Pelvic Health in Athletes with Amanda Olson - Episode 29

I’ve got to admit, pelvic health isn’t an area that I know a lot about. But I have often wondered if I was missing something in my athletes. So I really recommend that you become more aware of pelvic health issues and find someone in your area that you can refer patients to in the future.

In this episode, I’m joined by Amanda Olson, a pelvic health physical therapist, to talk about some of the symptoms of pelvic health issues, signs that we can look out for as sport physical therapists, how to collaborate with specialists in your area, and working with postpartum patients that want to return back to the gym or their sport.

Full show notes: https://mikereinold.com/pelvic-health-in-athletes-with-amanda-olson

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Transcript

0:34

On this episode of the sports physical therapy podcast. I am joined by Amanda Olson. Amanda's a pelvic health, physical therapist and president of the company, intimate rose, where she offers pelvic health, education and products. In this episode, we're going to talk about pelvic health issues and athletes. Some of the early signs to keep an eye out for and how to best collaborate with a specialist in your area. So that way you can help your athletes get back in the gym or back to their sport.

Mike: 1:10

Hey, what's up Amanda? Welcome to the podcast. Thanks so much for joining us.

Amanda: 1:14

Thank you so much for having me.

Mike: 1:16

Uh, I've been looking forward to this episode because you and I started talking several months ago about potentially getting you on here, and it's a topic that I openly admit I know just very, very little about. Um, enough that I know that I need to be friends with people like you, um, to help me with this, to help me and, and people like me in this. Um, you know, I, I, I totally. Realize that we've probably missed the boat on pelvic health, um, throughout the years, especially in athletes a little bit, I would say. Um, and I respect that and I, I wanna learn more and figure out how, um, people like me that deal with, uh, so many athletes can, can find some early signs, can get'em to the right people, that sort of thing. So this should be a really fun.

Amanda: 2:02

absolutely.

Mike: 2:03

Cool. All right. Well, why don't we start with this, because I'm always interested in hearing this. Um, I think, you know, you're a, a very niche physical therapist, which I love. Um, and I love your niche on pelvic health. Tell me a little bit about, you know, how you got involved, how'd you start specializing in this, you know, how can somebody that wants to do the same, like kind of following your footsteps a little bit.

Amanda: 2:25

It was actually a very adventurous event that happened. I went, I actually went to physical therapy school expressly to specialize in pediatrics and about a year after I graduated, so I had a doctorate degree in physical therapy. So I was smart enough to know better old enough to know better. Um, I found myself in a situation where I was out in nature here in Oregon and I was with a group of boys who were cliff jumping into the water at 40 feet. And it was one of those things where it's like a spot in the river. It's very deep. It's very. Still, people have been jumping off at this spot for decades or something. And I am not a thrill seeker. I'm a runner I much prefer steady as she goes, but, um, I apparently still felt like I needed to keep up with the boys. And when you jump off a cliff at 40 feet, apparently you're supposed to land straight in the water like a

Mike: 3:20

Right. Right.

Amanda: 3:22

I landed an L

Mike: 3:24

Oh,

Amanda: 3:25

Bottom first at 40 feet and at 40 feet water behaves much like concrete. Um, yes, so I annihilated myself

Mike: 3:35

Oh man. Bummer.

Amanda: 3:37

yes, it was a big bummer. had to be like fished outta the water, and um, I had significant injury to my tailbone, my pelvic. Floor, my low back. It was, it was a really bad situation and I'm so lucky because, you know, if I had to rotated a little bit, um, or hit a different way, I could be gone. Um, for sure. So I'm so lucky and I got out. I was able to walk and in interestingly enough, but by the time I got back to my primary care physician, she recognized immediately that I. Significant injury to my pelvic floor and to my pelvis. And she knew right away, and this was very interesting cuz this was 14 years ago to refer me to a pelvic health physical therapist. And at the time in, in the US there was a couple hundred, you know, we as a. As a, uh, population of, of physical therapists have actually been around for roughly 42 years, but as you mentioned, it has been very niche. So people, physical therapists have been doing this all the time, but I was so lucky that I had a great one there in my city and she fixed me up. And, um, it was a long process of rehabilitation, but she said, you need to quit pediatrics. You need to do this We, we need to get you trained up cuz there's not enough in the country and you have the right personality for it. So I did, I went back and re-certified and now this is my passion, you know, this is what I'm here to.

Mike: 5:02

And which, which is amazing too. And usually I tell people to follow in the footsteps of their mentors, but I don't think we should follow in your footsteps. Right? We don't wanna have to jump off a cliff to, to, to find our niche in this world. But I think we can, we can learn from the importance of all this from you,

Amanda: 5:18

Yes. If you do jump land straight

Mike: 5:21

Yes. Exactly. Feet first or hands first or doesn't matter. They're both the same, right? It doesn't matter. you can pencil or dive it doesn't matter. But definitely don't go bottom first. Okay. I like it. Okay. All right. So that's a wrap everybody. Great episode, Amanda. We learned a lot this Um, so I, I. That's amazing. And I give a lot of credit to not only your, your physician that you said, but then that person that you found because they're, they're probably, like you said, a trends center to an extent where they, they said, this is an important thing. And then I feel like, just like a lot of other niches is once you see it, you're like, oh, oh my gosh. How, how do we miss this? And why aren't more people specializing? So for, for me, I think that's like where I get excited when people like you say, this is what I wanna do. Um, as a sports pt, I know this is where I feel like I've, I've, every now and then I've, I've had that little like spidey sense where you're like, Hmm, I wonder if I'm missing something on this person. Maybe it's not a sport hernia. Maybe it's. F a I or a groin strain or whatever it may be. Um, tell me a little bit about that. Like, let's start with that and going over, like, what are some of the most common pelvic floor issues that you see in athletes?

Amanda: 6:37

Yeah, interestingly. All of those diagnoses that you just listed actually can be occurring in the person and they can as a, as a sequelae or as a secondary effect, be having pelvic floor dysfunction. So, um, for me, because that is my primary, uh, area of practice, um, in the athletic population, I tend to see a lot of incontinence. With exertion. So that could be the, what we call it in Nolo Paris. So somebody that's not been pregnant or had a baby, um, experiencing incontinence. And so that is actually pretty prevalent. Um, interestingly enough, there's been several different studies that show a range from anywhere from 28% to 82% of female athletes that have never had a baby are experiencing some degree of incontinence. And so when you look at that upper ceiling of like 82%, I hope that all of my orthopedic colleagues are. Whoa. Those people are in my clinic.

Mike: 7:31

That's all of them. right? I mean that's a, it,

Amanda: 7:33

At some

Mike: 7:34

all of them. now is, is that sport specific? Like, cuz you know, 28 or whatever it was to 82, I mean that's a large range. Was that, was there a sport, um, like is it like different levels of sports where that's a little bit more, more prevalent than others?

Amanda: 7:48

Yeah, they're saying high impact. So some of the studies look specifically at running, but a lot of them are broadly looking at high impact. And so in that they're including gymnasts, runners, basketball players, um, like lacrosse. Um, Jumpers, those kinds of things. So thinking impact. Um, and then across both genders or all the genders, um, pelvic pain, um, which can be masquerading as a hip pain or a low back pain, it can be associated with. Trauma or other injuries. And it can also be associated with stress and, um, how they are guarding against that. And then of course, in your cyclist population, it can be due to nerve compression with how they are seated and, um, the prolonged time that they're se they're spent on their seat.

Mike: 9:00

Right. And, and, and just to clarify, these are things that can happen to all genders, right? This isn't, this isn't a female thing. I know we, we, you know, postpartum makes this a real issue for, for females, obviously. But when you said, you know, athletes that were not postpartum, right? Not pregnant, no po well postpartum, um, that means this applies to everybody, right?

Amanda: 9:22

Yeah, it certainly.

Mike: 9:23

And is there, do you see that incidence, um, different between genders? Like is this more specific to females or could it be.

Amanda: 9:33

Um, a lot more of the data is taken on female athletes. Um, there's some new emerging data on the incontinence aspect on the males. Um, because of the anatomy, it does tend to affect females a little bit more. Um, there's a little bit more opportunity for. What we call gapping around the urethra are just different changes in the dynamic dynamics of their pressure system, um, that we see in sport that can result in those symptoms of urine linkage. Um, but there is more work being done to start collecting data on males. And then of course, in the pain category, we know that it is affecting both.

Mike: 10:10

Right. I can see that too, for sure. And, and, and just to clarify, incontinence in a young athlete is abnormal, right? So

Amanda: 10:21

In anyone. Yeah, it's common in the postpartum population, but not normal. And then in the young athlete who's never had surgery, never had a baby, we wanna be certainly picking that up and getting, getting that addressed right away.

Mike: 10:35

Right. So do you, you know, I know you're, you're a niche, but for me in the sports setting, um, at our clinic, you know, we have one of our therapists, Dave Tilley's, a big gymnastic specialist. Um, he's got, you know, almost exclusive, um, young female athletes that are, that are gymnasts. Um, when do you start adding this almost to like your intake forms or that sort of thing? Like when do you start adding this? To kinda ask some of these questions. They're, they're coming in, you've never seen before. Maybe their parents brought'em in because they have low back pain or hip pain or a groin strain. Right. Or whatever. Like when do you, when do you recommend that people in the sports and ortho section start to broach these subjects? And, and h how do we do that in a way that doesn't make the athlete uncomfortable?

Amanda: 11:19

I recommend that they do it yesterday, Um, I try to always educate, especially when I am, um, around my ortho friends, um, to advocating to get it. Put on the intake forms right away because, um, a couple of things in the dynamic, especially between like, say like a male with a young female athlete, it can be difficult to have those conversations. But if it's on the written intake form and they're filling it out privately or with their parent, they can fill in a bubble or they can circle something or they can check. And then when you receive that, say even if you're seeing them for their elbow or their knee or their foot, and you see that there, you can, as part of your therapeutic alliance when you're taking their medical history, say something to the effect of, I see that you've indicated here that you sometimes leak urine. That can indicate that there might be a problem with your pelvic floor. And I'd like to recommend, in addition to our care that we're doing here, that we get a consult. So you're not quarterbacking that patient outta your clinic, you're still managing them, and you're working with a, um, a very collaborative pelvic health PT that can be then helping to manage that person and then you. It's, it's just an easy way for an orthopedic PT who may not be comfortable having in-depth conversations to screen. And so the, there's like four or five questions that are just easy, easy to include on that basic medical intake form. And they are, do you experience loss of urine when you jump, run, sneeze, cough, or play your sport? Um, do you experience pain with bowel movements or issues having a bowel movement? Do. Feel a bulge or a sense of pressure in your pelvic area or in your vagina. And then also do you have any difficulty having a medical exam with a gynecologist, because sometimes they don't even bring it up there. So it may be that they're having issues using a tampon or tolerating a speculum in the older population, like if. Athlete is older, not like your nine year old gymnast sitting in front of you. It may be that they have pain with intercourse, and that may be not a conversation that you're interested in having as a orthopedic pt, but if it's on there, then you can be, you can be working collaboratively with your pelvic PT colleague.

Mike: 13:38

Well, and I, I think the fact that you even put those on an intake form, um, I, I wouldn't be surprised if a young athlete, like in their teens, like they didn't understand that those things were abnormal. So they just thought, oh, that's, that's me. That's what I do. That's maybe everybody's like that. Maybe everybody has. A little bit of incontinence here and there. Right. So I think just even putting them on that, on the form, um, actually might be helpful just for them to realize and open up a conversation that they didn't even realize was part of it.

Amanda: 14:07

absolutely.

Mike: 14:08

So you, I, so for me, I wanna know some of the early signs, right? So incontinence seems like, I don't wanna say a late sign, right? But it's like, um, like that, that, to me, that's an obvious one. What are, what are some of the, the more, more subtle things that we can look for or, or maybe the nuances of some, some pain that you mentioned earlier. What are some of the things that we can do when we say, oh, wait a minute. They said they had hip pain, they said they had back pain. I did my full orthopedic screen of their, of their back or their hip, and it didn't a hundred percent add up. What are some of the other things that we should look for?

Amanda: 14:43

um, if they have a history of constipation that can indicate a pelvic floor dysfunction, tailbone pain, and then when it comes to the hip, it's often deep. Hip pain that they can't reach, they can't stretch. Like you put'em into a figure four stretch. No, that's not quite it. Internally rotate'em, not quite there yet. Getting closer, you know, and they, they might point through it through the groin area and say it's deep in there. Um, which then you would need to be screening for the hernia. And they do tend to happen together. PE the floor dysfunction in hernia can happen together. Or they're like saying deep in. Not the sciatic nerve, it's not following the porous kind of thing. And just if, if you can imagine as you're doing your evaluation, the pelvic floor is literally on the other side of that special plane of the piora. Um, it is, you know, I think sometimes, especially in PT school, I'm thinking about how the way that my brain. Created that geography or that anatomy prior to pelvic health education. And you're thinking like, oh, you learn about ator, internists, but it's deep in there. You'll never reach it. No. In pelvic health, we palpate that every day, and we can reach it, and it is often a driver of pain. So it's kind of that, that deep hip pain where you're not able to quite reproduce it on the table.

Mike: 16:01

And I, I, I think that part is great because I bet you that happens more than people give a credit. They come in, it's in your head. You're like, oh, bam. This is an f a i patient for more oso tabular impingement, that this is easy. I got this right. And then you bring'em to the test and you're like, oh, wow. Nothing produced Pain Right. Which, so I, and as a sports PT in this conversation, I can tell you if you're listening, that's weird, right? If you have f a i, it is kind of clear you have f a i, right? Like we can reproduce it with some of our range of motion and internal, uh, rotation stuff that Amanda kind of just mentioned there. Um, so again, this is where, you know, I tell our PT students this all the time. Um, I don't like scratching my head. When I scratch my head and something confuses me, we're missing something or take, we gotta take a step back and think outside the box, what are we missing? So remember that orthopedically, if you're looking at something and it doesn't add up, you have to start thinking, okay, that should have. That f a I test, I just did, should have produced some symptoms and it didn't. So let, let, let me start working on that. So I guess that's my next question now. Okay. We found somebody, we have some questions. Uh, what do you recommend we do first you kind of alluded to this, that we, that we, you know, we work in collaboration with somebody. How do we find a good person in our area? Do you guys have like an association or something that, you know, like how can people in our area reach out and find some people near.

Amanda: 17:25

Absolutely. So the American Physical Therapy Association's Academy of Pelvic Health has a list served with pelvic providers throughout the country, and I will say back from 14 years ago to now, there are. Thousands. We are in every state. Um, we are, we, the numbers are growing. There's better awareness. So, um, that is a really reliable place to find them. Um, I have a listserv as well, so if people are listening and they, they want to find a colleague in their area, I can help connect them by zip code too. So, um, yeah. There's a, and then I always recommend too, like any, like at your state conferences, when you're there, if you're visiting for that or csm, try to try to find those providers and team up with them. And a great sports pelvic PT is going to be a tremendous asset. We're very collaborative. We're not gonna take your patient away. We're gonna be addressing the other side of that special plane. And you keep working on whatever it is you're addressing.

Mike: 18:24

I like that.

Amanda: 18:25

We're gonna service that patient and we're gonna help them reach their goals.

Mike: 18:29

I, I, I think you said it great too before is like, don't just punt. Right? I think you, you kind of alluded to that. Don't just punt say, oh, this might be something else. No, their, their hip and their, their exterior muscles that we're talking about in their hip and their low back, those might need some things too. And that could be something where it's, it's a collaborative effort. So I, I think that's a really, uh, good way of thinking of it. Um, I, I really think you should take Amanda up on that, by the way. Um, so I'll put some info on her website on, in the show notes, but you should probably check out the A P T A pelvic floor, um, uh, academy, uh, or pelvic health AC academy, I should say. Um, you should probably check that out because I think if you're working with athletes, you should probably have somebody just like you have a shoulder specialist, an elbow specialist, a knee specialist. Doctors, chiropractors, massage. I, I feel like you need to have one of these in your network, and I bet you a lot of my listeners don't, Amanda, unfortunately. So, um, make these connections and, and, and let's, let's do this, right. Um, let's, let's shift gears a little bit. Similar note here, but I think, um, a lot of my listeners probably do work with postpartum patients and, um, a lot of the people I think that, that listen to me are both fitness and. Professionals. So I think we, we have lots of different avenues there, but they're also helping people get back to some advanced level things like, like working out in the gym or, you know, if, if they're a runner or, or playing whatever their sport is. Um, I know this is a broad question because this is so fresh to me, but what are some of the keys to working with postpartum patients that you start with? What are the things you focus on? Help somebody like myself that's naive. Start getting into.

Amanda: 20:12

Absolutely. Um, so depending on how they've come to you, whether they're just coming in because they are postpartum and they are looking for a safe transition back in, or they're coming in with a driving injury, you know, they a specific reason. I always recommend that as a clinician, we realize and we help educate with this person that. Every cell in their body changed while they were pregnant. And their, their body has changed. Their, their abdominals have changed, their feet have changed. And so in this way, their brain map might not quite match the body that they have at this moment. It's almost like Alison Wonderland, where they were very, they were very tall yesterday and they're very short today. Um, you know, they, they had changes in their posture and elongation of certain muscles

Mike: 20:58

whoa, I could touch my toes. I could never touch my toes.

Amanda: 21:01

Yeah, I can roll over

Mike: 21:03

Yeah. Right. Exactly. Mm-hmm.

Amanda: 21:05

so along those lines, their coordination has changed, their timing and their speed of contraction has changed. And we have data now that demonstrates that, especially in their abdominal and trunk muscles, they are highly fatigable. are also sleepy fatigable. So we want to be providing this just general, almost like giving them, like reminding them to give themselves grace. It's not about like, oh, go easy on yourself. Cuz certainly an athlete does not want to go easy on themselves. They wanna be. Bounce back, you know, yesterday. Um, but it's just reminding them that their body has been through these changes and that their, their motor control, their ability to control those, uh, these new segments, um, is different. And so from that lens, we want to be doing a complete. Screen, you know, a, a complete posture movement screen of their trunk, their hips, looking at their feet, um, reminding them that oftentimes they have lost some intrinsic muscle control or strength, um, and that they are gonna be wanting to include foot training in their, in their retraining, because, That is the base of their contact. Um, and then from there, especially, I, I think that this return to run, uh, running readiness screen is really practical for all types of athletes. So just doing an overall screen of their form. It's a, you know, a single leg squat. It's a wall squat, looking at their endurance. I step up and. A two foot hop. So you're looking at their ability to mitigate force. You're looking at their fatigue ability and symmetry, right versus left, which is often crummy especially in their single egg squat. And then from there you can go on to design their plan of care or their exercise program and then of course screening for the pelvic floor. Um, but it's, you know, when we're looking at these, what's the magic? As to when they're appropriate. There is no hard and fast date. It's not six weeks, it's not 12. It's the person in front of you. And that's where working collaboratively with somebody that specializes can help you drive your exercise prescription and some of that, um, because they're going to be helping to ensure that there's no other contraindications or, um, like more like yellow flag type things to them participating in exer.

Mike: 23:32

Yeah, for sure. And, and call me crazy. It seems like everybody. Should go through this. I mean, we're, we're talking about athletes, we're talking about people that maybe, you know, weren't feeling great after pregnancy. Right? It, I mean, think about what happens to your body during pregnancy, right? There's, you have a lot of orthopedic things you gotta get back to. It's crazy that we just say like, oh yeah, no, it'll come back, right? Without, without working with somebody. Isn't that crazy?

Amanda: 23:58

Yes, very.

Mike: 24:00

So h how many people in your practice come to you without any issues? They just, they give birth and they say, you know, I, I know that just, that really changed me. Um, and I wanna do the best I can. How many people do you work with like that versus people that are coming because they have persistent back pain or something like that?

Amanda: 24:19

I would say roughly 10%. You know, it's the ones that already know what I do, and they, they just want to be doing the best they can. Or they recognize, you know, in countries like France, every woman gets 12 visits of pelvic health physiotherapy provided under their system to, to, they call it perineal, reeducation, and

Mike: 24:40

that,

Amanda: 24:41

That's exactly what it

Mike: 24:42

Right? Yeah, that's, that's, that's great.

Amanda: 24:44

Yes. So there's people that are recognizing that and that are, you know, wanting it, um, so that they can either mitigate any forces or really address any smaller things that they're, they're feeling.

Mike: 24:57

It just seems like a no-brainer and we haven't even talked about a C-section and I can't even imagine. You take all that plus then you. Disrupt your abdominal wall. I mean, like the, I I can, I can only imagine. Um, so, uh, yeah. Uh, so it sounds like we need more awareness. We need more awareness in this country. But why aren't doctors like telling their, their patients to do this? Why aren't primary cares or ob GYNs, why aren't they saying like, Hey, you know, by the way, after you give pregnancy, like you should go see this person and, and, and help you get back on your feet faster. Why isn't that a thing in the United.

Amanda: 25:31

You know, we are working on it. I have seen a vast improvement in the last 14 years, and I will say this younger generation of physicians are doing it. They are. I. You know, when I go to national conferences where physicians are present, it's, it's that younger, newer generation, uh, fresh outta residency to roughly, you know, five, 10 years out that are saying, oh yeah, we, we have a whole team of public health physical therapists. We send our patients there. Um, and I think from their perspective too, they are looking at it from their particular lens. And if they're not aware, it's, it's like we see what we look. We look for what we know. If they're not aware yet, that's our fault. As physical therapists and we are working on it, you know, we are working to raise awareness and I think that it, it has worked in that younger generation changing practice patterns of some of the set in their ways. Physicians can be more challenging, but it's when we get one or two in and they see the differe. It's, it's like anything, you know, when you're new in town as a physical therapist and you're having to prove yourself, it's, you know, send me, send me the one that is struggling, send me the one that's in incontinent or having pain and can't sit. Send me them and I will help them. And then they see the results and that, that's ingrained in their head when, when we're helping their patients. That makes a difference.

Mike: 26:49

Yeah, may I, I can see that making a lasting impression. And then that'll probably change their practice for forever once they go through a tough one. Um, you know, so well, hopefully at least, so um, awesome. So, all right, so we need more awareness. We know that you need to find a specialist in your ear. You need to, I, I would at least just say for people listening, you need to have this on your radar. And I think that's the most important thing cuz this wasn't something that I thought of earlier in my career, but I definitely, I, I had several patients, you know, and, uh, I think CrossFit, um, as that gained popularity like 10 years ago or so, and it got really, really popular. I think we started seeing more. More people in our, our clinics with this because, uh, it became more obvious, maybe because they were doing so much more activities. Um, but I definitely realized that this is something that I wanted to get better at or at least understand so I can collaborate. And that's really why I wanted you to, to come share this with us, Amanda. So I. Thank you so much for taking time out to do this. This was awesome. Um, before I let you go, we gotta have our high five segment at the end where five quick questions, five quick answers. Um, very curious here, but I like hearing it. I like hearing how people think. I like their brains. Right. And, and obviously you're, you're, you're smart. So I want to hear a little bit, but first question, what are you currently working on for your own professional development? I know you educate a lot of others. What are you.

Amanda: 28:08

I am brushing up on some of the newer data. So over the pandemic, all of our amazing colleagues that we're looking at how the Calvin running, produced a ton of new literature. Um, so I am going through and brushing up on that. We published a paper in April on that subject and are looking at doing another delphy, um, shortly that is international. So it's a lot of data there, but another one that I am having to re. Integrate into my practices, this change in IT band from friction syndrome to, we're calling it compression now, is

Mike: 28:42

Yeah. Yep, yep. Exactly. Yeah.

Amanda: 28:45

yes.

Mike: 28:46

friction. I mean, we'll

Amanda: 28:47

Yeah.

Mike: 28:47

it again in 10 years. It is what it is, but sure.

Amanda: 28:50

Yes. So I'm pouring back through that literature as well and changing, you know, cause I teach a two day course on, uh, pelvic floor dysfunction and runners, and it's pertinent because of the role of the hip. So I'm, I'm having to reacquaint my brain with some different, some changes in understanding of the mechanics.

Mike: 29:07

exactly. Well said. I like that. Um, what's one thing that you've recently changed your mind?

Amanda: 29:14

Oh, um, I would say two minute plank test. I still, I still like it, um, because I do like pushing patients into fatigable states in service of especially running, um, but less as a diagnostic tool, more as a, uh, training tool that they can do while they're. You know, maybe having to do other things with their brain, especially in the postpartum population, they're oftentimes having to multitask. So I feel like that's kind of an easy one, but not using it to let necessarily like diagnose, but more as just a training tool.

Mike: 29:46

I like that. That's a good one. What is your favorite piece of advice that you love to give your student?

Amanda: 29:51

Okay. Oh, um, well, I think the, the most pertinent is that what you are learning currently is not gonna be how you practice in three years. It's, I mean, it's not even five anymore. It's like

Mike: 30:04

right? Yeah.

Amanda: 30:05

turn and burn.

Mike: 30:06

Right, exactly. That's great. So keep an open mind and, and you know, I I, you know, it's funny you say that cause that is one of the areas I see so many young professionals like dig in on their opinions, like really hard, really fast. And, and, you know, people like us, we just watch on Instagram and you're like, they're gonna regret that post in three years. you know, they, that was a little aggressive. Uh, but nice. I like it. What's, uh, what's coming up next for.

Amanda: 30:34

Um, working on the Delphy with Shali, Christopher and Rita Dearing, and an international team of amazing, um, physios in the running and pelvic health space. So we're working on creating some recommendations for postpartum return to fitness and running. Um, and CSM CSMs coming up in like, what, five weeks? Six.

Mike: 30:56

Yeah, it's so close that I'll probably publish this podcast well after, but yes, I like that. Maybe it'll be next CSM that you're talking about in Boston. I like that

Amanda: 31:05

Are we coming your way?

Mike: 31:07

We're coming to Boston in February. It makes perfect sense. Like I don't even, I don't even wanna be in Boston in February, but yes, it should be good. Hopefully we'll have a good turnout

Amanda: 31:16

And we're all gonna be stuck there cause no flights come and go outta Boston in February.

Mike: 31:21

There's a solid chance I'll leave it at that, that there's a solid chance you don't get home or to the meeting on time, but we'll just leave it at that That's awesome. Well, Amanda, how can people find out more about you? Um, te tell me like where, where you like to, to collaborate with people. Is it Twitter, Instagram, your website? What, what's the best place to find more info from you?

Amanda: 31:40

I'm on all those places. I love Instagram, so I'm a Olsen, d p t and Intimate Rose, which is my company. And um, for website, the Intimate Rose website, I have hundreds of videos and blog articles and free education for patients and providers alike on every subject in Pelvic Cal under the sun.

Mike: 32:02

Awesome. That's great. Yeah, really appreciate you taking some time out today and just appreciate all you do for this niche and combining it with sports because I think that's what's really neat about what, what you're doing right now. So appreciate that and all your insight and um, thank you so much for coming on the podcast today.

Amanda: 32:19

Thank you so much for having me.