Pelvic Support Physiotherapy
Caroline Allen is one of the “original six” physiotherapists in Ontario. She was always my course mate and roommate when we had to travel to British Columbia and Alberta to take our pelvic health courses. There were almost no courses held in Ontario at that time. Things have changed significantly, but not Caroline. She is a great friend, an excellent clinician and a well-respected clinic owner in the Ottawa Region. She also took on the responsibilities of a College Assessor; she is detail oriented, experienced, and empathetic. What a great combination of attributes for a College Assessor to possess. Caroline has been a mentor to many physiotherapists over the years. Thank you Caroline for all that you do!!
How long have you been practicing pelvic health physiotherapy?
I’ve been a Physiotherapist for over 35 years, and in pelvic health since 2000. I have been a peer assessor with the College of Physiotherapists of Ontario for the past 5 years.
What lead you into the specialty of pelvic health?
In 2000 I moved with my family back to the UK for 3 years and started working in a private hospital. The PT department had been looking for a physiotherapist to start an incontinence clinic, but no one was interested! The only physiotherapist I knew in Women’s Health was Judy Fox at the Ottawa Hospital, so I contacted her and asked about her experience: she was so enthusiastic and encouraging and talked about changing patients’ lives. She said ‘give it a go: you’ll love it’.
I spent the next 3 years taking courses and participating in mentorship, and eventually I set up services within the hospital. I saw gynecological and surgical patients pre-operatively, post-operatively and as out-patients, setting up an incontinence clinic for women and men.
When I came back to Canada there were no pelvic health jobs, so I started my own clinic, and spent a lot of time talking about pelvic health to any groups/individuals who would listen.
I was asked to become a peer assessor for the College of Physiotherapists of Ontario shortly before the College instituted the system of ‘rostering’ for PTs who perform authorized activities (including internal pelvic exams). As a practice assessor my role is to visit the selected PT’s practice setting, gather information on behalf of the College and submit a report for the Quality Assurance Committee to review. Being an assessor gives me an opportunity to see a variety of other practice settings, connect with different peers and listen to what they have learnt and how they put these skills into practice. It’s eye-opening to see how conscientious most physiotherapists are!
What do you love most about your profession?
Where to start? I feel so privileged to be working as a PT in pelvic health. I really appreciate the relationships we have and the respect we receive from so many different health practitioners: gynecologists, urologists, psychologists, family doctors, naturopaths, osteopaths, midwives, other physiotherapists and chiropractors.
However, the most rewarding part has to be the relationships and trust that we develop with our patients: so they feel safe enough to be able to have the most difficult conversations, and to share their most intimate experiences, thoughts and fears with us.
It is such an honor to give them the tools, knowledge and understanding to be able to move forwards and to see their lives change.
Favourite course/what course has changed your clinical practice the most?
I will always remember the very first course I took on returning to Canada in 2003, with Marie-Josée Lord and the sexual psychologist Dr. Elke Reissing. Not only did it give me a better understanding of sexual pain conditions and how to treat them, it gave me a network and support system, so I no longer felt that I was working in isolation (remember this was in the days before Facebook and social media!)
The courses that have changed my practice most significantly have been those related to pain science: Lorimer Moseley, David Butler, Debbie Patterson, and Neil Pearson. This is so important and relevant to ALL of our patients. Figuring out how to ‘get into peoples’ heads’ to explain pain in a way that is meaningful to them and with words and examples that they can understand, is one of the most challenging and rewarding parts of the job.
What has been your most rewarding experience?
- Hearing from patients who have moved on and are confident and happy in their bodies
- The cryptic emails and notes that are sent saying ‘everything’s working well J’.
- The new moms who come in with their newborns and say ‘I couldn’t have done this without you’
- The gynecologist/urologist who says ‘can you assess this patient and tell me what you think?’
- Being shadowed by gynecology and family medicine residents because they realize the importance of pelvic health and want to know more
- Seeing how ‘mainstream’ pelvic health has become in the past 10 years
- Establishing a clinic and working with colleagues who all have such a passion for pelvic health – it is so much more than just ‘a job’
What advice would you provide to new physiotherapists getting started in pelvic health?
Talk less and listen more. When we are unsure of ourselves, it’s so easy to talk too much. Our patients need and deserve to be heard. You may be the first health practitioner to have really listened to their whole story and experience. This is worth a lot – do not rush to interrupt or educate.