About this episode
Dr. April Dominick // #ICEPelvic // www.ptonice.com In today's episode of the PT on ICE Daily Show, #ICEPelvic faculty member April Dominick shares some insights and a "big win" from a coffee marketing meetup with a physician. She cites 5 clinical pearls for how to approach challenging the status quo of practice patterns with the providers in your community. Take a listen to learn how to better serve this population of patients & athletes or check out the full show notes on our blog at www.ptonice.com/blog . If you're looking to learn more about our live pregnancy and postpartum physical therapy courses or our online physical therapy courses , check our entire list of continuing education courses for physical therapy including our physical therapy certifications by checking out our website. Don't forget about all of our FREE eBooks, prebuilt workshops, free CEUs, and other physical therapy continuing education on our Resources tab. Are you looking for more information on how to keep lifting weights while pregnant? Check out the ICE Pelvic bi-weekly newsletter! EPISODE TRANSCRIPTION INTRODUCTION Good morning, everyone. This is Dr. April Dominick. I am on faculty with the Ice Pelvic Division. And today I wanted to discuss a recent marketing win that I had with a physician and some insights regarding how to challenge the status quo of practice patterns within providers in your community. One concern that we often get with our ICE courses and especially in the pelvic division is someone will say, hey, I love all of this incredible research that you all are sharing that is completely different from the way that I practice and I'm so stoked and I'm so behind it. But how do I recommend or how do you recommend that I bring this back to a community of providers who are pretty steadfast in their practice patterns? So today I'll share that recent interaction. And again, it was a marketing meetup with a physician and I want to share how it went from an invite for a latte to an invite for a lecture that I could give And all of that happened in just under 35 minutes. So I met with an OB who I have a pretty solid referral relationship with. She refers folks to me, I refer folks to her, and we were just catching up over some mutual patients that we had. And the conversation ended up turning towards how she counsels patients in the pregnant and postpartum space in regards to exercise. And she absolutely encourages people to continue moving, keep exercising, working out. But she says, you know, I caution them against doing planks and I don't really support twisting and turning because I don't want to make that diastasis recti worsen or that thinning of the linea alba. And she also says that she cautions individuals with any sort of impact because she doesn't want to further any sort of urinary incontinence. In my head, I was like, ooh, gosh, there's so much research that has come out, especially in the past six to 10 years, that doesn't support that line of thinking. But how do I share that with her without, you know, stepping on her toes and interrupting this beautiful relationship that I've developed with her? So I asked, I said, would you mind if I shared some updated evidence that we have regarding all of those topics? And she was totally game. She was like, fire away. Yes. So I shared the benefits and the protective mechanisms that we know about as far as core strengthening during pregnancy and early postpartum. I relayed to her the reality of the situation regarding diastasis recti is we don't even really have a consensus in the literature for defining it. And I also quoted some studies that we also talk about in our live courses and our online courses about when it comes to someone who is one year postpartum, they are likely still, some of them still have a diastasis recti and that those with a persistent diastasis recti tend to have a weaker rectus and oblique strength score compared to those without a DRA about a year postpartum. I also anecdotally, I mean, I had to squeeze this in somehow, but I anecdotally shared that since I started loading the core more during pregnancy and early postpartum, that some of our mutual clients, I did some name drops, have actually had relatively quicker recoveries on the back end, on the PT side. And they've returned to their functional activities seemingly with more ease. And that was, of course, all things considered and just an anecdote, but it's something that a trend that I've noticed. And that's all for folks who have prioritize course strength training as opposed to those who have not or those who continued some sort of resistance training of some sort. We also talked about other topics and I threw in that we have a lot of evidence regarding the benefits of resistance training and lifting heavy during pregnancy and some preliminary evidence that says hey, exercise and heavy strength training may support the role of lowering some pregnancy complications, including gestational diabetes, gestational hypertension, and even some perinatal mood disorders. And then of course, I let her know, you know what, I am there to help support someone in their endurance training, their impact training, Um, and I help address that pelvic floor dysfunction. So I actually will come alongside someone, um, with those goals. And if there is any sort of pelvic floor dysfunction or urinary leakage, um, I got them. And, and that's not something that I discourage. Her mind was blown. Like she was glued to me as I was just rattling off all of this new information to her that differed from her current practice patterns and likely what she had been trained under when she went to school or in the last continuing education class that she went to. Or maybe she just hasn't really been to any of this because that's not necessarily her expertise. So she was just mind blown and she was so excited to learn this new information. And I said, you know what, this line of practice that I just shared with you, all of these recent updates and literature, this is more of a recent shift even for me. When I first started practicing in pelvic health, up until three to four years ago, I had many of the same practice patterns that you just shared with me. And in fact, many PTs, many other pelvic PTs are still currently practicing with those similar philosophies because that's how we were trained. And not everyone is caught up in respect to the latest evidence. So we talked about different concerns also that we hear in our clinic rooms. And that was fascinating, a whole nother podcast episode, but it was just really fascinating to hear that some of the concerns that her clients have, that our clients have, what they tell her in the clinic room is very different from what the conversations I have. And of course I shared with her, you know, a lot of the folks who are pregnant and postpartum, They have so much fear on board regarding getting a diastasis recti during pregnancy. By the way, it's 100% normal. And how they often pay for generic programs to get flat abs from Instagram influencers and they don't work and then they're frustrated. Or they share with me how they're just terrified about getting a perineal tear during delivery. or they're just determined not to have their organs fall on the ground after pregnancy. And it was so interesting because she, she was like, April, that is, those are not the main concerns in my sessions. And she was like, this is so informative to hear what's happening over there. She also doesn't have Instagram. So I feel like that may influence what it is that she sees and hears. But again, we were talking about in our clinic spaces. So I also got curious because I had some questions that were more on topics about her expertise, like perimenopause, menopause, and hormone replacement therapy, which all of those topics are being discussed way more in the pelvic PT space now. So at the end of the conversation, she thanked me so much for sharing the recent literature. She said, I am so much more confident now promoting whole body strength, including the core, like I feel comfortable because of what you shared with me, promoting people doing planks and promoting impact exercise throughout pregnancy and postpartum. She wanted those articles emailed to her immediately. And the most surprising and probably the best part of this entire meetup was that she asked if I would like to give a presentation at Grand Rounds of the do's and don'ts of exercise during pregnancy and postpartum. She was like, my colleagues would 100% benefit from hearing what you have to say. It'll be a tough crowd because she said many of her fellow nurses and physicians assistants and doctors practice from what they learned, uh, 20 to 30 years ago and are even way further behind than how she practices. She's like, some of them are still promoting bed rest. Um, even when the client doesn't meet that criteria. And she said that she often will come behind providers as she's rounding up the hospital and say to the clients, no, I want you to get up and move. Moving is good, exercise is good. Because I guess some of her other colleagues have said, no, no, no, just stay in the bed, stay in the bed, that's gonna be better for recovery. So I was of course ecstatic when she asked me to do a Grand Rounds lecture. I told her, you know what, it would even be very helpful from my perspective if clients heard about the benefits of continuing resistance training and core work and impact exercise from the medical community because Clients have so much respect for the medical community. So if they are hearing about it first from them and then they get to see me later, if that's the order that happens, even better that we are reinforcing that strength is queen and that can help knock down a lot of those fear-based messaging that our clients get. So, In a matter of 30 minutes, I went from coffee grounds to grand rounds. I want to identify just five things or themes that I came up with from that interaction that may help you cultivate a relationship with a provider, whether it's an OB, an orthopedic surgeon, or a chiropractor, massage therapist, whatever. Use these when you are going to market. LEVERAGE THE LITERATURE Number one, leverage the literature. and thoughtfully ask if it's okay for you to share that recent literature has overturned some of those old tiny beliefs. So reference some of the amazing evidence-based pearls that you've gotten from your ICE courses or from some of our posts. It's all about being respectful for that delivery in the question. So I'd recommend that you just be honest and say, would it be okay if I shared some of the recent literature with you that I have found incredibly helpful for my practice in bettering client outcomes? VALIDATE THE OTHER PERSON Number two, validate them. Share that it wasn't long ago that you were practicing in a different way that maybe didn't align with some of the recent clinical practice guidelines. Sometimes the oldest techniques don't necessarily stand the test of time and they may not be the most effective. SHARE CLINICAL OUTCOMES Number three, share some stellar clinical outcomes. Use wins from mutual patients if that's an already established referral source. ASK FOR ADVICE Number four, ask them for advice. When it comes to a topic that is in their expertise that you may be curious about, or maybe you have an uptick in this particular diagnosis on your caseload. There is nothing that people love more than talking about themselves. Exhibit A, just kidding. Um, but they love talking about how they treat their philosophy. And when you ask someone for insight that shows, you know what, that shows that you're curious and you're wanting to learn from them. So it becomes more of a two way street. LEAN INTO YOUR PERSONALITY & PASSION And then finally, number five, lean into your unique personality and passion. When people get a sense of how incredibly passionate you are about changing lives and how you practice being about it day in and day out, they listen. Think about the first time you tuned into a PTA on Ice podcast episode with Jeff Moore or Christina Prevett blasting their truths from behind the mic. how you can feel their excitement through your speaker as they rap about getting that PT version 2.0 going, about how we need to remove barriers to exercise in the older adult, the pregnant and postpartum space. So lean into your personality, whether it's loud and proud or quiet confidence, and let that drive your passion behind changing the status quo in your community. I hope you found this marketing one of mine and those insights helpful for your next marketing meeting. Remember, leverage recent literature, validate the provider and how you may have just recently shifted to using these more evidence-based interventions and strategies, share recent client wins and trends, get curious about their expertise, and then lean into your personality and let that elevate your passion for providing Fitness Forward, evidence-informed care in the PT space. SUMMARY If you're feeling like you need to brush up on some of the latest research and treatment strategies in regards to fitness, guidelines, and any sort of pelvic health issue, join us in our Ice Pelvic Courses. We have some live courses coming to you. Alexis and Rachel will be in Newark, California. the first weekend of March, and then Alexis and I will be in Bismarck, North Dakota the second weekend of March. There's still time to sign up for those. And then from an online perspective, our next level one cohort starts March 5th, and we only have a few seats away from being sold out for that cohort. So hop on in. Thank you so much for joining and remember to bring that Be About It attitude not just to your workouts but to your marketing meetings and coffee meetups as well. Cheers y'all! OUTRO Hey, thanks for tuning in to the PT on Ice daily show. If you enjoyed this content, head on over to iTunes and leave us a review, and be sure to check us out on Facebook and Instagram at the Institute of Clinical Excellence. If you're interested in getting plugged into more ice content on a weekly basis while earning CEUs from home, check out our virtual ice online mentorship program at ptonice.com. While you're there, sign up for our Hump Day Hustling newsletter for a free email every Wednesday morning with our top five research articles and social media posts that we think are worth reading. Head over to ptonice.com and scroll to the bottom of the page to sign up.