It’s time to learn about Pelvic Physiotherapy for Treating Endometriosis. Join us as we explore the impact pelvic physiotherapy can have on managing the symptoms of endometriosis.

Guest Expert Dr. Amanda Olson

We are honored to welcome Dr. Amanda Olson, a dedicated and passionate physical therapist specializing in pelvic floor disorders. With a Doctorate in Physical Therapy from Regis University and advanced certifications, Dr. Olson brings a wealth of knowledge to this episode. As the President and Chief Clinical Officer at Intimate Rose, she is committed to improving women's health through innovative care and education.

Notable Achievements:

• Winner of the 2025 Elizabeth Noble Award for her significant contributions to patient care and education.
• Published author of several influential articles and books, including Restoring The Pelvic Floor for Women.

Research

1. Clinical and exercise professional opinion on designing a postpartum return-to-running training programme: an international Delphi study and consensus statement - British Journal of Sports Medicine (2024).
2. Clinical and exercise professional opinion of return-to-running readiness after childbirth: an international Delphi study and consensus statement - British Journal of Sports Medicine (2023).
3. Clinical Commentary: A 4 Phase Approach for Postpartum Return to Running - Journal of Women’s Health Physical Therapy (April 2022).
4. Restoring The Pelvic Floor for Women - Published Book, available on Amazon.

Key Discussion Points

• Manual Therapy & Biofeedback: Techniques that help alleviate pelvic pain and improve mobility.
• Customized Exercise Programs at-home: How to access care designed to relax and strengthen the pelvic floor and enhance overall well-being.
• Pain Management Techniques: How pelvic physio can help manage pain effectively and improve quality of life.

Key Takeaways

Listeners will walk away with:

• A deeper understanding of how pelvic physiotherapy can alleviate symptoms of endometriosis.
• Practical insights into when and how to access vetted providers who can help tailor personalized programs that can be incorporated into their health journey.
• Empowerment through knowledge, allowing them to make informed decisions regarding their pelvic health.

Resources Mentioned

Intimate Rose for products and a service directory tailored to women's health, including telehealth services.

We hope you find this episode both informative and empowering. Remember, you are not alone in your journey towards better pelvic health!

Welcome to endometriosis a Z.

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We're here to separate fact from fiction,

from old myths to current reality, and

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to dive deep into the latest research

and medical interventions that can help.

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Endometriosis sufferers and Arces will

help us explore what's really happening,

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offering insights and hope along the way,

whether you're living with endometriosis.

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Supporting someone who is, or simply

curious, you're in the right place.

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Let's demystify endometriosis

one episode at a time.

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Carolyn: Hi, welcome

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Welcome to

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a Z.

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My name's Carolyn Pcan and

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mark: And I'm Dr.

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Carolyn: Yeah, we're co-hosts today.

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Um, we're really pleased to have Dr.

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Amanda Olson our podcast.

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And

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and today we're gonna be talking

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physiotherapy a management

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management tool

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uh, for

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for people who are experiencing

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of endometriosis and

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just.

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pelvic discomfort.

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Um,

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mark: So one of the, yeah.

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Yeah.

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One of the important things I think

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everyone to know is

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said, of course you're

hearing about medications,

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surgical

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therapy, and all sorts of other

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that you

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things,

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do,

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but there are many alternative therapies

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can

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that can help you

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you need to resort to surgery.

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perform.

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That's why it's so wonderful

to have Amanda, because

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because

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she's done a lot of this pioneering.

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and, and, and really

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Really has a lot.

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to teach us all.

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Carolyn: I just

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I just wanted to say a few words about,

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a

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uh, Dr.

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Amanda.

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She's a

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a pelvic physiotherapist and she

actually provides education for

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physiotherapists who wanna help their game

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and, uh,

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uh, develop

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additional, I don't know, specialized

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techniques

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to

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to deal with pelvic distress,

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Um, to

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to return patients to

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you know, a better

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a better quality.

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Um, I know

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I know that she has a

platform, um, to help

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Connect

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to patients,

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providers.

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So I'll

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so I'll have her talk about

that a little bit more.

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Uh, notably, she

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Amanda Olson: she learned that via

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Noble Award in

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2020

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Carolyn: for

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or her Impacts for patient

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and

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care education

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from

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from the A PTA for Academy of.

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Health and Physical Therapy.

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And I'm hoping she'll today be able to

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To share

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success

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stories and

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us

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understand

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how pelvic physiotherapy can help

manage and treat endometriosis, and

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how you can access a physiotherapist

with these specialized techniques.

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Dr.

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Amanda Olson, welcome to the show.

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Sure.

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Amanda Olson: Thank you

so much for having me.

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Carolyn: So one of

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So one of my first questions is

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if

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if someone has pelvic discomfort,

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when and

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and

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do they

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how do they.

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pelvic physiotherapy?

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'cause it's really

unknown to most patients.

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I.

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Amanda Olson: Yes.

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It's so interesting.

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This form of physiotherapy has actually

been around for almost 45 years now, and

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pelvic physiotherapists are found all

around the world in Canada and the US and

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Australia and the UK and um, South Africa.

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So it is growing in numbers.

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Um, depending on the country, um, patients

might access through a myriad of different

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physicians, so they might be coming in

through their primary care provider.

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Their gynecologist, their

gastroenterologist, or a pain specialist.

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Um, here in the US we have

direct access in most states.

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So a patient can make an appointment

and we can evaluate them and then

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be informing their physician or

their care team, um, about our plan

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of care and coordinating with them.

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Um, by and large, we're working

with that care team anyways.

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Um, so there's a lot of different

ways a patient might present.

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I will note.

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That I've been doing pelvic health for

15 years now, and when I started 15

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years ago, it was a big, uh, undertaking

to inform not just the patient

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population, the general population,

but also providers as to what our

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skillset is and what we have to offer.

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And now the, the popularity

is growing a lot.

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There's been a lot more patient advocacy

on behalf of themselves, and they are.

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Requesting it from their providers that

they are seeking us out, um, individually.

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So that has been a really positive change

and we hope that continues to grow.

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mark: I have

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Amanda Olson: I

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mark: you that when we moved into our

new offices here in the fall, I got to

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know some of the people in the building

and literally above where I'm sitting,

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there's a large physical therapy group.

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And when I went up to introduce

myself, I was pleasantly

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surprised.

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that they have four full-time

pelvic physiotherapists that

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That are running

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24

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7.

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up there.

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It's

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It's just amazing

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um, to see

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to see them and they were

very, very happy to hear

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we were

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we were doing down here,

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especially as,

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as in perhaps cover this,

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what

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but what does it mean

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a woman comes in

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actually with the diagnosis

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as

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as opposed to

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not

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not knowing each,

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How

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how does that affect what you decide,

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uh, or what

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Amanda Olson: what you account?

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Absolutely.

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When a patient comes in already diagnosed,

we already know certain patterns to

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look for when we do our evaluation.

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Um, and we know that we are managing

a complex autoimmune physiological

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process as well, which is really

helpful when we help that person plan

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out their, their daily activities,

their exercise levels, and helping to

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make sure that they have nutrition.

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Um.

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In place.

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And if they don't that they seek help

from a nutritionist, um, because we

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know then, um, that we are, we are

dealing with something that is not

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just musculoskeletal when, because when

a patient presents with pelvic pain,

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we do a really thorough evaluation.

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We're looking at how their spine

and how their hips move or examining

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strength and weaknesses in.

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All of those muscles in, in

addition to the pelvic floor itself.

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Um, but we, when, when a person comes in

with endometriosis, we know that we are

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probably looking at somebody that has some

guarding tendencies in their pelvic floor.

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So the pelvic floor muscles are probably

going to be quite tight and rigid.

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They might not be very well coordinated.

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And so we also know that

when we're going to.

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Palpate those muscles to, to touch

them and see where the different pain

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spots are, that we are gonna be really

closely looking at how the patient

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responds and how the muscle responds.

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Because it might be that there's

endometrial endometriomas present

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in in the muscles or in the

fascia surrounding the areas in

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addition to tender points or just.

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Um, muscles that are tight

from spasming and guarding.

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So, um, it's really helpful to have

that diagnosis in place ahead of time.

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But if they don't have it, we are

examining and our suspicion level

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rises when the muscles are not

responding in a very linear pattern

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like we would expect them to.

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mark: Are there particular

subtypes that you find are

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more responsive to what you do?

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For instance, I believe there was a recent

publication that talked about, um, in

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In particular, patients with dyspareunia,

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who

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those who come from that word,

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painful

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Amanda Olson: sexual relations seems

to respond extremely well to the bottom

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mark: the

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Amanda Olson: of the

pelvic physiotherapist.

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Absolutely.

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So with painful intercourse,

um, we look at the coordination

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of the pelvic floor muscles.

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Oftentimes what is happening is when

penetration's about to occur, the person

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subconsciously they're not doing it on

purpose, will, will contract the pelvic

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floor muscles and it creates like a wall

almost, um, that may make penetration

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impossible, or it might make it.

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Challenging and extremely painful.

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Um, so we are looking at the coordination

of the pelvic floor muscles because

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what we want to have happen is that the

muscles relax to allow for that to happen.

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Dys brunia can also happen because

of the presence of tender points or

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myofascial restrictions, little tight

points in the muscles themselves in the.

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Deeper aspects of the pelvic floor and in

pelvic physical therapy or physiotherapy,

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we address that using very, very gentle

manual techniques or using something

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like the pelvic wand, which I created.

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Um, and additionally at home the

patients can use dilators, which

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are, it's a set of tools that are.

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Built like a cylinder.

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The smallest is about the

size of my pinky, and they

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gradually get longer and wider.

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And the primary focus of those dilators

is to train the person's coordination

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when something's approaching the

vaginal canal to relax and open.

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We're also working with their

sensory system, so they start to

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perceive that that thing coming

into their body is not a threat.

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Um.

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Again, they don't do it on purpose.

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They may have had a history of trauma,

or it may be because of the pain,

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because they have endometriosis, but we

are working with their sensory system.

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And then finally we're working

with the actual properties of the

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muscles to get them to be more

flexible and mobile so that they

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can allow for something to come in.

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mark: Now you used the term myofascial.

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I think if I could get you to explain

that a little bit for those who may not

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be so medically or technically oriented.

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Amanda Olson: Yes, I would liken

it to some food groups, but I

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don't wanna ruin meat for people.

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Um, so muscles have certain properties

that, um, allow them to contract and

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relax and elongate and then encasing

all of those muscles is fascia.

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It's like a protective coating.

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Um, and we want the.

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The, the fascial lining on all

of the muscles to slide and glide

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with the surrounding organs.

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So when we think about the pelvic floor,

we think about a series of muscles

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that has nerves and tendons and blood

flow in it, just like everywhere else.

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Um, but it's also holding pelvic organs

that include the bladder, the bowel.

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The uterus for some.

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Um, and we want those, those organs

to be sliding and gliding within that.

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But there can be adhesions in there from

endometriosis or from other inflammatory

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processes that make them stick together.

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And that can also be a driver of

pain because if you could imagine.

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Think about like a spider web.

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If you stuck your finger in the

spiderweb and dragged it, it

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would deform the whole spider web.

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Um, so we wanna make sure that

the muscles have good mobility.

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The fascia around it have good mobility.

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Carolyn: And

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And my understanding,

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it's not

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not just,

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it's

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not just a muscle with fascia

or bag around it that all the

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fascia is

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shows attached

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other.

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Very

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very much like that spider.

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that you made.

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And

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And so yeah, we do have that, that

medication in a different location that

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the fascia and that muscle attached

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then actually

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actually the pain might be

somewhere else, but then

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sort

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sort

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uh, of, of pain

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pain ion

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I

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I guess.

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And can

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And can,

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on those adhe?

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So not

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so not only can,

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it

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it sounds like with some

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that you use, people

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people can psychologically.

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Identify where, when they're

pulling back and when to, so

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retrain themselves to relax.

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But what about the

adhesions that are there?

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Can you, can you, uh, reduce

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them.

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them up?

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What, what, what can pelvic

physiotherapy do for patients There?

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Amanda Olson: Yeah.

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We can use some manual teaks manual

techniques to help improve the mobility.

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Um, we can do some

techniques into the abdomen.

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Those that are trained

in visceral mobilization.

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It's not necessarily that we're gonna.

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Reach our hands in someone's

belly and break things apart.

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Um, it's more that manual touch,

either within the pelvic floor via

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the vagina or into the abdomen, is

bringing blood flow to the area.

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And mostly it's telling the

brain to relax a little bit.

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It's more like sending

a syn to shut down here.

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In the instances where we have really

significant endometriosis, and I'm

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not a surgeon, but I'm so lucky to

know many very skilled ones, and I've

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seen the, um, the videos of their

surgeries where these s stalagmite type

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looking structures form, um, that are

sticking to organs to each other, and

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that's where surgery can be really.

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Powerful and a really powerful tool.

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And a lot of those surgeons have

great techniques, um, that prevent

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those organs from re sticking to

each other once they, um, heal.

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So yes, we, we do handle it with some

manual therapy in pelvic physiotherapy

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and also additionally, um, lean into

some very skilled surgeons as well.

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mark: So along the pathway of searching

for treatment, a woman, let's say, who

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Take that.

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and pelvic pain, um, when,

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When she, she comes to you,

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you,

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you,

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do you

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where do you position with pelvic

physiotherapy in terms of therapy?

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Right, so

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knows about

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knows about medicine and everybody

knows about diet, and, uh, there's a

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number of things that can affect this.

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you

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you a step

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someone would.

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you take

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before

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even

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of surgery and then your

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York,

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would

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but Dominic

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the

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served?

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better in terms of what they're

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They're gonna do,

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is it

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is it

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surgery first and then pelvic therapy

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therapy

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is still

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Amanda Olson: physical?

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Without sounding too egotistical,

I strongly advocate for seeing

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the pelvic physical therapist

or physiotherapist first.

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Um, so that we can, um,

it, it's a lot of reasons.

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Number one, we are gonna start getting

you on a self-maintenance program

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to help make life easier at home.

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That's a big part of what we do is educate

and empower people For bowel movements.

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That might be tricky.

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That's something that they're not

doing in the clinic but doing at home.

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And they need to be educated as

soon as possible in getting their

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body into a position that makes

it easier, which is often really

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challenging with endometriosis.

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Um, and we are gonna get tools in place

again for addressing what is Mayo.

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Uh, musculoskeletal or myofascial

that we're gonna bring that,

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tamper that pain down a little bit.

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Um, and then additionally, getting

them on a good program for mobility and

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activity and exercise that works for them.

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And a lot of times, you know,

when someone's staring down the

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barrel of surgery, they have

to look at their whole life.

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Like, when am I, when am I gonna

be able to schedule this or.

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What's the cost going to be?

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That's a, that's a problem

here in the United States.

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Um, a lot of providers are cash

only, or it is a high deductible

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on their insurance plan.

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So they're having to schedule it out.

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It's not gonna be next week.

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They're not gonna get relief next week.

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It might be months out.

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Um, and we're gonna help them

tamp that pain down Today.

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It's not gonna be like a magic wand.

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It's not easy, but we are there to help

them start making changes right away.

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And then we're.

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Always there for them after that surgery,

which I also advocate for, um, to help

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restoring function and mobility again.

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And one thing I will say as someone

that's had surgery is that it's very

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humbling to see, um, that, that the

coordination between the brain and the

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pelvic floor and the abdomen can really

change after a surgical procedure.

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Even a little one that's laparoscopic

doesn't seem like it would be

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much, but there, there can be some

changes and we're there to help.

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Retrain that system so that they can

do the things that they want to do.

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mark: Oh, I have another

interesting question for you.

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So, uh, you know, as a, I was

a gastroenterologist before I

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started working just exclusively

with the, uh, endo short test.

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And one of the things that we

would routinely do after surgery

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is we would recommend for our

patients to get themselves a small

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Amanda Olson: Small,

personal size, trampoline.

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mark: And make

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Amanda Olson: Make sure that when,

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mark: when

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Amanda Olson: when they were okay.

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mark: physical activity to begin, 10

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Amanda Olson: 10 minutes a day jumping

lightly up and down on the, to help avoid

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mark: the

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Amanda Olson: development of

adhesions, which of course,

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mark: immediately after surgery, but over

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Amanda Olson: over the

course of a multi easier

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mark: of time.

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So,

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Amanda Olson: So

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mark: question for

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Amanda Olson: for you is,

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mark: is should the

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Amanda Olson: the recommendation

from a gynecological surgeon

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mark: be,

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Amanda Olson: me?

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mark: a

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Amanda Olson: you,

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mark: postoperative.

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Four months, five months, six months

down the road visit with the pelvic

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physiotherapist would go a long way

towards perhaps early detection of

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problems and then prevention as opposed

to letting it develop over time.

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Amanda Olson: I would scooch

that up and I would say a routine

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postoperative six week follow up.

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Okay.

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mark: Okay.

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Amanda Olson: And so then we

are, um, we're helping to make

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sure scars are healing properly.

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We can give them, you know, 'cause

scars are that outward symbol on the

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skin, on that very superficial layout.

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But all of those were where instruments

went deep down into the pelvis too.

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So we wanna make sure

scars are healing well.

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Um, sometimes patients can have pain

and restriction even around the scar,

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so there's things that we can do with

a Q-tip and a makeup brush, and then

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teaching them their own little manual

techniques to make sure that those stay.

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Nice and mobile.

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Um, and then we can also observe

the pelvic floor and get them going

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on pelvic floor and muscle, uh,

contractions and relaxations right away.

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Um, we want to make sure that no

la long-term neuromuscular patterns

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develop that are not conducive to

bowel, bladder, and sexual function.

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So, yes.

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And six weeks please.

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mark: Oh, no, no.

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Six weeks is fine.

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I didn't know the appropriate interval.

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Amanda Olson: Yeah.

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mark: now I'm gonna put you on the spot.

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Ready?

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Amanda Olson: Okay.

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mark: we're going to do, do, uh, we're

gonna, um, put the surgeon against

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the pelvic physiotherapist, comers

walking in the door, all diseases, or

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let's just, let's just keep it to endo.

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All comers walking in the door.

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Diagnosis of endometriosis.

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How many times do you, what

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What percentage,

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patients can you prevent

the need for surgery

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what percentage.

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to see you because of pelvic

discomfort, obviously.

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Carolyn: Your Mer stealing

my question by the way.

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mark: Sorry.

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Amanda Olson: you know, I'm trying to,

I'm, I'm trying to rack my brain of my

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patient caseload and think about what

percentage, um, have not had surgery.

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But I would say even like, not yet, you

know, I don't know who's going to reach

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a point in where their life, where the.

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The pain becomes insurmountable or

there's some change due to hormone shifts.

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You know, estrogen can drive a lot of

issues, you know, far better than I do.

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Um, so, and because every person

presents with different stages, I would,

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I would say from a conservative, a

conservative number would be maybe 10%.

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mark: So I, I think we have a

basis for a really good, uh,

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randomized trial where you take

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Take a hundred women coming

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you with a diagnosis, have

not yet been operated, then.

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Half

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half get pelvic with physiotherapy

and the other half get nothing

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And then you see over time, who ends up

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of having to.

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who have similar diagnoses.

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It would be kind, I think

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I think that would be a very

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study because

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valuable study because which searching

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for

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for alternatives.

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um, to try and

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Try and find out what kind of

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short

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of.

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as you say, staring down

the gun barrel of surgery.

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Carolyn: I,

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I do have a question

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just

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just for our listeners.

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If they're

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know, newly

493

really diagnosed

494

and I.

495

They're, when?

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When

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when is it appropriate for them to access,

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Like, or,

499

or, sorry, not,

500

pelvic physiotherapy.

501

Like

502

how should they do that?

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They're obviously,

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if they've actually gone

505

yeah.

506

a diagnostic test.

507

Yeah.

508

they already have those

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Symptom

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How

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how

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how

513

or how soon is appropriate, what age,

514

are appropriate, and then

515

and then what can they

expect when they enter it?

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pelvic physiotherapy program?

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Amanda Olson: Sure.

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I would say immediately because, you know,

the, the effects of Endo have all probably

519

already taken place, um, in terms of, you

know, they've had it for several, several

520

years, if not since they were born.

521

And, um, we want to make sure that,

again, we're working with the coordination

522

system and we can take all ages.

523

We change how we treat.

524

If it's a 16-year-old coming in versus

a 3-year-old or a 70-year-old, um,

525

we, there's, there's a different

way that we're gonna evaluate a,

526

a, a minor, um, a younger person in

that we don't do internal evaluation

527

unless they are like a late teenager.

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The caveat would be 16, 17, 18.

529

Um, in order for us to do an internal

assessment, they would need to have

530

been, they have need to have been

evaluated by their gynecologist.

531

Parental consent, patient consent,

and then we would consider

532

doing the internal assessment.

533

But we, a lot of times in our clinics as

pelvic physical therapists have ultrasound

534

imaging where we can place that ultrasound

head into their abdomen, into the belly,

535

and we can visualize bladder and pelvic

floor, and we use that as a training tool.

536

So instead of using it diagnostically

like you all do in medicine,

537

we use it as a training tool.

538

The patient can see their bladder and they

can see their pelvic floor, they can watch

539

it contract, they can watch it relax.

540

So we can train some new habits that way.

541

And that's not just the young people.

542

We can use that across the board.

543

Um, but in, in terms of what they would

expect when they first come in for pelvic

544

physical therapy, we are gonna spend.

545

Quite a bit of time just talking.

546

We're gonna talk about all of the

aspects of their past medical history.

547

We do ask questions about how

their bladder is functioning.

548

So how many times a day do you urinate?

549

Do you ever leak urine?

550

How's your bowel moving?

551

What do your stool look like?

552

Is it difficult?

553

Is it painful?

554

We ask questions about,

are you sexually active?

555

Do you experience pain?

556

Is the pain when you first start

or is it when it's deeper in?

557

Um, and then what their goals are.

558

All of our.

559

All of our goals as pelvic physical

therapists are patient-centered.

560

So if their goal is to work a

full day and not have to come home

561

because of pain, that's our goal too.

562

If their goal is to conceive,

then we wanna make sure they're

563

having pain-free intercourse, and

that's where we're beneficial in

564

fertility is making sure that we're

addressing those sexual health goals.

565

Um.

566

And then we do an evaluation.

567

We start with the whole body.

568

So we watch how you move, we

watch you bend over, we watch

569

how your hips are moving.

570

We measure your strength.

571

We're gonna gently press into your

abdomen and see how the musculo skeletal

572

structures are moving or not moving.

573

Um, see if there's pain there.

574

And then on our.

575

Vaginal assessments, we

don't use a speculum.

576

Um, we are using one finger and

we are looking at the control

577

of the pelvic floor muscles.

578

So if we tell you to contract,

does your brain and your pelvic

579

floor know how to contract?

580

If we ask you to drop it down and relax

as if you're gonna have a bowel movement.

581

Does, does the brain and the

pelvic floor know how to do that?

582

And then we measure strength and

then we, we touch four areas of pain

583

and we document that because we're

gonna go about addressing that.

584

And then we create that plan

of care based off of all those

585

unique individual findings.

586

So one person's plan of

care might look similar.

587

So if you took two DYS Brunia

patients, two patients with.

588

Um, pain with intercourse.

589

They might have a different plan

of care because there might be a

590

different driver in that, but it's

following all of the same principles.

591

We're working with the, the brain

and the muscle coordination.

592

We're working with the tissue and

we're working with the person as

593

to what they're doing at home.

594

Carolyn: I

595

I,

596

have a follow up question.

597

Do you find that,

598

uh, so

599

pain

600

pain symptoms

601

are

602

are addressed.

603

are some of the psychological

604

a symptoms like anxiety.

605

And depression,

606

The court, they get

607

through pelvic physiotherapy?

608

Amanda Olson: Yes, we do a lot with, um,

because of the role of breathing with

609

the pelvic floor, the diaphragm and the

pelvic floor work together like a piston.

610

So when we inhale, the diaphragm

drops and so does the pelvic floor.

611

And when we exhale, they both rise up.

612

Um, so we do a lot of, um.

613

More relaxation type work with breathing.

614

We also help to identify,

um, areas of stress.

615

We definitely work with

therapists and counselors.

616

We're not trying to do all the

different types of therapy.

617

We wanna make sure that those

people are in place as well.

618

Um, but we also use exercise as

a means of helping with that too.

619

So that might just be gentle

stretching or positioning that

620

gets their body more comfortable.

621

Um, what I've found in 15 years

of practices, a lot of times too.

622

We're the first person who's heard them

out and told them that they're not crazy,

623

you know, because prior to you all,

endometriosis is not shown up on imaging.

624

So they might have seen their

gynecologist or their primary care doc

625

send them through the MRI or send them

into x-ray or other types of imaging.

626

They don't see anything and they say,

sounds like your periods are rough.

627

You know, this is just

how it goes for you.

628

And they are.

629

Extremely traumatized by that

because they feel like they're crazy.

630

Um, so we do spend a lot of time

listening and reassuring and, um,

631

validating their experiences as well.

632

And because of the nature of physical

therapy, um, we see them chronically.

633

So a plan of care might be one

hour, once a week for several weeks.

634

We develop a really deep relationship

with them, so we're there to hear 'em out.

635

Sorry, I cut you off.

636

mark: That's very important.

637

I, I, you know, I'll remind everyone, you

know, historically, you know, uh, in the

638

15 and 16 hundreds, these women were being

drowned in rivers and burned at the stake.

639

And

640

And evens

641

Freud, uh.

642

Not

643

not to describe

644

I mean, where did

645

where did he come up

with the term hysterical.

646

It was a woman likely who had

endometriosis and intractable pain

647

Such

648

her periods.

649

And

650

so

651

uh, anything that you can do to affect the

652

the entire.

653

mind

654

body aspect,

655

Definitely improves

656

groups in psychological.

657

Um,

658

Um,

659

I've

660

I've seen a number of devices.

661

I don't know if we've used them or

not, but they did talk about bio,

662

yet.

663

anything

664

Talk

665

talk to us about the use of bio.

666

devices.

667

Amanda Olson: Sure.

668

Biofeedback is another tool

that we have in our tool belt.

669

Um, it, there's different forms.

670

There's a basic form where, um, a

little electrode that's about the

671

size of a tampon can be placed inside

the vagina, and it goes to a very

672

simple plaque where it shows a line.

673

So when the pelvic floor muscles contract,

the little line goes up and when then they

674

relax, it comes back down to more complex.

675

Fun software packs where, um,

it's connected to a terminal a,

676

a computer screen, um, still with

the, there's a vaginal electrode.

677

There are surface electrodes that stick to

the skin, but those tend to not give very

678

good readings because of the presence of

hair and, uh, oil on the skin and whatnot.

679

But, um, again, vaginal

sensor goes to the.

680

The terminal.

681

And you might see an image where

when you contract your pelvic floor

682

muscles, a rose turns into a little

rose bud, and then when you relax, it

683

blooms out and it looks like a rose.

684

And what that does is you're getting

visual in time, uh, reinforcement

685

as to what your body is doing.

686

So it can be a really powerful tool.

687

Um.

688

Prior to being, being more than

full-time in my business now and

689

teaching, um, I worked in a, I was very

beneficial to work in a hospital-based

690

outpatient system where I had both the

biofeedback and the realtime ultrasound.

691

And I gotta say, I really preferred

the real-time ultrasound because I

692

just, there's, there's no feeling as a

provider, like watching a patient see

693

their pelvic floor muscles for the first

time and watching them actually contract.

694

I think it's a really powerful tool that

helps create a brain map for them as to.

695

What the, the black cave of their

pelvis actually is and what's inside it.

696

Um, but I had other colleagues that really

loved the fun and playfulness of the

697

biofeedback packs with the, the flower.

698

There's like a little dolphin where

when you can track the, the dolphin

699

jumps, so it's, it's to each their own.

700

But it is a really wonderful tool

for, for teaching a patient how to

701

control their pelvic floor muscles

702

Carolyn: And

703

and.

704

have additional tools that

people can bring home as well.

705

Did you wanna talk about those a little

bit and how they can help patients?

706

I.

707

Amanda Olson: Yeah.

708

So, um, at my company, intimate

Rose, I've created tools that are

709

meant to empower patients at home.

710

So the pelvic wand, like

I mentioned, is a tool.

711

It kind of looks like a question mark and

it's covered in medical grade silicone.

712

Um, they're very bright and cheerful,

but it allows a patient to do

713

mild fascial release or tender

point release or a muscle massage.

714

Inside the pelvic floor E either

via the vagina or the rectum.

715

Actually the oneand can be

used by men and women, um, who

716

are experiencing pelvic pain.

717

Um, and it's been a game changer

for a lot of patients because,

718

you know, we do manual therapy

and they might get some relief.

719

But those, those habits die hard, and

that's part of what we're doing is

720

retraining those muscle guarding habits.

721

Um, but in the meanwhile, it allows them

to address that pain at home on their own.

722

And then the dilators, likewise, as I

mentioned, come in a set of nine now.

723

Um, they start very, very small, but

it's to help train the body to relax

724

when something's being inserted and

to tolerate something inside the

725

vaginal canal in service of using

a tampon or having a pain-free.

726

Medical exam with a speculum or

penetrative intercourse for those

727

that have that goal as well.

728

Carolyn: Yeah.

729

In in our show notes, I'm going to

make sure, um, Intimate Rose is a

730

link so people can check that out.

731

And I think there's also something

else on Intimate Rose about

732

providers, a provider directory.

733

Can you talk about those, how

people can, like what are,

734

What are, what is the level of training

of people on your provider directory

735

and how can the patient evaluate?

736

Is this someone.

737

really has

738

Amanda Olson: has this specialist with me.

739

Yes, on our website because over

the years we've grown relationships

740

with both patients and providers.

741

Um, we have a lot of different

types of providers now.

742

We have other pelvic

physiotherapists like myself.

743

We have occupational therapists,

we have, uh, sex therapists, nurse

744

practitioners, and then physicians of.

745

All different training types.

746

So we've got gynecologists,

gastroenterologists, um, pain specialists.

747

We've got some primary

care physicians as well.

748

Um, so if a person is looking for

one of those types of providers,

749

they can email us and will help them

find someone based off of their.

750

Here in the US zip code

or postal code in Canada.

751

Um, and we're growing that out into

Europe, um, and the UK as well.

752

So we, we just recognize we, we

have, we have both of these parties.

753

We need to bring them together and

make sure patients are getting care.

754

And then we also are in the process

of launching, um, telehealth

755

for pelvic physiotherapy.

756

So.

757

People that need to be getting some

relief and getting some help, um,

758

can be accessing that even from afar.

759

So we are getting ready

to roll that out as well.

760

mark: That's a phenomenal thought.

761

Yeah, that's

762

Amanda Olson: Thank you.

763

Carolyn: that you've built that.

764

Hey, we only have a few minutes

left, but I know that you do some

765

I know that you do

766

and actually

767

actually

768

of this techniques, um,

directly for physiotherapists

769

who wanna specialize in this.

770

Maybe they have a patient group that is

771

Amanda Olson: He's really

772

Carolyn: for this

773

Amanda Olson: service.

774

Carolyn: what

775

Amanda Olson: What does,

776

Carolyn: what are you

777

Amanda Olson: what are you

doing in the educational front

778

and how are you doing that?

779

I have offerings in person and live

and then prerecorded and some that

780

come up that are live via Zoom.

781

So, um, in lots of different avenues.

782

So, um, I've got a couple of

one to two hour talks that are

783

prerecorded on endometriosis,

um, inflammatory bowel disease.

784

Um.

785

Hip, the relationship between the hip and

the pelvic floor and lots of different

786

topics that are a little bit shorter.

787

I have a two hour talk on dilator use

alone, just body positioning and how to,

788

how to work with the dilator once it's

inside, how to carry it over into life.

789

Um, and then another passionary of

mine outside of endometriosis 'cause.

790

I'm also one in 10 is, um, pelvic

Health in runners specifically.

791

So I've actually published in

British Medical Journal and our

792

journal here in the US on the

topic of return to run postpartum.

793

And so I have, um, a two day course

that I teach in person and live

794

via Zoom on all the different

pelvic health issues with running.

795

So all different genders, um,

things that people might experience

796

and how to overcome those.

797

mark: Mm-hmm.

798

Carolyn, let's make sure we get a

list of the publications and get

799

them up on the site also so people

can take a look at some of the

800

groundbreaking work that Amanda is doing.

801

Amanda Olson: Thank you.

802

Carolyn: Like I

803

Amanda Olson: Like I said, there's there

804

Carolyn: better that I could

think of to bring onto this

805

mark: I.

806

Carolyn: to talk about pelvic

physiotherapy and what can be done

807

Amanda Olson: done for

808

Carolyn: how they can access it, and the

809

Amanda Olson: and the importance of

810

Carolyn: a modality for treatment.

811

Amanda Olson: thank you so much for.

812

Carolyn: our podcast, Amanda,

813

Amanda Olson: Is

814

there

815

there any take home message

816

Carolyn: that

817

Amanda Olson: that you wanna

send to patients listening

818

Carolyn: their

819

Amanda Olson: their loved ones

who are listening for them?

820

Carolyn: them through,

uh, through their disease?

821

Amanda Olson: Absolutely.

822

I would say don't give up.

823

Keep looking for great providers who are

listening to you, um, build your team.

824

All of us as providers are a person

in your canoe helping you row.

825

We're helping you move forward.

826

So keep looking and there's

hope and it does get better.

827

I promise you it gets better and

it's worth it to advocate for

828

yourself and to find the team that's

listening and working with you.