Welcome back to the Healing Pain Podcast with Dr. Sandy Hilton, PT, DPT
When we think of pelvic pain, we easily associate that with women disorders which they even call women’s health therapy or women’s health section. There aren’t enough specialized care provided for men who are experiencing pelvic pain, even more so for the LGBT community. Dr. Sandy Hilton is a Doctor of Physical Therapy and one of the world’s leading pelvic health experts and the co-founder of Entropy Physiotherapy which is a practice that specializes in the treatment of complex chronic pelvic pain conditions. She sheds light about women’s pelvic pain, men’s pelvic pain, the challenges of the LGBT community with regard to finding adequate pelvic health services, how the tragic events surrounding gymnastics doctor Larry Nassar and the #MeToo Movement affected the public’s perception of pelvic care, and the role of prevention and education plays in being a pelvic health physical therapist.
The Women’s Health section of the American Physical Therapy Association was founded in 1977 and originally served as a resource for continuing education for physical therapists interested in the healthcare of women before and after pregnancy. Now, the scope of practice for the more than 5,000 pelvic pain specialists has evolved and now includes a myriad of health, abdominal, and pelvic concerns not only for women, but also men and children. A pelvic health physical therapist treats ailments such as incontinence, vaginal pain, prenatal and postpartum, musculoskeletal pain, osteoporosis, rehabilitation following breast surgery, lower back pain, lymphedema, conditions specific to the female athlete, fibromyalgia, chronic pain nutrition, and of course exercise.
On this episode, you’ll meet my friend, Dr. Sandy Hilton. Sandy is a Doctor of Physical Therapy, one of the world’s leading pelvic health experts and the Founder of Entropy Physiotherapy, which is a practice that specializes in the treatment of complex chronic pelvic pain conditions. Sandy’s also cohosts of Pain Science and Sensibility, a podcast that focuses on the application of paint science into the clinic. We discussed women’s pelvic pain, men’s pelvic pain, the challenges of the LGBT Community with regard to finding adequate pelvic health services, how the tragic events surrounding gymnastics doctor, Larry Nassar, and the #MeToo Movement affected the public’s perception of pelvic care and finally the role of prevention and education plays in being a pelvic health physical therapist.
If this is your first time joining me on The Healing Pain Podcast, I want to extend a very special welcome and to let you know that you can receive the latest podcast delivered right to your inbox each week. All you have to do is go to www.DrJoeTatta.com/Podcast and on the right-hand side of the page, you’ll see a box where you can enter your name and your email address. By signing up, I’ll personally send you the latest episode right to your Inbox, plus you’ll get some really cool free gifts. Let’s get started with the wonderful Dr. Sandy Hilton.
Changing Paradigms For Chronic Pelvic Pain with Dr. Sandy Hilton, PT, DPT
Sandy, welcome to the podcast. It’s great to have you here.
Joe, I’m very happy to be here.
It’s great to have a friend and colleague on. I’m excited to talk to you. I’ve talked to you at conferences and all of us are active on social media as physical therapists in all our different Facebook groups. It’s nice to have you on and share some of your specialties with the world. I know you as a physical therapist and one of the leading women’s health specialists in the world and physiotherapy. Tell everyone how you’ve got involved in women’s health and pelvic health physical therapy as a PT?
It started in the world of physical therapy. I’m interested in working with people that have had strokes and head injuries or spinal cord injuries. That was going to be what I excelled in as a career. I married an army guy and then I moved and sometimes, you end up places where there aren’t the jobs that you want so you would take the job that you get. I worked with this lovely group of people and was working in outpatient orthopedics and it was near a logging camp in Oregon. The loggers would get hurt and their backs would hurt. This beautiful Family Practice doctor sent me a patient who walked in and he looked like the Brawny guy from the old television commercials for towels. He was very fit. A very handsome tall man and he walked in to my not quite 30-year-old self and said, “Doc Bailey said you’re going to show me how to have sex without my back hurting.”
I about turned that very shade of red and I said, “Excuse me.” I ran around the corner because we shared a facility with this physician. I went and found him and I said, “What?” He said, “PTs do that,” and I’m like, “No. PTs do not do that.” He said, ” It’s mechanical low back pain. You can help him.” I was like, “PTs do that, yes.” I went and I helped this guy and he went back to the logging camp and told all his friends that I was the person to go to if they were having problems having sex. I ended up in pelvic health working with men having really an avid following, but also it was mostly musculoskeletal back pain or just some bad training and overuse syndromes.
One day, I went up to this wonderful doctor and asked him why he never sent women and did women not have problems or did he just not ask? I insulted him and asked if he just didn’t care. Listeners, never do that to wonderful doctors, learn from my mistakes. He started asking women and he started sending women. Female pelvic pain is not the same as mechanical low back pain in men. I had to learn quickly what to do with these people that were having pain and had previously thought there was no help. What this doc and I did was stumble into a problem of people having a problem and not knowing who they can talk to or if you talk to a provider, that provider not knowing how to help you and not knowing that there is help. These are well-meaning, well-intentioned people that are just lacking the right information. We both got smarter, that doc and I. That’s what I tell people, “I’ve got into pelvic health because I have a big mouth,” and it was rude. Then I had to learn fast how to help these people. It’s been a passion ever since. People think they can’t get better and they can. You really can’t turn away from that once you get to knowing, “I can help you.”
It’s so interesting that your first dive into pelvic health was with men because so often, people who have been practicing for a couple of decades, their first venture into pelvic health and probably still now, it with women, not necessarily with men. What percent of your practice up in Chicago at Entropy Physiotherapy is men?
At any given time, I have about 50% men on the schedule and that’s true for me and for Sarah Haag, my business partner. Not enough therapists treat men and I think that not enough men are treating in pelvic health because there are some gentlemen and some ladies who would prefer to have a male therapist. We need more options, but for sure the guys have a hard time sometimes finding someone and it may be because pelvic health physios hide under the name of women’s health. I’m not sure a guy is going to know to go look for women’s health therapist to help him with his pelvic pain. We have a name change needed for that clarity.
That’s true because even at the APTA level, it’s still the women’s health section, is it not?
It is. There’s been some rather robust conversation for the last five or six years of trying to change the name, but there is not a universal agreement of what that name should be. Some people feel very strongly that women’s health needs to stay in there because there are a lot of women that don’t know there is help available and that helps them find it. The section on women’s health and men’s health and pediatric health and transgender health would get long and be a very awkward acronym.
Is it the SIG, the Special Interest Group under orthopedics?
Nope, it’s a section all on its own. There is a Pain SIG under orthopedics, but the section on women’s health is one of the sections in the American Physical Therapy Association.
You brought up transgender care, something not traditionally most PTs don’t have a whole lot of awareness around I would say. It seems like I would think the pelvic health and women’s health physical therapists are seeing that group either be underserved or perhaps starting to knock on doors and saying, “I need some help with pelvic pain.”
I can tell you globally because I was talking to Paul Hodges about this and he is looking into it in Australia and really with anyone he can talk to of trying to find good information what help are these people needing and are they getting it and what is it? There is not a lot of solid information that we have right now. There are some great therapists trying to sort it all out, but right now we’re trying to find out. I think one of the challenges to that is if you flipped this story around and say you are transgender individual and my apologies if I get these words wrong, the guts and the courage that it takes to go to a healthcare provider with a problem, unfortunately not knowing if that healthcare provider will help you or can help you. Usually, it’s the, “Can you help me?” that’s the main question.
Unfortunately, in the LGBTQ Community, “Will you help me?” is a big problem right now. It probably was before and in my naiveness, I’m only just becoming aware in the last six years or so. That there are providers that will refuse service to people and not do that just politely and quietly, but to do that in a rather aggressive refusal of service way. If you have a problem finding a provider that you can trust, that can also help you, I would imagine as a bit of a brave situation. I hope that it’s not as bleak as it looks like. I hope that that is because people tend to only report online the bad stories. I’m open to reporting bias and that there are more people that need help that are easily finding caring practitioners than what is happening. I know a fair bit of people that that would gladly provide a wonderful caring environment and not even think about it. We’re trying to figure out how to get that out there like do we put a particular flag out or a dove on your window or something that says, “We’re not going to be mean, rude, horrible to you when you come in here.”
That would just be given but apparently, it’s not. I wonder if that’s part of it. The other thing that I wonder about particularly I treat pain for the most part in continence and on other pelvic health issues, but predominantly pain is I wonder if it’s the people who had to work so hard and do so much prep and eat and save and really work diligently for years to get to the operation, that discomfort and soreness and rehab following may not have a high level of threat to them that might make sense. That the nature of pain itself, maybe, “I’m sore, but I’m so glad this surgery is done and I’m going to work this out,” could be part of what’s happening, but honestly, we just don’t know. I do know that there are great therapists around the US and around the world that are studying and reading everything they can to be able to help if needed. There are courses that are being put together with the best evidence that’s out there and it will keep up and help the community as help is needed, but it’s in development right now.
It’s so interesting how pain has progressed in our profession. It’s so interesting how women’s health and pelvic health has progressed in our profession. With the #MeToo Movement and the unfortunate history of Dr. Larry Nassar molesting young female athletes, it came into the public that he was pretending that he was doing some pelvic treatment for people. It’s put people’s guard up about pelvic health a little bit and certain treatments. What do you see happening in the pelvic health world with that entire scam, how it’s affected women’s health and pelvic health?
The first response that I saw was absolute indignation, horror, and all of those appropriate words a pelvic health therapist, just livid that someone would do this. I was one of them. Then exquisite sadness that those people went through that and also, I’m trying to use it as an opportunity to educate the public about what is and isn’t appropriate. One of the signs would be that if someone is going to do an internal evaluation, there should be very clear understanding of why and what this is a medical evaluation. Checking for sensitivity or pain or muscle function and there should be a clear why and full informed consent. The report that you got on that is that he was not even using gloves and things that is not done appropriately.
There were some beautiful responses by a couple of public health physios that were printed and they did a really great job of saying, “No, that’s not how it works. Here’s what you would expect.” You would know what’s happening. You can have a chaperone if you want one. Here at our clinic, we don’t provide them. That’s part of the intake is if you want to chaperone, please bring someone with you and we’ll keep this as safe and as comfortable for you. There are protocols in place. The worst thing is if someone can get helped and is afraid to seek help. Whether that’s the conversation we just had or wondering if this is not real like, “You’re saying you’re going to do this and this. It’s just you get it in your jollies,” and that’s something we have to make sure doesn’t happen.
If there’s anything one can take positive out of a situation like this, it can be that we’re having these conversations out in the open and acknowledging that what happened was wrong and saying that, “Please don’t let this happen to you or anyone you care about.” There are legitimate reasons why you would have someone to a vaginal or rectal assessment and give you a plan to work on. These conditions can be helped. That was a horrible situation. Unfortunately, it’s not a unique situation, but pelvic health has legit reasons to do that and it’s well in the field of physical therapy for why you would do that. We used gloves all the time. I tell the joke to my patients, “I can make sex, so not sexy because we’re talking about touch and pressure and shearing forces and things.” Pelvic health therapy isn’t about arousal and orgasms and things other than from a very clinical discussion about what that is. Then you go do all that stuff on your own and come back and let me know through words, not images, no videos needed of what any problems you might have and we can adjust the program to help you more. While we talk about all of those things, it’s done very clinically and in a very safe, careful, well-informed environment. For the very practical reason besides just humanity, is that the pelvic floor muscles are like this if you’re scared. We’re trying to teach them how to move well. You don’t want to be the threat they are having to protect against. That’s not going to be helpful.
With the research that’s mounting around pelvic health and pelvic physical therapy, is there a movement to bring pelvic screening into standard physio care and maybe even to primary healthcare?
There are a lot of people working on doing that. My business partner, Sarah Haag, has a class that she teaches on pelvic health for the non-pelvic therapists. I feel strongly that should be in PT schools as well as interdisciplinary programs, of basic knowledge of what’s normal for continence, for urine and bowel and that sex should never hurt. I would love to have everyone automatically go back to the original hospital X-ray that has the sex question on it because it’s a great screening form. The answer to that should always be no. There is no pain with that. If it’s a yes at all, then that’s a referral to pelvic health if it’s not a spinal problem. That is how I got into pelvic health was through mechanical back issues. There’s that in the world of physical therapy is pelvic health therapists actively reaching out to their colleagues saying, “If you’re working with people that have a pelvis, you’re doing pelvic health.” Anytime you’re teaching them squats and lunges and breathing and movement and any core work, please incorporate the rest of those muscles.
Also, be aware if they’re stopping every ten minutes during your workout to go pee, that’s not normal and it’s changeable. Lots of more work with open discussions following pregnancy and during pregnancy and that it’s never normal to leak. It might be common but you’re not stuck with that. Despite the great products that we have, you don’t have to use them for the rest of your life. We can make that go away. There’s also some great work internationally and here in the country of people that are cutting into menopause and changing and busting through some of those old beliefs that once you’re past a certain age, that you need to stop running or you need to do these things because you won’t be able to. There’s a great movement called Old Not Weak that doesn’t know they’re doing pelvic health work but they are.
Keeping people moving and getting up and down off the floor and lifting weights keeps us healthy to include the pelvic floor and the gut and the breathing patterns that are needed for good function. All the emphasis on people eating good food and sleeping well and the population health group is also helping with the autonomic nervous system that’s required for all the digestion and pelvic function. As we get better at globally treating patients, not quite so siloed but taking a look at the whole person. The pelvis is getting put back in the body whether people know that they’re doing it or not. We’re all trying to work to make that a conscious evolution. Not just a happy accident but work on nutrition, work on breathing, optimize the movement that you want them to do and help them not stop doing the activities they love.
The physio can screen for pelvic health and if they don’t feel comfortable treating it, then they can obviously refer out, right?
Right. There are websites all over the place that you can look for that. The APTA has them. Some educational companies have them for finding a pelvic health physio near you. Also, to not be afraid to talk about peeing and pooping and sex and just have those conversations. Even if the person doesn’t answer your question, you put it in their head that there might be a solution to that problem. That’s amazing. The other thing I love looking outside of the world of physical therapy is there are some population health groups that are working specifically to target children eight to twelve-year-old young girls at first. They’re looking across the youth to get better information, not on a sex ed class, but, “This is normal for bowels and this is how peeing works.”
Things that you would hope kids would know so that as problems start to develop, we can get them addressed right away. Trying to get ahead of some issues that we’ve seen that it was like, “I’ve always hurt when I had periods or I had to stay in bed for three days.” Those kinds of things to get them into the public. Some of those people will grow up to be health professionals and other of them will grow up to be people that seek care and were trying to get some early education going to get ahead of that curve. This stuff is preventable and it can be a short problem instead of a long problem. The more we do that, the more we can make a difference in healthcare.
What, in your view, has changed with regards to pelvic health as we brought the biopsychosocial model into pain care, but it should be the entire healthcare system? How has that impacted how you see things? How has that impacted how we think we’re going to treat pelvic pain moving forward?
I see it as less fear, both not treating it as delicately. Sarah, my business partner, she said that, with people, if they have an amputation or some physical massive debilitation, we work really hard to get them back skiing or some really cool activity, but you ended up with pelvic pain and people hand you a little pillow and say, “Only sit on this. Be Very careful. Don’t exercise. You will never ride your bike again and start taking that stuff away. I’ve seen that change so much over the last five or six years where there’s less, be very afraid. Unload it. Don’t exercise. Don’t run.” Let’s figure out a way to do this different so that you can jump without leaking or you can ride your motorcycle and you don’t hurt or you can do these things.
A little less backing away from it and teaching people to cope with what they’re left with and a lot more, “You’re hurt. Let’s find a way through this pain.” Teach you ways and understanding about pain, but also ways to get the activities back you love. I wonder if some of that is because so much more of us are getting a better understanding about pain. The therapists themselves are a little less often thinking that the person in hurts because something much could be damaged and more thinking, “Let’s look at this whole biopsychosocial approach and find all the contributors and how can we modify this and keep you going.” That’s been a huge, very positive shift.
It’s a good point. We need education more first probably than the patient does. If we’re not coming from a place where we’re fully informed, then our education and working with the patient is going to be harder, whether it’s pelvic health or just regular health.
We have to know this much, but we only have to say about this much. We do have to keep up and the information’s changing so fast.
Speaking of things changing, what are you working on right now in the worlds of pelvic health?
I’m trying to finish up a project. I’m lucky, I’ve had some connections from around the world and people that have had offered to work with me to do some translation of some of the things I’ve written around how to treat pelvic health, but to translate it not just from one language to another, but to a culturally competent, the right metaphors. All of those things that could make it actually be absorbed. Just from English to English is necessary sometimes and that’s with how you would approach teaching return to having sex. An example I can use is I will get the words wrong because it’s not my faith, but a very conservative, religious sect, if that’s the right word, where there’s really rigid rules for when after you’ve had your period, what you need to do to know that you are clean and ready to be able to be intimate with your spouse again. That procedure hurt. I had to translate all of it. What would you do to do sensory integration and graded exposure around that religious observance with communication with the spouse and the religious leader.
It was very much a translation of this information and woven through the right words. Doing that with religious sensitivity and cultural sensitivity and different language is important. You can’t just take the English translation and put it into to French and hope that the metaphors will work. I’m excited about that and it’s people that have volunteered to help me with it, that we’re going to share authorship of those little chunks so that they can be in the appropriate language and the appropriate culture and just get the information out there. It was inspired by the Australian Continence Society that has on their website about the information in every language you could possibly find. They’ve translated it on their website. I thought, “I need to do that around pain and especially return to intimacy and sexual function,” with the adaptations we make with the pain science, but also with how do you get back to having sex when it hurts and put that in a culturally appropriate way. I’m excited we’re starting with some English to English translations and then I have some people lined up through some of the Caribbean Islands and through Europe. It’s going to be fun.
These are PTs and other pelvic health specialists that joining with you sending the information.
They’re different health professionals, not always PTs, but I would say bio-psychosocially trained and informed pain science geeks that are going to get pain right through their translations. Also, in the process are learning an awful lot about pelvic health. That’s my sub plot. I am then also getting that how do you translate pelvic health to get it put back in the body across professions and more around the world. That’s one sneaky way to do it. I’d say, “Orthopedic therapist in Brazil, how would you like to translate this for me? You’re going to learn all about peeing and pooping and penises and vaginas and stuff.”
It’s amazing how much stuff comes out of Australia from the world of physio and pain. Sometimes I think as an American physio or physical therapist, we’re not far behind. We’ve come a long way. They put so much stuff out. Every time you turn around there’s something coming out.
I wrote a paper that the goal I set for myself was to try and find good resources that weren’t from Australia. I am going to put that one off to the side and I’m going to go look again and see if I can find something that isn’t from there. It’s a well-supported system and they took advantage of it and ran with it.
We don’t have that in the States. The States in general, knowing that each state is different and physios are different each state, it makes it 50 times harder basically for us.
It’s a little challenging and funding has not been awesome for the research here. Frankly, some of the research that was done in pelvic health, I don’t know if they’d passed an IRB here where they are taking supposedly normal people who want to volunteer for a pain study and inducing pain and seeing what happens.
I don’t think it would actually.
Then we get a lot of no normative studies and how do we make assumptions. That’s changing. Social media and that connection that we get from all over around the world is helping because for all of the part that makes us maybe a little uncomfortable and crazy with social media, we also get connections and we get to learn so fast and get ideas from other sides of the planet that we would not have otherwise seen. The post production peer review is robust. We have a paper I’m working on with my current students on I want to call it, “So What’s Next?” which is the trying to get strength and conditioning principles laid out for how you would get pelvic health complaints back to running, jumping, rock climbing and all of that, and push that edge a little further away from here is your very wonderful, great yoga positions. Here’s how we’re going to get you back to running and here’s how we’re going to get you back to CrossFit and here’s how we’re going to get you back to all these other things.
Not, “You’re not stuck being gentle.” Being gentle is amazing, but you also love to use to run so let’s get you back to that too. We’re writing a paper on that and I was telling my student and I said, “These are thoughts, this is an opinion piece, but what we’re going to do is try and get it published and then we’re going to sit back and watch the postproduction peer review happen.” All of those very helpful people who will give me research, that I should have known before I read the paper but I couldn’t find. It’s really all about me getting smarter by all of you helping me through that. Sometimes we do that through our almost right ideas and people can help you nudge that a little closer.
I know you’ve written a couple papers. Where do you go to keep the evidence-based research in the pelvic health world?
I have a small little list on Twitter that it’s titled Pain Science and that’s where I go and go see people that think are really smarter in a world of pain do things like a book that just came, Nick Bakker said, “I’m reading this one. It seems to be good.” I was like, “Excellent.” I ordered it. It shortens the time. When they say here’s a good paper or this is a really bad paper and you should read it to understand why it’s not right or this is a great book. There are some conferences that I love, The International Association for the Study of Pain does world congress every two years. It is not a clinical conference. There was nothing I could walk away going, “I use this in the clinic.” I go and get a lot of really strictly consumer reading of the research and talking to the researchers and trying to figure out, “Does this inform my practice at all? Can this help me maybe get better?” Then the San Diego Pain Summit brings together a lot of interdisciplinary people from around the world that are all interested in pain and we have interesting conversations with no name tags.
You don’t know that you’re sitting talking to a massage therapist, a chiropractor and a naturopath and a PT and it sounds like a great joke. Four people were sitting by the fire pit and from different countries and you’re just all talking about how to help people. That’s been really fun too. It’s like the two ends of the bell curve of one very much science and ideas we’re going forward, and then one that is really, “How can we apply this? How would this work? That looks great, but could you ever use that?” and a lot of nice discussions. Those are fun. I’m blessed with working with a physical therapist that is smart. We bounce ideas off each other and read papers and have theoretical discussions usually over lunch about what could be better or what is fantastic and it should be better known and that’s helpful.
Where would you like to see pelvic health go in the future with regards to from a PT perspective?
I want the PT schools to include all of the muscles and nerves in the body in cadaver and physiology discussions and just don’t leave out the inside of the pelvis. Pick up any orthopedic book, manual therapy and hip and pelvis, they don’t talk about the inside and they are many of them. I would like it included in all of the orthopedic courses that talk about the hip and pelvis to remember there’s an inside and discuss that. It doesn’t take very long. I’m happy to help with them with content. Honestly, I would like clinicians to remember to ask and to keep an eye out for if a patient, when you ask them about exercise and movement, if they get uncomfortable with jumping or force absorption. Wonder, “Is that pain? Is it inexperience or they’re afraid they’re going to pee on themselves? Are they leaving to go to the bathroom before you ask them to do any plyometric work? Once, yeah, but every time? Is that because they think they’re not going to be okay or they think they’re going to leak?”
Start looking for the incontinence. One in three women have it at some point in their life and guys too. Especially as guys get a little older and they end up with some prostate changes. Take a look for that, just check. If just incontinence we screen for, so many people would get help. We’d save thousands of dollars in pads and testing and surgeries and things, and that would be fantastic. It is one of the things that in physical therapy we have level one evidence for all of those work. We have evidence the over 80% of people will get complete resolution of symptoms within twelve weeks.
Which is amazing because we can’t say that about a lot of things in physical therapy.
We can’t, but we can about this and we’re missing the opportunity. I want that.
How do we educate primary care physicians about pelvic health? It probably starts there even before the people think the OB-GYN.
It starts in high school courses. Let’s get humans understanding how their body works so that when they go to school, they understand how their body works and they’re not afraid to talking about it. That needs to happen, but yes, every health professional should have an understanding of that and at least know that it’s helpable and changeable so that with proper referral and treatment, we can help people and make it go away. The internet will help a lot with that. So much of it in this country comes down to timing. They have six minutes roughly with the person. They’re only supposed to see that one part. That’s how the systems are done. Maybe that’s not the answer. Maybe we have to go direct to humans and tell them that there’s hope.
I haven’t been speaking with Sandy Hilton. She is a Doctor of Physical Therapy who practices in Chicago at a practice called Entropy Physiotherapy and you can find her at Entropy-Physio.com. Tell us about your practice up there so people have an idea of what a pelvic health and pain practice is like from your perspective?
We were told that we’re unique. Sarah Haag and I, it’s us, two people. It looks more like a loft. You can see one of the treatment room walls behind me. We have exposed brick and it’s nice. We designed it. We had the opportunity to design it and we did it so that people would walk in and feel comfortable. We see people will want at a time for however long they need. It’s not always an hour. That’s really up to them. We’re an out of network practice. We’re not bound by the insurance time and number visits or it’s like you get twelve visits, but it has to be within 30 days. I might need six, but over a course of six months. We can make that very fluid. We like to play. You come in, it looks like you’re walking into a loft and there’s a big empty space that we hide all the fun stuff so you don’t see it right away. We have plyo boxes and Kettlebells, TRX system. We just got a yoga swing which is amazing. All of the fun things to get movement happening again. We have private treatment rooms for when you need to go talk about your left testicle hurting and you might not want anyone that’s listening. You have both privacy and room to move. We bring in really great speakers from around the world to come do courses here at Entropy so that we can get smarter and not have to close the clinic to go travel the world. We bring them here to us and let everyone else sign up and come and learn as well.
I love the concept that you mentioned of play because I think play is missing from a lot of PT clinics.
It gets regimented out. We were talking, it gets flow-sheeted away. We’re going to do these things. The spontaneity and the exploration might be challenging. I know plenty of therapists around the country that did incorporate it well. It comes to the personality of the people. Sarah and I are both color outside the line people and we like mixing things up a little bit. That comes through very much in how we treat.
It’s been a pleasure speaking to you, Sandy. If people want to learn more about you, how can they find you online and at your practice?
They can find us on Entropy. I’m always happy to chat through DMs on. Mostly I hang out on Twitter and I’m @SandyHiltonPT on Twitter. I’m on Facebook as well, but not as often. Just reach out and talk and we can have fun. You can also get me at Sandy@Entropy-Physio.com if email is your thing and if I don’t answer right away, email me again. If you want me fast, find me on Twitter.
You’ll find her as well as her great partner, Sarah, with a great practice in Chicago, Illinois where they treat pelvic pain as well as regular chronic musculoskeletal pain. Share this out with your friends and family on Facebook, Twitter, or whatever your favorite social media platform is. Make sure it’s a hop on to DrJoeTatta.com/Podcast where you can sign up for the podcast email list so each week you will receive a brand-new podcast about natural ways to heal pain and learn about the power of knowledge and how we can heal pain through using the mind. I want to thank Sandy for being here.
About Sandy Hilton
Sandy graduated from Pacific University (Oregon) in 1988 with a Master of Science in Physical Therapy and a Doctor of Physical Therapy degree from Des Moines University in December 2013. She has worked in multiple settings across the US with neurologic and orthopaedic emphasis combining these with a focus in pelvic rehabilitation for pain and dysfunction since 1995. Sandy teaches Health Professionals and Community Education classes on returning to function following back and pelvic pain, has assisted with Myofascial Release education, and co-teaches Advanced Level Male Pelvic Floor Evaluation and Treatment. Sandy’s clinical interest is chronic pain with a particular interest in complex pelvic pain disorders for men and women. Sandy is the co-host of Pain Science and Sensibility, a podcast on the application of research into the clinic.
The Healing Pain Podcast features expert interviews and serves as:
A community for both practitioners and seekers of health.
A free resource describing the least invasive, non-pharmacologic methods to heal pain.
A resource for safe alternatives to long-term opioid use and addiction.
A catalyst to broaden the conversation around pain emphasizing biopsychosocial treatments.
A platform to discuss pain treatment, research and advocacy.
If you would like to appear in an episode of The Healing Pain Podcast or know someone with an incredible story of overcoming pain contact Dr. Joe Tatta at firstname.lastname@example.org. Experts from the fields of medicine, physical therapy, chiropractic, nutrition, psychology, spirituality, personal development and more are welcome.Love the show? Subscribe, rate, review, and share!
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