Specialist Susan C. Clinton of Embody Physiotherapy & Wellness Talks About Patient-Centered Care

Wellness

Susan C. Clinton (PT DScPT OCS WCS FAAOMPT) is the co-owner of specialty physical therapy private practice Embody Physiotherapy & Wellness LLC, international instructor and co-founder of the Global Women’s Health Initiative.

Tell us about your practice. What sets you apart from other practitioners in your area?

We founded Embody Physiotherapy & Wellness, LLC as a practice that focuses on client-centered care in an atmosphere that would allow each individual to explore the changes they seek in an environment that quiet, relaxing in a nontraditional medical setting. The practice follows evidence-based parameters for pelvic health, persistent pain, pregnancy and post partum, spinal and extremity injuries with a focus on post-treatment wellness in movement classes, yoga, balance, dance, music and fitness.

We’d like to talk about a patient success story you’re especially proud of. Tell us about the patient. How did she learn about your practice?

This 1 year post-partum patient was a mother of one that had a difficult birth and had complications post-partum of pelvic organ prolapse, stress urinary incontinence and diastasis rectus abdominus (DRA). She found our practice from a link on a website after trying to take care of her issues on her own. She had been looking at various websites that provided patient education and exercise programs to purchase regarding her health conditions and became worried that she may be doing herself more harm than good since she wasn’t making any progress to her own goals.

Why did this patient come to your practice? What problems was she experiencing?

She made the decision to come into our practice after speaking with me on the phone. She expressed great concern and fear that any of her movements, trial at exercise and simply lifting and carrying her young child were making her diastasis and pelvic organ prolapse worse. She was afraid to move and was very worried that she would not regain previous pre-pregnancy function, much less pursue a second pregnancy. She also had a recent history a fall when her child was a baby with a fractured patella and reported she was also not walking, kneeling moving well because of this.

How did you go about diagnosing her?

I was able to help her connect the pieces of her physical problems with a thorough evaluation which included everything from her pelvis, pelvic floor, abdominal canister to her breathing strategies, movement strategies and dominant strategies of alignment for holding her child, playing the violin and general standing/walking. Through the conversations on the phone and in the clinic, it was clear that she was very afraid of anything that would make the diastasis worse – and spent much of her time posturing with her hands holding her abdomen.

What treatment course did you decide on?

Her goals to return to normal movement, running, lifting/carrying and good improvement of her prolapse, DRA and incontinence were the driving pieces of the intervention.

Patient education was the first course of treatment – although she was not in pain, she had a very heightened fear avoidance pattern preventing her from engaging in normal life and activities. She would not sit straight up, nor lean over a table or bed or get on her hands and knees for fear of “her organs falling out”. Time was spent really helping her understand her anatomy, physiology and what was safe and OK for her to pursue. Along with ongoing education was changing her breathing strategies and getting her to recognize how much breath-holding was occurring with even the simplest of tasks. We progressed steadily changing the abdominal/pelvic floor strategies and load transfer with laughing, coughing, sneezing, talking, singing. The movements in all postures and positions became more complex and she eventually gained the confidence to reach, lift, hold and carry without fear of her DRA worsening.

What was the impact your treatment had on the patient? How did you help her?

She quickly became continent again and the pelvic organ prolapse returned to a minor stage 1 position without symptoms. The ability to really believe her DRA was stable and non-threatening took a bit longer, but eventually she returned to all of her activities without symptoms or fear. She told me upon her last visit that she was pregnant with her second child and was thrilled to be in this position when she originally thought it wouldn’t be safe 6 months earlier. She regained her life, her dreams and her movements with education, guidance and the belief that she would recover.

What advice would you give PT students today? For instance looking back at your own career is there anything you would do differently?

The best advice I would give to students today is something that I learned in the mid to later part of my career. First of all, seek out a mentor, even if it over the phone or by Skype, as there is nothing that will equal having someone with greater experience help you develop your clinical reasoning and your intervention paradigms. Secondly, do not grow complacent that the knowledge you have gained will not change. It will change! Update your knowledge as regularly as possible as our field is in rapid growth. Finally, do not ever let a job or life’s circumstances keep you from defining and living your passion! Find it, live it and do not forget to take care of yourself every day!

Please talk about any ways you are trying to impact the community you’re a part of, such as:

– Mentoring/Teaching?
– Community involvement/awareness?
– Working with veterans or the disabled?

My community work has come in several forms through the years. My passion is teaching both at the University level but mainly in post-professional education. Sharing knowledge amongst colleagues has been the most sustainable form of energy in my professional life. I have been blessed to do this on an international stage and this has shaped my practice more than any other avenue I persue.

I have also fueled community awareness through various organizations and foundations within my field. I have been active in the American Physical Therapy Association with leadership positions in the Orthopedic and Women’s Health Sections. I am serving on the Board of Directors for the Association of Pelvic Organ Prolapse Support (APOPS) and I am a founding Board Member of the Global Women’s Health Initiative (GWHI).

Finally, my clinical work takes me into many venues including backstage at dance/theatre performances, dance studios and in musicians practice arenas.

What is the funniest thing, if any, that has happened to you in practice?

The funniest thing that has ever happened to me in practice was during a dance performance, one of the dancers went down with a foot injury. The funny part was hiding behind and moving the scenery to get to her without the awareness of the audience. The rest of the performers had to suddenly alter their patterns of movement and their acting skills to change the scene suddenly to help her to safety. The dancer did not have a fracture or a tear and the show was saved! We all had a great laugh for weeks!

Anything (that you care to admit) that you would never do again?
We all have regrets in life – alas, most of mine do not involve my professional career, but instead making a perceived choice that music and physical therapy would not fit in my life together.

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