Pelvic Floor Therapy Explained with Emily Dumont | Buying Local #82

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Speaker 2
Welcome, everyone, to buying local. I’m your host, Mike Nelson from Five Towers Media, joined today by Emily Dumont from Poppy physical therapy. Hi, Emily.

00;00;09;08 – 00;00;10;02
Speaker 1
Hi.

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Speaker 2
Hi. How are you?

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Speaker 1
Good. How are you?

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Speaker 2
I’m good, I’m good. Welcome to the show.

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Speaker 1
Thank you.

00;00;16;22 – 00;00;28;00
Speaker 2
Yeah, yeah. So, Emily, you know, just in case there’s a couple people out there who haven’t heard of the poppy physical therapy. Why you gotta go ahead and introduce yourself and your business a little bit.

00;00;28;02 – 00;00;59;19
Speaker 1
Okay, so I’m Emily, and I own Poppy physical therapy, and it is a pelvic floor physical therapy clinic, so we specialize in bowel bladder sexual dysfunction. We also do orthopedic issues. Back hip, you know, all that kind of fun stuff. So I have been a therapist now for 14 years. Started pelvic floor therapy over five years now after the birth of my son, which had some issues and, needed to go to pelvic floor therapy myself.

00;00;59;21 – 00;01;16;08
Speaker 1
So I went there. They hired me on, had a mentor who’d been doing it for like 20 years, and she kind of trained me, and, I loved it. So then moved here a couple of years ago and, yeah, decided to open my own thing.

00;01;16;11 – 00;01;32;21
Speaker 2
Open your own thing? Yeah. What I I’m curious. I it’s always a question I love hearing about with business owners and entrepreneurs is like, what prompted you to want to have your own practice as opposed to working inside somebody else’s practice?

00;01;32;23 – 00;02;00;12
Speaker 1
Oh, yeah, a lot. I felt, you know, there are so many restrictions when you’re working inside of, someone else’s practice, especially like a big hospital facility. Right. Like we would normally get 20 to 30 minutes with a patient, which I just didn’t feel was enough time, especially with pelvic floor therapy. You would also have limitations to what you could treat.

00;02;00;12 – 00;02;28;24
Speaker 1
Right? So if I assess someone and they’re leaking with running and I was like, oh, well, your foot is actually a big contributor to why you’re leaking with running. It would be hard especially to insurance sometimes to justify like why I’m treating the foot when they’re dealing with a pelvic floor issue. Right. They a lot of times wouldn’t like it, or would deny it or would only give you, like, maybe for visits to see somebody.

00;02;28;27 – 00;02;51;27
Speaker 1
And, you know, there’s always the push of getting more and more people in, like, we need to see more people. You need to see more people in a day, right? That’s why I like visits decreased to 20 to 30 visit or minutes. So you could see, you know, 20 people in a day. And it was just yeah, at that point I just didn’t feel like I was doing good care.

00;02;52;00 – 00;03;15;28
Speaker 2
Yeah. It’s it’s interesting that you bring that up too, because over the years I’ve interviewed a few health care providers and different, you know, modalities of health care. And every single one of them says that same thing that they just could not give the quality of care that they wanted to give in that 20 to 30 minute window that they’re allotted by larger practices and hospitals.

00;03;15;28 – 00;03;23;29
Speaker 2
And again, nothing against those facilities. They’re trying to run a business. They’ve got huge overhead. Like, you know, I can’t even imagine. Yeah.

00;03;24;03 – 00;03;43;24
Speaker 1
No, I mean, yeah, I totally get it right. Like insurance reimbursement goes down every year. They have to make their money somehow, so. Right that they’re just going to decrease the amount of time you can spend with people. So you can see more people in the door. And like I, I totally understand it. It just yeah, I it’s just not for me.

00;03;43;26 – 00;04;03;16
Speaker 2
Wow. Yeah. And which to be fair, I think is amazing because it, you know, it’s kind of reassuring that there’s people out there that really do care about their patients and care about the quality of care and actually getting to the root of the issue instead of just, you know, fast food, health care, where we get them in, you know, we make a quick diagnosis.

00;04;03;16 – 00;04;06;20
Speaker 2
We just we prescribe a pill and we get them out the door. Right. Like, I.

00;04;06;20 – 00;04;27;17
Speaker 1
Know. And it’s it’s really sad because I always say, like, I think most health care providers got into the field to help people, right? It’s rare that a nurse or a therapist or doctor didn’t get into the field to help people. But then I think you get in our system and you just get so worn down by the system, right?

00;04;27;17 – 00;04;31;02
Speaker 1
And that’s just I think that’s where the problem lies.

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Speaker 2
Yeah, yeah. Your your hands are really tied and you’ve got to, you know, you got to do with the what the boss say. Right. That’s. Yeah. And Hammond de it. So it’s, it’s fascinating to me that when you’re talking about the, the leaking issue, which from what I understand is very common for a lot of women especially. Yeah.

00;04;53;10 – 00;04;59;20
Speaker 2
But that like, it has to do with their foot, like, at, like, you know, in the gear, like that’s.

00;04;59;22 – 00;05;23;03
Speaker 1
There was actually just a study that came out because that love research studies, there’s actually just a research study that came out that did an assessment on people who leak with running, and they checked their pelvic floor. And the people who leaked with running actually had a stronger pelvic floor than people who didn’t leak. So you’d think, well, if their pelvic floor is stronger than, why are they leaking?

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Speaker 1
But they actually determined a lot of that, that the foot was actually a big driver, because in order to accept ground reaction forces, right, that come up right, you have to be able to prone or get that flat foot that’s been demonized flat feet. But flat feet is actually a good thing when we’re talking about running and things right.

00;05;43;10 – 00;06;01;07
Speaker 1
It that’s how we disperse forces up to our spine. And so they did this study and it showed that they weren’t doing that with their foot. So their pelvic floor and their hips had to actually do that to decrease the amount of pressure going up to their spinal cord. So at the problem is actually working really, really hard, harder than it really should have had to.

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Speaker 1
And I find that a lot of times in pelvic floor like that really is the issue, right? Because you should be able to have a baby, be pregnant, have a baby, all that stuff. And there are plenty of people who don’t leak after that. So why are there some people who do great? Like usually there’s some underlying thing also going along at the same time.

00;06;24;08 – 00;06;49;02
Speaker 2
Yes, I always found it interesting about with injuries. Not necessarily people look for issues, but just with injuries in general where like where you’re experiencing the pain or where you’re experiencing the problem isn’t always actually the problem, that you have to go upstream and downstream from the problem in order to actually see what’s causing it. And I just always thought that that was really, really interesting because you’re like, oh, my knee hurts.

00;06;49;03 – 00;06;59;11
Speaker 2
And it’s like, yeah, but it’s got nothing to do with your knee. Your knee hurts because of above it and below it, and something some other dysfunction that’s going on. It’s like the human body. So wild.

00;06;59;14 – 00;07;26;03
Speaker 1
Which is another reason, right where I started my own business. Right. Because it also like you can’t discover that in 120 to 30 minute session. Right. There’s no way to assess someone’s foot. Knee hits low back middle back neck. Right. Like in one like you. It takes time to really do thorough assessments of all that, to really determine what is causing this issue.

00;07;26;05 – 00;07;37;25
Speaker 1
Right. And if you just don’t have the time, you could be the best therapist in the world. And I think there are tons of good therapists out there, but they just don’t have the time to actually figure that out.

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Speaker 2
Do you? So I, I think I first heard the term pelvic floor and, the issues that come along with pelvic floor maybe like ten years ago. Okay. But since since then I hear more and more and more and more about it all the time. Is it like, is this something that is increasingly becoming more of a problem, or is it just always kind of been a problem and people just didn’t really understand it?

00;08;02;21 – 00;08;28;25
Speaker 1
Yeah, I think I mean, it’s always been a problem. I think it’s been a problem for a long lot for as long as women have been having children, most likely. Right. But even men, right. Even men have pelvic floors and they have plenty of issues. I would say it’s been a problem forever. It’s finally getting recognition, honestly, somewhat due to the social media, great social media has improved the recognition of pelvic floor therapy.

00;08;28;27 – 00;08;44;23
Speaker 1
But I think also women are just especially women, right? Like they’re just getting more vocal about it, right? Like they’re just not accepting like a lot of times it was just like, yeah, you had a baby. So now you’re going to like little when you laugh, cough or sneeze. And now people are realizing like, yeah, that’s just not okay.

00;08;44;23 – 00;09;09;22
Speaker 1
Like you shouldn’t do that. Right. And I think another sad thing is when you do like it shows that like 50% of women, almost 50% of women actually stop exercise because they like. Right. So like just an exercise is one of the best things you can do for your body. And we have almost half of the population of women stopping it because they’re leaking.

00;09;09;24 – 00;09;16;27
Speaker 1
Right. Which is not going to improve your symptoms. Right. And then it’s going to lead to a whole host of other things.

00;09;16;29 – 00;09;23;17
Speaker 2
Yeah. So it really was just kind of it accepted, I guess would be the way to say it was.

00;09;23;19 – 00;09;49;03
Speaker 1
And, and I, I’m sad to say, but it almost still kind of is right. It’s social media has improved awareness. But like doctors, a lot of doctors still aren’t just referring to pelvic floor therapy after you have a baby. Right. And they still kind of just expect leaking or pain and things like that. And it’s still almost just normalized.

00;09;49;05 – 00;09;54;09
Speaker 2
Yeah. Or it’s one of those things where it’s like, oh, we had a baby. So yeah, you can expect this to happen.

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Speaker 1
And yeah.

00;09;55;21 – 00;09;56;25
Speaker 2
Just part of life.

00;09;56;27 – 00;10;21;07
Speaker 1
Right? Yeah. And I think, you know. Yeah. And I think it was delayed too. Right. Because people in general don’t want to talk about it. Right. Like people aren’t really like talking about their bladder and bowel habits at the dinner table all the time. So it did kind of go under the radar for a while. But yeah, I think people are just becoming more vocal and just not being okay with the symptoms that they’re experiencing.

00;10;21;09 – 00;10;43;29
Speaker 2
I’m curious, I know a lot of private practitioners that I speak to these days, not just physical therapy but all over the board. Like I, you know, I’ve talked to quite a few direct patient care providers that have, you know, left either offices or hospitals and gone out on their own. And it seems like most of them are not accepting or working with insurance.

00;10;44;01 – 00;10;46;27
Speaker 2
Are you in that camp as well.

00;10;46;29 – 00;11;12;10
Speaker 1
Though? Yes. I’m considered an out-of-network provider. Right. Which means so yes, it is essentially cash pay. But every insurance is different. So I give everyone like a super bill at the end of their visit, and then they can submit that super bill to their insurance. And then depending on their benefits that their insurance has, because everyone generally has out-of-network benefits, they might get reimbursed somewhat based on that.

00;11;12;17 – 00;11;24;04
Speaker 1
And you can also use like your flex plan or your health savings account. Right. Because high deductible plans are becoming really common nowadays. Right? So you can even use like an HSA and things like that.

00;11;24;06 – 00;11;28;28
Speaker 2
Yeah. Yeah. That whole insurance came as wild to me as well. Like.

00;11;29;00 – 00;11;29;24
Speaker 1
Yes.

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Speaker 2
Well and like as a small practice, would you even be able to deal with the amount of people that goes along with insurance.

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Speaker 1
You know. And no. Right. I would have to have like a whole billing company because there are specific codes and you have to know what codes to bill where and then, you know, just to even the amount of. Yeah, like there was one insurance company that they would only give us like four visits, we got four visits.

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Speaker 1
And then you’d have to fill out this whole form, send them all of your paperwork, and then you’d have to do like a peer to peer review, right, where you’re talking to another clinician on why this person needs more therapy. Right. And all of this takes considerable time. It’s not reimbursable time. Right. So every health care agency is different, whether they’re actually going to reimburse you for that time.

00;12;23;15 – 00;12;42;25
Speaker 1
And then they would usually give me like one more visit. I feel like it was just to like, appease me, you know what I mean? Yeah. And. Yeah. And I mean, one time I was on a peer to peer review and a talking to, like, an ophthalmologist, and I’m like, why am I talking to an ophthalmologist? Like, should I be talking to a physical therapist like that?

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Speaker 1
I don’t know, it was just like, oh yeah, like I guess. And it was just, you know. Yeah.

00;12;49;27 – 00;12;54;28
Speaker 2
Yeah. Well, not to beat up on the system too much, but I just, I was curious about that. It’s.

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Speaker 1
Yeah. I mean, yes, it would be really, it would be really hard. Right. And then and then they don’t pay you for like three months and then they can, you know, decide to not pay you if they look back on notes and say, yeah, I don’t think this is right. And so then you have to decide what to do in that situation, right?

00;13;12;01 – 00;13;25;20
Speaker 1
Am I going to eat that cost or am I going to charge that on to my patient? Right. Like because they might not tell you until you’re done with that whole patient’s plan of care that they’re actually not going to give you anything for it. Yeah.

00;13;25;22 – 00;13;53;27
Speaker 2
So I mean running a business is easy right. I, I’m curious about how you juggle, you know, meeting with patients and providing care and running the business and the challenges that go along with that. I think that’s kind of the, you know, similar to like people just don’t talk about incontinence issues or other things that happened with pelvic floor, like when something’s done.

00;13;53;27 – 00;14;03;11
Speaker 2
I always talk about like how hard it really is to do all the things right. I’d love to hear about how you’re handling all the many hats that you have to wear on a daily basis.

00;14;03;12 – 00;14;23;18
Speaker 1
I don’t, I don’t know, I mean, it’s hard. I’m still learning. Right? Like I just opened in January here. So, like, I feel like I’m still so new to, like, running a business and like, the patient care I love and that part I can handle. And then all of the other stuff is stuff I’m not used to. Right?

00;14;23;18 – 00;14;47;07
Speaker 1
Like so I am trying and I’m learning and. Right. It’s all just experimental. Yeah. Especially because. Right, I have two little kids running around most of the time. But luckily my husband is very helpful. That’s great. And he has his job is a little bit more flexible, I would say, than mine. So that’s really helpful. I also have a business coach.

00;14;47;07 – 00;15;13;27
Speaker 1
So that’s, all the kind of teach my everybody saying, yeah, yeah, I mean, I have all the spreadsheets in, all right, like, I don’t know how to do that stuff. So that has been very helpful. But yeah, I don’t know if I have a good answer to that. It’s hard. It’s really hard. Yeah. Yes. You know, basically, I try to spend as much time.

00;15;14;00 – 00;15;31;08
Speaker 1
I’m with my kids as, like, be with them when I, when I could be with them. But. And then, you know, when I’m at the office, I am, like, doing everything right. I’m trying to meet with other health care providers and, yeah, do my patient care and, do my notes. I still have to do all of those.

00;15;31;10 – 00;15;41;15
Speaker 1
But I think I have a lot of lists. Yeah. And I usually try to do the things that I don’t want to do first and then work from there.

00;15;41;18 – 00;15;42;10
Speaker 2
That’s fair.

00;15;42;13 – 00;15;43;15
Speaker 1
Right.

00;15;43;18 – 00;15;48;08
Speaker 2
And then kick down the, you know, kick whatever canvas down the road that you have to. I guess it’s,

00;15;48;11 – 00;16;01;04
Speaker 1
Yeah. I mean, for right now it’s just me. So, like, right, like everything falls on me, but, yeah, I mean, honestly, nights after my kids go to bed, that’s when I.

00;16;01;07 – 00;16;02;17
Speaker 2
On the laptop.

00;16;02;19 – 00;16;04;24
Speaker 1
Yeah. So I do a lot of work.

00;16;04;26 – 00;16;12;08
Speaker 2
Yeah, yeah, I think we can all attest to that for sure. So now you said you just opened in January.

00;16;12;10 – 00;16;12;28
Speaker 1
Yeah.

00;16;13;00 – 00;16;22;18
Speaker 2
But. And do I remember this correctly that you opened in January, but you’ve already had to move offices to get more space for you, like, that’s.

00;16;22;20 – 00;16;41;09
Speaker 1
No, I did move, I moved, so I’m on Maple Ave in Saratoga and I was at this there was a lovely space on Maple Ave, but it was just a little bit too small. And so now I moved into, another space where I have two offices, so I have one where I have, like, my treatment room, and then I have another that’s more devoted to, like, exercise.

00;16;41;09 – 00;16;49;22
Speaker 1
Right. And like being able to do more exercise and things like that. Because I do love incorporating exercise into into what we do.

00;16;49;24 – 00;16;57;26
Speaker 2
Yeah. So that’s good though. Sounds like, you know, good, good. Good sign of growth and patience and, you know, so.

00;16;57;29 – 00;17;21;06
Speaker 1
No, it’s it’s been great. And I love the space where I am now. So yeah, no, it’s been really great. And I love to have the ability to have more exercise, especially. Right if someone’s like leaking with running. Right? I have like a little treadmill and things like that where we can really work on things, versus just being in a room with a table and, and minimal space.

00;17;21;08 – 00;17;37;26
Speaker 2
Yeah. So what what are some of the, the signs or symptoms that people might have that they should start thinking like, maybe I have a pelvic floor issue. Like what does that look like initially for men and women?

00;17;37;28 – 00;17;58;11
Speaker 1
Okay. So any form of leaking or any, any form of urinary incontinence is something that we don’t want. Whether it’s laughing, sneezing, coughing, running, all of it is not okay. I would also say urinary urgency or frequency. Right. If you get an urge and you feel like you have.

00;17;58;13 – 00;18;14;03
Speaker 1
To pee and then you can’t fold it on the way to the bathroom, or you feel like you have to run to the bathroom, right? Those generally are things that we don’t want. We don’t want you going to the bathroom, more than every 2 to 4 hours. Right? Every 2 to 4 hours for peeing is considered okay.

00;18;14;03 – 00;18;15;17
Speaker 1
But if you’re going more than that.

00;18;15;19 – 00;18;18;19
Speaker 1
then maybe you have some frequency, right? If you’re like.

00;18;18;22 – 00;18;39;03
Speaker 1
Dealing with your bowel, that’s unacceptable. Any kind of constipation, constipation a lot of times can be a pelvic floor issue. Also, pain with sex, right? You shouldn’t have pain with sex. That’s unacceptable. And I think a lot of people, especially a lot of the older generation, were just thought that that was okay. So those things.

00;18;39;03 – 00;19;02;25
Speaker 1
Right. Any kind of pelvic pain, actually low back pain and hip pain are both really correlated with pelvic floor issues too. And then we can go into like prolapse, right. If anyone feels like they have prolapse, any heaviness or bulging feeling that is something that we’d want to work on, because that probably means that you have some sort of pressure management problem.

00;19;02;28 – 00;19;07;04
Speaker 1
And yeah, any any bowel bladder.

00;19;07;08 – 00;19;23;29
Speaker 1
Or sexual dysfunction, pelvic pain. Gosh, I feel like I’m probably missing whether they’re having difficulty peeing or unable to control it. Even Ed can be assigned a pelvic floor to issues. Right. So, all of that and more and more.

00;19;23;29 – 00;19;41;15
Speaker 2
Yeah, it’s wild that, you know, again, that kind of like we talked about before, but as you’re saying, it’s just like they give hip pain or back pain like your first thought is not going to be that I’ve got a pelvic floor, she said. I’ve got I’ve got back pain. So I’m going to go deal with the back pain, right?

00;19;41;17 – 00;19;59;00
Speaker 1
Yeah, yeah. Like I always tell people, like, I have my little pelvis model here, right? I always tell people like, so this is like your pelvic floor, but like, this is a hip muscle. That’s a hip muscle. And that’s your pelvic floor. So, like, how are they not related? And in some way.

00;19;59;02 – 00;20;09;10
Speaker 2
Yeah. Yeah. So what does the future look like for a puppy. Physical therapy. Like what’s, what’s next.

00;20;09;13 – 00;20;33;21
Speaker 1
Here is just to help as many people as possible. Right. Like, I have been through it. I had pelvic floor issues after my son. And I know the fear that comes with that. Right? Like, I mean, it’s terrifying and it’s embarrassing and you don’t want people to go through it. So if I can help people, like, not feel that, that’s my goal, right?

00;20;33;21 – 00;20;46;18
Speaker 1
Like, I want to help as many people as I can. So I want to just. Yeah, that’s what I want to focus on. Just being in the clinic, helping as many people as I can.

00;20;46;20 – 00;20;54;21
Speaker 2
It’s amazing. So if people want to get some help or want, I think maybe they have an issue. Where do they find you guys?

00;20;54;23 – 00;21;18;19
Speaker 1
So, yeah, you, you know, I’ve Instagram and Facebook at Poppy physical Therapy. You can always send me an email info at Poppy physical therapy.com. My web page is just poppy physical therapy. You know, all of its online. Call me all that good stuff. I’ll try to be. Yeah. Better be everywhere as I can.

00;21;18;22 – 00;21;21;27
Speaker 2
Yeah. And now accepting new patients, right?

00;21;22;00 – 00;21;44;11
Speaker 1
Yes. Always accepting new patients. You know, I think that’s the, the thing about being with like this kind of practice too is like, yeah, I’m always accepting new patients. I can usually get people in within a few weeks. So that you’re not waiting, you know, 6 to 12 months to get your pelvic floor issues. Like, a lot of, like, other places.

00;21;44;11 – 00;21;52;22
Speaker 1
I know they really have. Yeah. Crazy, crazy waitlist. And the, you know, the longer you wait, you know, the worse your symptoms tend to get.

00;21;52;24 – 00;21;55;21
Speaker 2
Yeah, yeah. It’s not not going to go away on its own.

00;21;55;24 – 00;21;59;05
Speaker 1
No. Unfortunately not.

00;21;59;07 – 00;22;14;23
Speaker 2
Well, Emily, I really appreciate you coming on. And I know you’ve got a crazy busy schedule, as all business owners do. And, so taking a little bit of time to talk to me and our listeners, really grateful, really appreciate it. And, excited for your practice and what you’re doing.

00;22;14;25 – 00;22;16;14
Speaker 1
Awesome. Thank you so much.

00;22;16;16 – 00;22;30;17
Speaker 2
Yeah, absolutely. And thanks, everybody for listening. Of course, you can find us at buying local.us. And you can listen or watch our podcast on Apple Rumble Spotify and YouTube. Thanks for listening everybody. And you’ll hear from us next week.