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Pelvic PT Rising

Nicole Cozean, PT, DPT, WCS & Jesse Cozean

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Helping pelvic physical therapists improve as clinicians, in their careers or business, and their lives. Hosted by Dr. Nicole Cozean and Jesse Cozean, the founders of PelvicSanity physical therapy and the Pelvic PT Huddle, the podcast explores all aspects of pelvic physical therapy. You'll find the clinical pearls that Dr. Nicole teaches in her continuing education courses, the business and career advice that catapulted PelvicSanity into one of the largest cash-based physical therapy practic ...
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We pull back the curtain and talk about our love of business and helping others in their business journey in this 'sode. We know how hard it is to run a business. How much time it takes. How much mental energy. How much risk. How many evenings and nights and weekends thinking about the business. And we wanted to lighten the load for others who are …
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How do we build resilience in our body so symptoms not only can go away, but stay away? At PelvicSanity, we do this by addressing both the muscles of the pelvic floor, but also the 4 Foundations of pelvic health. The pelvis doesn't exist in isolation. It's affected by the rest of the body and other major symptoms. These often are major underlying c…
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How can we get better buy-in from our patients, reduce self-discharges and help our people finish their full plan of care? Regardless of your work setting, getting clinical buy-in is critical to getting the outcomes our patients want. In this 'sode we go through the five biggest mistakes we see in that process of getting buy-in and keeping our pati…
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Business systems streamline the practice, save you time, ensure a consistent product and a great experience for your patients. They keep you organized. They allow you to hire. They're also chronically overlooked! Systems are what people are talking about when they say "work ON your business, not IN your business". But how do we do that? It's a reas…
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Pelvic PTs are the pregnancy experts - we want to help you have a more comfortable pregnancy, a smoother delivery, and prevent postpartum issues after delivery! 1. Have a more comfortable pregnancy Working with a pelvic floor physical therapist throughout your pregnancy can reduce or eliminate issues like back pain, hand or foot pain, painful inter…
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Male patients are an awesome group to work with and chronically underserved by our system. But there's also a lot of concerns and misinformation about working with men. We go through the five most common questions we get about treating male patients! With how pelvic health education has been structured, many of us don't get training in treating mal…
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Marketing is the engine that drives the business. A steady flow of leads is critical (and can often cover a multitude of sins within the business). For a cash-based practice, marketing is often the limiting factor. So why do we consistently see people getting marketing so wrong? It's not your fault - there are so many misconceptions out there. Or t…
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Often there's a rosy picture painted of business ownership, but the hidden reality is entrepreneurship is hard, anxiety-producing, and definitely not for everyone. We firmly believe anyone listening to this podcast CAN start their own business, but just because you can doesn't mean you should. There's a myth that business owners have unlimited time…
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Tailbone pain is a common symptom and is integrally related to the pelvic floor. All muscles of the pelvic floor attach at the tailbone. When these are tight and irritated they can radiate or refer pain to the tailbone itself. The vast majority of the time there’s nothing wrong with the tailbone itself. It’s actually a pelvic floor issue masqueradi…
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We've been promising it for a while now, but here are 10 huge mistakes we've made as PelvicSanity business owners. As painful as many of these are to relive, we hope you learn from them. The reason we do business coaching is to create the resources and help we wish had been available for ourselves! There are always going to be mistakes in business …
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Is where you work working for you? If it is, we need to celebrate it. If not, it might be time to look for another position. Let's start with this - no position is perfect. The best setting, time with patients, flexibility scheduling, reduced documentation, stress, quality of management, job responsibilities, fun coworkers, nice treatment rooms, gr…
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In the third trimester the ‘sixpack’ abdominal muscles separate to allow room for the baby to grow. Within the first three months postpartum, in about half of women these muscles come back together properly. In the other half a separation remains, known as a diastasis recti. We hear about this often as an aesthetic issue. It can create a ‘mommy poo…
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We hear it from PT schools, insurance-based practices and even worry about this as cash-based business owners - are we 'decreasing access to care' by not contracting with insurance companies? The rise of cash practices has dramatically INCREASED access to care over the last 5-10 years. It's driven the rapid growth of our specialty and field. It's n…
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Continuing our series on 'Happier at Work', we have 3 easy tips to improve your work experience. If we decide work can be a source of fulfillment, growth and purpose then it's incumbent on us to do the little things to make it as good as possible! Here are three suggestions from this 'sode to get your mind working... Take the initiative and plan so…
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The answer will surprise you! The myth that acidity in the body or bladder is responsible for IC symptoms is one of the most harmful out there. In this 'sode we go through why the pH of urine has no effect on symptoms, how 'acid in' does not equal 'acid out', and what we should be doing instead. We hope this 'sode helps to free you from 'food jail'…
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We dive into community workshops, a CEO mindset, leading a team and integrating your past experience into your Clinical Ethos in this 'sode! You won't want to miss this conversation with Hannah! Hannah is a member of the CEO Boardroom Program and a Rising Coach for other business owners - in this 'sode, you'll hear why her experience is so valuable…
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There's a wide variety of expertise when it comes to pelvic floor physical therapy. Unfortunately many patients have to go to several different ones before finding a true expert. You might think that finding a pelvic PT who has a lot of experience means you'll be getting great care. But that's not necessarily the case. In this 'sode we discuss why …
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Is the term 'work-life balance' actually making us unhappier? This 'sode explores how to be happier at work and build actual balance into your life. The assumption when we use the phrase 'work-life balance' is that work takes away from 'life.' Every minute spent working subtracts from your happiness. The only way to be happier is to work less. Exce…
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Can you become a successful solopreneur, prioritize your family and create a business that truly works for you...all while enjoying the process? In this 'sode you'll hear from Kat Terrian, Rising coach and founder of Rythm Pelvic Health. She made the deliberate choice to stay as a solopreneur (even when she could have easily continued to grow) beca…
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Incontinence is certainly common. More than half of people have incontinence after a baby, it can accompany pelvic pain, prolapse, low back pain or following a surgery. But it’s never normal, and never something you have to live with. Sometimes this is normalized - we joke about it with friends, or hear about it from our mothers. But we often don’t…
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This month, we're going to be doing a series on 'Happier at Work.' Our rates of stress and burnout are high. If we want long, productive careers where we help the most people we have to be taking care of ourselves! In this 'sode we go through 3 mental habits Nicole has used to practice for nearly 20 years and that we try and cultivate in our team a…
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Fascinating conversation with Rising business coach and CEO Boardroom member Brittaney Sargent! A leader in the OT space, she's built a multi-site, 5-clinician, multi-disciplinary practice in just the last three years. And all coming off maternity leave with three little ones at home! We discuss her clinical philosophy, why she works with 'clients'…
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When many of think about nervous system downregulation and treatment, pelvic pain springs to mind. But this is something that is critical for all types of patients. Nervous system safety is a prerequisite to healing! Intellectually I think we would all agree with that, but often we jump into treating diagnoses like incontinence, prolapse, constipat…
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For many people (almost 90% of those diagnosed with IC) tight muscles in the pelvic floor irritate the nerves running through the area. One of the most important of these is the pudendal nerve. So what symptoms might be caused by pudendal nerve irritation? One is urethral burning or pain. One branch of the pudendal runs right to the urethra, so it …
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Can't wait for you to hear this conversation with Shante Cofield (aka The Movement Maestro)! In addition to being one of the most authentic people we know, Shante is an expert in all things Instagram and online business. We cover a ton of ground in this interview. We hear about Shante's journey from from patient care to teaching to online business.…
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Where does your mind go when you have that complex patient. The one with pages of medical history. Who has a pre-written timeline for you. Or who is undergoing testing for multiple other conditions? One of my clinicians at PelvicSanity was asking me about a patient like this. And she was genuinely complex! I think often our assumption is a complex …
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Have you heard or been told you 'just need to Kegel'? Here's why that's never the answer to pelvic health issues. Kegels (or the voluntary squeezing of the pelvic floor muscles) are often one of the only areas of pelvic health we’ve heard about. It’s often surprising to people to learn Kegels are often ineffective, antiquated and can cause flares o…
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What do you need in place before you're ready to hire another clinician? We always say the decision to hire - especially another clinician - is as big as the decision to start your practice. You want to make sure you're hiring because it's something you really want to do - not because you're busy, or you feel bad about a wait list, or because someo…
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Why do most specialty pelvic health clinics see patients for a full hour, 1:1 with the therapist? Ultimately it’s so we have time to ‘find the why’ for actual relief. If you aren’t working with a qualified pelvic PT to ‘find the why’, one of three things happens: You don’t improve at all You see little, temporary improvements that don't 'stick' Sym…
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Can't wait for you to hear this conversation with Carrie Pagliano, past Academy President, course creator and founder of Carrie Pagliano Physical Therapy. Clinical and business pearls abound in this conversation - enjoy! One of the most powerful points of this conversation was hearing from Carrie how she deliberately structures her business to supp…
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This is a topic we've changed our perspective on over the years of coaching - when are you ready to hire an admin? And hiring is never something to be taken lightly. It's not as simple as 'just hire an admin' and life will be better. You have to create all the systems for them. Onboard them to get them up to speed. Continue to train them, manage th…
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If you (or someone you know) has had a C-section, make sure to listen to this full 'sode! As anyone who has had one will attest, a C-section is a major surgery. And in the US, almost 1 in 3 give birth via a C-section. But we are so cavalier about recovery! After every other major surgery you are immediately referred to physical therapy to aid in th…
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Adding another revenue stream, 'diversifying', finding passive income, stop trading time for money....these are all becoming buzzwords in the entrepreneur world. But is the juice worth the squeeze? We dive in! There's really two different categories of possible additional revenue streams. One is to leverage your in-person business in another way. T…
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So excited to bring you this conversation with Dr. Jen Fraboni (aka @DocJenFit)! Jen has been a pioneer for physical therapists in the online space and finding new ways to connect and serve our people. We talk clinical philosophy, her journey from treating patients in the clinic to online mogul, the joys and challenges of motherhood while running a…
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With recent evidence Elmiron can cause long-term eye damage, many people with IC are reconsidering their use of the drug. In this ‘sode we dive into the evidence for Elmiron’s efficacy and safety to help you make an informed decision. Elmiron remains the only FDA-approved oral medication specifically for IC and many urologists prescribe it automati…
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Often breathing techniques are both the beginning and end of what we focus on when it comes to 'downtraining.' But there's so much more we can be doing, especially when it comes to the vagus nerve. Breathing techniques are fantastic and important, but they also have their challenges for patients. They take time to work. They are dependent on the pa…
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Today we go into the pros and cons of having your pricing on your website. Ultimately, putting prices on your website will reduce the number of people who call, but those who do call will be more likely to book. Whenever you field calls, there are three types of people: Those who are definitely going to book (regardless of the booking experience). …
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In pelvic physical therapy you’re dealing with dysfunctional tissue, reduced blood flow, increased inflammation and in an area the body is wired to pay close attention to. But pelvic physical therapy should never hurt. We can’t treat pain with more pain. And the idea of ‘no pain, no gain’ not only isn’t true, it’s actively harmful. Now, it can be u…
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We created the Cozean Screening Protocol because we wanted a way to help patients and other practitioners realize when pelvic floor dysfunction was causing symptoms. We first published this as a poster at IPPS. Using PelvicSanity as our site we reviewed patient intake forms and charts to see what symptoms or history were most predictive of pelvic f…
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Coming off the high of our in-person CEO Retreat, we wanted to share 5 major takeaways from an incredible group of business owners. Together this group of business owners is shattering what we thought was possible for a pelvic rehab practice. When we first started PelvicSanity, most 'experts' thought no one would ever actually pay more than a small…
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In short, yes! There's a reason every other surgery - foot, ankle, knee, hip, shoulder, back, elbow, hand, and many more - automatically results in you going to physical therapy to recover. Physical therapists are the experts in guiding recovery. Making sure you continue to move well. Guiding your body's healing response. Ensuring scar tissue doesn…
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Most of us struggle to use our assessments well. This is an amazing tool to clarify your thinking and guide your care that we aren't taking advantage of. It's something I spend a lot of team teaching to our PelvicSanity staff. An assessment is not: A laundry list of impairments A single conclusion ("the pelvic floor is tight. Or weak.") So vague it…
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Whether you're an employee or business owner, finances can be challenging. They hit a whole new level of risk and uncertainty when you run your own business. All of us struggle with money mindset issues. Our conversations about money are often negative and reactive. We might not even realize what we're making until the year-end W2 or P&L. We judge …
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You're probably giving too much homework to your patients. There, we've said it! In this 'sode we dive into how to give your patient the correct amount of home exercise work. Here's one clue - have you ever had a patient come back in and complain they didn't get enough HEP? One thing to think about - you're never going to give the perfect amount of…
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Not everyone with IC experiences the same condition. Symptoms vary. The way they manifest is different. Some people respond to certain medications while others don’t. This led researchers to propose several different types of systems to break IC into sub-categories called ‘phenotypes’. The entire point of a phenotype is it needs to be 1) easily ide…
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It's one of the most common business questions we get asked, and it's important! Your rent is going to be one of your two biggest expenses (along with payroll). It's sometimes hard to find that 'Goldilocks' zone. If we overspend we can hurt our profit margin and have to work more hours to pay for space we didn't really need. If we underspend we mig…
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Clinical pearls, being happier as a clinician, the role of telehealth and three questions to transform your evaluation - this conversation with Susan Clinton has it all! Early in the 'sode we dive into the question of where you start with a challenging patient. There's so many different routes we can take and skills we can use, but Susan manages to…
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In short, our answer is ‘yes’. With all of the physical challenges of pregnancy, delivery and the early post-partum period, we believe everyone should get pelvic floor physical therapy. But let’s dive into why that is! First, let’s recognize in America we are significantly behind the rest of the world with this. In many places in the developed worl…
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How long does your average patient come in for? I know, I know - but hear us out! I know you may have a deep-seated aversion to tracking our individual metrics or turning our patient visits into data. I'm sure you've had (or heard of) a terrible boss who was all about the numbers. But it's not unreasonable to know how long a patient usually sees yo…
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How would you respond to someone who told you they were only drinking 24 ounces of water each day? You might be tempted to tell them about how important hydration is. Or how more water intake can dilute bladder irritants. Or show them a cool new water bottle you bought that can help. But sometimes we're so excited to share what we know we forget to…
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