We wanted to learn more about how pelvic care can help with bladder leaks, so we caught up with Allison Oswald, P.T., D.P.T., W.C.S., a physical therapist and the founder of Plumb Line Pilates in Los Angeles. Allison takes a personalized, holistic approach to women’s wellness, integrating different modalities, including Pilates, manual techniques, movement education and more. She specializes in treating women who are pre-, mid-, or post-pregnancy or experiencing pelvic pain, incontinence, or frozen shoulder, among other conditions.
Q: Were there any early influences in particular that propelled you towards becoming a physical therapist?
A: At a young age, I knew that I wanted to go into medicine in one way or another. My oldest sister had health challenges, so she was in hospitals, at doctors appointments and therapy often. Being exposed to that at a young age can either turn you off from it or pull you in, and for me it did the later. I saw the impact that health professionals had on her life and knew that I wanted to do the same in some capacity.
Q: What exactly is “holistic pelvic care”?
A: It is pelvic health and wellness through the lense of addressing the whole person. It is not lost on me how connected our body systems are, as well as our emotional and spiritual selves. Therefore in my practice, I discuss all of the impacts our life has on our pelvic health with my clients, so we can see the entire picture and become empowered to make changes on a greater level for more optimal and long lasting healing. This means we discuss things such as stress management, sleep hygiene, nutrition, gut health and more.
Q: What inspired you to focus your practice on women’s health and even more specifically on holistic pelvic care?
A: It honestly just organically morphed into what it is today. Women’s health struck a cord with me in my doctorate program so I quickly geared my continuing education in that direction. And as I learned more, I started to see more patients under this umbrella, and pretty soon exclusively. I love bringing awareness, education and empowerment to a group of issues that are often overlooked, ignored and mistreated.
Q: What is pelvic floor therapy, for those who aren’t familiar with this modality? And what conditions can it help with?
A: Pelvic floor therapy includes management and treatment of pelvic floor and abdominal wall issues throughout the lifespan. Pelvic floor therapists are trained to work within the vaginal and rectal openings if and when appropriate. This allows us to get to the tissue and muscles necessary to help healing. This can include symptoms such as pelvic pain, painful intercourse, bowel and bladder incontinence, hemorrhoids, prolapse, diastasis, hip pain, back pain and more.
Q: Can you speak in a little more detail about how pelvic floor therapy can help with bladder leakage?
A: Absolutely. In order to be continent, women need to have a variety of systems working properly. Included in that is adequate pelvic floor strength and length so that the muscles can tighten to hold back urine, or relax and lengthen in order to urinate. Pelvic floor therapy helps women accomplish this successfully by teaching the muscles how to contact and relax through manual palpation, feedback, movement practice and much more. Therapy also addresses the neurological and behavioral component of allowing the bladder to fill completely before emptying and improving bathroom habits. There can be other contributing factors such as gut health or scar tissue that can also be addressed with a pelvic therapist.
Q: Are there types of bladder leaks that pelvic floor therapy is better treating than others? For instance, does it work better with stress vs. urge incontinence? Lighter leaks vs. more moderate leaks and so forth?
A: I wouldn’t say there are types that are better, because physical therapy can help with both. But the more progressive the leaking (larger amount, more often, long duration) the more challenging the rehab and potentially the longer the amount of time it might take to reach goals.
Q: Through your work as a physical therapist, how have you worked to destigmatize aging for women?
A: I have and will continue to advocate for women across the lifespan. I hear it all the time from patients that their symptoms are just par for the course for their age. And I continually educate them that improvements can be made at any time in their lives. As we age, women should not have to endure any pelvic floor dysfunctions or assume they can’t improve them.
Q: What are some of the most common challenges or struggles that your clients share with you and how do you support them in navigating these issues?
A: Great question. Most often women tell me that they wish they had sought support sooner. I see a trend of shame and embarrassment around pelvic health issues, no matter what they are. Women put these issues on the back burner and struggle to make them a priority. When in fact, I believe pelvic health is a huge part of our wellness physically, emotionally, spiritually and sexually. I am doing my best to create space for women to feel comfortable to share, as well as educate women about these issues before they come up or support is needed, so they know to ask and where to go. I want the topic to not be taboo, I want to not have to explain what a pelvic floor PT is and I want women to put their pelvic health at a higher priority.
Q: What’s one health and wellness tip you recommend every woman add to her daily routine?
A: Drink water. It sounds so simple, but yet it is a challenge for so many.
Q: What’s one thing you wish everyone knew about pelvic health as it relates to wellness and aging?
A: Pelvic health and wellness can prevent age related symptoms. Get to know your pelvic floor, understand what it does, what is normal, what is not normal and know when to ask for help.
Q: If someone wants to find a good pelvic floor therapist in their area, where should they start?
A: I always recommend going to our national association’s pelvic health section where you can type in your zip code and find somebody close to you. (https://ptl.womenshealthapta.org/)
Q: How have you cared for your well-being during 2020? Are you drawing inspiration from any particular sources right now?
A: This is obviously more important than ever right now! And with the constant shifts of the year and the unpredictability of the future, my saving grace has been my daily breathwork/meditation/sit. I wake up each morning and sit for just a few minutes alone. Everyday looks a little different as I sit, but it is usually either me taking some deep breaths, connecting with my body, acknowledging what I am grateful for that day or simply pausing to not think of anything before the day gets underway. When I skip it, I feel unsettled and all over the place, it has been my rock for sure.
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