I'm sometimes asked why the Journal of Women's Health Physical Therapy (JWHPT) didn't change its name when the section became the Academy of Pelvic Health (APH). The answer is simple; there are so many aspects of women's health that extend well beyond the pelvis. I wanted to maintain the journal's vast landscape on all aspects of women's health physical therapy (PT) while extending its reach to include pelvic health for everyone. On JWHPT's Web page, I have tried to describe this under both our scope and mission. However, it seems that there is still some confusion. The editors and I regularly get asked by researchers whether their topic is appropriate for the journal because it's not about the pelvis or it is about male pelvic health. The concept of women's health is easy to define. Although women have previously been largely overlooked in the medical literature, research regarding issues somewhat unique to females using female subjects is a bit more obvious. The question then is, "How do you define pelvic health?" Once defined, "How do you convey this information to the public in a few simple sentences?"

I decided to put this question to any pelvic health academy members I could easily contact. Using this completely nonrandom, unscientific sampling method, I haphazardly sent out e-mails, contacted the student special interest group (SSIG), and then just anyone who I happened to be speaking with. First to respond was Molly Walsh, a PT student from Ithaca College, who liked the idea and is excited to hear other responses. She thoughtfully sent me the following:

When I tell people I'm interested in pelvic health physical therapy, I am often prompted with the question, "What does that look like?" Sometimes, it's difficult to answer because I have yet to be fully immersed in the specialty. However, the way I would explain pelvic health in the simplest of terms is we essentially are a OBGYNs best friend. We are rehabilitation specialists that focus on pain with sex/bowel movements, urinary incontinence, pre/postpartum, regaining function after reconstruction surgery/any abdominal surgery, sexual trauma, you name it! If it's below the belt, we most likely treat it. We discuss the taboos of sexual health and embrace all persons regardless of gender identity. Everyone has a pelvic floor, so everyone is welcome with open arms to pelvic floor physical therapy!

I always mention that we also treat low back pain, hip pain, and knee pain because the health of the pelvic floor affects those joints/tissues directly. Lastly, I am sure to include that it's not just for women, but for men as well!

Jillian Watson, a PT student at Mercer University and one of the directors of the APH SSIG, kindly posed this question on the SSIG's Instagram. With more than 1000 followers, she anticipated an outpouring of ideas but was a little disappointed that more students did not respond. Here is what Jillian found:

An integral part of health care that is often overlooked and underutilized.

A PT specialty that addresses intimate issues that most people are scared to talk about.

Pelvic health is a PT specialty the same as outpatient ortho but focused on the pelvis. It serves a taboo part of health care that is not talked about.

Pelvic health PT is overlooked as a "women's only" specialty, when in reality we treat men and all genders as well!

Pelvic health is empowering. Pelvic health specialists listen and treat pt's [patients] who have been living in fear/pain their whole life because they are too afraid to talk about what's going on "down there."

Pelvic health is taking care of a part of your body that some might say is embarrassing to talk about. It's making sure that your pelvic organs and their support systems are functioning healthy.

Pelvic health physical therapy is the intersection where patients and physical therapists can come together to address the often-unspoken issues and progress towards a more functional, less painful, and mentally satisfying day-to-day quality of life.

I happened to be speaking with Jessica Probst, PT, DPT, MTC, PRPC, from ThriveAgain Physical Therapy & Wellness in Washington, District of Columbia, whose thoughtful definition is as follows:

Evaluation and treatment (both structurally and functionally) of the pelvic floor muscles, pelvic organs, bony pelvis, pelvic fascia, and related vascular and lymphatics. This also includes related psychosocial and behavioral factors and considerations as well as musculoskeletal and other issues and conditions throughout the body which are impacting the pelvic region or pelvic symptoms.

Beth Shelly, PT, DPT, WCS, BCB, PMD, did respond to my e-mail request, who after being involved for more than 10 years in the terminology process for the International Continence Society, stated that "the meaning of words is very important and that less is more." Beth's insightful definitions are as follows:

Pelvic health: The state of wellness, illness, or injury in the pelvic area.

Good pelvic health: A state of being free from illness or injury in the pelvic area.

Pelvic health care: The provision of medical care of the pelvic area.

Beth considers these open-ended definitions allow for the inclusion of all genders, ages, diagnosis, structures, and professions.

I'm not surprised that more didn't respond. Pelvic health and pelvic health PT are difficult concepts to encapsulate. I sincerely thank those individuals who formulated these concepts in a brief and understandable fashion. There is lots of food for thought here. I agree with Beth that words matter. A concise description of pelvic health and pelvic health PT would help both identify and delineate this unique area of PT practice. These definitions are beyond brand recognition and encompass your professional identity. What I hope is that we have begun to have this discussion and perhaps can reach consensus in a more organized and inclusive fashion. Let's give it a try. I invite you to think about these ideas. Maybe, we can put our heads together and come up with an "elevator speech" in which everyone can grasp this type of work.

-Cynthia M. Chiarello, PT, PhD

Editor-in-Chief

Highlights in This Issue:

In this the last issue of 2021, we thank both our manuscript and book reviewers for their dedication and service as well as several studies to enhance clinical practice. In a prospective observational study of postpartum women, Leopold and colleagues found a decrease in interrectus distance and improvements in both low back pain-related disability and stress urinary incontinence following a 12-week online core strengthening program. Studying women with urgency- and frequency-predominant lower urinary tract symptoms (UFLUTS) during a standardized PT examination for hip and pelvic girdle impairments, Erbes and associates found that movement and positional testing produced provoked symptoms of UFLUTS. LaCross and colleagues conducted a systematic review of the literature finding moderate evidence for using rehabilitative ultrasound imaging biofeedback to improve motor performance of the pelvic floor in males and females with stress urinary incontinence. In a qualitative study exploring the lived health care experiences of patient-provider interactions for women with chronic pelvic pain, Kays found a need for greater empathy. In an interesting case report, Fricke and associates present a novel intervention, mini-trampoline jumping, for a postmenopausal woman several years after a stroke.