Take time to breathe deeply. One of the first things we often work on in a pelvic floor therapy session is how to breathe. The diaphragm is part of the inner core just as are the pelvic floor muscles. If the diaphragm isn’t working correctly, I can almost guarantee that the pelvic floor isn’t working correctly either. So taking nice deep breaths can make a big difference in how the pelvic floor functions.
Asa part of my series about the women in wellness, I had the pleasure of interviewing Katherine (Katy) Rush. Katherine has been a physical therapist for more than 20 years. She currently owns The Perfect Pelvis, her clinic in a suburb of Kansas City, Missouri where she focuses on helping people with pelvic floor dysfunction. This condition commonly presents as incontinence, painful intercourse, and low back pain.
Thank you so much for doing this with us! What is your “backstory”?
When I began as a physical therapist, I had never even heard of pelvic floor physical therapy. My plan was to work in a hospital and to help people recover after strokes, falls, and surgery. Then two of my colleagues completed training to be pelvic floor therapists. The hospital purchased equipment and promoted the specialty. However, shortly afterward they each left the hospital for personal reasons. My boss nominated me to be trained and take over the program. I was super nervous because I didn’t fully know what it involved. I did know that during training you were in a room with 40 other women learning how to do vaginal exams…and you had to practice on each other. It was very intimidating. But once I went through the training and started treating patients for pelvic floor issues, I realized how necessary this type of treatment was. People had nowhere else to go and physicians weren’t giving them good solutions. I had people come to me who had been considering suicide because they were going to the bathroom so many times a day they could never accomplish anything they wanted to do. Many told me how worried they were that they might pee their pants in public, so they just stayed home. They became depressed. However, after treatment they were able to go out and do things they loved without being embarrassed anymore or being in pain. It was a life-changing treatment. When I saw the changes it made in people’s lives, I knew that this was going to be my focus.
Can you share your top three “lifestyle tweaks” that you believe will help support people’s journey towards better wellbeing?
- Take time to breathe deeply. One of the first things we often work on in a pelvic floor therapy session is how to breathe. The diaphragm is part of the inner core just as are the pelvic floor muscles. If the diaphragm isn’t working correctly, I can almost guarantee that the pelvic floor isn’t working correctly either. So taking nice deep breaths can make a big difference in how the pelvic floor functions.
- Drink water. Water is the best liquid you can drink. Many of the issues people deal with can be traced back to not drinking enough water. Water can help flush out irritants in your bladder, so it can be instrumental in helping decrease the frequent urge to go to the bathroom. In addition, it can help decrease headaches and assist with weight loss. There really are no downsides to drinking enough water.
- Eat plenty of fruits and vegetables. So many people deal with constipation. Eating a diet full of fruits and vegetables can decrease issues with constipation. How does this relate to the pelvic floor? An individual who is constipated will often strain to empty their bowels. This can lead to prolapse, the full rectum can place pressure on the bladder leading to bladder frequency and it can also cause issues with fecal and bladder leakage. So eat your vegetables!
Can you share the most interesting story that happened to you since you started your career?
My best stories come from my patients, but I’m not going to share their stories here.
At one of the trainings I attended, a vendor was there giving us free samples of lubricant. The name of the lubricant was Slippery Stuff. At the time, I worked in a hospital where many of the patients we saw didn’t have the money to purchase lubricant, so a colleague and I filled our bags full of “Slippery Stuff” samples.
When flying home from a very small airport, our bags were selected for extra security checks (this was before all of the changes associated with 9/11 limiting what you can bring in your in-flight carry-on bag). As the security agent, an older man, was examining our bags and saw all of that lubricant, he kept looking down at our bags and then looking up at us. I often wonder what he was thinking, and it makes me chuckle.
Can you share a story about the biggest mistake you made when you were first starting?
Before I went to training I assumed that kegels were the best way to work the pelvic floor muscles and treat incontinence. This couldn’t be farther from the truth. Many people who deal with incontinence actually have muscles that are too tight to function well.
Can you tell us what lesson you learned from that?
I learned to never assume the problem before I completed a full exam. Once the actual problem has been found, then correct treatment can be prescribed and that leads to the best results.
When it comes to health and wellness, how is the work you are doing helping to make a bigger impact in the world?
Millions of women have babies every year. They are almost universally told that pregnancy and childbirth is normal and that they will recover just fine on their own. Unfortunately, many women do not recover well from pregnancy and childbirth. They deal with incontinence, painful sex and low back pain and are given no solutions because “that’s just what happens after you have a baby.” Just having the knowledge that this isn’t normal, and that there are things that you can do is hugely empowering to women. For women who are unable to work because of the pain they deal with or the amount of times they’re going to the bathroom every day, this kind of treatment can be life-changing. The more women receive the care they need, the more each of them individually can have an impact on the people in their lives.
None of us are able to achieve success without some help along the way. Is there a particular person who you are grateful towards who helped get you to where you are?
There are many, many people who have helped me along the way. But the first person to encourage me in this type of treatment was one of the co-workers who was unable to continue with women’s health treatment because of her own medical issues. She was an incredible mentor, both in showing me the technical aspects of the job, and by encouraging me to see what truly could be possible in this field. I will be forever grateful to Melissa for her help and support that she gave me.
Can you share a story about that?
Early in my career, Melissa encouraged me to start writing. At the time, not many physical therapists knew about treatments for pelvic floor dysfunctions. So together, Melissa and I wrote an article about pelvic floor physical therapy in a PT journal. I don’t know how many people read it or if it affected anyone’s life. But it certainly gave me the confidence to talk about this type of treatment with other people. I likely would not be doing this interview if it wasn’t for Melissa’s encouragement.
If you could start a movement that would bring the most amount of wellness to the most amount of people, what would that be?
My husband spent time in Germany when he was a child. He has spoken of the habits in Germany and how they are different from those here in the United States. For example, it was the custom at that time for the people of the neighborhood to go take a walk in the evenings. They did this as a group. Not only did it have social benefits, but it established a precedent for daily exercise and activity. I wish something similar could be successfully implemented here in the United States
What are your “3 Things I Wish Someone Told Me Before I Started” and why?
- I wish someone had told me to seek out more than one mentor. Every person has a different way of approaching the same problem. At times, it’s helpful to have more than one opinion at your disposal to be able to make the best decision.
- I wish I had known how much of a difference it would make in people’s lives. I think I would have started doing this sooner.
- I wish I had known how important it was to talk to the people directly who were having an issue. In the hospital system, it’s common to only speak with physicians and leave it with them to determine who needs help. Unfortunately, a lot of people who are dealing with these types of issues are too embarrassed to admit it to their physician. As a consequence, it often gets overlooked. Or in some cases, a physician doesn’t know the treatment options for them.
Do you have a “girl-crush” in this industry?
Absolutely — Tracy Sher founder of Pelvic Guru. The way she has focused attention on this aspect of women’s health is amazing.
If you could take one person to brunch, who would it be? (Let another “woman in wellness” know that you respect her as a teacher and guide! )
Hollis Herman. She was one of my very first teachers. Not only can she tell a good story, she was instrumental in normalizing pelvic floor therapy and pelvic floor therapy education in the U.S.
Sustainability, veganism, mental health and environmental changes are big topics at the moment. Which one of these causes is dearest to you, and why?
Good mental health is something that’s very important to me. Mental health affects everything. My mother has vascular dementia, and my father has severe Parkinson’s and has also developed a Parkinsonian dementia. It’s awful to watch. When they first started to show symptoms, it was very difficult to get a diagnosis, and to get them the help that they needed. It is assumed that as an adult, you can take care of yourself. Unfortunately, this is not always the case. When someone does need additional help, it is a challenge to make sure that they can get it. I wish that there were better medical service screenings to help people get help sooner.