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By Fiona McMahon, DPT

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On the journey towards becoming a physical therapist, you have to take a lot of classes, days are long and the studying can be more than a little bit arduous. After you build up a sufficient base of knowledge in school, you get to round out your education by getting the experience to learn hands on in the clinic. Beyond Basics takes a Physical Therapy student every year with an expressed interest in the specialty of pelvic floor rehabilitation. We’ve had many students throughout the years, and both myself and Stephanie Stamas did our training here as students.

This year, our student is someone who is already close to the Beyond Basics family. Denise Small has been a Pilates instructor at BBPT for years and has played an integral role in helping our patients get back to their active lifestyle during and after treatment for pelvic floor dysfunction. When Denise decided to go to physical therapy school we were so excited, and we are so glad to have her back in the practice in her new role!

What made you want to go into physical therapy?
Physical therapy has been a constant part of my life. As a professional ballet dancer, I saw physical therapists who helped me recover from injuries, maintain healthy joint and muscle mobility. While I was a professional dancer in NYC, I realized I needed a job on the side to make money while I wasn’t performing. I decided to get my Pilates certification because the schedule could be flexible and it was training that I had practiced as a dancer. My Pilates teachers were Certified Movement Analyst (CMAs) from the Laban school, and they approached Pilates training in a very unorthodox way. They were interested in using the Pilates method to help people with chronic pain issues and dancers who wanted to investigate their full movement potential. My teachers introduced me to really amazing PTs who went out of the box of traditional treatment, and using movement analysis to help heal chronic movement dysfunction.

Eventually, I came to the conclusion that I wanted to retire from dancing, which is a whole other story. I wanted to transition into something that I would be as passionate about as I was performing. I wanted something that would involve movement and movement analysis, but also something that had job stability, salary, health insurance, etc. Add all those together and PT seemed like the obvious answer to me.

You have a pretty fascinating background outside of physical therapy, can you tell us what other work experiences you have had and how they shape you as a physical therapist?
Thank you! I think my experience in jobs that were centered around movement, dance and Pilates, have influenced the way that I work with patients. My main concern is getting people to move more and to enjoy movement. We live in a three dimensional world with many different planes and directions to explore. I feel that most people only explore what’s directly in front of them, and maybe occasionally what’s behind them and what’s to their side. I believe that if people explored different heights, levels, and directions, they can break their habitual patterns and with them their chronic aches and pains.

I also believe that my undergraduate studies in psychology have helped me tremendously in my teaching skills. Realizing that there are many different personalities that are shaped by many different experiences, helps me to teach each patient in whatever way helps them best receive whatever information I have to offer. Basically, it taught me to be flexible to people’s different personalities and learning styles.

Pelvic floor rehabilitation is a pretty advanced specialty for someone to take on while they are still in PT school. What made you want to undertake such a challenge?
I’m glad you said that. It is a very difficult and complicated subject to explore for a PT student! But I think my age (I’m 36) and my life experience help me to be able to handle and understand all the different variables that go into having pelvic dysfunction. Also I am a survivor of pelvic pain and I received the benefits of what pelvic floor therapist are capable of. I, like a lot of the patients that come to BBPT, saw a few different doctors, body workers, and acupuncturists to try and relieve the pain I was feeling, but no one was able understand or help until I went to Physical Therapy. I want to be able to pay that gift forward and help others who are suffering from that type of pain.

Where did you go and what did you do for your other clinical experiences?
I have had some really wonderful experiences. At my school your affils are established by lottery, so I didn’t know what I was going to get. I was really lucky. I know not all students can say that. My first affil was at King’s County Hospital in East Flatbush, Brooklyn. It was in both inpatient and outpatient settings. I saw so many amazing cases there, working with people who had amputations, gunshot wounds, rare neurological conditions, the specific cases were fascinating and provided me with a wide breadth and depth of understanding of these conditions.

After that I was in an outpatient clinic. This clinic was the type of place you imagine when you think physical therapist’s office. I had a really great clinical instructor (CI), who was very knowledgeable and I appreciated having such a talented CI to guide me. After that, I was at Mt. Sinai on the Upper East Side in the Traumatic Brain Injury Unit. It was incredible. Again, I had such amazingly talented clinical instructors. I learned so much and I really enjoyed the patient population. In the inpatient setting with TBI patients, you are a part of restoring their basic functions like walking, sitting, standing. It was so humbling to watch these patients work so hard to achieve skills that we often take for granted. Mt Sinai was probably my most favorite of the three.

What advice do you have for an aspiring physical therapy student?
Honestly, I would say to establish a movement practice for yourself, meaning start a regime in which you can gain a deeper understanding of your own body, like yoga, Pilates, gyrotonics, tai chi, etc. If you have a deeper understanding of your own body, you can better understand how movement patterns can limit or enhance your patient’s functioning. With that knowledge not only can you have a better understanding of how to treat your patient, you can also be more empathetic toward their healing process.

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