Kelly is welcoming in the most familiar way. Instantly, you know she is exactly who she seems, whether in a professional or personal setting. This makes it incredibly easy to discuss intimate issues with her. That is how I first met Dr. Kelly Frank, PT, DPT, over 3 years ago, at a corporate pelvic health facility. I was 9 months postpartum with back issues. She was my therapist, and pregnant with her second, Carson, who is now 3. Dr. Frank was a Godsend. It was an even greater pleasure to learn she has since gone out on her own, establishing Frankly Pelvic, a pelvic health physical therapy practice, in order to help patients in a more customized way than she felt able to previously. I sat down with Kelly for a frank talk about pelvic health, one of our most intimate and vulnerable areas.
On Frankly Pelvic and patients’ homes:
I own and operate Frankly Pelvic. What makes us unique is I can treat patients in the comfort of their own home. We also utilize space at the Awakening Well House at Sacred Birth Midwifery, in Winter Park, Florida. We offer 90-minute evaluations, and 60-minute treatment follow ups. When we first meet, we’re going to sit down and talk. What I like about going into patients’ homes is that I get to understand more about what is going on. It helps me be more effective by preventing future issues.
In several instances, I have been at a pregnant patient’s home and able to observe their living room setup. No one thinks about requesting things not on a standard registry, like a variety of random-sized pillows versus the obvious breastfeeding pillow or support. It’s an easy way to prevent potential postpartum postural issues. Helping my patients ensure they’re properly supported in sitting and resting postures before nursing, pumping or feeding makes a big difference.
Had they come in postpartum with postural neck, shoulder and back pain? We’d have the same conversation, but by then their babies might have learned to latch a certain way with mom in a less-than-ideal position. Bad habits are harder to break.
How did you decide to specialize in pelvic health physical therapy?
Every PT story starts with you wanting to help people and enjoying sports. Growing up, I really enjoyed spending time with my grandma and great aunt, who were older than most, so I thought I would go into geriatrics and love it.
I worked for a skilled nursing facility when I first got out of PT school. I noticed these older people, they all had incontinence. They were wearing diapers, chuck pads under their beds and it was never addressed. Everyone asks, can you walk? Can you eat? Basic functions of life, which are great, but it started to click for me that pelvic health was truly important for quality of life.
Becoming a mother enhanced Kelly’s approach to therapy. She recalls being at her 6-week check up after her second, when she experienced pain, as well as intrusive thoughts. She knew she needed help. While she was given the basic checklist by her physician, those weren’t the right questions to alert her doctor that she needed help. Dr. Frank knew enough to find physical and emotional support, but many moms, whether first time or veterans, may not view their own discomfort as a priority.
“When you’re dealing with the pelvis, above and below is everything. That is key; I rarely have a patient who only leaks urine.”
Dr. Kelly Frank, PT, DPT
How do you help those struggling, or who may have put their healthcare on the back burner?
It helped me realize I can make your life better. Pelvic health physical therapy can make your life better. Working with clients so they can have sex with their partner pain-free, those are important goals. No one in their life knows that, besides their partner. Sometimes, their partner may not even know intercourse was a painful experience. That is a crucial quality of life improvement. Just hearing the adage of: “I had kids. Of course I’m gonna leak when I pee. This is my life now.” No one tells you that’s not normal.
Working with moms or older adults who were able to sit for an entire movie with their grandkids or kids, go to the bounce parks. I am not a therapist who can take a cast off and show everyone visual progress, but being able to live a full life without being scared or worried or ashamed about intimate daily functions is vital. I call it “hidden quality of life.”
I’m able to meet with other providers: mental health providers, sex therapists, and really, truly help that person heal. Even in conversations, discussing urinary frequency for example, someone may recall an incident with a parent they may have thought nothing of, only to realize it has affected them long-term. Whether from a physical standpoint or not, it took my physical touch, me asking incredibly specific and intimate questions, to ultimately connect and achieve these solutions.
All of us have this “black box” of things that we just store away. We have to drive the kids, or finish work, daily tasks, so we say: I can’t deal with this right now. Usually it’s not even for yourself, it’s for your family, loved ones, job, etc. Years go by and that black box is packed and buried, until someone asks a simple question that should’ve been asked a long time ago. And general practitioners don’t have time to ask every single question.
“Being able to live a full life without being scared or worried or ashamed about intimate daily functions is vital. I call it hidden quality of life.”
Dr. Kelly Frank, PT, DPT
Tell me about your healthcare team:
Aside from the gynecologists, obstetricians, urogynecologists, and urologists that I work with, it’s also midwives, doulas, massage therapists, sex therapists, mental health therapists, nutritionists, fitness experts, different fitness groups, Pilates instructors. For every pelvic health physical therapy patient, it’s about finding their team. How can I support them? Having that community helps because I know that it’s not going to be just pelvic health PT that fixes this person’s issue. For my pre and postnatal patients, what kind of care team is bringing this child into the world? How do I best support this mother?
What are common challenges you see?
Intra-abdominal pressure: it can cause diastasis (tummy separation in the front), rib and/or back injuries. There is this pressure management system in our trunk. People focus on the core and flexion, so they do crunches and abs. But a house has a lot of parts. If it’s a beach house, you have stilts. Those are your legs. What is the ground made of? Our feet and our ankles. What’s the roof looking like? Our diaphragm, ribcage, neck. It’s looking at all the aspects to fix the issue. That’s the intra-abdominal pressure system, core, back, hips, the whole trunk. From there it could lead to pain, which is likely a mix of tightness and weakness in muscles.
Any pelvic pain disorder, which could be pain with any penetration: speculum, intercourse, orgasm, tampons, etc. Pain sitting or even wearing underwear.
Incontinence: urinary, fecal, prolapse, any kind of feeling like that heaviness.
Constipation is going to affect all of those. Then we have the whole gut and all of our systemic issues: endometriosis, Ehlers Danlos (a hypermobility disorder), etc.
In physical therapy school, they teach you to look above and below. When you’re dealing with the pelvis, above and below is everything. That is key; I rarely have a patient who only leaks urine.
You can say no…especially if they’re not listening to you. You’re allowed to change your mind.
Dr. Kelly Frank, PT, DPT
What advice would you give to our readers and moms?
You can say no. Whether it’s a provider that’s asking you to do certain exercises, tests or a certain technique. Don’t feel like you have to agree and go with the flow just because you’re supposed to do something a certain way. You can also change providers, especially if they’re not listening to you. You’re allowed to change your mind.
Dr. Kelly Frank, PT, DPT, is married with two children, Carson and Penelope, 3 and 6. She and her husband share a love of all things Teenage Mutant Ninja Turtles, and frequent the theme parks. Kelly grew up in St. Augustine, FL, loves the water, and creating. She and her husband have worked together to help renovate their beautiful home. I have no doubt she puts as much of herself into helping each of her patients.
