Knowledge of Pelvic Health Among Undergraduate Students

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The Ideafest presentation below discussed a different population (high school graduates).

Taylor Hovaldt, SPT, ATC, Kelsey Grosshuesch, SPT, Erica Thyen, SPT, ACSM-EP, & Lexie Weier, SPT

33 Comments on “Knowledge of Pelvic Health Among Undergraduate Students

  1. Great presentation! My question for you guys is do you have an idea how to combat the lack of information that students who attend private schools receive on the topics of pelvic health? I went to a Catholic school and we did not receive any education on these topics in the school setting whatsoever.

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    • Hi Lindsay. Thanks for the question. I, like you, attended a private catholic school where these topics were not discussed whatsoever. Unfortunately, because private schools have full autonomy of what they teach, exposing students to this information would be very difficult. One way to approach the issue is to contact the school directly and supply the information personally. Attending the school, offering health fairs, etc. could be an easy way to educate students that may not receive this kind of information.

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  2. Great presentation! It is amazing the lack of education on something that is so common. Have you guys considered /brainstormed ways that us as physical therapist can help with getting this information out earlier to help prevent these issues?

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    • Hi Leslie!

      Thanks so much! We have definitely discussed it throughout the entirety of our research. It’s really tough to come up with a perfect solution, but we definitely think just advocating for the profession and what we are capable of treating is incredibly important. Now that newer PT grads are starting to get more pelvic health education it will be important that we educate our patients and physicians in our area of what we are able to help with and just how important it truly is. For those really passionate about pursuing the pelvic health specialty, it would be worth possibly looking into finding ways to provide inservices to other clinicians or guest talks at schools to educate students.

      Thanks for your feedback!
      Kelsey Grosshuesch

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    • Hi Leslie! Thanks for the question. We haven’t necessarily brainstormed ways to distribute this information but just personally, I think health fairs or a one-day seminar in school could be ways to initiate a conversation regarding these topics that are often overlooked. I think it would be easier to contact athletes as they require physicals every year to perform. That could be a way to bring up these topics and educate what is normal/abnormal and when they should seek help.

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  3. Very interesting poster with a lot of useful information. The last point of the poster in the conclusion talks about education from reliable sources which I think is very important because I think that information like this should be readily available and reliable. My question is, since you all have done research in this area, what are some good resources that a therapist or even a patient could use to become more educated in pelvic health?

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    • Thank you, Barry! We agree that this information should be readily available and reliable. To answer your question, the APTA offers a pelvic health section that people can join if they are interested. The link for the webpage is here: https://aptapelvichealth.org. At this link, you can explore the “Education” tab which offers upcoming certifications, conferences, and courses to become further educated in pelvic health. I would also recommend the Journal of Women’s Health Physical Therapy, the American Journal of Obstetrics and Gynecology, and the Journal of Pediatric and Adolescent Gynecology. Hope this helps!

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  4. Great question, Barry! In today’s world, a simple google can bring so much information but often not very reliable and often misleading. Some great websites to utilize for patient education and therapist education could include APTA’s Pelvic Health chapter. Their website provides phenomenal information and education (https://aptapelvichealth.org/) or the NAFC (National Association For Continence) is also very patient friendly and educates on what incontinence is, managing it, and resources to use. If your patient (or you) still want information, a simple search in “google scholar” could be another option for research articles.

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  5. Great presentation ladies! I guess my concern/question is how do you even start implementing this type of information and education into school curriculum, if they don’t have it? What does that process look like? Will health teachers have to get more training in order to teach this information, especially if they never received this education in the first place? If they do have to get more education, does that money come from the school districts and do you think they would be willing to provide that financial support? I do believe that this information is extremely important and should be discussed in health classes across the country. I received no education on this topic until PT school, which is crazy to me regarding the high prevalence rates!

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    • Hi Chloe! Great questions. I think the process all has to begin with educating school officials, parents, and other community members on why it is so important we make the effort and find money in the budget to educate students early on. We need to get them to realize the increased health risks and long term negative effects of individuals having no knowledge on pelvic health and all its related topics. Like anything starting out, it will require our education officials to take a chance on a new program, a program most education systems have never even considered implementing. It will not only require the formation of new curriculum, but also special training for the teachers in charge of educating students on these topics. Because there is sort of a “leap of faith” required on the part of the education officials to approve such a program, it is crucial we take the education we have been given and work hard to keep spreading the word so more people give this topic the attention it deserves!

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  6. This was such an interesting presentation! I know that I did not receive any information in high school about any of these topics and I agree that more education would be helpful. My question is what are the possible reasons that the incidence of pelvic floor disorders is expected to increase by 2050? My thoughts are that it wouldn’t be increasing per say, but that awareness is increasing so more women are cognizant of the pelvic floor dysfunction.

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    • Cassidy,
      I agree with how Lexie answered this question. I would also like to add that along with there being a widespread lack of knowledge of pelvic health, most people also do not know that physical therapists can help treat pelvic floor disorders. It is our job to educate patients that we are capable of helping them with their pelvic floor disorders, as well as to advocate for physical therapists to be part of the healthcare team when treating these types of disorders.
      Thank you!

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  7. Hi Cassidy. Thanks for the question. According to research, the trend is showing more prevalence of pelvic floor disorders due to the lack of knowledge and education. Also, there seems to be a mindset that pelvic floor disruptions (i.e. prolapse, weak musculature in the pelvic floor) is a common and normal occurrence for women to experience. Unfortunately there is a stigma revolving around this issue. It’s thought of as taboo, especially in men. With the lack of knowledge plus the stigma along with not knowing who to contract or see about these issues, prevalence continues to rise.

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  8. Very interesting information, especially regarding a topic that is gaining a lot of traction in terms of importance and awareness. Fantastic job with the whole process. First, I found it very interesting that only 130ish participants were sampled when over 3000 were given the opportunity to take the survey. I don’t think it would have swayed the results in any way, but improving statistical power is always a plus. Some questions for you: Do you feel that some results may have changed if a larger portion of the participants were male? Do you think you would see similar statistics if high school teachers were surveyed regarding their beliefs? I only ask about the high school teachers because I feel some of them may say that their curriculum does cover those topics and that their health classes are adequate. Fantastic job with this research, and thank you for helping to contribute to such an important topic for PTs!

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    • Hi Kristi! We definitely agree that a larger number of survey participants would have been beneficial to our research, but we felt like the 130ish quality responses we received was a good start. We certainly have discussed hypotheticals regarding the male vs. female responses. It would certainly be interesting to see how more males would have responded and how their overall accuracy would have compared to females. It is definitely a possible future research goal to address. As far as high school teachers, that’s a great question! I’m sure some would argue that they do cover a large portion of this content throughout their classes, whether it’s in Biology or Anatomy or Health class. However, I know several would agree that this content certainly isn’t given enough attention and should have more class time dedicated to it. I was fortunate enough to have Health class in middle school, but I know shortly after it was cut from the curriculum due to budget issues. It’s incredibly unfortunate to see such an important topic getting cut from academic programs. We really hope our efforts and the efforts of others to make people aware of the importance of education on these topics will encourage school boards to reconsider cutting health-related topics from the curriculum. Thanks for the great feedback!

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  9. Nice job everyone! My question is, why do you think that the majority of respondents stated that they would feel comfortable seeking help although the statistics say otherwise? Could that be an effect of having an anonymous survey possibly?

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    • Hey, Chris! Great question. I definitely would say that you’re probably correct in assuming that people are much more comfortable addressing the nature of these types of questions when there is more anonymity involved. This is likely from the nature of pelvic health commonly being considered “taboo” to discuss openly and honestly. There is a stigma that discussing pelvic health might be “dirty” or “inappropriate” which is likely why people may be hesitant to initiate a conversation or seek help regarding this topic. This is all the more reason to advocate for proper education regarding pelvic health and to advocate for PT being considered a go-to professional to seek out for advice/treatment!

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  10. Hey everyone! Overall great job on the presentation and I found it very informative as far as general knowledge of students regarding pelvic health. I am wondering if/how you think the results of this study would change if the same survey was answered by adults of an older age, potentially 40-65 years old and >65? Do you think there is a lack of education on pelvic health across the lifespan? How can we, as PTs, promote pelvic health education to our patients across the lifespan?

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    • Hi Jenny, thank you for the question! I think some of the results could be different depending on how curriculum in schools have changed over time. I hypothesize that their knowledge could potentially be less due to less schooling/higher education and potentially less access to the internet and the ability to interpret the information they read on the internet appropriately. On the flip side, the internet was one of the major resources our participants indicated using to receive information, so how well can young people interpret that information as well? I do think younger generations have the perk of more research being done in this area compared to older generation, but as you could see from the responses we received there are still some major misconceptions when it comes to pelvic health. I think that as PT’s we can do a better job of promoting all of the skills within our tool box and not just the treatments that patients typically think of. I think we can also do a better job of marketing our skills to other healthcare providers and network with other professionals so they have a better idea of what we can provide to patients. Finally, we could even reach out to local school districts and work with their health teachers to ensure proper information is being taught to students so they have a better understanding of the body parts that are considered more “taboo” to discuss.

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  11. Awesome presentation! I really enjoyed learning about this topic and understanding further the need for advocating that PTs can help with these types of disorders. I found some of the statistics quite alarming about questions answered wrong or with uncertainty especially the ones pertaining to large blot clots, constant LBP, and separation of the abdominal muscles post-partum. These issues are quite concerning and should not be overlooked, and it would be very beneficial for students to know the facts before even encountering something like this. Personally, I also was never exposed properly to this information until PT school. I agree with your group’s responses to some of the other questions that it is hard to implement changes and all we can do is work together as healthcare professionals to promote the need for more information at a younger age.
    My question is quite simple, but what are your group’s thoughts on creating interactions with other health professions to create awareness about the treatments PTs can provide for pelvic health dysfunctions, and trying to get them to also advocate for PT pelvic health? Does your group believe that if this information was coming from a PCP, patients would be more willing to seek help from us? Does your group believe if this information was posted at other healthcare offices and given out as a resource, the numbers of those seeking pelvic health help from PTs would rise? Thank you!

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    • Hi, Cassidy! Great questions!
      Creating interactions with other healthcare professionals to create awareness about PT treatments for pelvic health would be incredibly beneficial for our patients, and for our profession as a whole. Many people, both in the public and in the healthcare system, do not associate PT with pelvic health, which is all the more reason to increase awareness and provide education on the benefits of PT on pelvic health disorders. If we as PT’s can educate our fellow healthcare professionals on our qualifications for treating pelvic health disorders, they will likely pass this information on to their patients and refer them to PT if they ever have a patient with a pelvic health disorder. Unfortunately, a lot of patients do not understand that PT is a doctorate profession or recognize the qualifications/expertise that PT’s can have in various fields, and are more likely to seek and accept help from a PCP for a majority of their healthcare concerns since they are widely recognized for their doctorate degree. If we can include PCP’s in our plan to educate healthcare professionals, they can also refer them on to a pelvic health PT and patients may be more willing to seek/accept help from a PT. We should definitely post more information about this topic, and if we could promote it in our healthcare offices as well as out in the general public those who seek help for their pelvic health disorders would surely rise!

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  12. Great job everyone! I think it a crazy that an important topic like pelvic health is so easily neglected in high school education. I actually did not learn the majority of my pelvic health knowledge until I got into PT school so I could just imagine the lack of knowledge in the general population. My first question is, was there a specific statistic that your group gathered that was especially surprising? Also, if your group were to create high school curriculum for pelvic health, what are the 3 biggest things that you find most important to educate on? Again, great job!

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    • Thank you for your question, Michaela! I think there are many striking statistics that we found but the one I was most surprised by was the number of participants who felt comfortable seeking help. It is very difficult to only pick 3 topics that would be the most important to educate students on but I think proper toileting habits would be a great one for students in middle and high school to learn because their habits at that point in their lives could potentially create problems down the road if abnormal and not corrected. I think educating them on different types of pelvic health providers and what each one could do for them would be helpful so they have an understanding of what each different profession can treat (ex: pelvic PT vs. OB/GYN vs. urologist vs. gastroenterologist, etc.). I also think sexual health would be another thing to emphasize with individuals in this age group, especially high schoolers. I feel that schools don’t do the greatest job teaching sex ed as it tends to be considered an uncomfortable topic by most. I think schools can be a bit too concerned about promoting sexual behavior when really they are missing out on teaching the population that arguably needs to understand proper sexual health and functioning the most at that point in their lives, as some will not go on to higher education and most will not major in anything healthcare related to learn more about what is normal versus what is not. You could also tie this into the pre and postpartum side of things where high school may be the only place they receive any form of sex ed before they have children even if reproduction does not occur until they are in their 30s. I hope this makes sense! I could talk about this topic for days so it was difficult to just pick 3! 🙂

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  13. Awesome job! I found your presentation so interesting because I was never educated about pelvic health in high school or college. I did not really understand how much a physical therapist could do for pelvic health until PT school. Your presentation really highlights the lack of awareness for all the different roles a physical therapist has. My question for you group is, do you think your results would have been different if the majority of participants would have been from urban communities rather than rural communities?

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    • Hi Paige! That’s a great question. In my opinion, I really don’t think it would have been too terribly different. While some of the urban schools might have slightly higher budgets (depending on their location), I still think most of that extra money would have likely gone to different subjects. Even if more Health classes are available in urban community schools, I doubt they would really touch on these specific pelvic health topics. It’s unfortunate because it clearly is an incredibly important subject for kids to learn about, but I think it’s going to take educating the adults on it’s importance before they are willing to consider making it a top priority for the kids. I don’t think a lot of the adults know what their kids are missing because they were never educated on these topics either.

      Thanks for the feedback!
      Kelsey Grosshuesch

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  14. Awesome job! I thought that this presentation was very interesting as I received no education about the topic in high school or even undergraduate schooling. I think it is definitely a topic that we should be educating people about in high school, so that they are more informed about when they should seek help due to things not being right. My question for you is, what do you think would be a good way to increase the awareness about physical therapists being able to help with pelvic floor symptoms?

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    • Hi Deandra! Great question. Ways to increase awareness about physical therapists being able to help with pelvic floor symptoms would include providing patient education and promoting awareness to the general public. Right now, the APTA is advocating for building awareness through various forms of media. For example, sharing research articles/blog posts, having verbal or virtual conversations with both your current patients and the general public, and posting about the benefits of physical therapy on pelvic health on various social media networks. Pelvic health inservices can also be held by both current PT’s and students in various medical or community settings to help promote education on this topic. Hope this gives you just a few ideas to start with!

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  15. Great presentation everyone! In future studies, it would be nice to have a larger pool of participants especially males. I noticed that gender bias was one of the studies limitations, so my question is, would you expect to see/hear the same results if there were more male participants in this study? Also, now that these participants have received information through the survey, do you believe they will be more aware of when to seek help? I know the poster said they reported feeling more comfortable, but the statistic of only 1 in 12 actually seeking help makes me curious!

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    • Hey, Emma!
      I definitely agree with you that it would be even better in future studies to include a larger pool of participants with more males. If more males participated in this study, the results would likely change in various ways. One way it may change would be that males would likely not be as educated on various topics addressed in some of the survey questions including those that address female anatomy, physical changes that come with puberty, or childbirth. Unfortunately, pelvic health has historically been “tabboo” to talk about, especially in the male population. Hopefully in the future, both educational and healthcare systems can change this stigma and promote more positive associations with talking about pelvic health–for all populations! Now that these participants have received information through the survey, our hope is that they will be more aware of when to seek help!

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  16. Very interesting topic and presentation! It is sad that the population is not educated on this topic because there are many conservative treatments that can be done to combat these issues. How do you guys think it would be best for PT to get involved in the education of these topics? Would it be best if local pelvic health PTs gave a lecture during a health class or do you think it would be beneficial for the Academy of Pelvic Health Physical Therapy to create a video which could be played in schools?

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    • Thank you for the question, Cassandra! I personally think that both of those ideas would be great solutions. I think the video may work better for more rural communities who maybe don’t have a pelvic therapist within the area that they can reach out to. I think students would get the most out of an actual therapist coming into their classroom or even zooming in to teach the class live, however this wouldn’t always be feasible with the amount of school districts compared to the amount of pelvic PTs. I also think it would be beneficial for PTs to make some type of easy to follow educational handout for teachers to better teach and understand the material themselves and for students to gain a better understanding that could be easily disseminated amongst multiple schools. I think there are so many ways pelvic PT can be promoted and I hope to see a day where pelvic health is not such a taboo topic to discuss and the general population has a better understanding of it.

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  17. I really enjoyed your presentation as it really demonstrates how unknowledgeable many individuals are regarding pelvic health topics. One of my current clinical instructors practices pelvic health. Most of our treatment is centered around education regarding “normal” toileting habits, how our food and drink intake can act as irritants and about the various tools which can assist in regaining bowel/bladder control. It has been amazing to see how, within a few sessions, many of our patients see improvements in their symptoms. One of the struggles my clinical instructor and I discuss within the pelvic health realm is how few pelvic health PT’s there are within the SD and southern MN region. Her schedule can make it challenging for patients to see a pelvic health specialist immediately and she will commonly see patients once every few weeks after developing the initial plan of care to assist as many patients as possible. With increased education about “normal” urinary/stool habits likely comes an increased demand for pelvic PT’s. Do you have any suggestions on how to combat the lack of pelvic PT providers? Would it be beneficial for students to experience a one-day clinical with a pelvic health PT which may catch their interest?

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    • Hi Cay, thanks for sharing your experience with pelvic health! Our group, along with Dr. Adamson, would completely agree. There is definitely a lack of pelvic health PT’s in South Dakota/Minnesota, especially those that specialize. I think promoting this realm of PT, as it is fairly new and not known about by most, may increase awareness and may increase therapists interests in working with these types of patients. Along with this, seeing this niche of therapy may cause therapists to complete continuing education credits regarding pelvic therapy. They may not specialize, but having some knowledge in how to treat these patients is a start. I think the more exposure to different types of therapy (ortho, pediatrics, pelvic health) is always a benefit for students. This allows them to make educated decisions on whether this is something they are interested in or not!

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