The following is our interview with Jennifer Eller, PT, DPT, PRPC. Jenni recently passed the Pelvic Rehabilitation Practitioner Certification (PRPC) exam. She practices at Enloe Medical Center in Chico, CA and is a Teaching Assistant for local California satellite courses with H&W. Jenni was kind enough to share some thoughts about her career with us. Thank you, Jenni - and congratulations on receiving your PRPC!
Q: Who are you? Describe your clinical practice.
A: My name is Jenni Eller, and I am a pelvic floor physical therapist at Enloe Rehabilitation Center (hospital-based outpatient clinic) in Chico, CA. I specialize in pelvic floor, orthopedic, and oncological diagnoses. Specifically, conditions related to incontinence, pelvic pain, dyspareunia, vaginismus, interstitial cystitis, and the post-surgical pelvis, as well as pelvic floor issues, post-oncological treatment pelvic floor issues, pre and postnatal issues, male pelvic floor dysfunction, and other pelvic floor dysfunctions.
Q: How did you get involved in the pelvic rehabilitation field, and what has your educational journey as a pelvic rehab therapist looked like?
A: I grew up in Oregon and Washington, and completed my undergraduate degree in Exercise Science at Linfield College in 2009. I completed my Doctorate Degree in Physical Therapy at Regis University in Denver, CO in 2013.
After graduate school, I worked in a small rehabilitation hospital but quickly transitioned to outpatient rehabilitation and started working with the orthopedic and oncological patient population. The hospital system I was in had hired 3 new gynecology oncologists and were interested in developing the pelvic health program there. I started my training for pelvic floor physical therapy with Herman and Wallace in 2015. I have completed the Herman and Wallace Pelvic Floor series in 2017 and passed the Pelvic Rehabilitation Practitioner Certification in May 2021.
Q: What patient population do you find most rewarding in treating and why?
A: Over the past 6 years, I have enjoyed helping both women and men with issues related to their pelvic floor, connecting it to their spine, hip, abdominal, and lower extremity issues. I help them return to an active lifestyle and feel empowered over something so limiting and invisible to others.
Patients with pelvic floor dysfunction are often overlooked because their symptoms are too sensitive to speak about. I truly believe they deserve the best care possible and am grateful to be part of a team that focuses on patient-centered care. Treating both pelvic floor dysfunction and the oncological patient population benefits under-served patient populations. Both demographics have my heart for personal reasons. I always knew I wanted to help those who are in need able to get much support.
Q: What has been your favorite Herman & Wallace Course and why?
A: I have enjoyed the whole pelvic floor series, but Pelvic Floor Level 1 and Level 2B, taught by Tina Allen and Holly Tanner, were so great! These courses just inspired me to give my full attention to pelvic health. They are easy to learn from and full of so much knowledge.
Q: What is in store for you in the future as a clinician?
A: Right now, I am focused on building the pelvic health program in this smaller northern California city and hopefully bringing more providers to serve this community. I have a dream of teaching in the future and helping build the next generation of physical therapists and pelvic floor physical therapists.
Portions of this blog are from an interview with Dustienne Miller. Dustienne is the creator of the two-day course Yoga for Pelvic Pain. She passionately believes in the integration of physical therapy and yoga in a holistic model of care, helping individuals navigate through pelvic pain and incontinence to live a healthy and pain-free life.
Have you noticed when you are afraid or don’t want to feel something you hold your breath? Imagine what it's like to have daily pain that limits function and how that could impact rib cage, abdominal and pelvic floor expansion. Dustienne Miller discusses this in her remote course, Yoga for Pelvic Pain, upcoming on July 31 - August 1, 2021. Her course focuses on two of the eight limbs of Patanjali’s eightfold path: pranayama (breathing) and asana (postures) and how they can be applied for patients who have hip, back, and pelvic pain.
Dustienne explains "We teach our patients how breathing patterns inform our digestion, our spine, our emotional state, our pelvic floor, etc. It’s one of the most powerful tools we have to inform our system that we are safe. Despite this knowledge, we will often find ourselves holding our breath or breathing in non-optimal ways without even realizing it." Dustienne focuses her practice on introducing yoga to patients within the medical model. Yoga can be included in pelvic rehabilitation in so many ways, including incorporating yoga home programs as therapeutic exercise and neuromuscular re-education (both between visits and after discharge).
Pelvic conditions that can be positively impacted by yoga are interstitial cystitis/painful bladder syndrome, vulvar pain, coccydynia, hip pain, and pudendal neuralgia. Treatment for these conditions often involves an individualized approach that may include both pharmacologic therapies (prescription drugs, analgesics, and NSAIDs) and nonpharmacologic interventions such as exercise, muscle strength training, cognitive behavioral therapy, movement/body awareness practices, massage, acupuncture, and nutrition.
A systematic review of the 2017 clinical practice guidelines evaluated 14 randomized controlled trials and found that yoga was associated with lower pain scores (1). Similarly, in 2020 there was a review of 25 randomized controlled trials that examined the effects of yoga on back pain. Out of these trials, 20 studies reported positive outcomes in pain, psychological distress, and energy (2).
The great thing about yoga is that the asanas (postures) can be modified to accommodate your strength, experience, and health conditions. An example of this is the Downward Facing Dog pose. There are so many ways to made Downward Facing Dog work for your body. Use straps, the wall, or the plinth/countertop to provide support for your body as needed, which might look different each day.
Some folks think you need to be flexible to have a yoga practice. Dustienne stresses "What is necessary is to be flexible with understanding that every day might feel different. If you are in an active pain flare your practice will look different than on the days you are feeling better. That can be a challenging aspect of a mindful practice - embracing that every day is different. Have the courage not to judge yourself, but to celebrate that you are meeting your needs with kindness."
People have been doing yoga for thousands of years. It is a mind-body and exercise practice that combines breath control, meditation, and movements to stretch and strengthen muscles. Join Dustienne Miller in Yoga for Pelvic Pain on July 31 - August 1, 2021, to learn more about incorporating yoga into your clinical practice.
No prior experience with teaching yoga is required to attend the course. However, all participants must possess a working knowledge of pelvic pain conditions and foundational rehabilitation principles.
This blog contains an interview with Alyson N Lowrey, PT, DPT, OCS. Alyson treats the pelvic floor patient population through an orthopedic approach, working closely with pelvic floor specialists. Alyson’s clinical interests include evaluation/treatment of chronic pain, lumbar and cervical spine disorders, foot and ankle disorders, pelvic pain, and clinical instruction. Alyson is the co-instructor for the new H&W course, Pain Science for the Chronic Pelvic Pain Population - Remote Course scheduled for July 17-18, 2021.
Q: Who are you? Describe your clinical practice.
A: I work in an outpatient hospital-based clinic where I am able to provide true 1:1 care to patients of all ages and orthopedic conditions. Since pelvic floor therapy came to our clinic, I have developed strong clinical and personal relationships with pelvic floor therapists. We have been able to successfully combine our respective expertise into a wholistic approach for improving patient’s functional outcomes. My knowledge and relationships with pelvic floor therapy have allowed me as an ortho clinician to recognize when a patient’s dysfunction may have a pelvic floor component and refer appropriately. I am also in a unique opportunity where my pelvic floor colleagues will co-treat or transition care of a patient to me to continue to improve their overall function by providing functional strengthening and neuromuscular re-education to the pelvic floor musculature and other supportive muscular systems. This relationship also allows us to treat comorbid orthopedic conditions and pelvic dysfunctions such as low back pain or SIJ dysfunction as well.
Q: How did you get involved in the pelvic rehabilitation field?
A: I became involved with pelvic rehabilitation through working in a clinic with Tara Sullivan. Her knowledge is immense and our working relationship has shaped and changed how I assess patients. My practice has expanded drastically knowing so much more about pelvic floor dysfunction. I also have personal struggles with pelvic pain, which has given me a patient’s perspective as well on how important pelvic rehabilitation is.
Q: If you could get a message out to other clinicians about pelvic rehab what would it be?
A: I would encourage all ortho clinicians to educate themselves on pelvic rehab. Pelvic rehab is not yet fully integrated into our DPT curriculums and is often treated as a very separate area of dysfunction. Integrating pelvic floor function and dysfunction into my ortho world has drastically changed how I see and treat many patients.
Q: What made you want to create this course, Pain Science for the Chronic Pelvic Pain Population?
A: Tara and I wanted to create this course to help other clinicians become more proficient at treating chronic pain. A large portion of our caseloads is chronic pain both generally and with pelvic conditions. Patients with these conditions are often overlooked and not treated appropriately by the medical system at large. They are often dismissed or mislead that they have something drastically wrong with them, or worse, nothing wrong with them at all. This population often has the most functional deficits and the worst clinical outcomes. We want to change that.
Q: What need does your course fill in the field of pelvic rehabilitation?
A: There is a need in rehabilitation and medicine to understand pain from a biopsychosocial approach and to treat chronic pain conditions from that perspective. Pain is complex, and treatment is complex. Chronic pelvic pain is a subdivision of prevalent chronic pain that is not talked about or treated often enough.
Q: Who, what demographic, would benefit from your course?
A: Any clinician who treats chronic pain conditions can benefit from this course.
If you would like to learn more about chronic pelvic pain, you can join Alyson at Pain Science for the Chronic Pelvic Pain Population - Remote Course scheduled for July 17-18, 2021.
Herman & Wallace currently has satellite courses, remote courses, and online courses offered through our partner, Medbridge. These online courses provide education and patient engagement tools for pelvic floor dysfunction. H&W faculty have put together a collection of online continuing education courses with our partners at MedBridge. These convenient learning resources and can be purchased individually or as part of an annual subscription
The truth is that we all have hectic busy schedules that can make setting aside time for a live course can be difficult. Annual subscribers get access to all 800+ courses on the Medbridge site, their Home Exercise Program, and Patient Engagement platforms! As a Herman & Wallace referral, you are eligible for a discounted subscription with access to all of the content at MedBridge with promo code HWoverview.
Heather Rader, PT, DPT, PRPC, BCB-PMD recorded a new series for Medbridge last summer. Her courses explore:
The Medbridge online course catalog contains an in-depth physical therapy section with many familiar instructors including Holly Tanner and Steven Dischiavi. These online courses are a great way for pelvic rehabilitation specialists to gain knowledge and skills and complete CEU requirements without having to commit to a predetermined schedule.
Herman & Wallace continuing education courses are developed and instructed by our nationally recognized faculty members. Contact hours vary by course and may apply towards continuing education requirements according to each state.
The following is our interview with Jazma Dobbins PT, DPT, PRPC, CAPP-Pelvic. Jazma recently passed the Pelvic Rehabilitation Practitioner Certification (PRPC) exam. She practices in at TherapySouth in Gadsen, AL and is a Teaching Assistant for local Alabama satellite courses with H&W. Jazma was kind enough to share some thoughts about her career with us. Thank you, Jazma - and congratulations on receiving your PRPC!
Q: How did you get involved in the pelvic rehabilitation field?
A: Educating others about ways to empower themselves through healthcare advocacy is extremely important to me. I knew I wanted to be a pelvic health physical therapist the moment I read a similarly titled article in a women’s health magazine over 10 years ago. I was experiencing painful intercourse and urge incontinence. I was 20 years old and felt ashamed, abnormal, and alone. I had been given the unfortunate advice of “try drinking wine to relax” and “never drink alcohol if you have urge incontinence." So many inconsistencies to my young and frustrated mind.
That is when it dawned on me that I could do that, I could be a pelvic health physical therapist. Then we would have that service in my community. I was certain, and rightly so, that there were plenty of other women (I did not yet know of men’s health issues) who needed these services.
Q: What has your educational journey as a pelvic rehab therapist looked like?
A: I started my pelvic rehab education journey as a third-year student in PT school. I took the pelvic health level 1 course through the then called Section on Women’s Health. Needless to say, I was hooked on pelvic rehab. Over the following year, I completed the APTA pelvic series and earned my CAPP-Pelvic. In 2019 I did the Coccydynia and painful sitting course through Herman and Wallace and fell in love with H&W! Since then, I have had the pleasure of being a Teaching Assistant for multiple H&W courses.
Q: What do you love about assisting at courses?
A: What I love most about serving as a teaching assistant is the opportunity to learn from the participants. I have yet to TA a course where I didn’t learn a new skill or thought process. I love to TA the pelvic level 1 course most of all because of the eagerness and anticipation around learning a whole new world of what PT can do for our clients. I love to spread energy and passion and help create an environment of truly nonjudgmental learning.
Q: What is your message to course participants who are just starting their journey?
A: Keep pursuing your passion! Let no learning opportunity go unutilized and never stop learning!
This blog contains excerpts from an interview with Tara Sullivan, PT, DPT, PRPC, WCS, IF. Tara started in the healthcare field as a massage therapist, practicing over ten years including three years of teaching massage and anatomy and physiology. Tara has specialized exclusively in Pelvic Floor Dysfunction treating bowel, bladder, sexual dysfunctions, and pelvic pain since 2012.
Acute pain can indicate specific injury to the body. Chronic pain is very different. With Chronic Pelvic Pain (CPP) the initial injury has healed, but the pain continues because of changes in the nervous system, muscles, and tissues. Recognizing that the nervous system influences pain perception, especially in the chronic pelvic pain population, is the first step in treating these patients, but is it enough? Tara Sullivan and Alyson Lowrey are presenting a new remote course on chronic pelvic pain called Pain Science for the Chronic Pelvic Pain Population scheduled for July 17-18, 2021.
The medical definition of pain is an unpleasant feeling that is conveyed to the brain by sensory neurons. Pain is a universal experience that serves to alert the brain to potential damage to the body. It performs the function of triggering avoidance to preserve itself from harm. Oddly, the strength and unpleasantness of pain is not directly related to the nature or extent of the damage.
When the pain signal remains active in the nervous system for longer than six months and persists after the triggering event has healed, then it is cataloged as chronic pain. There is another layer when experiencing chronic pain known as central sensitization. This is an increased responsiveness of the nervous system that results in hypersensitivity and an increased pain response outside the area of injury. Pain itself can produce systematic and chemical brain changes resulting in more pain from fewer stimuli.
The course, Pain Science for the Chronic Pelvic Pain Population, offers tools to recognize when sensitization may be playing a role and provides the framework needed to apply pain science to the chronic pelvic pain population. In this course, you will gain an understanding and expand your knowledge on how pain science specifically presents in patients suffering from endometriosis, interstitial cystitis, primary dysmenorrhea, pelvic floor muscle overactivity, vulvodynia/vestibulodynia, vaginismus, and prostatitis.
Case studies and specific intervention techniques, including how to explain pain to a patient, are discussed so participants leave with the confidence to address the missing link in treating your patient’s chronic pelvic pain. We will also discuss how common rehab interventions such as manual therapy, dry needling, biofeedback, graded exposure, and therapeutic exercise assist in downregulating the nervous system.
On July 17-18th, 2021, Alyson Lowrey and Tara Sullivan team up to give you their combined experience of orthopedic and pelvic health in treating this population in the course Pain Science for the Chronic Pelvic Pain Population.
This blog contains excerpts from an interview with Pamela A. Downey, PT, DPT, WCS, BCB-PMD, PRPC, Pamela is a Board Certified Clinical Specialist in Women’s Health Physical Therapy and Board Certified in Biofeedback for Pelvic Muscle Dysfunction. She is the owner of Partnership in Therapy, private practice in Coral Gables, Florida. Dr. Downey's treatment focuses are pelvic floor dysfunction, urogynecological and colorectal issues, spine dysfunction, osteoporosis, and complaints associated with pregnancy and postpartum. Her mission is to educate and integrate healthy lifestyles for patients on the road to wellness.
Physical therapists often require special training to treat pudendal neuralgia. Pamela A. Downey is partnering with H&W to teach the Pudendal Neuralgia and Nerve Entrapment Remote Course, scheduled for June 19-20, 2021. This course teaches pudendal neuralgia diagnostic skills for practitioners to have an improved impact in treating patients with pudendal nerve/pelvic floor muscle dysfunctions.
Pudendal neuralgia is also known as Alcock’s syndrome, pudendal canal syndrome, or cyclist syndrome. This condition is caused by tension, compression, or entrapment of the pudendal nerve, and leads to pelvic pain, sexual dysfunction, difficulty with urination and defecation, among other issues.
Pudendal neuralgia is often unrecognized by physicians, including gynecologists, urologists, and neurologists. Dr. Downey observes that “Organizing your clinical decision-making process is key in determining the source of seated pain. Pudendal neuralgia can be a chicken and egg clinical phenomenon. My success comes from relying on a solid anatomy background in helping solve the pudendal puzzle.”
Successful treatments can include connective tissue mobilization, neural mobilization, and a home exercise program. Poor movement patterns can contribute to the symptoms of pudendal neuralgia. Physical therapy evaluation in these cases can include movement assessment and a gentle internal assessment of the patient's pelvic muscles. This provides information about the muscles’ ability to contract and relax. Exercises recommended to relax the pudendal nerve and provide temporary relief include cobra pose, side-lying hip abduction and extension, and wide-leg bridges.
Dr. Downey shares that she loves teaching the Pudendal Neuralgia and Nerve Entrapment Remote Course. “We teach the participants, in real-time, how to use evidence-based criteria to see if pudendal neuralgia makes sense as the driving diagnosis. Then we develop this confidence by careful dissection of case studies of real patients treated out over multiple visits, just like you do in the clinic."
Hone your decision-making process and gain confidence in the Pudendal Neuralgia and Nerve Entrapment Remote Course to treat pelvic pain with Pamela Downey on June 19-20, 2021.
Working with Physiatry for Pelvic Pain is a new remote course created by Dr. Allyson Shrikhande, scheduled for Jun 27, 2021. This course overviews the synergistic nature of pelvic physiatry with pelvic floor physical therapy, in hopes of promoting collaboration for the care of male and female chronic pelvic pain patients.
Dr. Allyson Shrikhande is a board-certified Physical Medicine and Rehabilitation specialist and is the Chair of the Medical Education Committee for the International Pelvic Pain Society. Allyson has published peer-reviewed articles on the treatment of muscle pain in academic journals and works closely with renowned pelvic pain gynecologists and urologists. Taking a team approach, she works with specialists in pelvic floor physical therapy, kinetics and movement, as well as acupuncturists, nutritionists, cognitive-behavioral therapists, and functional medicine physicians.
The following is our interview with Allyson Shrikhande on physiatry.
Q: What is a physiatrist?
A: A physiatrist is an MD or DO with a specialty in Physical Medicine and Rehabilitation. This non-operative medical discipline involves focusing on the neuromusculoskeletal system to help patients recover their functional well-being and quality of life. We describe physiatry as an extension of physical therapy because a physiatrist diagnoses, manages, and treats pain from injury, illness, or medical conditions, incorporating other methods in concert with physical therapy to rehabilitate the body. Physiatrists are trained not solely in one organ system – rather, they take a holistic, full-body approach that accounts for the interplay of different organ systems, both with each other and with the neuromuscular and myofascial systems.
Q: What does a physiatrist do?
A: Physiatrists work with physical therapy to rehabilitate the neuromuscular system. A core underlying theme in physiatry is the concept of Neuroplasticity. This is the understanding that the nervous system has the ability to form and reorganize synaptic connections, especially in response to experience or learning following injury.
Q: What do physiatrists treat?
A: Because physiatrists focus on the interconnected systems of the entire body, they treat a wide range of injuries and disorders. Physiatrists commonly work with patients who have pelvic, back or neck pain who are recovering from issues such as sports injuries, neuromuscular disorders, arthritis, or injuries to the brain or spinal cord.
Q: Why would I see a physiatrist?
A: At Pelvic Rehabilitation Medicine, our Pelvic Physiatrists diagnose and treat the structures of the pelvis – the muscles, nerves, and joints. One of our physiatrists can provide non-operative options to medically manage and treat pelvic pain and pelvic floor muscle dysfunction. We treat an array of symptoms under the umbrella of pelvic pain which includes pain with intercourse, urinary urgency/frequency or pain with urination, constipation or painful bowel movements, and pain affecting the coccyx, groin, pelvis, lower back, and lower abdomen.
Q: As a pelvic floor physical therapist, what can I learn from a physiatrist?
A: The relationship between physiatry and physical therapy is vital to the collaborative approach that our pelvic pain patients require. Physiatrists perform a full neuromuscular exam (including an internal pelvic floor exam) and can order imaging, prescribe oral medications, suppositories, and topical medications for some patients. Our physiatrists can also perform safe outpatient ultrasound-guided procedures to treat underlying neuromuscular dysfunction, all in combination with continued pelvic floor PT when appropriate.
Rachna Mehta, PT, DPT, CIMT, OCS, PRPC is the author and instructor of the new Acupressure for Pelvic Health course. She is Board certified in Orthopedics, is a Certified Integrated Manual Therapist and is also a Herman and Wallace certified Pelvic Rehab Practitioner. An alumni of Columbia University, Rachna brings a wealth of experience to her physical therapy practice with a special interest in complex orthopedic patients with bowel, bladder and sexual health issues. Rachna has a personal interest in various eastern holistic healing traditions and she noticed that many of her chronic pain patients were using complementary health care approaches including Acupuncture and Yoga. Building on her orthopedic and pelvic health experience, Rachna trained with renowned teachers in Acupressure and Yin Yoga. Her course Acupressure for Pelvic Health brings a unique evidence-based approach and explores complementary medicine as a powerful tool for holistic management of the individual as a whole focusing on the physical, emotional and energy body. Rachna is a member of the American Physical Therapy Association and a member of APTA’s Pelvic Health section.
According to the National Center for Complementary and Integrative Health (NCCIH), a branch of NIH, pain is the most common reason for seeking medical care1. Over the last several decades there has been an increasing interest in safe and efficacious treatment options as our healthcare system faces a crisis of pills and opioid use. Among complementary medicine approaches, Acupressure has come forth as an effective non-pharmacologic therapeutic modality for symptom management.
Acupressure is widely considered to be a noninvasive, low cost, and efficient complementary alternative medical approach to alleviate pain. It is easy to do anywhere at any time and empowers the individual by putting their health in their hands. Acupressure involves the application of pressure to points located along the energy meridians of the body. These acupoints are thought to exert certain psychologic, neurologic, and immunologic effects to balance optimum physiologic and psychologic functions2. Acupressure can be used for alleviating anxiety, stress and treating a variety of pelvic health conditions including Chronic Pelvic Pain, Dysmenorrhea, Constipation, digestive disturbances and urinary dysfunctions to name a few.
Acupressure uses the same points as Acupuncture; however, it is a very active practice in that we can teach our patients potent acupressure points as part of a wellness self-care regimen to manage their pain, anxiety and stress in addition to traditional physical therapy interventions. Traditional Chinese Medicine (TCM) believes in Meridian theory and energy channels which are connected to the function of the visceral organs. There is emerging scientific evidence of Acupoints transmitting energy through interstitial connective tissue with potentially powerful integrative applications through multiple systems.
Acupressure has also been used with various types of mindfulness and breathing practices including Qigong and Yoga. Yoga is an umbrella term for various physical, mental, and spiritual practices originating in ancient India, Hath Yoga being the most popular form of Yoga in western society. Yin Yoga, a derivative of Hath Yoga, is a much calmer meditative practice that uses seated and supine postures, held three to five minutes while maintaining deep breathing. Its focus on calmness and mindfulness makes Yin Yoga a tool for relaxation and stress coping, thereby improving psychological health3. Yin Yoga facilitates energy flow through the meridians and can be used for stimulating acupressure points along specific meridian and energy channels bringing the body to its physiological resting state.
As Pelvic health rehabilitation specialists, we are uniquely trained to combine our orthopedic skills with mindfulness based holistic interventions to improve the quality of life of our patients. We can empower our patients to recognize the mind-body-energy interconnections and how they affect multiple systems, giving them the tools and self-care regimens to live healthier pain free lives. Please join me on this evidence-based journey of holistic healing and empowerment as we explore Acupressure and Yin Yoga as powerful tools in the realm of energy medicine to complement our best evidence-based practices.
1. Pain: Considering Complementary Approaches published by National Center for Complementary and Integrative Health.2019.
2. Monson E, Arney D, Benham B, et al. Beyond Pills: Acupressure Impact on Self-Rated Pain and Anxiety Scores. J Altern Complement Med. 2019;25(5):517-521.
3. Daukantaitė D, Tellhed U, Maddux RE, Svensson T, Melander O. Five-week yin yoga-based interventions decreased plasma adrenomedullin and increased psychological health in stressed adults: A randomized controlled trial. PLoS One. 2018;13(7).
Pauline H. Lucas, PT, DPT, WCS, NBC-HWC joins the Herman & Wallace faculty with her new course, Mindfulness for Rehabilitation Professionals. The course launches January 2021 and discusses the impact of chronic stress on health and wellbeing, and the latest research on the benefits of mindfulness training for both patients and healthcare providers. The following comes from Pauline, who hopes you will join her for her course.
As an integrative physical therapist treating people with pelvic pain, digestive issues, headaches, and various persistent pain conditions, I council my patients on strategies to reduce a chronically activated stress response (sympathetic dominance). Many of them are living stressful lives, and their medical condition can be an additional stressor. I share with them that by reducing their stress level and improving their overall awareness of what makes them feel better and worse, they may affect their condition in a positive way. When I ask if they have any experience with meditation, I often get the response: “Oh I tried that many years ago and I’m really bad at it; I just can’t meditate.” When I ask them to explain a bit more, they tell me that their mind is always super busy, they are always thinking, and when they try to stop the thoughts during meditation, it doesn’t work.
This is when I explain one of the essential concepts of meditation: It’s okay to have thoughts. In fact, it’s completely normal to become more aware of the busy thoughts when you first sit down to meditate. The trick is to allow the thoughts to be there, and at the same time keeping awareness with the focus of the meditation practice (i.e., the breath, a mantra, etc.). When we don’t resist the thoughts, the mind naturally gradually calms down, resulting in fewer and calmer thoughts. This is when I typically see relief on my patient’s face when they realize they may not be a bad meditator after all, and they are often willing to give the practice another try.
To learn more about using mindfulness and meditation in your personal life and in patient care, please join our 1 day virtual course Mindfulness for Rehabilitation Professionals.