Interview with Allison Poole, PT, MPT, WHC

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Empowerment Through Healing: Pelvic floor physical therapy with

Allison Poole, PT, MPT, WHC

When Whitney and I began integrating ourselves into the holistic community in Portland, Maine- one of the first people we met was Allison Poole, PT, MPT, WHC. We were immediately struck by not only her fun personality and kind spirit, but also her unique and incredibly important work with women.

Many women that we work with have experienced trauma, childbirth, aging, and physical changes that can effect their relationships and views of themselves. If you fall into one of those categories- take a moment to read our interview with Allison below and consider contacting her for services!

What is pelvic floor physical therapy?

Basically, I help women who leak or have pain with sex take control of their bodies so they can feel confident in their lives. The pelvic floor is a group of muscles that live in the pelvis and help keep us continent, enjoy sex and stabilize the pelvis (which supports both our upper and lower body...think of it as the foundation of your house). These muscles can be injured and weakened from surgery, childbirth or can become tight and painful as a response to trauma, persistent pain or intense exercise. A pelvic floor PT is trained to assess these muscles specifically, and look at how they interact and work with the rest of the body at rest and during activity.

Who could pelvic floor physical therapy benefit?

Pelvic floor physical therapy can help women who leak during their activities (running, jumping, walking) or when the sneeze or cough, women who have pain with intercourse and women with low back, tailbone or hip pain that has not been helped with other treatments (as the pelvic floor is often the missing puzzle piece). Men can also benefit, however I do not see men at this time.

Can you describe what a typical first appointment would look like?

The first appointment consists of a lot of talking to get a clear picture of your symptoms, what makes them better or worse, when they started etc. I also ask about your daily life (sleep, eating, stress), review your past medical history, childbirth history and daily habits that have to do with your pelvic floor. Most importantly, we discuss your goals and what you want to be able to do and why you want to do them.

The interview portion is then followed by me describing exactly what the pelvic floor is, how it works and why you may be experiencing some of your symptoms. I have a great model and some anatomy pictures so you can get a really clear picture  of what the pelvic floor is and how it is so intricately connected with the rest of the body (it’s more than a lot of med students get)! I will then describe what the evaluation will consist of, first an assessment of your posture and strength and then the internal assessment of the pelvic floor. The pelvic floor assessment does not need to happen on the first visit, or ever for that matter. Though, it is the gold standard to get a true picture of what is going on, the pelvic floor is just one peice of the puzzle and there are many things to address without having to directly assess the pelvic floor. (I wrote a blog post about what to expect from a pelvic floor evaluation).

You will leave the first appointment with having learned about a very important part of your body, what is going on and why you are having the symptoms you are having. You’ll have an outline of what the process will consist of to meet your goals and a few tools to begin to incorporate into your daily routine that day.

What are some possible services or treatments that may be offered after the first appointment?

Treatment is very individual and specific to each woman’s needs. All of the follow-up appointments are one-on-one with me. Treatments may include, hands-on manual release of tight muscles, scar tissue mobilization, strengthening the deep core muscles, education about posture, breathing and relaxation strategies. Every treatment will include tools for home and self-management.

Are you able to modify treatment if a client isn’t comfortable with touch or is struggling with side effects from trauma?

Absolutely. A lot of what I do is education and teaching exercise, stretches and techniques for a woman to take treatment into her own hands. I think a lot of medical appointments are centered on the provider telling the patient what she should do. I help women figure out what they could do, how to incorporate it into their daily lives and feel empowered to heal.

How have you seen pelvic floor troubles affect emotions, relationships or self esteem?

The pelvic floor is said to be the seat of safety. When our pelvic floor is affecting our daily life, we feel insecure, alone, embarrassed, ashamed. This is a topic no one talks about, so it can feel extremely isolating. When we do bring it up to our physicians, it is often brushed off or there is poor advice given (ie. just do kegels or just have a glass of wine to relax). As you might imagine, pelvic floor dysfunction is a big player in libido, which affects intimacy and sexual relationships physically and emotionally.

What are the common misconceptions about what you do for work? And can you take a moment to dispel them?

The three biggest misconceptions are 1. “Pain or leaking are normal.” It is common, but it is certainly not normal and there are a lot of conservative, highly effective ways to address pelvic floor dysfunction. 2. “Pelvic floor PT is for new moms or old ladies.” You do not need to have had a child to have a pelvic floor issue. I see many young women who have pelvic pain or incontinence and have never had a baby. On that same token, I think society associated leaking (adult diapers) with older women, but I see women as young as 15 and as old as 80, and everyone in between. 3. “I just need to do kegels.” Kegels (or a pelvic floor muscle contraction like you’re stopping the flow of urine) is just one exercise in a much larger picture. They can be an effective tool if the pelvic floor is weak, but the goal is to get the pelvic floor functioning in all activities (not just when you’re at a stop light). Often the problem is not that the pelvic floor is weak, but that it’s overactive- working too hard. In that case, kegels can make symptoms worse!

How did you fall into this line of work?

I had a brilliant professor in PT school that was passionate about women’s health and what an underserved population it was. She really inspired me, however my career after college did not take me in the directions of women’s health. It wasn’t until after I had my son, that I had gained a whole new appreciation for my body and what it did to create life (and what happened to it during and after birth!). An opportunity presented itself and there was no turning back.

Can you name one of your favorite aspects about what you do for work?

My favorite aspect of my work is getting to know incredible women and being a part of their healing journey. It’s a remarkable thing to see a woman gain control of a piece of themselves they hadn’t realized was affecting so many facets of their lives.

How can someone who has more questions or who wants to visit get in touch with you?

I offer complimentary phone consults if you are interested in learning more about what I offer and if we might be a good fit. I have lots of information on my website and blog: www.korumaine.com and of course, you can call 207-358-8161 or email apoole@korumaine.com