Diastasic, Prolapse & Childbirth

Action Steps To Take Prior To Returning To Physical Activity

Many women have questions regarding returning to physical activity after surgery or childbirth. Holly provides answers, action steps and clarification.

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With Holly Durney, PT, DPT, OCS

Crissy Fishbane: Hi Holly! Can you tell us a little about your professional background?

 

Holly Durney: Yes! I’ve been a physical therapist for 10 years. Started right out of the gate having a passion for women’s health, but also have experience with orthopedics, which actually is really helpful. 

I started out working with dancers in the DC area. I worked with the Washington Ballet and I started a women’s health program for a private clinic there.

I’m from Raleigh. So, I returned to Raleigh and I’ve been doing women’s health with Smart Athlete for a year or so. I’m coming back around and trying to start the same program I did up in DC here in Raleigh. 

But I also treat orthopedic injuries. Low back pain, neck pain, that kind of thing. So, currently, I’m doing both orthopedics and women’s health.

 

Crissy: Do you just work with female athletes or is this all women?

 

Holly: All women! All shapes and sizes. 

Anyone trying to move that doesn’t currently move and of course the higher level athlete. But, I would honestly say that higher level athletes are 10% of my population. Most of it’s just day to day moms or women trying to find movement in life. I treat men as well in the orthopedic realm.

 

Cindi Michaelson: When you had mentioned that you still have people that have had surgery, that explains it. So what type of surgeries do you help rehabilitate?

 

Holly: I work directly with an orthopedic surgical clinic, Bone and Joint Surgical Clinic. 

I treat total joint replacement – shoulder, hips, knees, back or neck fusions. There are a couple of spine surgeries I see occasionally. Some occasional ankle, but I’d say the primary things I see are knees and hip and then shoulder, like a rotator cuff repair.

 

Cindi: Out of curiosity, do you see any patients that have had diastasis surgery or pelvic floor prolapse surgery?

 

Holly: Diastasis surgery, no. 

Most of the time I see women trying to avoid diastasis surgery. So I see them on the front end trying to avoid the plastic surgery piece if possible. Typically post-op at that point if I see them beforehand I give them enough things to continue to do after the surgery. I might see them for one or two sessions, but at that point, conservative treatment has failed. Not that they can’t benefit from physical therapy after, but I typically see them more pre-op than post-op.

As far as pelvic surgery, occasionally. It’s the same sort of thing. 

Once they’ve had to have the bladder sling surgery or maybe a prolapse repair, again not that physical therapy isn’t helpful – it absolutely is, but a lot of times I will see them beforehand hoping that they don’t have to go that route and coach them through that if I feel that we aren’t making the progress we want to see. 

If I do see them, Cindi, honestly it’s like two or three years later and they’re coming for something else. Maybe back pain because their pelvic floor and core never functioned properly, but it’s more of a medical history.  

I’m not directly connected to an OBGYN or a pelvic surgery clinic so if I were there is a chance I would see more than I do. In my outpatient setting, it’s not as common. But I’m sure there is some women’s health therapists that see more than I do.

Understanding what your body has gone through no matter how tough, or how in shape you are, or how determined you are, starting earlier can actually be detrimental in the long run. Just allow your body time to repair itself. The body is amazing.

- Holly Durney

Crissy: Holly, were you the kid that would geek out on bones and stuff?

 

Holly: (laughing) Yes, absolutely! 

I was a tomboy as well so things didn’t gross me out. I was always like “oh cool!  A cut.” Still to this day if I get to see a surgery I get excited.

 I joke with my female patients because women’s health physical therapy is weird, right? We are doing some intravaginal muscle work. Women are so confused and embarrassed, so I do the best I can to be like “Look, this is weird. But I think it’s cool. It’s just another muscle to me. So I’m going to do the best I can to make you feel comfortable.” 

It goes a little against my training, where they say you should be incredibly medical, make sure you’re referring to all the anatomy parts and I’ve actually found that women respond a little bit better when I’m more real and just say, “Hey, this is going to be a crazy experience that you and I go through together and I’m going to help you understand your body.” 

I think being a tomboy – unafraid of blood and guts – helps me treat women’s health. It’s just another part of your body.

 

Crissy: That approach certainly resonates with me. As you said it I felt myself take a deep sigh and think “oh, I feel comfortable with that.”

 

Holly: Some of my older patients, if they’re in their 50s or 60s and they’ve had a few kids and they’re like I’ve been exposed to the world. I don’t really care. But, when I get my 20-40-year-old set and they are still self-conscious it seems to work really well. And it’s true.  I feel the more real I can be with them the more comfortable they are sharing with me.

 

Cindi: Well you gave us a little fact saying you were a tomboy. Is there any other little known fact you’d like to share?

 

Holly: Yes! I am a horse nerd. I got on my first horse when I was 5. I joke that it was my dad’s way of keeping me away from boys. My first boyfriend wasn’t until I was 17. I spent every Saturday at the barn smelling like a horse. I still have a horse now. I’ve had him for 22 years. I joke that he’s my longest relationship to date.

I loved riding horses. I rode on the equestrian team in college. That’s something I still enjoy doing. They speak to my soul.

I try not to talk about it too much because I just completely geek out.

 

Crissy: Horses and bones!  We did a horse playdate for some of our moms yesterday afternoon and it was fantastic. Kyra my daughter is almost three and she just kept asking to touch them.

 

Holly: When all this is over, I’ll take her out to the barn! Getting kids to love horses is one of my favorite things. To see how special they are, not to be afraid of them, it’s just kind of magical. There are a few horse physical therapy places in Raleigh that I volunteered with when I was in high school.

 

Cindi: How do you feel having that connection with a horse has shaped you as a person? 


Holly: As vivacious as I seem right now, I think it helped me be quiet. It helped me listen and read bodies because you can’t talk to animals but you grow up around them and they do communicate with you. I think it helped shape me in that sense. I just loved the outdoors too.  But, I’d say the biggest thing it taught me growing up was just to be quiet and to be with myself because I did spend a lot of time out at the barn by myself and I loved it. The barn is still my safe space.

Access to Care

Crissy: Holly, what is your greatest passion regarding your work? 

 

Holly: I feel like women in general — whether its something like incontinence, prolapse, diastasis, or pelvic pain — that they feel like they shouldn’t talk about it. 

I’ve lived in the DC Metro area and grew up in the Raleigh area and there is something about the southern woman silently suffering. I can’t explain it, but as I’ve come back here and am trying to help women think about what their bodies go through, whether it’s 6-weeks postpartum or 40-years postpartum, they went through an extensive injury, whether vaginal delivery or C-section.

We get these orthopedic patients, with total knee or total hip or ACL repair and they get rehab. Why is a woman not proscribed physical therapy, even if just for 2-3 sessions when she’s 6-weeks postpartum to help the injury that occurred to her body heal?

Instead, women are just expected to go back, be a mom, sometimes even work, take care of a family, clean a house, do all that while they’re nursing an injury to their body. I feel like that’s not fair. Providing telehealth sessions in the evening or at times that work for moms is a start. 

Finding a way to help women understand their body and what’s normal, what’s not normal, what’s okay, what’s not okay, and somehow finding a way for them to take a little bit of time to care for themself – it doesn’t have to be two times a week for 8 weeks like a typical orthopedic patient, but just 2 or 3 sessions are so important. 

Again, it’s never too late.  Taking some time to take care of themself. That’s what I’m finding transitioning into women’s health 10 years into my career versus when I first started out.  Wanting to take care of women in that way and helping them with their frustration of “why is my body not doing what I want it to?” 

Just providing that knowledge seems to empower women.

 

Crissy: I’m interested to know, have you seen a difference with women up north with regard to seeking access to care?

 

Holly: I have. I’m trying not to stereotype too much, so I’m just going to do the best I can with my observations. 

A lot of women are starting motherhood later in their careers up there. It’s a 38-41 age group,  their career is established and then they decide to have a child. In that case, they have their job and their career, they likely have a daycare or already have a nanny, they have the help available. 

I see younger moms here.  And of course, this is stereotyping so all types exist everywhere. But, I see a little bit of the younger population here and they are more overwhelmed. I don’t know if there are not enough resources, or not enough later hours available. Clinics are open before and after work in DC and that’s not as common here, so I’ve started that over the past year trying to make that available. Perhaps that is the issue, just lack of time.

 

Crissy: The sociology nerd in me is kind of geeking out over that!

 

Holly: I know right! This is just a new observation, but it was easier to have women just come in during the day. Again, I don’t necessarily have an answer for that, but here I feel like women are more like “I’ll get to it eventually” and then they don’t.

Also, to me, it seems like people don’t talk about it. That’s the biggest thing I’ve found. 

We’ll finally get in a groove and people will start sharing – and they’re like “Oh my gosh, I have that!” I recently offered a postpartum core workshop and I think I had one question. 

But, they all emailed me after, which is perfectly fine, people get nervous to ask questions or it’s brand new information that “this is not okay.” They’ve just had a baby so many people think “of course I’m going to leak” or “of course I’m not going to be able to sneeze without having to wear a pad.” 

But, that’s not normal. Well, it’s normal, but it’s not okay!

 

Cindi: Have you found that postpartum care in the United States is different from other countries?

 

Holly: Yes, especially in European countries. 

There is a midwife. There is at least a year allowed for women to take care of themself. There is a lot of prep work and there is also that postpartum care – where you have that midwife staying with you after delivery. So I think there is a lot more time allowed for women to go through the delivery process as well as for healing and recovery.

As I develop my model here I am hoping that OB’s will begin to make physical therapy a part of the process.  Just so I can look at their posture, their hips, and their core and say “do this first, and then three weeks from now you can resume exercise. So now I don’t have to see you a year from now when you’re still having issues.” 

Most of the stuff I see is a quick fix. If someone just told you two or three things, if they just taught you a little bit about your body you wouldn’t have to go through this for however many years.

 

Cindi: Is there anything more natural than giving birth? I mean reproduction is primal.

 

Holly: Yes, your body goes through so much. So why is that different from an ankle sprain and needing to repair a ligament? 

You tear through so many muscles and ligaments in delivery or c-section where they cut through your entire abdominal… why is that not the same?

In my orthopedic mind that doesn’t make sense to me. The OB, of course, doesn’t have the orthopedic background and they are looking at the woman as a whole and that’s great but I’d love to take that in a little more natural approach

To me, it’s the same thing I see with post-op orthopedics. It’s just with the pelvic floor.

 

Cindi: It sounds like a common struggle you have is 1) having moms recognize that help is available and 2) being able to convince hospitals and care providers to readily give your care to these moms.

 

Holly: Yes this is where my orthopedic background makes me approach it a little bit differently. 

For example, in orthopedics occasionally a patient may have a knee scope, which means they just got their knee cleaned out. In a few weeks, they’re going to be fine. 

So doctors won’t send patients to me. But, then I see them 6 months down the line because their hip is bothering them and their knee fell apart again.  

For me, I see pelvic floor patients after there is a problem, they’re having pain with sex, or have developed a prolapse, or are still having leakage that didn’t go away. Not that I still can’t help them, but if I had seen them 6 months prior just as a routine I could have fixed it earlier. 

I do think if it was more of a standard referral — and I don’t think it’s because doctors are opposed to it. I just think it’s because it’s not thought of.  I think it just requires a bit of education and conversation. 

 

Crissy: That education piece is huge though.


Holly: It is, and having women become advocates for themselves. It’s not like you’re asking for a prescription, it’s a pretty conservative thing.

Breathing

Crissy: Holly, what are three actionable items or takeaways for our moms? 

 

Holly: Yes, you sent me a few things ahead of time so I definitely tailored these to what your moms were asking about. The first thing that I would incorporate that deals with all three is breathing.

It’s such an easy thing for a woman to do a couple of tests to see if she’s doing it right. Just correcting this can fix a lot of things.

You have your diaphragm which is what helps you breathe. 

But you also have a pelvic diaphragm that is like a hammock of muscles that holds your pelvic floor up. Those muscles get torn through with delivery. We are talking about moms here, of course, but this could also be a woman that was a dancer that was incredibly mobile and has overstretched her pelvic floor.  So you don’t necessarily have to have had a child.

You need to coordinate your breath with your pelvic floor.  

For women, they should sit cross-legged on the floor and inhale through the nose and exhale through the mouth like they’re blowing up a balloon or blowing through a straw. 

Pay attention to what the pelvic floor does. If they feel like their vaginal muscles or their pelvic floor descends or balloons out, or they leak a little bit, they likely have a breathing dysfunction.

Just correcting that, when you exhale through your lips blow through a balloon, you can even practice blowing up a balloon. When you blow through that balloon you should feel your abdominals coming in and feel your pelvic floor lifting. 

I’d say 50-60% of my class when I go through this have it going down or notice some leaking.

Just by bringing awareness to that, and it’s easier to do in sitting because you can feel the movement of the pelvic floor, but you can of course do it standing or laying down, but in sitting you can feel if your pelvic floor goes down or lifts up. 

Just visually going through that can help. We have to understand there is a little more complication to that in terms of what your alignment is and what your hips are like, so if you came to me I’d do a bit more, but for a takeaway of something a woman can just try is to see if her breathing is functional. 

That then becomes an exercise. You would do a repetition of about 10 and take about 3-4 seconds to exhale. 

Practice! Practice trying to lift and then you’re actually doing a proper kegel. 

A lot of people hold their breath and bear down on their pelvic floor.  That’s where leakage comes especially. Prolapse patients, you’ll see this dysfunction a lot. So undoing that dysfunction is half of my battle a lot of times.  If women can do that on their own and they don’t need to see me, great! We fixed it!

Kegels

Crissy: I have a quick question for you, Holly. The pelvic floor is a new concept for a lot of women, do you find that some women have trouble connecting to the pelvic floor and knowing what you’re talking about?

 

Holly: Absolutely. A lot of women think the pelvic floor is more of the rectum and they squeeze their glutes. I get a lot of glute dominant patients. 

When I teach this breathing technique in a class I’ll have them rock back and forth on their seat bones and do what’s called a pelvic tilt and then try to find the middle of their seat bones. They are sitting squarely on the seat bones and then try to pull them closer together. 

(Laughing) You both are trying it. I can tell. 

 

Crissy: (Laughing) You can tell by our face?

 

Holly: It’s amazing! 

Pull those seat bones close together and that’s a better cue. If you feel more of your rectum or your tailbone then you’re sitting too far back. If you feel more of your pubic bone and it’s really weak then you’re sitting too far forward. 

You want to sit right in the middle of those seat bones. Try to pull the two seat bones closer together and that is a proper kegel. 

If you don’t feel anything don’t get frustrated. I’d rather you feel nothing than feel like your glutes are squeezing. 

When patients are really weak sometimes they won’t know if they are even doing it. If they’re alone I can tell them to actually put a hand on the vaginal muscles and you may feel some movement that way if you can’t actually feel the muscle contracting.

Pretty early on with pelvic floor weakness, you’ll feel these little tremors deep in the pelvic floor, and that’s the weakness.

Most women try to do Kegels in the car. But a car seat is terrible because you’re slumped over and you’re probably just squeezing your glutes and that’s not the same thing.

So proper position with good alignment and then using that breath is huge. If you can breathe properly that pelvic floor and core will engage whether or not you know you’re doing it. So that’s a helpful cheat if you can get that breath to work.

 

Cindi: Is it actually good to do random Kegels?

 

Holly: Yes and no, Cindi.  

If it’s truly weak, yes. By random I mean you need to do 50-80 a day. Just doing 2 or 3 doesn’t really do much more than just help you with your awareness. 

But the patients I get that say they’ve been doing Kegels at the stoplight every day for 3 months and are still leaking — sometimes the pelvic floor can be too tight.

If you squeeze your fist really tight and then you try to squeeze it more, there’s nowhere for it to go. So I do tell a few patients if they feel like they’re doing Kegels and I check them and they are doing them correctly, which again is half the battle. Sometimes it’s just watching them do it to see if the pelvic floor lifts or bears down and fixing that. Then in one session, done! Your problem is fixed.

But, sometimes if the pelvic floor is too tight I have to do some manual therapy to loosen the pelvic floor first and then patients can strengthen after. So I get both types of dysfunction.

Doing random Kegels is helpful, sort of. I guess (laughing).  It can be but it can also not be, which can be frustrating.

I will say if you’re doing them and feel like you’re doing them well to do at least five sets of ten a day to make a difference.  Do some two-second holds and then try some five-second holds and try to hold them for a little bit longer.

Prolapse

Crissy: Okay, so you mentioned breathing. What’s another takeaway for our moms?

 

Holly:  Prolapse, just for those who don’t know what it is, it is when the organs start to descend. 

The symptoms women usually feel is a heaviness or fullness in the pelvis.  They feel like they have trouble emptying their bladder all the way, occasionally the rectum too – that is a type of prolapse that exists as well. Feeling like you’re sitting on a golf ball, like your tampon’s falling out. Those are the symptoms I hear from patients when they have a prolapse. 

Sometimes you can actually see the organ descending. That’s a higher stage of prolapse. Occasionally it’s just that uncomfortable full feeling in the pelvic floor.

A lot of times it’s a breathing dysfunction, so tying it back to breathwork. 

Patients are straining, bearing down. When they lift things or lift their child, they are holding their breath. So there is that descending pressure on the pelvic floor. 

The pelvic floor is that hammock that holds up the organs. If you increase the intra-abdominal pressure, you push down on that pelvis and your organs are descending.  

Or you had a baby and you did a lot of bearing down when you were having that baby and the organs never quite got back into the right place.

So, a quick easy fix is to do Kegels with your pelvis lifted on a couple of pillows. 

Thinking about working against gravity when you’re sitting, standing, or walking around.  If you can lie on your back that’s helpful, but take it up a notch and lift your pelvis up even higher and then do Kegels so that you are actually retracting. You can visualize you’re retracting those organs back into your body.

If you can spend five minutes a day, while kids are napping or maybe it’s 9:00 at night, but doing Kegels and breathing with your pelvis lifted for the earlier stages of prolapse, and even the later stages, but the earlier stages of prolapse – practicing that and adding that little piece can help.

If you’re doing a kegel and the organs have fallen a bit, you’re strengthening around fallen organs and that’s not as helpful. So just adding 2-3 pillows, and assuming you don’ thave neck issues as well, and doing a pelvic lift, abdominal squeeze, or breathing.

I’d give it 3-4 weeks of consistent trying before you can tell if it’s helping you or not.

 

Crissy: How common is prolapse and is it possible to have one and not be aware of it?

 

Holly: It is possible to have one and not be aware of it. But, I would argue then that it’s such an early stage that it doesn’t really matter. If you just do some pelvic floor strengthening it should improve.  

I think probably 50-60% of women have it.  It’s pretty high. But again, a lot of times doesn’t affect their daily function. 

The higher stages, stage 3 or 4 prolaps, there is something called a pessary – which is like a diaphragm (meaning a diaphragm like a contraceptive) it’s something that you insert and it holds your organs up and you can do Kegels with the pessary.

They are less commonly prescribed because most people just go straight to surgery. I prefer all the conservative routes first if you can. 

If it’s stage 1 or 2, which means you’re not even seeing the organs prolapse you just have some discomfort, it’s pretty easily treated conservatively. Stages 3 and 4 where the organs are coming out is a little harder, but I still try. So we will do a pessary and some exercises with the pelvis elevated.

It’s pretty common. Symptoms are light to moderate. If you’re not having symptoms I wouldn’t worry about it. But I do always screen my patients when they come in.

 

Cindi: People can have surgery anywhere between stage 2 and stage 4 correct?

 

Holly: Yes, and there are some that are just surgical candidates. It never hurts to strengthen your pelvic floor. Whether you’re going to have the surgery or not, it will help the surgery to be more effective.

Diastasis

Cindi: We are so excited to hear about your third takeaway.

 

Holly: Yes, the third is about diastasis. That is the separation of the abdominals that occurs for a lot of women. 

I can see the fittest woman in the world going into pregnancy and she has that separation, in fact, I may argue those women have it more because their abs were so tight and flat that they don’t have anywhere to go. 

I always screen for this. In my personal experience, I see it about 80% of the time.

You can also screen yourself for it. 

Lie on your back and put two fingers above your belly button and then just lift your head. See if your fingers sink in or you feel a bulging out. You check there, then you check below your umbilicus, and then you can also check as high up as your sternum.

Knowing if you have one is important when you’re trying to return to exercise.

I teach this a lot when my patients get frustrated because they can’t get that pooch to go away and a lot of it is because they have that abdominal separation. They are doing a bunch of crunches which is just training their abdominals to sit in that pooch. That’s not how I would train them.

My personal trainer side comes in and I just teach them how to do a neutral spine with their abdominals flat to get their body back.

But, healthwise there is no proof that diastasis correlates to back pain, but it makes sense to me. If your abdominals are separated and not functioning then your back muscles are going to work too much to help you lift and carry.

I tell patients to avoid excessive bending over, which is hard to do but to try to do a flat back pickup. To not slump too much because again that helps separate the abdominals. I train them on how to do a neutral spine abdominal exercise. 

You have horizontal muscles, the transverse abdominis, that will help close that diastasis. Teaching them how to find that transverse abdominis can help them close the gap.  

There are surgical candidates but that’s typically when the diastasis is all the way up to the sternum and it’s separated all the way. There can still be healing even there.

The last class I taught I received the question of if it never goes away is that a concern. 

If it’s only two-finger width above and below the belly button that’s considered normal. If I’m not palpating a split all the way up to the sternum, it helps me make their exercise program and it’s something I would want women to know if they have one or not, but they shouldn’t obsess over whether or not it’s there. 

A lot of times it will heal all the way, but sometimes it heals about 90% and that’s okay.

 

Cindi: There is so much confusion out there on the best time to resume a workout routine, whether postpartum, post-surgery. So for example, if someone had prolapse surgery are they able to run again? Should they limit their lifting exercises? Because it’s not just moms that get prolapse.

 

Holly: Right! Same thing with diastasis. I mean I see it in my men with beer bellies.

My general rule of thumb is 6 to 8 weeks. Give your body time to heal. 

This is kind of across the board. Of course, if they are post-op I want clearance from the doctor first as well.  It depends on how complicated the surgery was, but the standard is still 6-8 weeks.

Depending on the type of delivery and how traumatic it was, you can start to do some of that breathing and a little bit of muscle contraction earlier than that, but as far as exercise goes I would wait. 

I know that’s frustrating because women want to get that weight off and are ready to move. You can go on a light walk, but if you go too early, just like if you jump with an ACL repair too early, you are going to damage yourself in the long run.

As frustrating as it might be to wait, bringing it full circle to what my passion is, understanding what your body has gone through no matter how tough, or how in shape you are, or how determined you are, starting earlier can actually be detrimental in the long run. 

Just allow your body time to repair itself. The body is amazing. A lot of the scarring will heal itself, often the diastasis will heal itself. Just allow yourself that time.

Then at that 6-8 week mark, I would start with that foundational core and hip strength first. 

You could start to go on a walk, start a little bit of cardio. Potentially non-impact cardio like a stationary bike or elliptical. 

But if you’re looking at impact through that pelvic floor that has just healed from having a child inside of you with all that extra weight, and the postural changes that occurred with that, we need to address those first for about three weeks. 

Then when you have that baseline strength you can go start to jump and do some of those additional things. 

I try to work with my moms knowing I personally would be going crazy if I couldn’t do anything for three months. That’s not what I would want to hear.  I try to give them some safe things to do that won’t do any damage to the pelvic floor. But I would give that standard 6-8 week time to heal. 

Gentle Kegels, long holds and short holds to get your pelvic floor back, let’s find your abdominal muscles again, now here’s some pilates hip exercises to do, and now you can really start to push your body.

If you do it that correct way, long-term, 6-months postpartum you’re going to have a stronger, better body than if you dove right into it a month out because you feel like you’re ready to go.

 

Cindi: Could you share about other people besides moms that deal with these issues?

 

Holly: Absolutely, people that deal with chronic constipation, whether it’s from use of opioids, bowel dysfunction, they’ve done straining and bearing down their entire life so I’ll see patients with prolapse from constipation. 

Hypermobile patients, those that are double-jointed, even at age 16 they could do party tricks – palm the floor, they’re great dancers and gymnasts — now they’re 30 and they feel like they’re tight.  But, they’re not really tight because their ligaments are loose. 

Well the same ligaments that hold the joints together that are overstretched also hold the uterus and bladder in place, so they are overstretched as well. That’s just how they’re made. There is not necessarily anything  I can do except help their muscles compensate for what their ligaments don’t do. I’ll see prolapse in extra flexible patients.

With diastasis, I’ll see overweight men and women.  I’ll see that same stretching of the abdominals. 

I had a patient — this is just a case study —  who gardened for 7 to 8 hours a day. 

She bent over for hours and hours and she had a diastasis. She had never had a baby. 

It was just from that consistent stress hanging down on the abdominals that caused that separation and then made it worse over time.  Those are just some examples but you don’t have to be postpartum to have these issues and could still benefit from physical therapy.

 

Crissy: We always like to ask our experts if they have any favorite podcasts or books. It doesn’t have to be related to physical therapy.

 

Holly: Yes, when I first moved back here in 2014 and had just bought a house and was starting life over again I discovered the enneagram and read The Road Back To You and I listen to the Enneagram podcast learn a lot about myself.

 

Crissy: What number are you?

 

Holly: I’m a 9. Peacemaker, save the world, it makes sense I guess. 

I listen to some Rob Bell as well, it’s the Robcast I’ll listen to occasionally. 

I’m a big reader. I read about five books at a time, which is really annoying. It depends on my mood. So I’ve got fiction, non-fiction, self-help.

 

Cindi: How can people get in touch with you?

 

Holly: I didn’t touch on pelvic pain, that’s a different animal. But people are welcome to reach out with any questions. holly@smartathletept.com. If women just want to talk I can help. I’m happy to chat with them. I’m excited to be a part of the movement to empower women to take care of themself. 

 

Crissy: We appreciate you so much.

 

Cindi: Yes, we need people like you out there providing accurate and true information.

 

Holly: I do take a little bit of a different approach, but there are plenty of great women’s health PT’s in the Raleigh area. The more of us out there providing help and education the better.


Crissy: Thank you so much for joining us, Holly!

Holly Durney has worked in the areas of orthopedics and pelvic health for 10 years. She received her Doctor of Physical Therapy degree from Columbia University in 2009 with emphasis in orthopedics. She utilizes her knowledge of orthopedics to treat patients pelvic pain, pre and post natal issues, and incontinence. Holly is an APTA Orthopedic Certified Specialist and has pelvic floor rehabilitation training from the Herman and Wallace Pelvic Rehabilitation Institute. Her pelvic health training focuses on treating pelvic floor dysfunction and related issues in the pelvis, hip, and spine. Her pelvic floor treatments involve assessment including movement patterns, ligament structure, current activity level, and pregnancy history. She believes that treating the whole person is the key to complete health and wellness and to help her patients achieve their goals. Holly is on the team at Smart Athlete Physiotherapy.

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