As a pelvic floor physical therapist, KCP’s Ashley Williams knows that the initial pelvic exam / assessment can cause anxiety among both men and women. That uncertainty may cause them to delay scheduling much-needed treatment. Two of Dr. Williams’ biggest priorities in her practice are educating her patients and ensuring that they are comfortable at all times. In today’s blog, Dr. Williams answers some common questions that patients have prior to their first appointments.

Appointment Preparation – What Are We Going to Talk About?

I want clients to know that we always start by talking first! We don’t ask anyone to undress before we’ve had a chance to talk and come up with a game plan that we both agree to.

I assure them that they are not likely to share something I’ve never heard before! I know that we are discussing details that seem very personal that they don’t typically share with strangers – or even friends – but these are usually common conversations for me, and nobody should feel embarrassed to share!

We’ll start by discussing the issues that clients are having as well as their goals for treatment. I would suggest that clients bring a list of concerns and symptoms. I like to understand how long the issues have been around, what makes the symptoms better or worse, and what treatments they have tried in the past. I also want to understand what activities clients are avoiding and what they would like to return to.

What Should I Wear?

Clients can wear anything that they are comfortable moving in. Shorts or yoga pants and a T-shirt are great. We also keep extra shorts on hand if you’re wearing a dress, skirt, or restrictive jeans and would like to borrow a pair while you’re here! As part of our assessment, we’ll look at movement patterns, posture, and strength. Don’t worry – there’s nothing to prepare for and we don’t ask you to do anything difficult!

I will likely also ask you to perform some simple movements while standing and lying down. I’ll be palpating some of your bones and muscles, so it’s helpful if you wear something that’s not too thick.

What Happens with an Internal Exam

Again, I want to reiterate that we always go at the client’s comfort level. It’s often helpful for me to do an internal exam to examine internal muscle structure, but it doesn’t have to be on that first day. I’ll always make sure that clients are comfortable first.

That said, if we do determine that an internal exam would be helpful, I’ll provide a gown, ask them to undress from the waist down, and then step out of the room. Once they’re ready, they can ring a bell and I’ll come back in.

The internal exam is a one-gloved finger vaginally or rectally. There are no forceps or additional tools involved. I’ll look at some of the structures outside the vulva. I’ll look for skin discoloration and see if there’s any vaginal dryness or irritation.  I’ll also be evaluating muscle tension in the pelvic floor and/or the degree and positioning of any pelvic organ prolapse. As I’m examining, I’m talking clients through the whole process, letting them know where I am and what I’m doing and asking how they’re feeling.

If for whatever reason during the internal exam, if someone is uncomfortable, they can just say the word and we stop. Maybe it brings up past trauma or they just decide ‘I don’t want to do this anymore.’ Whatever the reason, we stop and it’s completely okay. Consent is always a priority!

Clean Up

Once I’ve finished the exam, I’ll leave the room again and provide wipes and tissues, allowing them to clean up and get changed again. I’ll tell them to crack the door open when they’ve finished, and then I’ll come back in and we’ll talk about what I found and what the game plan is moving forward.

Follow Up

Depending on what I find, I’ll suggest a plan of at-home exercises supplemented by in-person physical therapy. We may or may not need to do internal work on a weekly basis in the office; sometimes we’ll only have to do it again when we’re checking progress along the way.

Typically, we’ll schedule one to two visits weekly and monitor progress as we go. We’re always talking openly at each session with the goal of helping the client improve their quality of life. Pelvic floor dysfunction, like incontinence or painful intercourse, can be challenging issues for individuals to navigate. We want them to know that there are solutions to these challenges, we are there to help, and we love being a part of their journey towards greater freedom and abilities.

Who Should Schedule a Pelvic Floor Assessment?

There are many people needlessly suffering out there and dealing with pelvic floor dysfunction because they believe that their symptoms are ‘normal.’ I tell patients all the time, it may be common, but it’s not ‘normal,’ and many of these issues are addressable through pelvic floor therapy.

Some examples include, but are not limited to:

• Pelvic Pain
• Vulvodynia
• Painful Intercourse
• Urinary and Fecal Incontinence
• Urinary Urgency/Frequency
• Prolapse
• Pregnancy Preparation and Pain Management
• Postpartum Recovery
• Endometriosis
• Post-Prostatectomy Urinary Incontinence
• Erectile Dysfunction
• Chronic Pelvic Pain
• Scrotal, Testicular, and Penile Pain
• Constipation
• Low Back Pain and Sacroiliac Dysfunction
• Sciatica
• Hip Pain

Individuals can come to us directly if they are dealing with any of these areas, even without a referral from their doctor or gynecologist in most cases. You should always check with your insurance provider, but most allow direct bookings without referrals. We work hand in hand with the other members of your medical team and will be sure to collaborate to ensure that we are all working from the same page to provide the best care for our clients.

Schedule Your Appointment Today

If you’d like to book an appointment with Dr. Williams, call the office at 704-541-1191 or click here to Request an Appointment.

KCP orthopedic and pelvic floor physical therapist Ashley Williams had the honor of serving on a panel of women’s health experts at a recent event discussing menopause in Charlotte.

On Saturday, March 22, a sold out crowd gathered at the Independent Picture House for a screening of the short film The M Factor. Organized by Jasmine Cutlip of Signature Wellness, the event was designed to bring awareness about menopause, a topic that impacts millions of women annually. The film featured leading experts from Johns Hopkins School of Medicine, The Menopause Society, Mayo Clinic and more.

Created with the goal of helping women to feel more supported in their journeys to and through menopause, the film exposed many of the challenges that women face while being ignored, ridiculed and / or shamed, and ultimately left untreated.

The film attempts to “shred the silence on menopause” and be a part of a movement to foster change in a broken healthcare system.

In the panel discussion that followed, Ashley was joined by other experts in the field to discuss some of the challenges that they have seen in their respective practices from women who are menopausal or going through perimenopause.

Ashley talked about the role that estrogen plays in women’s bodies and the effects that declining levels can have on the musculoskeletal system. A weak pelvic floor, accompanied by urinary incontinence or pelvic organ prolapse, can be a common occurrence during these years. “But remember – ‘common’ doesn’t equal ‘normal’, and ‘not normal’ doesn’t mean ‘not fixable,” says Ashley. These common issues can often be dramatically improved or completely resolved with the right combination of exercises.

“Addressing the problem earlier is going to make your outcome so much better,” advises Ashley. She noted that many women begin experiencing some leakage postpartum and never seek treatment, thinking that to leak after childbirth is normal. These same women, who have been experiencing minor leakage for years, may be experiencing even greater issues with incontinence and prolapse in menopause. While it’s never too late to address the problem, clients are likely to experience results on a much quicker timeline when they seek treatment sooner than later.

We were thrilled to be a part of the event and plan to continue collaborating with other leaders in this field to educate women and provide resources for them in their perimenopause and menopausal journeys. If you’d like to learn more about working with Ashley Williams for issues such as incontinence, pelvic prolapse, painful intercourse, lower back pain, or other pelvic floor issues, please contact our office at 704-541-1191.

Anne had already been a client at KCP for the last several years. She initially came for shoulder rehabilitation and then found support for managing her arthritis and unstable pelvis. When she began to face urinary incontinence and prolapse around the age of 70, her doctor recommended pelvic floor physical therapy. Anne knew that this was an area of specialization for KCP physical therapist Ashley Williams and made an appointment.

Not knowing what to expect, Anne admits she had some nervousness about pelvic floor PT. “Ashley immediately put me at ease,” she says. “She told me the first visit would be just to talk. And we did. She asked me about the issues I was having. She asked me what the women’s center told me. And she kind of prepped me by telling me, ‘If you are OK with it, at some future visit I would like to do an internal exam.’ I left there thinking Holy Moly! You know, we were programmed to believe that you go to the gynecologist for that.”

Anne went back for her second visit. When asked if she was comfortable with the internal exam that day, she joked with Ashley about why she would choose such a career and admitted her nervousness. “Ashley is just really good with putting you at ease,” she says. “She told me we did not have to do this if I was not comfortable, but I just decided to trust her. She’s very mindful of your modesty. She tells you every single place she is going to touch and what she’s going to do before she does it. And she’s very attentive to not hurting you. She was just gentle and told me everything that was happening.  It was like being in a gynecology office, if you want to know the truth. And I never got embarrassed, which was amazing.”

In addition to the manual work during their PT sessions and the at-home exercises that Anne now does, she is also learning more about other factors that may be contributing to her urinary incontinence. “Ashley is also big on helping you understand the big picture. She talked to me about nutrition and gave me some handouts that listed foods that are irritating to the bladder. She also talked to me about making a daily diary of what I was putting into my body for a few days to see if there might be some connections with what was causing my leakage. The total approach was just wonderful. I can’t say enough good things. I’m just blown away by the level of care,” she says.

Anne says that she appreciates the lessons she is taking away from the sessions with Ashley. “I’m learning how everything works together. I’m also learning that just because I’m getting older, it doesn’t mean I have to stop doing the things that I like and accept them as they are. I can get help and work to improve my situation. You know, I’m approaching a big birthday, but when I walked out of there, I felt young. How’s that?!”

70-year-old Anne says that she has arthritis “everywhere” and has experienced aches and pains related to it for over half her life. “There’s not a part of my body that hasn’t needed something,” she says. “I’ve had both of my shoulders operated on. I’ve had a hip replacement. I’ve had my foot done twice. I’ve had both my hands done.”

No stranger to the healthcare system or to physical therapy, Anne says she has had wonderful physicians who have helped her greatly but mixed experiences with their associated physical therapy practices. “The place that I went before was large. There would always be like a hundred other people in there and all different levels of PT’s. It just didn’t have a real personal touch,” she says.

Anne didn’t realize that she had a choice in selecting a physical therapist. While a member of a swim club, she began to hear several of the members talking about KCP Physical Therapy. Her friend Patty told her how much KCP had helped her, and she also explained that residents in North Carolina have “direct access” to physical therapists, meaning that a physician’s referral is not necessary to set an appointment with the provider of your choice.

Anne was having shoulder issues at the time and decided to try KCP. She made an appointment with physical therapist Joyce Kight. Soon after, Joyce encouraged Anne to get an MRI of her shoulder. The image revealed a torn rotator cuff and biceps tendon, which would require surgery.

“I relied on Joyce for her recommendation, because physical therapists have a better feel for what a physician does than anybody else,” says Anne. “They sent me to a great physician, and I was able to start PT within a couple of days of the surgery. Most people don’t get that option. But that was so important. I have 100% range of motion in my shoulder that was repaired. I cannot tell you how many people I have met who can barely raise their arm to their ear. So, I give KCP all the credit for that. I regained full use of my arm, and now I tell everybody to go to them and to start as early as possible after surgery.”

Anne says that KCP prepared her well for the physical therapy that would follow her shoulder surgery.  “It’s really painful,” she says, “but they tell you ahead of time what to expect. And they tell you what outcome you can achieve if you see it through. And I trusted them. Without that trust, you could wimp out and question the process. They would help you with pain control and listen to how you were feeling. They always knew the balance of how much to push and when to back down. They are so kind and compassionate and encouraging!”

Since that first experience, Anne has sought PT exclusively from KCP. She has learned how to manage pelvic instability, recovered from a hip replacement, participated in group exercise classes, and is now undergoing pelvic floor physical therapy to address pelvic prolapse and urinary incontinence. “I will never go anywhere else,” she says. “I can walk better today. I have great range of motion in my arms. I have so many things that they have fixed, and I also know that when I call them, I can get right in and not have to wait six months or six weeks. I have seen all three of their therapists, and I think that these three women are some of the smartest women I’ve ever met.”

“I tell all my friends about KCP, and I have referred several people there, including my husband,” says Anne. “And I tell them all that they have freedom of choice. You can pick your physical therapist. You do not have to go to the practice that is affiliated with your surgeon. Just because they are big and their physicians are good doesn’t mean their PT’s are good. If you want to be part of a cattle herd, go ahead. But I don’t want that. And after my friends have gone to KCP, they come back and thank me and tell me they wish they had done it long ago!”

“Ann was dedicated in her recovery and her desire to return to the activities she loves,” says Joyce. “It is such a thrill to see her back in the water swimming with her Masters Teammates.”

Mimi first became a client of KCP Physical Therapy over 15 years ago when she was having neck pain. She worked with physical therapist Joy Pfuhl who was able to help resolve the issue.

After she had moved past the rehab stage, Mimi decided to try the 1:1 personal fitness training program that KCP had begun offering. “Joy taught me the concepts of strength training and toning,” she says. “I had been a cardio junkie prior to that – I would never lift a weight or do a plank or push up unless you forced me to. Strength training is so important though.”

Mimi committed to improving her health by both improving her activity level as well as her nutrition. She joined Weight Watchers in addition to going to personal training sessions twice a week. “By the time she finished with me, I was a stud!” Mimi says. “I had the best arms, I was strong, and I’d lost 40 pounds.”

She left Charlotte after that to live in San Diego for some many years. When she returned and injured herself lunging for her dad’s runaway wheelchair, she reconnected with Joy and KCP.

“I hurt my lower back and pulled my piriformis muscle with that incident,” she says. “I was in a ton of pain. I couldn’t sit or do anything – it was crazy bad. We did some PT and I got a steroid shot, which dulled the pain but didn’t take it away. Finally Joy suggested that we try some dry needling, and that got me the rest of the way. I made it back to 95% of where I was previously and was so much more functional. She helped me so much.”

“Mimi’s fortitude is inspiring.” says Joy. “She has been through life altering back pain on a few occasions, and I was happy to help her get back to her golf game!  She has learned the value of strength training and rarely misses a workout unless she is traveling.”

Mimi has not strayed from the fitness habits she developed fifteen years ago. She joined KCP’s group fitness program, which offers both Zoom and in-person workouts throughout the week. “I love working out in a group,” she says. “It makes the hour go by so fast.”

“Joy is one of those people who has changed my life,” she says. “And the rest of the staff there is amazing. They hire well there. In a time where medical care has become so impersonal and you feel like you are a cog in a wheel, KCP is the opposite. They listen to understand what’s going on, they understand your pain tolerance, and they come up with the right treatment plan for you. It’s not like a mill where you have a different person every week. It’s like Cheers – everybody knows your name.

“I tell anyone who needs a PT to go see them. You get phenomenal care at the highest level with real humans. It’s a really nice and great place,” she says.  Nice is nice, but it’s also all about the results. I’ve gotten results every single time.”

“I was broken in mind, body, and spirit when I first came to KCP,” says Christina. “I had been in chronic pain for almost five years and didn’t know if I would ever get better. But Joy gave me the courage to hope. She fought for me and made me believe that I could have a better life.”

When Christina’s back pain began, she went to a chiropractor for over six months. When she failed to make improvement, she saw a spine surgeon who she told her there wasn’t much he could do. “He told me this was my life now and that I would just have to get used to it. But it was horrible – I didn’t want to get used to it! He referred me to their internal PT clinic, but I tried it twice and didn’t go back. They were rude and the experience was not good.”

“I couldn’t believe this was my life,” she says. She went back to the chiropractor who referred her to a soft tissue specialist. She found it “super helpful” and started to feel hopeful.

Then, after going sledding with her son, Christina says, “The entire disc herniated. It was horrible, horrible, horrible!”

Surgery came next. “I had a super great surgeon,” she says. “They performed a microdiscectomy. But after six months, I still wasn’t doing well. I had no idea what to do. I applied for another surgery called an intersect procedure to kill the nerves inside my vertebrae. I was hoping this was going to be the miracle, but it wasn’t. I went back to the soft tissue specialist, but it didn’t help this time. I was going to doctors all the time and no one could figure it out.”

As a young mother, Christina says she was frustrated with not being able to do things with her kids or have any kind of social support. “I was at home in my bed all the time,” she says. “I couldn’t drive carpool for my kids or even make them dinner. I couldn’t do anything with friends. I couldn’t go to events at church because of the pain. I thought, How am I supposed to live like this?”

When she told her friend Melissa from church about her situation, she learned that Melissa had been helped by KCP. Having undergone many surgeries herself, Melissa shared how KCP had helped her over the years and strongly recommended that Christina make an appointment. “Part of me rolled my eyes,” admits Christina. “I thought, Do I really want to go and retell all of these stories to another new person? I’d been to so many providers already. But the sense of chronic pain is so overwhelming. It consumes every piece of your life. I know and trust Melissa, so I thought that I had to try.”

After only a few visits, physical therapist Joy Pfuhl encouraged Christina to get an MRI. While it showed “a few small things,” Joy didn’t see anything that explained Christina’s pain. “There’s still something else going on,” she told Christina. “I can feel this with my hands!” She suggested an additional MRI of a different location.

“When she told me she could put her hands on it, it meant so much to me!” says Christina. “I needed that. My friends were telling me to go to a counselor and that it was all in my head. I was starting to feel crazy and have self doubt. I needed that assurance from her.”

After the second MRI came back, showing a fractured disc, Christina’s surgeon told her that he did not want to perform a fusion surgery for her. He was concerned that it would lead to more surgeries and even further limitations. He referred her to a doctor in Texas who performed artificial disc replacement surgeries and had operated on Tiger Woods.

“I was desperate,” Christina says. “I made the call to him and went to see him in Texas. He said to me, ‘You do not need to live like this. This is not okay. You are 100% a candidate for this surgery.”

He explained how to begin the process of getting scheduled for surgery. First, Christina would have to file with her insurance company. “He told me that insurance would deny it, but that I couldn’t qualify for self-pay until we got the denial. He told us to expect to wait around 8 weeks for that, which would have been mid-October. We had no idea how we would be able to afford it, but we applied and began the process,” she says.

The day after she applied, the scheduler at the doctor’s office called to schedule her surgery. Confused, Christina said, “Wait, I thought we couldn’t schedule it until after they denied it.”

The scheduler said, “Oh no – you’re approved! Apparently you have some rider on your insurance that we’ve never seen before. If you have any surgery before October 1^st of this year, it will be paid in full. Your whole surgery is covered.”

“I just started crying,” says Christina. “I asked her if she believed in God, and I told her this was a God thing! This was a miracle! What a crazy miracle!”

The surgery (which Christina learned cost $350,000) was performed in Dallas two weeks later. She received three artificial discs – L4, L5, and S1. She returned to Charlotte and began PT at KCP again.

“I was still in a lot of pain after that third surgery,” she says. “I was a mess when I went in there (to KCP). I was wearing compression socks, I had a blood clot in my arm, and I had a ciroma sac (4 pounds of liquid gathered inside of me) draining outside my stomach with a catheter. And My Sherona was playing in the office and Joy said, Hey, this is your song! And she started singing My Ciroma! I laughed so hard! I had been mortified to go in there in my condition, and it just did me so good to have that laugh!”

“That was one of the greatest things about Joy,” she says. “She could always look past me at  a low moment and know that I was more than that. She just met me wherever I was and cast a vision for me and told me that it would get better. She would remind me, ‘You’re only at 6 weeks. You’re only at 3 months. You’re doing great. Don’t worry if you’re having a bad day – just keep doing the work and hang on.’ She is your cheerleader all the way. ‘You go, girl. Hang in there, you’re going to have setbacks. It’s OK, we’re not going to leave you there.’”

“I wouldn’t have gotten through all of that without her,” says Christina. “My recovery would have stalled. She saw me as a human and she cared about me. She would text me or make room on her schedule if I needed it. She pulled me though. And the other people at KCP – both the staff and other patients – helped me too. My PT time was my social time. My friends had written me off, but I could go there and laugh We could talk about movies, vacations, whatever. It was such an uplifting atmosphere where everyone was always so kind. I always wanted to be there.”

“Now, it’s been a year post-surgery, and  I’m doing all the things! I actually took my kids to Disney. I can go out on the boat. We’re living again! Five years ago, I never thought any of this would be possible. She gave me my life back.”

Christina is also now attending water fitness classes at the YMCA 3-4 several mornings a week. Additionally, she continues to have monthly sessions at KCP. “I don’t want to fall backwards, and I’d like to be doing even more in another year, which I now believe is possible.”

“Christina had such a long journey before she came to KCP,” says Joy.  “I am honored to have been part of her recovery and was I thrilled to see pictures of her water skiing this past summer.  Less than a year ago she could not sit on the couch to read to her children.  She is an example of ‘never give up’  and willingness to go the extra mile.  Congrats Christina!”

“My story of shoulder pain and rehab involves a bizarre pseudo skiing accident that happened in March of 2023,” begins 62-year old Lindsay. “I was on a chair lift with a young snowboarder on my right. He had his left foot forward in the board and kept resting his board on my skis. I kept saying to him, ‘Hey, buddy, the rail for the chair lift is below you. You’re on my skis and all the weight of your legs is on my legs.’ I kept trying to get him off me. I made a mental note that when we came to the top of the chair lift, I was going to ski off to the left as far as I could go.

“So when I got off the lift, I put all my weight on my left ski and I skied off to the left. And I was picking up speed and getting ready to transfer my weight onto both skis. I had a moment of thinking that something didn’t feel right when we got off the chairlift, but I tried to put my right ski down anyway and found out there was no ski there. There was just a boot.  When he put his board down diagonally, it had to have popped my right boot out of my binding. So the boot caught in the snow and I did a face plant.”

Lindsay was knocked out by the incident. Over the next few days, she had a sore shoulder. On the return home from the trip, she found that she couldn’t lift her luggage to put in the airplane’s overhead compartment. Once home, she began having trouble sleeping due to the discomfort. She scheduled a visit with the doctor, where an MRI revealed that she had a torn rotator cuff.

She began physical therapy and says she was diligent in her efforts for two months. The injury had not been healing adequately, however, and the surgeon proposed rotator cuff surgery. Due to an international trip for a memorial service that had planned, Lindsay decided to delay the surgery until after the trip was over.

“During that time, my shoulder completely froze in the joint,” she says. “I could do things right after the injury that I could not do days before the surgery. My range of motion was awful.
I could not get a mug out of the kitchen cabinet. I could not get my hand above the height of my shoulder. I could not get clothing off the rail in my closet. I had to start doing everything with my left hand.”

Lindsay reports that the surgery was very successful. “They completely repaired my torn rotator cuff, took some scar tissue off the labrum, and also reattached my bicep. It was very painful as all shoulder surgeries are.  Afterward I was sleeping in a recliner and doing physical therapy, but after four weeks of doing PT, I felt like I was almost going backward and I did not feel like I was getting very good attention. I was very frustrated and upset that I was not making any progess at all,” she says.

During this time, Lindsays’ neighbor Mimi came to bring food and check on her. Lindsay remembers crying and sharing her frustration during the visit. Mimi took the opportunity to tell her about her physical therapist, Joy Pfuhl at KCP Physical Therapy.

Lindsay spoke to Joy, set an appointment, and began physical therapy at KCP.

“Good news, bad news,” she says. “I began making some progress, but I was still in tremendous pain. My range of motion was not coming back. Because I was not back to range of motion, I couldn’t start doing weight bearing exercises to get my strength and stamina back.”

For nine months, she traveled between her two homes (in North Carolina and Florida) and worked with KCP in Charlotte and a physical therapist in Florida. She says she was still frustrated with the minimal improvement. Her surgeon continued to push his estimate of her healing timeline. Lindsay says she thought, “No. I can’t do this anymore. I’ve lost sports. I’ve gained about ten pounds. I’d become very inactive – I didn’t even want to walk anymore because of the pain. And don’t even think about sleep. There was no sleep in my life during any of this. I could not lay flat in a bed.
I still was propped up a lot of times, you know, just giving up and going down to the recliner that we had purchased for my recovery time.”

Both physical therapists told Lindsay that they believed that there was something more going on since the physical therapy was not as effective as hoped. She returned to the surgeon to discuss the lack of progress and the options available going forward. She says, “He determined that my frozen shoulder was of such a level that even nine months of post rotator cuff surgery PT was not touching it.”

She returned for a second surgery. “My rotator cuff repair was perfect,” she says. “It was what my body did with the injury. He did a shoulder encapsulation release procedure. He told my husband later that my shoulder was one of the worst he’d ever seen. When I went for my post op checkup, he asked if I had ever been in a total whiteout situation, like trying to drive a car in the snow where everything in front of you is white. He told me that when he went into my shoulder arthroscopically for the second time, it was like being in a white out condition. He said he could not see anything until he finally saw the teal colored stitches that were in my rotator cuff from the  repair the previous September. Once he found that, he could orient himself into my joint and just started removing scar tissue.

“While I was still under anesthesia, they moved my arm for the first time in months. The surgeon said, yeah, we got you to about a 95% of your uninjured shoulder range of motion.”

After the surgery came more PT and, according to Lindsay, one of her favorite parts of her KCP relationship story.

The surgery had been offered for the first week of July. Daily physical therapy is needed immediately after surgery, which was causing Lindsay great concern. She wanted to take the opening but felt that she needed to delay due to the physical therapy office being closed four days for the holiday weekend. She told Joy about her scheduling dilemma.

Joy simply told her, “Get the surgery. I’m not traveling, and I live close by. I’ll come meet you.”

“And even though it was a holiday week,” says Lindsay, “she saw me every single day.”

“Daily physical therapy lasted for about two weeks, and then for the next six weeks, I did three times a week. After Labor Day, I dropped down to twice a week. And now after 12 weeks they have me somewhere between 95 and 98 percent. Joy thinks I’m going to be able to get to 100% of my uninjured shoulder. I have very, very few range of motion limitations – just a little bit on my external rotation. Ladies, I can now reach my bra strap with my right hand. It’s not comfortable yet, but I at least can get there!  I can get things out of my wall-mounted kitchen cabinets. I can hang my laundry up in my closet. “

“We’d been in North Carolina for a while, so my friends in Florida hadn’t seen me since I could barely lift my arm and was in pain all the time. Now, they can’t believe how much better I’m doing. It’s like a little celebration when they see me. I do my little ballet motion and everywhere I go I get cheers and accolades. So I’m flying high on this!”

“It’s kind of funny, but it’s been life changing,” she says. “It was such a crazy, weird thing that happened. I just think that I was so very fortunate that I had a sympathetic neighbor who was looking out for me and happened to have a personal relationship with KCP. I just grabbed that and it was my lifeline and. And boy, have they  been with me through every step of the tremendous struggling months and they have celebrated every gain that I’ve made since that second surgery. It’s been a great experience, great experience.”

“Lindsay had a long and arduous course to get to the finish line,” says Joy. “But no one works harder than Lindsay! She is one determined and disciplined lady. It was a pleasure to be part of her journey to recovery. I’m happy to see her back to doing yoga, playing pickleball, and tennis.”

Bill has always enjoyed athletics of some sort for most of his life. Over his life, he has especially enjoyed swimming, basketball, and running. In his 40’s, he began Taekwondo lessons with his daughters. He had achieved the level of third degree black belt when he had a sparring match with a younger third-degree partner. At one point in the match, he threw a punch that missed. He remembers feeling a tug on his shoulder and thinking “That felt weird.”

He didn’t seek treatment at the time, but the “weird” feeling progressed into the inability to move his arm over his head. At a company softball game, Bill attempted to throw a ball from the outfield and realized he couldn’t even throw the ball. He was experiencing more pain and was unable to sleep on the affected side. “Finally, I went to a orthopedic doctor and they discovered that I had pulled the bicep off my shoulder, which they call a slap tear,” he says. “So they had to go back in and tack it back down.”

While discussing the plan for surgery with some friends, one of them suggested that Bill should consider KCP for his physical therapy. He called, explained his situation, and they made a plan to start his PT once his post-surgery six-week immobilization period was completed.

“At the first session, we had to see what kind of range of motion I had after all those weeks.” Bill says. We got it to move about six inches. It was so painful, but the goal was to get me back to full mobility. I had to go three times a week – mostly with Joy (Pfuhl) but sometimes with Joyce (Kight).

“Each session, the goal was to get that motion just a little bit further,” he continues. “I have to say it was one of the more painful experiences I’ve had, but they know what they have to do and they are there to support you on the journey. Joy always knew just how far she could push. As painful as it was, it was also kind of fun. They are so good-natured. About the time I was there for that injury (2008-2009) there was a movie out called The Punisher and they were selling t-shirts that said Punisher on them. I got them a couple of Punisher t-shirts. We just had fun with it. And it took about three months, but we finally got there.”

Over the years, Bill has continued to work with KCP for other issues as they have arisen. When he needed rehab for a frozen shoulder and later for sciatic pain, he came back to KCP. “At this point, I know where to go on an as-needed basis,” he says. “Later in life, things get harder and harder, and knowing someone that knows how to deal with these things is very important.”

Bill’s wife also became a client at KCP after she began suffering from inflammation problems and pelvic instability. “It’s a family affair for us,” he says.

“They just really know what they’re doing,” Bill says. “They’ve got all the equipment necessary to treat just about anything. And they have the space to do it. And they’re not only helping with the range of motion issues, they’re also helping to strengthen the muscle groups so that you won’t have issues anymore. Even now, I’ve got several exercises that I do at home to keep strengthening my shoulder. They help you function without pain.”

Talking about sex was not something that 60-year-old Cindy* was typically comfortable with.  In the dating world again after a long absence, she found herself in a long-term relationship with a patient and caring partner. Wanting to become more intimate with her partner, she was willing to put her nervousness aside and seek help.

As someone with a history of mental and physical challenges with sex, she was nervous about pelvic floor PT in general but also to work with a provider who was significantly younger than she was.

“My first concern was that I am so much older than Ashley,” she admits. “But I found out that she is so mature and so good at what she does. She makes it so easy to talk and ask questions. She told me ‘You can’t say anything I haven’t heard before!’ I was so surprised – it wasn’t awkward at all!”

Cindy has had a long history of health issues. Since she was diagnosed with Crohn’s disease in her thirties, she has all undergone multiple surgeries and experienced intestinal issues. She knows that all of this has affected her pelvic floor. During the course of her therapy, she has learned exercises to relax her pelvic floor and how to communicate with her partner about how she’s feeling.

During some sessions, Ashley would also use manual therapy techniques to help release tension in Cindy’s pelvic floor. “During those sessions, she always made it very clear that if I was uncomfortable, I should give her a signal and we would stop,” Cindy says. “Pelvic floor physical therapy can be uncomfortable and we think we shouldn’t say anything. Ashley makes sure to get input all along the way and make sure that I am always comfortable. I really appreciate the way she does her job.”

Cindy reports that sex is getting better, little by little. “She has made a world of difference in my life,” she says. “I’m almost where I need to be, and it’s all because of her.”

Ashley credits Cindy with being consistent with her work outside of PT. “She’s very diligent about her home exercise program, and I believe this has helped contribute to her major progress. She told me at the beginning that she was nervous to work with someone who appeared so much younger. She quickly overcame her reservations though and has been able to talk about things that have always seemed taboo to her. I’ve enjoyed getting to see her achieve her goals!”

*Name changed for client privacy.

39-year-old Angela was discussing her endometriosis-related pelvic pain with her gynecologist when she learned about the pelvic floor physical therapy available at KCP.

As she explained to her doctor, there were days that Angela experienced such severe pain that she was unable to leave her house. On these days, she resigned herself to staying on the couch all day with a heating pad. Sex was also becoming more painful in general.

During pelvic floor physical therapy, Angela says that she was impressed with the friendliness and professionalism of the KCP staff. “Ashley was the physical therapist assigned to me and was an absolute gem to work with! She has a wealth of knowledge that she shared in a way that was easy to understand. Every time I met with her, I felt that she genuinely cared about my well-being,” she says.

“During our sessions, Ashley taught me how to use a pelvic wand to release muscle tension. She also taught me how to perform abdominal massages on myself to break up scar tissue from previous surgeries.

“While I will always experience pain due to my endometriosis, I now have the tools to specifically address the pain resulting from muscle tension and scar tissues related to my endometriosis. These tools have allowed me to have sex again without severe pain,” she shares.

Ashley, her physical therapist, says “Angela has come such a long way! We’ve been working on return to physical activity while also addressing symptoms of endometriosis. She’s been maintaining through physical exercises, stretches, and pelvic wand. And, she’s now able to participate in things she never thought she could have done before.”

As the Endometriosis Foundation of America shares in their article Everything You Need to Know About Pelvic Floor Physical Therapy (PFPT) for Endometriosis, “Someone with endometriosis should come to pelvic floor physical therapy if they experience pelvic, abdominal, or back pain in general but specifically if it is interfering with completing activities throughout the day, exercises, recreation, sexual activity, and work.” Based on an assessment, a pelvic floor physical therapist can determine if the pelvic floor muscles or abdominals are contributing to your symptoms and devise a treatment plan if needed.

They also stress that you don’t need to have a diagnosis to be seen. “Simply experiencing pain and/or dysfunction is enough of a reason to seek pelvic floor therapy. While pelvic floor therapy will not cure your endometriosis or take away all of your pain, it can be a great tool to ease some of your symptoms,” says the article.

If you struggle with pelvic pain, back pain, or pain with sex or periods, you may be a candidate for pelvic physical floor therapy.

Schedule an appointment with Dr. Ashley Williams if you’d like to learn more.