AIBD Episode 126 - Pelvic Health With Amanda Olson, DPT, PRPC

About IBD Podcast Episode 126 – Pelvic Health With Amanda Olson, DPT, PRPC

Caring for pelvic health is important for people of all genders who live with an inflammatory bowel disease (Crohn’s disease or ulcerative colitis). Dr. Amanda Olson, who holds a doctorate in physical therapy and is the President and Chief Clinical Officer for Intimate Rose, has dedicated her professional life to helping people improve their pelvic health. Learn more about pelvic therapy and how she has developed resources and tools to help people living with all types of conditions.

Find Amanda Olson, DPT, PRPC at:

Find Amber J Tresca at:

Find Mac Cooney (mix, sound design, and theme music) at:

Episode transcript and more information at: https:/bit.ly/AIBD126

These show notes contain affiliate links. If you choose to purchase after clicking a link, Mal and Tal Enterprises, LLC may receive a commission at no extra cost to you.


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[Music: IBD Dance Party]

Transcript

Amber Tresca  00:04

I’m Amber Tresca, and this is about IBD. I’m a medical writer and patient educator who lives with a J pouch due to ulcerative colitis. It’s my mission to educate people living with Crohn’s disease or ulcerative colitis, about their disease, and to bring awareness to the patient journey.

Amber Tresca  00:20

Welcome to Episode 126.

Amber Tresca  00:22

My guest is Dr. Amanda Olson, who holds a doctorate in physical therapy and is the President and Chief Clinical Officer for Intimate Rose, Dr. Olsen began her professional journey in pediatrics, but she switched to pelvic physical therapy after her own recovery from a horrible accident that significantly damaged her pelvic floor.

Amber Tresca  00:43

Today, Dr. Olson specializes in treating pelvic floor disorders including incontinence, pelvic organ prolapse, pelvic pain, and pregnancy related issues. She’s also the author of restoring the pelvic floor for women. How Kegel exercises, vaginal training and relaxation, solve incontinence, constipation, and heal pelvic pain to avoid surgery, she shared some of the signs and symptoms that might prompt people with IBD to consider pelvic floor therapy, how to find a therapist, and what to expect when therapy starts.

Amber Tresca  01:17

Coming up next, my conversation with Dr. Amanda Olson of Intimate Rose.

Amber Tresca  01:24

Dr. Olson, thank you so much for coming on about IBD.

Dr Amanda Olson  01:28

Thank you so much for having me.

Amber Tresca  01:30

I wonder if we could start first by you introducing yourself so that everyone gets an idea of your background and your education?

Dr Amanda Olson  01:37

Sure. I have a doctorate degree in physical therapy. And my specialty is in pelvic health. So I have a certification in pelvic health rehabilitation. And I’ve been doing that for about 14 years now.

Amber Tresca  01:50

That’s really amazing. When I was doing my research before I started talking to you, I came across how you had a very interesting story. And that was What first got you started in physical therapy. Could you tell me about what happened and how that unfolded? And how it led you to where you are today?

Dr Amanda Olson  02:10

Yes, it’s really interesting. So I expressly went into the doctorate program for physical therapy, to specialize in pediatrics. And when I graduated, I was working in a children’s hospital and specializing in motion analysis and research around children with cerebral palsy and Down syndrome. And that was my life. And that’s why I became a physical therapist. And then I found myself out camping. Having an adventure, I was still young, but out in nature here in Oregon. It’s really beautiful. And I found myself in a situation where the boys of the group, were doing some clip jumping into the river at 40 feet. So it’s this area of the river that’s very still in very deep. People have been doing it for a very long time. None of these are good reasons to do it.

Amber Tresca  03:01

You did. It wasn’t like you were doing something that was really wild. You were doing something that people that something that people do, okay,

Dr Amanda Olson  03:08

Yes. And I’m not a thrill seeker. I’m a runner, but all the boys were doing it. So if I went and apparently when you jump off a cliff, you are supposed to be in straight like a pencil. And I landed in an L bottom burst, and I significantly injured myself. So 40 feet, water acts and feels just like cement.

Dr Amanda Olson  03:30

So I had significant injuries to my spine and my pelvis. I annihilated my pelvic floor, I had to be pulled out of the river. It was a bad situation. But I was okay. And I went to my physician promptly. And she, you know, she went through and we looked at the injuries and she referred me to a colleague, a physical therapist who specializes in pelvic health to help manage the injuries. And she totally fixed me up. It was a long process.

Dr Amanda Olson  03:57

And I came through it and I was totally on my way to being fine. And she said, Amanda, you need to quit pediatrics, you need to do pelvic health. You have the right personality for it. And we don’t have enough in the country. And this was roughly 14 years ago. And at that time, there was just a few, 100 in the country. So I was so lucky to have gotten one. And she totally changed my life.

Dr Amanda Olson  04:21

So I did I went back I had I had to go back to classes and back to certifications. And it’s my new purpose. And I am I’m very thankful. And now I’m here to help other people struggling with pelvic health and abdominal health problems. And here we are today.

Amber Tresca  04:37

Right that is quite a story. How long was your recovery from this accident?

Dr Amanda Olson  04:43

It was roughly six months. Yeah. Yeah, so I dislocated, my coccyx injured all the muscles and tendons and ligaments. I couldn’t sit I couldn’t. I wasn’t moving very well. You know, all of the things that are associated with bowel and bladder I had all of those issues because of what had happened. And so I came through and honestly, I am fine. I’ve gone on trend marathons, I got on to have two boys vaginally. So for all intents and purposes, you know, I self manage, and I still have things that I have to work on and keep up with just as part of my maintenance care. But for all intensive purposes, I am totally behind.

Amber Tresca  05:23

How would that have been different had you not had such a genius, pelvic floor health person to help you with all of this,

Dr Amanda Olson  05:31

I have to imagine I would have had long standing issues with pelvic pain because that was the primary driver. And so when we’re talking about the pelvic floor, we’re talking about all of the structures that it supports, which includes bowel, bladder, and in people with the vagina, the uterus, and the vaginal tissue, and all of that, and then sexual health, and digestion and all of that, and then my spine as well.

Dr Amanda Olson  05:55

The pelvic segment is part of a team of the entire trunk and of the legs, you know, it helps to mitigate forces, it helps us to bend and move and, and to have a bowel movement and to retain urine and all of those good things. So I, I think that I would have been a very miserable and not high functioning person without the help of my pelvic floor physical therapist.

Amber Tresca  06:18

So that leads me into my next question is that how do you describe pelvic floor therapy? How do you explain it to people so that they understand what it involves? And then when they come to, for instance, an appointment, you know, what does that look like?

Dr Amanda Olson  06:34

Absolutely. So in pelvic health, physical therapy, we treat patients of all different genders and backgrounds and age ranges. So I think a lot of people think like older lady with problems we treat men, women, non binary transgender, we treat little children that have certain issues, we treat people throughout the lifespan.

Dr Amanda Olson  06:54

And the issues that we help address are issues with bowel and bladder and sexual functioning and abdominal health. So that could include constipation, diarrhea, urinary incontinence, urinary retention, pain, with intercourse, pain with sitting tailbone pain, and then after cancer, so all the different types of cancer, prostate cancer, gynecological cancer, people with IBD, who are having constipation issues, or maybe they’re transitioning after surgery to being able to have a bowel movement again, and then abdominal pain because of the systematic relationship with the pelvic floor.

Amber Tresca  07:33

So you’ve described a lot of signs and symptoms already that people might benefit from or seek out, pelvic floor therapy. But I think sometimes in IBD, and then probably also in IBS or other conditions, people are sort of just living with a thing. They’re living with the diarrhea, they’re living with the constipation, maybe I’m thinking about IBD, specifically, but it can happen in a lot of places.

Amber Tresca  08:00

Your post surgical, so you’re having pain with intercourse, for instance, at what point or what would be assigned to someone to say to themselves, I really should be looking into, into these issues being caused by a problem with my pelvic floor, and I need to seek out some help in order to start to get them resolved and, you know, get on with my life and improve my quality of life.

Dr Amanda Olson  08:25

Absolutely, I would say if any of the symptoms we just described are present, or any level of bothered Ness that someone’s experiencing, because as you mentioned, people with IBD are living with a lot of discomfort on a day to day basis. And that’s baseline. And it’s not including the flip flops and the poster during the post hospitalizations that they experience.

Dr Amanda Olson  08:46

So I would say asking for the referral now, you know, and that’s not to say it’s, it’s never too late, like try to get it now. But if you’re not in a spa, if you’re experiencing a flare up and you’re not feeling well and you’re just simply not feeling up for the appointments, pelvic physical therapy will be there waiting for you when you are feeling ready, and they can be flexible and work with you through those different flare ups scenarios.

Dr Amanda Olson  09:09

So, yes, asking your gastroenterologist or your primary care physician or your gynecologist if you’re a person with a vagina it for a referral is a great thing to do. And seeking out a pelvic health specialist who has some knowledge in IBD is also really helpful because some pelvic health physical therapists specialize in certain areas and don’t treat as many patients in other areas. So that can be really helpful for you as well.

Amber Tresca  09:34

So I’m thinking from a practical standpoint, you’ve told us how there are not enough people like you in the world, or in the country to help everybody that is trying to seek them out. So I’m also thinking about patients who might not have someone near them, that they can physically get to an appointment, or if they perhaps can make a couple of imp appointments, but then they need to shift to some other modality.

Amber Tresca  10:04

Are there things that people can do on their own? Are there things that people shouldn’t do on their own? Is there a way to receive this care that goes beyond going to someone local to you? And in getting those hands on services so that more people can access them?

Dr Amanda Olson  10:23

Absolutely. And that’s a great question. So the good news is, since since my accident, like 14 years ago, there are now 1000s 10s of 1000s in the country. And we, with my company Intimate Rose, we can always help connect people with a pelvic provider in their area, but also with the beauty of telehealth is that if you are still too far away, because some sometimes that still happens, if you are still too far away, even having an initial evaluation via telehealth with somebody in your state, so somebody that has a state license, they can still advise you via telehealth in your state to help get you get a grip on what your symptoms are.

Dr Amanda Olson  11:01

And to help provide some one on one consultation to your unique situation. Because we know people with pelvic health considerations just because they fall into a certain diagnosis doesn’t mean that every treatment or plan of care is going to be appropriate for them. So that’s a really great step, especially considering that they may be in a lot of different appointments and may not be able to get in.

Dr Amanda Olson  11:23

And then also there is some self care techniques that can be implicated. And so at intimate rose, I create different pelvic health devices to help people manage various types of symptoms, including pelvic pain, which is prevalent in people with IBD.

Dr Amanda Olson  11:39

And that would include the wand, and that’s to address restriction in the pelvic floor that is often associated with gripping and having pelvic floor muscles that are too tight as a byproduct of guarding either from abdominal pain itself, or enthis, and unconscious muscle activation, kind of like people that elevate their shoulders into their ears and they get headaches.

Amber Tresca  12:00

I shake out my shoulders, as you said that yes, I do that.

Dr Amanda Olson  12:07

Yes, super common, that that same muscle pattern is actually often done in the pelvic floor. And so the wand is one tool to help people manage that on a day to day basis. And that can be helpful, especially those that are experiencing the constipation or that intermittent constipation, diarrhea type symptoms.

Dr Amanda Olson  12:27

And then the dilators are for people that have pain with penetration, whether it’s with intercourse or during their medical exam, those are in place and now we have rectal dilators as well, which can be really helpful for people that have had surgery around the colorectal area, or who are experiencing restriction or fistulas.

Dr Amanda Olson  12:45

 After they’ve healed from that in that way. The dilators can be used to help retrain the brain and the body to tolerate sensation in that area to have that bowel movement. And they can also be used in what we call exposure and training. So a lot of times, especially people who have had a pouch, or an ostomy bag, and then they’re transitioning back and they are having it removed and going back to having bowel movements, the rectal dilators can be used to retrain that coordination.

Dr Amanda Olson  13:15

Having that bowel movement again, it sounds silly, because it sounds like oh, well, I’m a person, my body knows how to have a bowel movement. Isn’t this just natural, and it’s actually not. And so we can be very instrumental into just retraining that process so that it’s as pain free as possible, and it’s smooth, for lack of as possible.

Amber Tresca  13:37

It’s funny that you say that I live with a J pouch, I only had an ostomy for three months in between the two surgeries to get reconnected. But that was definitely a thing, thinking about engaging those muscles again. And that was a relatively short time, I think that might be one of the shortest time periods that they let people go in between those surgeries. And I know people that have gone much longer. For instance, there are people who decide to complete a pregnancy and a birth before they have their J pouch created.

Amber Tresca  14:13

So for instance, that might be years that you’re not using your rectum and then you go back to it. So I could see that that would be something that you might need to learn how to engage those those muscles again and how to use them and what the sensation is like against that’s a very good point very relevant to people with IBD.

[MUSIC: About IBD Transition]

Amber Tresca  14:53

All right, so somebody finds a pelvic floor therapist, they get all the things in place and They are going to come to their first appointment, or their first touch point, I guess I should say, what does that look like? How do you get started?

Dr Amanda Olson  15:09

So an in person well, both actually telehealth and in person he are as a patient and a provider, we’re going to spend a considerable amount of time getting to know each other and going over your medical history. And going over your goals. In physical therapy, we are very concerned with what is bringing you to this point where you’re seeking our services, and what your goals are.

Dr Amanda Olson  15:30

And that is our primary concern is to getting you to where you want to be, whether it’s to have a bowel movement, or to be able to sit without pain, or to have intercourse, all of those are relevant. So we do, we spent a lot of time going over your medical history, we want you to feel comfortable in the appointment. So we go over any concerns that you may have.

Dr Amanda Olson  15:50

We then in our review, and our evaluation of your body, we are concerned with you as a whole person. So we’re looking at your posture, we’re looking at how your spine and your hips move, and what your mobility and your strength and coordination is through your hips and through your back and your pelvis. And then generally, we want to evaluate your pelvic floor. And we may do that on the first visit. And we may wait several visits until either you’re ready emotionally, or you’re ready physically, because some people are not in a place due to medical reasons.

Dr Amanda Olson  16:21

And some people are not in a place due to emotional reasons. So it may be on the first day if you’re feeling ready, and it may be on a later date. But in that evaluation of your pelvic floor, we are watching to see if your pelvic floor understands cueing and coordination patterns. So we’re going to ask you to contract the pelvic floor muscles. And then we’re going to ask you to relax and expand them. We’re interested in the mobility.

Dr Amanda Olson  16:46

And then during our internal evaluation, we don’t use a speculum. In people with vaginas in people that have don’t we would do a rectal exam if they were in a place to have it. But we’re measuring the strength of the pelvic floor muscles, and then also the timing and coordination and the endurance. So they are muscles just like everywhere else in the body.

Dr Amanda Olson  17:08

And if you think about your shoulder and your rotator cuff, we would be interested to know what’s the mobility like? What is the strength like in certain positions? What are you having trouble with? Can you reach up, and the pelvic floor is very, very similar in that way. So we would measure those, it’s usually about 10 to 15 minutes.

Dr Amanda Olson  17:24

And then we use that information to help guide our plan of care and our treatment for you as an individual person. We are also assessing scar tissue from any surgeries. If you have a pouch, we’re looking to see the location and how your abdominal muscles are coordinating around that. So it’s a very holistic perspective that’s going to help us get you where you want to be.

Amber Tresca  17:48

It’s a very intimate relationship, I guess is so we’d put it is there a way that you help patients feel more comfortable with how this proceeds and so that they’re getting the most out of it? Because I’m also thinking about people that may have trauma, for whatever reason, either medical or otherwise, and then entering into this relationship with a pelvic health professional, it might take a little bit extra to be comfortable and to achieve their goals. How would you go about that?

Dr Amanda Olson  18:24

Absolutely. So it’s interestingly, up for us as providers, most of our patients are experiencing some form of trauma for whether it’s medically or whether it was a an abuse situation. So just we’re in a state as people where people, especially if they’re coming in for pelvic health rehabilitation, have often seen a lot of different types of providers, and we’re just another one in that cog.

Dr Amanda Olson  18:53

So the way that we get through that is, again, going back to that statement of you know, we are not on a mission, medically we are here to serve that person, and whether they’re ready on the first day or they’re ready in three months, that is completely driven by the patient and respected by us. And if that’s not happening, fire that person, right. So find somebody that is respectful that you feel heard with.

Dr Amanda Olson  19:17

And along those lines, we’re all different people. So as providers, we all have different personalities, patients need different things from their providers. So it may just be that somebody’s not a good personality fit and you need to see a different provider, they may be a good sound provider, but it’s just not the person for you. So finding a good personality match and then just understanding that we are here in service of you. It’s different from other forms of medicine where it’s like, well, we got to do your colonoscopy today. You’re here jump on the table

Amber Tresca  19:54

Say that because because I’ve had that, I don’t know how common this is anymore but as a person that had ulcerative colitis, it’s happened to me a few times before I had my surgery is that you go in to see your provider and they say, Well, let’s take a look at what’s going on hop up, you know, and then they get out the sigmoid scope, and you go, Whoa, I was not ready for this to happen today.

Amber Tresca  20:16

But I guess, I guess we got to do you know, like, I don’t know, like, I know that I would have preferred I think a more gentle. This is gonna sound terrible. And we’re gentle entry into that sort of.

Amber Tresca  20:30

You don’t always have you know, you don’t always have the benefit of time. But it sounds like this is this is a long tail situation, pelvic floor health. So it’s not a you know, you have to do this today. You can do it when you’re ready.

Dr Amanda Olson  20:44

Absolutely.

Amber Tresca  20:45

Okay.

Dr Amanda Olson  20:46

You got it.

Amber Tresca  20:46

Okay, good. That’s I love I hopefully that makes people feel a little bit better about the whole situation. Because I think there’s I don’t have to tell you, there’s there’s misconceptions. There’s misunderstandings about what pelvic floor therapy is. And so it’s really great to speak to you and get get some of these things uncovered. I want to hear Dr. Olson about Intimate Rose. And I want to hear about the resources that you have available on pelvic health. Because as I was taking a peek around, you’ve got a lot, it’s really pretty great. So what are some of them that you have?

Dr Amanda Olson  21:23

Thank you. Yes, so Intimate Rose is my company where I have pelvic health devices of various types to address different issues that people have. And then on that we have hundreds of videos and blog articles spanning almost every issue under the sun. And if I find something new, you just we’ve got videos on how to manage all these different types of issues, whether it’s incontinence or constipation.

Dr Amanda Olson  21:51

And then the tools themselves are different devices, as I mentioned, to address things like urinary incontinence, and that’s the vaginal weights. And then as I mentioned previously, the wand and the dilators are for people with pelvic pain, the one can be used either rectally or vaginally. And it’s a tool to help relieve pelvic pain, whether it’s superficially or deep, it’s kind of the way you know, there are these hook cane devices where if you haven’t thought in your back, and it reaches back, and it helps relieve the knot for you. Very, very similar, although in pelvic health, it’s not a no pain, no gain situation.

Dr Amanda Olson  22:23

So you’re, you’re not pushing really hard. It’s just there to help relieve that pain. And so with that there’s a manual in every device, we have a really wonderful supportive customer service team that is guided by myself. And then we have a private support group as well, for people to be asking questions and sharing stories, asking for support or just venting, sometimes they need some help. So we try to provide like that extension of care beyond medical team to just be there for people wherever they may be, and to help just be there through their journey.

Dr Amanda Olson  22:58

So our devices are really pretty, they’re very bright. I wanted something to invoke hope and cheerfulness. I think that a spoonful of sugar helps the medicine go down. And that’s kind of the guiding light of the brand. And so they’re very soft, smooth silicone. So if when you feel it, it’s it’s very pleasant. It’s not like other products that may be hard and plastic or a sticky or silicone. They’re they’re just really nice. And people have been getting amazing results. So it’s been it’s been a great process so far. Right?

Amber Tresca  23:29

That’s fantastic. So if people don’t know where to start, they should reach out to the customer service and intimate rows and just maybe get some ideas on on where to go and what might be helpful for them.

Dr Amanda Olson  23:40

They certainly can I always advise that the best place to start is with an evaluation by a pelvic floor physiotherapist, and even if it’s that console, because that person is either going to do your medical exam or to help get a better sense of what your symptoms are, that are driving some of your issues. And they can help point you in the right direction as well. So I always advise that that’s step one. But if they can’t get access, certainly they can go to our website, they can email us at support at intimate rose.com. And we can help point them in the right direction.

Amber Tresca  24:12

So let’s go through some of the other places that Intimate Rose has resources available on social media. And what’s the website as well?

Dr Amanda Olson  24:20

Yes, so the website is www.intimaterose.com. And on Instagram, we are at intimate rose, and we are now on tick tock is that intimate? Is that sillier form of social media? You’re finding that people, you know, people with a sense of humor really resonate, and they are receptive to getting their information on that platform? So we’re doing it? Yeah, absolutely. Of course. Yeah. It’s everyone learns differently. Everyone, everyone has different needs to when they’re learning so it’s kind of a fun, new thing. And then we’re on Facebook as well. At Intimate Rose.

Amber Tresca  24:59

Yeah, because If we can’t have a laugh about some of this stuff, I think we’ll just cry all the time.

Dr Amanda Olson  25:04

So I strongly feel that. Yes, exactly. That’s great.

Amber Tresca  25:09

Yeah. I highly recommend that people follow Intimate Rose across social media for you know, come for the information stay for the laughs

Dr Amanda Olson  25:18

Yes.

Amber Tresca  25:20

So, Dr. Olsen, you mentioned that you have two boys. What’s it like being a boy mom? What what are they into these days?

Dr Amanda Olson  25:29

I love being a boy mom so much. So they are six and eight. My big guys almost nine. And so they play soccer, which I think is just a great outlet for them at this stage. I don’t know that we’ll ride that out, you know, to the sunset, but they are loving it right now. And then they also love to ride their bikes and be outside and they like like spider man and Batman and dinosaurs and all those fun things. The noise level is but I love it. I really love being a boy mom. Yeah, I would have been happy with whatever you know. Yeah, I’m just grateful to have healthy little people and it’s a lot of fun. But they’re really sweet to like my my youngest likes to bake with me or cook dinner. He’s very interested in what the ingredients are.

Amber Tresca  26:22

Yeah, bring that along. And you know, get him to start making. Give yourself a little bit. I love that nurture. Nurture that skill for sure. It’ll pay off huge dividends.

Amber Tresca  26:39

Well, Dr. Olson, thank you so much. Thank you for everything that you’re doing for the world of pelvic health. demystifying bringing some fun bringing some light into this, which is can be a heavy topic for a lot of people. I really appreciate it. And thank you for all of your time and talking to me and bringing some of this information to my audience.

Dr Amanda Olson  26:59

Thank you so much for having me. It’s been so much fun.

Amber Tresca  27:07

Hey, super listener. Thanks to Dr. Amanda Olsen for uncovering how pelvic floor therapy can help people with IBD Be sure to follow her company intimate rose all over the interwebs as at intimate rose, and at their website, intimate rose.com. They have all kinds of products that can address issues with pelvic health, plus so much educational information in the form of videos, articles, and community support. I will put all the contact information as well as more resources on pelvic health in the show notes,

Amber Tresca  27:41

Links to a written transcript, everyone’s social media handles and more information on the topics we discussed is in the show notes and on my episode 126 page on about ibd.com

Amber Tresca  27:52

You can follow me Amber Tresca across all social media as About IBD

Amber Tresca  27:58

Thanks for listening. And remember until next time, I want you to know more about IBD.

Amber Tresca  28:06

About IBD is a production of Mal and Tal Enterprises.

It is written, produced, and directed by me, Amber Tresca.

Mix and sound design is by Mac Cooney.

Theme music is from Cooney Studio

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