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?!”

DeeDee* had gone to see a urogynecologist to discuss both the pelvic pain and urine leakage she had been having. At 30 years old, she was frustrated (and embarrassed) to be leaking on nights out and to be having so much fear and anxiety as a result.

While she had been waiting for the appointment, she recalls reading a magazine article about some of the experiences that women put up with, thinking they are normal when they are most definitely not. Her visit with the doctor confirmed that her pain and leakage issues were indeed not normal. The specialist referred DeeDee to KCP for pelvic floor physical therapy.

She admits that she did not know much about pelvic floor therapy but decided to give it a try. During her first appointment, she says “First and foremost, Ashley (pelvic floor therapist) made me feel very comfortable. She was big on education and helping me understand what was going on in my body. I really appreciated the holistic approach.”

While at KCP, DeeDee shared some of the other recurring issues that she had been having, which included back pain, knee pain, pelvic instability, and hypermobility. She learned how to “connect the dots” of how her pelvic floor weakness contributed to other issues as well as how to identify the different types pain she was experiencing. In addition to working with Ashley Williams on her pelvic floor, she also began working with Joyce Kight to address her pelvic instability.

DeeDee says, “I think that the two-pronged approach with both therapists helping me is not something that would happen normally. Most places would just print some exercises for you to do and say godspeed.” Working with both therapists, Daisy learned how to relax her pelvic floor, how to engage her core, and how to employ diaphragmatic breathing.

“At KCP, I learned how to manage my symptoms and maintain my body. It gave me more autonomy in my life and took away my fear and anxiety. I used to dread getting up in the morning, because I would always think ‘What is going to hurt?’ It sounds so basic, but it really helped give me my life back,” she says.

“It’s just such a relief. I thought I had to power through this pain. As women, we’re used to showing up 100%. We try to make sure that things are running smoothly in our households and we’re maintaining a seat at the table in our careers. We feel like everything has to be a battle. I wish that other women who are struggling out there and fighting these invisible battles could know that you can CHOOSE not to. Help is out there,” she says.

Now, DeeDee enjoys going on hikes with her dogs, going to concerts, cycling, and not being scared to try new things. “I’m not a tennis player or gymnast or dedicated athlete,” she says, “but having the freedom and peace of mind to be able to live and move in your own body is so important – I can’t stress that enough.”

Her physical therapist, Ashley, says, “DeeDee told me that she previously had little awareness of her body and what could be contributing to her overall health. We worked together on finding a program that was tailored to her tolerance and goals. Now, she has a better understanding of how to care for her body, and I’m so happy to see her doing the things she enjoys.”

*Name changed to protect client privacy.

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.

Urinary incontinence, among both men and women, is a common occurrence.

Just because it is “common,” however, does not mean that it is normal, unavoidable, or untreatable. Many cases of urinary incontinence can be resolved or well-managed with treatment, which a qualified pelvic floor physical therapist can provide.

Ashley Williams, a pelvic floor therapist at KCP, has helped many patients improve their lives through treatment for their leaky bladders. In a recent interview, she shared more about the types of urinary incontinence and effective treatment strategies for each.

Below are Ashley’s answers to some frequently asked questions on the subject.

What is Urinary Incontinence?

Any type of bladder leakage is considered urinary incontinence. But there are many types of incontinence, and it’s not helpful to lump all of them together as just one diagnosis. Different types require different approaches, so it’s important to understand which type someone is experiencing.

The two most common types that we can talk about today are stress incontinence and urge incontinence.

What is Stress Incontinence?

Stress incontinence is leaking that occurs when you cough, sneeze, or laugh too hard. Or, it could be that you’re running or lifting something heavy, which causes you to leak a little.

It can happen when you’re doing something that puts stress on the pelvic floor, and the pelvic floor cannot provide strong enough support to prevent the leak.

Stress incontinence can occur as a result of pelvic floor muscle dysfunction that can result from many common life experiences, like pregnancy and childbirth, pelvic injuries, inflammation, surgeries in the pelvic area, sedentary lifestyles, and even pelvic floor tension.

What is Urge Incontinence?

Urge incontinence is when your leakage is accompanied or preceded by a strong sense of urgency to void. It’s the constant feeling of needing to go or feeling like you must do what I call a “Just in Case Pee.”  You might be leaving our office, for example, and your home is only 15 minutes away, but you go anyway because you’re afraid you might pee yourself before you get home. Sometimes you’re rushing to the bathroom, but you can’t quite get there in time before you leak a little -or a lot.

Sometimes urge incontinence goes along with a stimulus, like water. For example, when people wash the dishes or hear running water, they feel the urge. Maybe they traditionally pee in the shower, and so anytime they get into a body of water or touch water, they pee themselves a little. That’s urge incontinence.

Usually, urge incontinence is habitual, being related to habits that put the bladder in a position where it has altered.

How Can Physical Therapy Help?

Thankfully, pelvic floor therapy can help with both types of incontinence.

Stress Incontinence: With stress incontinence, we usually work on strengthening and load management. The pelvic floor may be really tight and not strong enough to contract. In other cases, it could be very fatigued or atrophied.

We typically start with an internal exam to determine if we’re dealing with tightness/tension or weakness from atrophy. Once we determine that, we know where to start with a treatment strategy.

During treatment, we’ll not only work on exercises that will strengthen the pelvic floor but also discuss healthy bladder habits. We might talk about how to empty the bladder completely, positioning on the toilet, avoiding bladder irritants, and breathing mechanics.  All these techniques help to ensure that incontinence does not become a continuous issue.

Urge Incontinence: With urge incontinence, we emphasize correcting bladder habits. Maybe you’ll have to stop peeing in the shower or drinking too much coffee or diet coke. We’ll work on positioning on the toilet, avoiding bladder irritants, and bladder scheduling. The bladder can be like a toddler- it requires consistent scheduling. When we ignore signals from the bladder, it can cause the bladder to stop sending us alerts. The contrary is also true- if we always use the bathroom when our bladder tells us to, then we will get alerts when our bladder is hardly full.

A healthy bladder requires using the bathroom every two hours. A healthy bladder volume is indicated by an 8-10 second stream. Sometimes we work on prolonging the amount of time in between using the bathroom; other times, we make sure to schedule bathroom breaks for people, like teachers, who may be used to going hours without using the restroom.

Overall, it’s a mix of different treatment approaches. It’s dependent on what the individual presents with; sometimes people need both approaches at the same time. Everybody is different. The biggest thing to remember is that even though incontinence is common, it’s not normal, and it’s quite treatable. And it’s nothing to be ashamed of!

Incontinence in any form (urinary or fecal, which we can also treat) can have an impact on people’s quality of life. Helping people to manage or move beyond their issues can be extremely satisfying for this reason!

The earlier we can address the issues, the better, so I urge people not to wait until it gets worse. We can help at any stage, but if you’re starting to experience little leaks, you don’t have to wait until it’s a bigger problem to seek treatment.

KCP Physical Therapy is thrilled to announce that Ashley Williams, DPT  is joining our staff as a full-time physical therapist.

Ashley recently completed her Doctorate of Physical Therapy at Elon University. Prior to that, she received her undergraduate degree from University of North Carolina at Charlotte in Exercise Science, with a focus in Strength and Conditioning.

While attending Elon, Ashley developed a passion for Women’s Health and sought additional training from the Herman and Wallace Institute of Pelvic Rehabilitation. She also completed a 16-week internship with a clinical focus on pelvic floor dysfunction. 

At KCP, Ashley will offer general orthopedic physical therapy, manual PT, and pelvic floor physical therapy. Orthopedic disorders that she will treat include low back pain, sacroiliac pain, and joint pain and dysfunction. Pelvic floor patients suffering from incontinence, prolapse, painful intercourse, general pelvic pain, endometriosis, interstitial cystitis, constipation, and chronic pain are invited to request an appointment with Ashley. Other areas of specialty include sexual health and wellness, pregnancy and postpartum care, and post-operative abdominal surgery care.

The KCP staff now includes three physical therapists (Ashley joins Joy Pfuhl and Joyce Kight), an exercise specialist (Karina Buechner), and a dedicated staff of technicians and support personnel. Our office is located in the Ballantyne area of Charlotte and provides physical therapy, dry needling, and fitness classes to our clients.

Many KCP patients remember Ashley from her early days here as an intern. During college, she interned at KCP which helped provide a vision for her future as a physical therapist. Not only was she clear on the type of career that she wanted, but she also says that the “patient-centered care” she saw on display at KCP helped to define the type of practice she wanted to join. Seeing her complete her journey of PT education and return to us with her Doctorate of Physical Therapy has been immensely exciting and rewarding.

Welcome (Back!) to KCP, Ashley!

Nancy has been a client at KCP Physical Therapy for over 15 years. A minor injury brought her to practice initially. She was pleased to be seen quickly and receive prompt treatment; she says she healed well and made KCP her first choice of treatment over the years for occasional injuries.

In 2014, she says a freak accident occurred, leaving her with a serious injury and crushed vertebrae in her back. Once again, she came to KCP for treatment, but physical therapist Joyce Kight advised her that she needed to continue exercising on a consistent basis to help with injury prevention as she aged.

Nancy took her advice and joined one of the senior exercise classes offered at KCP.

In 2016, she began spending her winters in Florida. She says it was important for her to continue with her core exercise program, and she joined the classes virtually through FaceTime.

Over the years, she has continued to choose KCP for both physical therapy and fitness classes.

“I can’t say how much I value them,” she says. “Anytime I have an ache or pain, they have a suggestion. I think that I’m often able to head off more serious injuries. If I come for a couple of sessions and Joyce thinks I need to see the doctor, she gives me questions to ask. It gives me more confidence when I’m talking to the doctor and helps me make the visit more fruitful.”

With regard to the fitness program, Nancy says, “The value is in the consistency and showing up, even when you don’t feel like showing up. There are days I’d like to roll over and go back to sleep, but I’m always glad when I finish. I feel like I’ve rewarded myself and that it’s been time well spent.”

The camaraderie she feels at KCP is also a draw for Nancy. “Everybody there is a little bit like me – dealing with current injuries or injuries from the past. I like to go in person since I’m retired; it’s good to be with other people my age.”

She also notes a lack of pretentiousness in the classes. “I’ve been to gyms where the women show up in their Barbie doll costumes, and I feel like a beached whale. I’m not obese, but I’m not slim. I feel like I belong at KCP. I feel comfortable. They know me. They treat me like I’m a person. They make everybody feel special. You won’t find that in every gym.”

Because Nancy has remained committed to her exercise routine, she says “I’m pretty strong for 70 years old. It’s a good feeling.”

Being strong allows her to enjoy the things in life that are important to her: family and travel.

“I can get down on the floor to play with my toddler nephew. I can catch him if he wants to jump off the monkey bars. I can do things other women my age can’t do,” she says.

Nancy also loves to travel and recently took a bucket list trip to New Zealand. “Traveling involves a certain level of stamina and fitness,” she says. “When you have that, you can enjoy the whole experience more. On our trip, we got to go kayaking across a lake in the rain, hiking up some very steep grade hills, and walking on the beaches. Being able to do all of that was just so meaningful to me.”

Ashley Williams has completed the Pelvic Function Level 1 Coursework with Herman & Wallace Pelvic Rehabilitation Institute.

The coursework focuses on treatment for incontinence, pelvic pain, and prolapse in women and was designed to provide a thorough introduction to pelvic floor function, dysfunction, and treatment interventions.

Ashley is finishing a three-year Doctor of Physical Therapy program at Elon University and is a candidate for graduation in December 2023. She will take her Board examinations in January and intends to continue her physical therapy career with KCP Physical Therapy.

With a special interest in pelvic PT, Ashley has also completed an independent study and 16 week clinical internship in Pelvic Health. During this time, she was able to observe different treatment techniques and gain experience in treating women of different ages, backgrounds, and pelvic floor conditions.

She has also helped to create Pelvic Health community events for the City of Charlotte, with the goal of providing accessible care and education to all.

KCP has enjoyed seeing Ashley’s journey from physical therapy intern to Doctor of Physical Therapy unfold. We will continue to cheer her on to the finish line and look forward to welcoming her into the practice in 2024.