The boundaries of the internet for pelvic health education
This piece is a bit of a departure from our typical content. While I love to share pelvic health education and actionable content on this blog, this topic is something I find myself contemplating day in and day out as I navigate the internet as a physical therapist.
To set the stage and perspective, let me give you a bit of background on myself and how I came to be writing this blog post, filming Youtube videos and bumbling my way through Canva to create IG content and more.
I am a pelvic floor physical therapist. I got my undergraduate degree from the University of Pittsburgh and my three year Doctorate in Physical Therapy from Temple University in Philadelphia. During those three years, I spent over 1,300 hours practicing as a student physical therapist under licensed physical therapists. I was trained in in-patient rehab, spinal cord and traumatic brain injury rehab, outpatient orthopedics for pediatric and geriatric populations and worked with amateur and professional athletes to improve levels of performance and recover from injury. Upon graduating, I shifted my focus to pelvic health and worked alongside PT mentors, continued to take hundreds of hours of continuing education in my field and now have over 10,000 hours working as a pelvic floor physical therapist. I’ve built a multi-clinician team of pelvic floor physical therapists for a pelvic floor focused physical therapy clinic that I founded and independently own.
And even so, I do not know everything. I still need to consult my team and colleagues on difficult cases. I do this weekly. I still find myself doing something different for every individual patient. I still haven’t figured out a template for how to get every single person better. I still register for in-person and online courses multiple times per year. I still feel that with all the time in the world I couldn’t take all the classes I’d love to take to learn everything I’d love to learn to better serve my patients and the broader community of folks seeking pelvic health education.
That’s where I’m coming from. Anywho, on to the internet.
The internet has so many incredible benefits for those seeking pelvic health and general health education. You can find loads of information written by credible sources and experts on blogs, online magazines, Youtube, Instagram, Facebook groups and more. You can find published journal articles and summaries of those journal articles for easier reading. You can find Ted Talks and interviews with top leaders in almost every field across almost every platform.
And for every physical therapist, physician, lactation consultant and nutritional therapist sharing their expertise in their specialties, there are others taking the time to share their personal experiences navigating their various diagnoses. These individuals help normalize so many common pelvic health and perinatal conditions. So many of these people are the reason my patients are better educated on their bodies, care and conditions than they used to be. They can find information on their bodies online and that is a gift.
But there’s a more sinister side to the internet, too. On one hand, we have well intentioned folks with minimal to no background sharing their personal experience which sometimes get oversold as fact or global truth. On the other hand, we have less well intentioned influencers and businesses trying to make a quick buck by promising a 6 week solution for whatever diagnosis someone has googled. We also have really thoughtful, educated and intentional professionals sharing programs they’ve put serious work into thrown into the online mix. As a result, navigating who is sharing what and understanding the boundaries of that person’s knowledge is getting harder and harder for consumers, even as consumers of this information become more and more shrewd.
To additionally complicate things, healthcare providers who volunteer their time online often find themselves fielding personal questions from their followers and being unable to provide satisfactory answers. Though no one wants to hear this answer, “it depends” is often the most accurate response we can provide without being misleading or overpromising. These ambiguous answers further push those people seeking information into the arms of less credible sources with more convenient lists of “the top 5 things you can do for x.”
Now before you think I’m starting to crap all over online courses and programs, I’m not. We have a massive accessibility issue in the United States for folks needing healthcare services. Pelvic floor physical therapy and other health services are unaffordable for many, with others struggling to find the time away from work or the ability to afford the childcare to make it to appointments or follow through on care. I’ve made plenty of these lists, webinars and online courses. We need online programs. We need people making accessible, albeit less personalized, content for folks to utilize when seeing a physical therapist or provider in-person isn’t an option for whatever reason.
But as pelvic health becomes a buzzword and perinatal health becomes a sexier area of focus for big and small business, we need to remember that the most convenient program is not always the right program. The best marketing is not always paired with the best solution. And the people or person who creates the program or content as well as who they consult in the creation of whatever it is they are selling is incredibly important. And a note on marketing.. the sexiest marketing is often the marketing you want to question most. You cannot “defeat diastasis” if 100% of people develop this natural separation during pregnancy. You cannot “get your body back” with three easy movements in three quick weeks and you cannot do anything to guarantee “the birth of your dreams.”
And while these programs range from ineffective to harmful, one major downside is that folks forget that basic information from an instagram post or a generalized online program is not the same thing as personalized rehab. People find themselves believing that if this program didn’t work, or this hot tip wasn’t effective, that they can’t get better. That if the best 5 exercises for sacroiliac joint pain didn’t cure their sacroiliac joint pain they must be stuck with this pain because they tried and it didn’t work. But that simply is not true. The best programs, videos and posts by the most educated experts in the field are still just generalized information.
Kegels may be a terrible idea for you during pregnancy, they may be a really valuable part of the solution for your neighbor. While you may need glute and core strengthening, your best friend may need global stretœching and relaxation. While your pelvic pain may be caused by weakness, your parent’s pain might be caused by tension. While the best online program may help half the people who use it, that doesn’t mean the other half can’t get better. They may just need something different.
If you’ve made it this far in this piece, I want to offer a few suggestions for navigating health information on the internet.
Know who you’re listening to.
Know who they are, what their background is and why they are an appropriate source to be sharing the information they’re sharing with you. Credible sources should be able to tell you why they’re credible. If you’re following a licensed practitioner, they’ll almost definitely lead with that in their bio. If they’re not letting you know why they’re credible, proceed with caution.
Fact check.
Even credible sources can be wrong. Medicine is not an exact science no matter how much we wish it could be. The “facts” are always changing as we learn more. Not to mention, not every post will be applicable for every person. If you find a compelling piece of information online, do your own research on the topic before committing that information to your brain.
If at all possible, opt for an in-person evaluation with the licensed practitioner relevant to your symptom or diagnosis.
Seeing a pelvic floor physical therapist for an in-person evaluation will almost always be better than guessing what’s going on with your body via online information. I recognized that this may not resonate for folks with medical trauma or who feel they are unable to access care in a safe place for a multitude of reasons.
Remember that someone having a particular diagnosis or experience themselves does not automatically make them a reliable source of information.
That’s called a case study and it’s amongst the least reliable form of evidence. While your favorite pregnant influencer is absolutely reliable in sharing the belly belt that felt best for them, they’re not necessarily reliable in sharing information about how you can choose the right one for yourself.
Question whether people are getting paid for the information they’re sharing.
And as always, thanks for being here. Thanks for choosing to trust me as that is not something I take lightly. Thanks for questioning what I say, too, because we’re all constantly learning and growing.
<3
This post was written by Dr. Rebecca Maidansky, PT, DPT, owner and founder of Lady Bird Physical Therapy. Rebecca is a pelvic floor physical therapist in Austin, TX and founded Lady Bird Physical Therapy in 2019. She is the creator of Birth Preparation and Postpartum Planning, Baby Steps Fitness and the head writer and editor of The Pelvic Press.
Rebecca is a passionate writer and vocal advocate for pelvic health and the importance of improving access to perinatal care. She believes strongly that many common pregnancy pains and postpartum symptoms can be eased or even prevented with basic education and care.
She created this blog to help all birthing people manage common pregnancy pains, prepare for birth and recover postpartum.