itis. That's another common thing
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that we typically see podendal neuralgia.
So we talked about that early our at
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length, about the podental nerve and
that tumultuous path that the podental nerve has
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to go through to make itself into
the pelvic cavity. One of the things
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that I would also indicate with this
one is that you if you treat a
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lot of men who are cyclist and
cyclists that they're sitting on their cycle seat
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or their bike seat for prolonged period
periods of time. That is a huge
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differential diagnosis for that patient population.
Men's pelvises are a little bit more narrow
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in stature than females are, so
the issue two rossi's are a little bit
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closer together, and so sitting on
the bike seat, when they sit on
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there can compress where the pidental nerve
comes down through and it can create compression
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and the area. So cyclists often
have podental nerve problems. Also levator Ani
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syndrome. Levator Ani syndrome is just
another word for that third layer of the
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pelvic floor having too much tone in
it that can create pelvic floor problems.
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Like so pelvic pain, they can
create opt greater in turn is issues pdindal
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problem printed on neuralgia, So those
types of things. Another one is psiatica.
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Psiatica could be more of driven from
a lumbbar issue of spinal issue,
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and the research does show I'm going
to get a little ahead of myself for
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a second, but the research does
show that the having a history of low
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back pain, that ninety percent of
patients with history of low back pain also
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have a pelvic floor dysfunction. So
definitely keep that in mind when you are
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treating your low back pain patients.
This is something that I saw when I
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was just specifically an orthopedics. It
seemed like with my low back pain patients,
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I could get them maybe ninety ninety
five percent better, and then that's
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pretty much it. I really wish
I had the capacity that I have now
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to go in and look at the
pelvic floor internally and see what the pelvic
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floor was doing and see if those
works contributing factors to their low back pain.
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So I would say probably low back
pain should be almost an immediate referral
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to a pelvic floor. But we'll
talk about that and a couple of other
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associated factors that would also refer to
pelvic floor pt. Another one is chronic
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pelvic pain syndrome, So this can
be chronic prostatitis, inter social systitis for
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men bladder pain syndrome where a patient
feels like they have to urinate constantly.
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They can never get any relief even
when they try to urinate. They just
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have this constant like pressure or urge
or burning sensation before urination, during urination,
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or after urination. And those also
would warrant further investigation from pelvic floor
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i PT other associated pelvic floor dysfunctions
besides the ones that we just discussed.
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Number one was the low back pain
we already talked about that ninety person scent
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of patient population of flow back pain
also have a pelvic floor issue hip ostarthritis.
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Something that I would also classify into
hip ost arthritis would also be label
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tears just because of that close association
of the obturator internus. Any type of
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hip issue, whether that be OA
of the hip, a labral any type
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of limited mobility and the hip just
because of its association with the opturator internus.
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The second one or like another one
that I would discuss would be also
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growing pain. Growing pain could be
from the adductors. It could also be
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from the pelvic floor. Also to
sometimes growing pain could be in combination with
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scrotal pain. And if that is
the case, scrotal pain definitely referring to
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pelic floor PT that can be coming
specifically from the pelvic floor itself, can
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also be coming from the passoas muscle
nerves that surround the pelvic floor that could
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be producing growing pain or scrotal pain. And then also that thoracic lumbard junction
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so all of those areas can produce
the growing pain are also the scrotal pain.
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Hamstring strains that's another one that could
often be the opterator in turnus.
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So if you have a hamstring strain
that's just not getting better, maybe not
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getting better as fast as you would
like it to, that would be another
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reason for referral to pelvic floor PT. Umbilica hernia is another one because that's
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a pressure management problem. M Bilica
hernias can happen for various reasons. It
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can be with or without association with
diastasis recti. I know, diastasis recti
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tends to be one of those key
terms that we only think women can have
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diastasis recti. That is not true. Men can have it too, especially
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if men more a little larger and
decided to lose a little bit of weight
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pretty rapidly, they can develop diastasis
rectie. Too much pressure being displaced on
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the linea alba very rapid weight loss. It can create issues. So mbilicahernia
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diastasis rectie is a pressure management issue
and also a global problem. But definitely
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referral to pellet floor PT to look
at the pelvic floor is warranted as well.
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And then also patients with psoas strained, because oftentimes those can be a
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referral from the pelvic floor, So
pelvic floor dysfunction can refer to the passois
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area and create those types of issues. So here are some examination questions that
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you may be wanting to ask yourself. I feel like at one point,
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before I became a pellet for therapist, I never really asked these questions.
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It never really dawned on me in
a patient what is there for low back
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pain or for hip pain? I
never once thought about asking these questions.
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And I think that these questions are
phenomenal questions. If you've never had the
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opportunity or maybe even uncomfortable to talk
about sexual dysfunction, to talk about urineary
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issues or bowel issues. If you
feel like you're uncomfortable these questions, here
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are good questions to ask. And
on the next slide in just a second,
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we actually have a screening protocol that
you can give your patients and have
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them answer the questions and then kind
of go from there. But we'll talk
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about those. So one of the
questions for your patient is is there a
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history of low back pain, hip
pain, growing pain, or sciatica.
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With those it's typically also there's a
prevalence of pelvic floor dysfunction, and so
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with that you can send your patient
to pelvic floor PT so that you guys
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can co treat those patients together.
Another one is a fall on the telbone.
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Remember back earlier we talked about all
the muscles that attached to the tailbone
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and the pelvic floor, which are
pretty much all of them or have some
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type of associated pathway to attach to
the tailbone. So if even if there's
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a fall as a child, a
fall in a telebone is definitely warranted for
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further investigation. If your patient is
complaining of pain and their general area,
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the perennial area, their pelvic area, bladder area, or also have pain
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with urine nation, that's another referral
to pelvic floor PT. Also loss of
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urine, difficulty starting or stopping the
urine, or the inability to completely evacuate
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the bowels or bladder oftentimes is another
big indicator that there's a too much tension
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in the pelvic floor system and that
is what's striving those things. Post void
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dribble. Also difficulty initiating a bowel
movement or incomplete emptying of the bowels,
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are also straining to have a bowel
movement pain with intercourse, difficulty in maintaining
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and or achieving erection. Prolonged sitting
may increase your symptoms as well, and
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so these are good questions. So
on the next slide, Jessica is going
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to go ahead and give you guys
this tool. This is the Cozine Pelvic
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Floor screening tool. There are actually
ten questions and so if you're not comfortable
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asking your patients some of these questions
about their sexual health or about having bowel
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movements or urinary function, this is
a great screening tool to have into your
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clinic. Ask the patient to go
ahead, fill it out and if they
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indicate three or more, So if
they put checks on three or more of
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these, then that is a highly
likelihood that there's a pelvic floor dysfunction and
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a pelvic floor referral to pelvic floor
pt would be indicated. So go ahead,
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take a look at that and download
that and use that into your your
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clinic. So we've covered a lot
of information about what is the pelvic floor,
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what is its function, what are
some common diagnoses that we may see
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end's men's health, and where do
we go without. What do we do
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with that? I truly believe that
a better recovery really starts with gaining a
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great relationship between you as the healthcare
practitioner, whether you be a PT and
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OT, a chiropractor, whatever that
may be. Is you recognizing that there
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is an issue firsthand, especially in
men's health. Remember I'd mentioned earlier on
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that men typically go four years before
getting to the right place to help them
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with their pelvic floor dysfunction. And
so being able to screen these patients better
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and sending them over to a pelvic
floor therapist, and it's really ultimately going
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to be a better recovery for the
patient. And so I truly feel like
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it is a central for referral to
a pelvic floor PT if you suspect that
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there is a pelvic floor dysfunction.
We've talked at length so far about different
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things that can create pelvic floor dysfunction, about common diagnoses to look at,
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how to screen your patient for those, a screening tool, and then a
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pelvic floor PT can help look at
the pelvic floor from a local area,
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so they locally can assess, address
and treat the pelvic floor internally. So
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we do do internal assessment as long
as the patient is comfortable, for that
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is how we gain our information of
the overall health and success of the pelvic
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floor is internally also the PT,
so some things that you should be able
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to get on your end as the
PT. So if you refer that patient
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to a PT, the PT should
communicate with you as well about their findings
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and how do you both work together
with the findings that the therapists found at
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the local level and how you can
work together at a global level. Because
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there are many factors that affect the
pelvic floor, even down to the foot
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affects the pelvic floor. The striking
of the foot and how the forces are
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transmitted from the foot and angle to
the knee to the pelvis has an impact
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on the function of the pelvic floor. So you both should be working hand
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in hand together for the overall better
improvement of this patient. So together it
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would be best if you both can
come up with a plan to help that
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patient the pelvic floor PT internally,
the other healthcare professional externally, and a
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global plan together to ultimate success for
your patients. At Southeast Professional Education Group,
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course modules that interest you. To
learn more, visit the acupuncture link in
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our show notes, or you can
go to online dot sports hyphen Seminars dot
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com for details. Back to the
show and that it concludes this module here
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about pelvic floor men's health, What
are some common factors some diagnosis, and
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how do you assess and be able
to refer your patients to pelvic floor physical
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therapy. I think at this time
we're going to go ahead and open it
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up to any questions that you may
have. Awesome, thank you so much.
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I do have a few questions that
have come in here. We'll kind
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of dive into those, okay,
right away. Are there any specific sports
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that you find I know you mentioned
ling is sometimes something that can contribute to
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pelvic floor dysfunction and men. Are
there any other sports such as bodybuilding,
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any extreme sports that would be very
likely to cause injuries that may kind of
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start a cascade of unfortunate events to
cause pelvot floor dysfunction? Yeah, great
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question. The answer that is yes, we see a lot of it.
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And body builders are men who are
lifting very very heavy that have an increase
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of intrabdominal pressure, so they're descending
that pressure either anterior onto the abdominals or
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downwards onto the pelvic floor for prolonged
periods of time. When I say prolonged
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periods of time, I don't mean
like in time of their like intrabdominal pressure,
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they're holding it for thirty seconds.
I mean for the course of their
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lifting, and they've been lifting for
five, six, seven years. This
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way can contribute to the increased tension
of pelvic floor issues. So we typically
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see that more and like bodybuilders or
physique patients who are doing like were physique
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type of building. But anytime there's
an increase in inter abdominal pressure, it's
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going to directly unpack the public floor. Absolutely. That definitely makes total sense
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when it comes to having this discussion
with your male patients. Let's say I'm
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a practitioner, I'm seeing some of
these red flags. I've given them the
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assessment that you provided, and it
looks like it's time to refer out for
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public floor PT. How do you
begin to have that conversation when maybe your
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patient just thought they were having low
back pain and you're a chiropractor. You
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should be able to fix my low
back pain. Or I come into PT
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because I have psiatica, that's not
what this is. How do you have
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that conversation in a gentle way that
helps them understand that it affects so much
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more than just their low back pain. We get that all of the time,
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and to answer it is when a
patient's coming to see you for psiotica
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or for low back pain. It's
not going to be on the forefront.
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It may now be on the front
forefront that there might be a public floor
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dysfunction going on, but that's not
generally what's on the forefront of your mind
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as the practitioner. And so I
definitely think what you do is you actually
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treat that patient for a bit,
right, three, four or five sessions,
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and you're going to see improvement.
But it could be where you're not
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kind of getting to the end,
like the end game of what you were
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hoping to see very quickly with just
let something simple as low back pain.
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So it is something where you would
want to screen your patient, tell them
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say, hey, the research shows
that with low back pain, ninety percent
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of the patients have a pelvic floor
dysfunction. Look, we've been after this
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thing for a couple of sessions.
Now we've been doing it four or five,
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six sessions. I've given you the
screening tool that does indicate that there
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is a pelvic floor dysfunction going on. And I think that's what's going to
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take care of the last ten five
percent of your pain that you are having.
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That I do think that is actually
referral pain coming from your pelvic floor,
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and there's no longer really an issue
with the low back. So let's
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go ahead and get you over to
a colleague of mine, whoever that may
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be, that's a public health specialist, and let's let them take a look
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at you and let's see if we
can't resolve that last ten or fifteen percent
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of your symptoms. They'll evaluate you, they'll connect with me, we'll talk
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about it, and we'll make a
good game plan going from there, because
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really we're after this hundred percent,
so we want one hundred percent improvement.
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So I think that's really it.
I think, honestly, is the best
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policy here. Right. You just
got to tell them what you think.
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They came to you because you're the
doctor and they have full confidence in you,
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and there is a skill or a
subset that you just may not have.
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And referring them over to another healthcare
practitioner and take a look at but
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you guys co collaborating on this,
I think is the best practice here.
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Absolutely, And often times I would
imagine when you have those conversations, the
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patient may have questions about what is
that going to look like from an assessment
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standpoint I'd imagine that a lot of
alarms go off if any discussion of internal
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exams sure go on. How do
you handle that in a delicate way?
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If the next question is, okay, doc, so I'm willing to go
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see this person, what are they
going to do with me? What is
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that going to look like? Just
so that they have a better comfort level
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with knowing that this is something that's
necessary, but there is a much better
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outcome as the end goal for them, right. I think the first thing
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is, just like you said,
is that you have to educate your patient
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on what is the best thing for
them. And that's why another reason why
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I think there's so many dysfunctions in
men's health is because the idea of like,
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what I'm going to have to go
through a rectal exam? Right?
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Doing a vaginal exam is that's common, right, We know that happens all
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of the time, and that's acceptable
and that's okay, But it comes to
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rectal exam. Sorry to say this
quote unquote, but we kind of puck
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her up a little bit, right, who wants to do a rectal exam?
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And so I think that you just
have to tell your patient that they're
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what they'll do is first a external
assessment, so we will look externally at
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the musculature, so we will pow
pate externally. We can just do that
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with the first layer, but their
possibility could be an internal examined. This
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is how they get to those muscles
by doing that, just like I can
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get to your bicep by having you
bend your elbow and I can poke on
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your bicep. Here we just don't
have that same tool. Said when it
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comes to the pelvic floor, and
the best practice is to go into rectally,
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but I would call a local pelvic
floor physical therapist and then see what
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is their best practice. We always
tell our patients what they're going to expect
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on their first visit, but at
the end of the day they can say
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yea or nay to an internal assessment. Right. There are other strategies that
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we look at. We look at
breathing strategies, will look at pelvic alignment
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issues, and we can kind of
already say, Okay, this person has
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a hypertonic pelvic floor. This person
has this, and so not necessarily do
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we have to do a rectal exam, but it is highly highly indicated.
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Wererant it, but I definitely think
you should just tell your patients like this
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is a possibility, just go see
what they have to say, and then
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we have tools in our toolbacks to
get the patient comfortable with that if that's
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what they choose to do. Another
question that we had here was related to
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the umbilical hernias. Obviously these are
things that are somewhat common, but we
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hear more about hernias when it comes
to men, and specifically the umbilical hernia.
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Do you find that it's better for
that to be addressed first surgically before
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doing pelvic work or do you do
pelvic floor work first? Or is it
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a chicken or egg type situation.
So it's a chicken or egg type situation,
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And let me tell you a little
bit about and what we do here
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and kind of in my experience is
typically at a billicahernia, it can be
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repaired surgically or not, and either
most of the time it's an aesthetic issue,
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right that the gentleman doesn't like the
way that it bulges are the way
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that it looks right, So that
is where the firsthand most of the time
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says, go to a surgeon,
get that repaired. But the underlying problem
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never was fixed, and so that
can create another umbilicahernia, and so you
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have to fix the problem I feel
personally at firsthand. So I would say
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a referral to public floor pt looking
at pelvic floor, looking at the system
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of how they are using their intra
abdominal pressure, changing the way that they're
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using their intrabdominal pressure, trying to
strengthen up the system around it, changing
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the way that they move, changing
the way that they function, to help
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decrease and offload the tendency for that
pressure to go anterior onto the abdominal system.
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I think that is the best practice. And then within the course of
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six, eight, twelve weeks,
if things haven't changed, and then we
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go potentially down the surgical route.
But I definitely think at first it is
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better to figure out why is than
beiligahernia. There is it an issue with
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function for that reasons, So I'm
definitely more on the conservative method of doing
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trying this first and then if it
is needed, let's do it. Kind
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of problem with that absolutely, and
I would venture to say that most of
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our audience is the same mindset and
that we try a conservative approach first before
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we go to surgery. For many
things along that same vein, and this
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could be an anecdotal response based upon
your experience or something that you know from
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the research. Statistically speaking, does
umbilical hernia oftentimes indicate pelvot floor dysfunction?
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And then the second part of that
question was the same for erectile dysfunction.
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Does erectile dysfunction typically point to a
pelvic floor dysfunction? Yes. The answer
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to both of those questions yes,
absolutely. One is going to be an
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interup. Both of them can actually
be inter abdominal pressure. It's just where
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are you're putting that pressure. So
whether that pressure goes enter onto the linea
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alba creating a thinning of the linea
alba to allow the hernia to protrude through,
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or also for the rectum as well, that pressure can go down and
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create also to a pelvic floor dysfunction. So both to answer both of them,
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yes, wonderful. The next question
talks a little bit more about treatments
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and with you being very specialized and
being able to do specific internal assessments that
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are often sort of outside of scope
of practice of many of the practitioners that
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are listening today, we always like
to take a peek behind the curtain and
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say, okay, what kind of
tools does she have in her toolbox?
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Are there specific devices you use?
Is a lot of your treatment exercise based?
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Is a lot of it retraining,
breathing patterns. What are some of
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your go to treatment approaches that you
typically will utilize in treating men's public floor
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One of several tools that we have, And honestly, it just depends on
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the practitioner. I am more of
an exercise based practitioner than I am with
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someone who is going to stick you
on e stem and do more biofeedback.
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We do hear more of intradigital so
using obviously one finger into the rectum to
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assess the pelvic floor and then from
there we do interdigital biofeedback. So we
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try to teach the patient how to
relax and let go of those muscles.
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A lot of that is an association
with breathing techniques, helping them learn how
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to use their diaphragm correctly, being
able to expand the rib cage allow the
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diaphragm to come down. A lot
of it may be looking at hip mobility
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as well. Externally, that has
a major factor of pelvic floor issues.
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While we are in rectally, we
can do a little bit of soft tissue
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work for those pelvic floor muscles.
We could do a little bit of contract
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relax PNF, those types of things
fascial stacking to the pelvic floor directly.
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That has a huge impact to the
pelvic floor of associated tools that most of
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the practice sact depending on the practitioner, may not have. So that's a
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different tool set that we have because
we do have the ability to go in
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internally and trarectily to help change the
tissue function. A lot of our discussion
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in some of our previous trainings,
and I think a lot of the discussion
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now within several professional circles within healthcare
involves the biopsychosocial aspect of different conditions or
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different symptoms patients may be experiencing.
What are you finding in terms of the
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impact a lot of these dysfunction components
may have on patients mental and emotional help,
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even maybe so much their social life, Like how does this transform their
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lives in a negative way when they
have it? And then how have you
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seen that improve their lives after things
improve? This is something that we see
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daily across the board. I definitely
feel like it affects men mostly I think
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a little bit more than it does
women, just because it's kind of like
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more accepted for us, but with
men it's not right. And men is
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supposed to be able to have intercourse
with their significant other, able to please
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their significant other, and when that
is taken away from them, that really
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impacts a man, that really impacts
the man, the man's ego. So
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we see a lot of mental health
issues with that when you're even talking about
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more just on the terms of incontinence, whether that be bow or bladder.
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When a man is losing the ability
to have control of their bow or bladder,
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that hugely impacts their world. The
fact that they potentially have to wear
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a diaper right or a pat or
something because of incontinence. It really does.
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Honestly, it just takes the carpet
right underneath the man's feet and it
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impacts them greatly. And so we
see a huge association with pelvic health and
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being able also to refer to a
mental health specialist just because of the impact
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directly that it does have on the
mental health. Absolutely, I can certainly
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see that being the case. Finally, the final question we had here was
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talking about managing with a pelvic floor
specialist. What type of relationship do you
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prefer to have with practitioners that you
co manage care with. What should they
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be prepared to provide you as far
as information about the patient and their history
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and what they've done so far,
and then how does that communication go while
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you're both co managing that case.
I like to have a direct, one
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on one relationship with my other practitioners. I like to see notes, because
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typically these patients are seeing you before
they're seeing me. I'd like to see
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what's been going on, what globally
has been done that gives me a zest
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of potentially what I'm going to find
internally. And then when I find something
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internally, I also want to discuss
those things with the other healthcare practitioner more
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on the realm of like I know
about pelvic floor and how can we work
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together to help with this pelvic floor
more common like we've talked about, is
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a pelvic floor that has too much
tension in it, and so how are
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we going to be able to work
together to do my internal things that I'm
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going to do here, and then
I'm going to look to you to do
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external things, and those external things
maybe depends on what that person specializes in,
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right, looking at manipulations of the
thoracic spine, trying to get that
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autonomic nervous system downregulation, looking at
the t L junction, so thoracic lumbard
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junction, because we know those nerves
they do have an association with the lumbar
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spine, with the podental nerve.
Those sorts of things that helped to downrate
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the pelvic floor as well. Maybe
some visceral mobilizations, if that is what
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the healthcare provider is known for,
mobilizing the diaphragm, helping to improve the
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diaphragm mobility, trying to improve how
the ribcage moves. So those are some
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techniques and some things that I would
look for for the healthcare provider to work
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hand in hand because that's what is
going to help to downregulate and improve the
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function of the pelvic floor. So
that's something that I look at for us
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to work together on. Absolutely.
That sounds wonderful. Well, thank you
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so much today. This has been
great information, a very interesting topic,
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and I think definitely has been eye
opening for many of our practitioners about some
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things to look for. And Brittany
tell us a little bit about your practice,
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where you're located, and if someone
was in Texas and wanted to refer
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someone to you, how would they
go about doing it? Yeah? Absolutely,
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and so I am here at Empower
Pelvic Health. We are located in
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Webster, Texas, Nasau Bay Area, so we are located at eleven twenty
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00:34:35.199 --> 00:34:39.400
NASA Parkway. And the best way
if you're interested in sending a patient our
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00:34:39.480 --> 00:34:43.480
way, we could do it by
two ways. Can either call us,
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00:34:43.519 --> 00:34:50.199
so our phone number is three four
six six seven seven zero one five zero.
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00:34:50.880 --> 00:34:57.440
Also you can email us and that
email addresses info at Empower Pelvic Health
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00:34:57.639 --> 00:35:02.320
all one word Empower Pelvic Health the
dot com and that way you can refer
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00:35:02.400 --> 00:35:07.280
a patient over you can give the
patient the information when you download the file
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00:35:07.280 --> 00:35:12.239
of the co Scene screening tool.
On the very bottom of that it has
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00:35:12.280 --> 00:35:15.480
our clinic information, so you all, if you're downloading that, you'll all
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00:35:15.559 --> 00:35:22.480
have that clinic information and ways to
communicate with us, whether that be phone
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00:35:22.719 --> 00:35:25.320
or also by facts. One thing
that we do have I'll share really quickly
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00:35:25.400 --> 00:35:30.519
with you and that typically we see
our evaluations are actually ninety minutes in duration
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00:35:30.960 --> 00:35:36.719
and then our treatment follow up sessions
are sixty minutes. Those are for our
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00:35:36.760 --> 00:35:40.159
patients who were local. We also
have an out of town program because pelvic
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00:35:40.239 --> 00:35:44.480
floor are there's not many of us, and they're also not very many of
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00:35:44.519 --> 00:35:49.000
us that do men's health as well, so not every peblvic floor therapist does
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00:35:49.039 --> 00:35:52.280
men's health. So you definitely want
to make sure if you're going to send
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00:35:52.320 --> 00:35:54.039
a man to a public floor therapist, you want to make sure that they
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00:35:54.079 --> 00:36:00.320
do men's health. But we also
have an out of town program and we
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00:36:00.400 --> 00:36:06.760
have two hour availabilities for those patients
who are traveling a longer distance to come
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00:36:06.840 --> 00:36:09.519
and see us. So there's some
information, and then you're also more than
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00:36:09.559 --> 00:36:16.119
welcome to contact me directly and my
email address is Brittany at empower pelvic health
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00:36:16.199 --> 00:36:21.000
dot com, and I'll be more
than happy to answer any questions or help
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00:36:21.039 --> 00:36:25.119
you with getting patients, even if
you're not in this area of Houston,
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00:36:25.199 --> 00:36:30.880
Texas and you are in a different
low state. I do have many colleagues
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00:36:30.880 --> 00:36:35.079
in pelvic Health that I can also
get you connected with and help you get
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00:36:35.079 --> 00:36:39.000
your patient over to them. All
right, that's another great question. Actually,
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00:36:39.079 --> 00:36:44.199
if they are looking for someone in
their local area to develop a relationship
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00:36:44.280 --> 00:36:50.440
with a pelvic floor specialist. Is
there a certain national organization or credentialing body.
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00:36:50.880 --> 00:36:53.000
What is the best resource for them
to look to if they're trying to
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00:36:53.119 --> 00:36:59.119
establish that referral relationship in their area. Yeah, so you can go to
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00:36:59.159 --> 00:37:04.599
the International Pelvic Pain Society. Good
to type in your zip code and they
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00:37:04.599 --> 00:37:08.480
will connect you with a practitioner in
your area. Again, I want to
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00:37:08.519 --> 00:37:13.199
emphasize the fact that if that's what
you choose to do, that you are
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00:37:13.320 --> 00:37:17.280
asking if they treat men's health wonderful. That's definitely important information to have.
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00:37:17.840 --> 00:37:30.920
Thank you again, we do appreciate
you. That's it for today's episode.
441
00:37:31.360 --> 00:37:35.960
Be sure to tune in for episode
sixty four, where we kick off a
442
00:37:36.000 --> 00:37:40.000
new training with best selling author and
renown expert on gut health, doctor Robert
443
00:37:40.000 --> 00:37:47.199
Silverman, titled Immune Reboot a Guide
to Maximizing Immunity and Optimizing Vitality. You
444
00:37:47.199 --> 00:37:52.639
won't want to miss it. Episode
sixty four drops in two weeks. Be
445
00:37:52.719 --> 00:37:55.280
sure to visit our show notes for
all the freebees and special offers that we
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mentioned in our episode, as well
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all that you do to support us. We'll see you next time. Hey
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guys, if you like what you
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and bookmark any of these upcoming live
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