Cervical, Pelvic Floor, and Diaphragm Connection: An Interview with Susan Clinton

Pelvic Physical Therapy?

You mean “kegels”, right?

Sometimes we get tunnel vision, don’t we? If we’ve got a pelvic floor issue, we tune into that area specifically and forget that our urinary system, digestive system, and reproductive system are part of our whole body. Did you know that even your voice and ways you create sound can not only be indicative of dysfunction but also be part of the solution? Sing your way to continence? Sound more fun than kegels? I think so… but let’s see what Susan Clinton has to say in the matter. She has a course coming up with Pelvic Guru Academy, Cervical Spine and Diaphragm to Pelvic FLoor: The Whole body Connection in Boston, MA on September 14-15, 2019. Here are some great pieces from the interview:

PG: There’s discussion about “what is good posture and does it really matter” going around. I understand questioning how we, as physical therapists, communicate about posture and dysfunction with our patients, but it seems like alignment matters. What are your thoughts on this? 

Susan: Postural alignment does matter for performance – whatever that performance may be – however – most people tend to adopt postural habits that may not be as efficient for various performances – such as – humans need a forward head for a good and efficient cough – but do they need that posture when relaxing or eating/swallowing?  If we change our spinal posture – breathing may become more efficient (or easier) for quiet work – but we may need a different posture for lifting heavy with different breath mechanics.

PG: That makes so much sense! A very dynamic way of thinking about alignment instead of the “book on the head” version.

What are some of the things that people are surprised about learning in your Cervical, Diaphragm, and Pelvic Floor course? 

Susan: Most professionals are very surprised about the neurological underpinnings of the systems approach that connects the upper cervical/trigeminal/vagal connections through the core system.  The system can be significantly modulated with the voice as well as the breath. They are also excited about the trunk neural glides and use of voice to train pelvic coordination.

PG: In your opinion, what are pelvic physical therapists often missing when it comes to working with pelvic floor dysfunction?  

Susan: They seem to be missing the systems approach of connecting the neurology, physiology (including endocrine) and the cranial system to the pelvic region.  There is so much that the pelvis has to balance and so many connections through the diaphragm, thorax and cervical/cranial region that affect the entire system.  The muscosal system is continuous from the nose/throat/mouth to the pelvic floor.

PG: If you could have one big pearl of wisdom that you would hope everyone can take from integrating pelvic floor treatment with the whole body connection, what would it be? 

Susan: The old brain is set up to be efficient – it will create patterns around the movement system and requires consistency, efficiency and functional meaning for these movement patterns to change.  Intrinsic cues for change trump extrinsic cues every time.

PG: For folks who rely on their voice for work (vocalists, actors, radio personalities), can pelvic floor or core strength make a difference in their voice longevity?  

Susan: I am not sure it is all about the strength of one system – it is about getting the spine moving with variance, the visceral/diaphragm system mobile, the muscles of postural control coordinated – all to enhance the facility for vocalization and performance.

PG: When you hear feedback from course participants, what are the things that they seem to be able to take back to the clinic and implement easily with confidence? 

Susan: Everyone loves working with the vocalizations, breathing and the nerve mobilizations.

PG: Are there any songs you recommend for home programs? I’m picturing a whole class sing-along happening here.

Susan: I am not sure I recommend songs to sing to people as music is so very personal and they should be listening and singing to their own jams!  I do however recommend reading aloud – children’s books are the best – do all of the character voices (big bad wolf or little bitty fairy).

PG: Hmmm…. I wonder if Kiss by Prince fits the bill for “little bitty fairy” voice. That’s a mean falsetto he maintains… Guess I’ll have to go to the course and find out.

Thanks for being part of our team, Susan! We’re thrilled to have you as an instructor for Pelvic Guru Academy!

Inspired by this? You can learn more by registering for her course: Cervical Spine and Diaphragm to Pelvic FLoor: The Whole Body Connection in Boston, MA on September 14-15, 2019
Or you can take a look at all of the courses that Pelvic Guru Academy is offering HERE.

Susan C. Clinton PT, DScPT, OCS, WCS, COMT, FAAOMPT received her Physical Therapy degree from Southwestern Medical Center in Dallas, Texas and a Masters of Health Sciences at LSU Health Science Center in New Orleans, Louisiana. She completed her Doctor of Science degree at Andrews University in Berrien Springs, Michigan and graduated with her NAIOMT fellowship in orthopedic manual therapy in 2013. She was accepted as a Fellow by the American Academy of Orthopedic Manual Therapists in 2014 and serves as a clinical faculty and specialty course faculty for NAIOMT. As a Board Certified Clinical Specialist in Manual Therapy, Orthopedics and Women’s Health, she has been actively treating patients with pelvic floor, urinary, bowel, reproductive, oncology, persistent pain, sports injuries and post-surgical diagnoses. She currently practices in Sewickley, Pennsylvania and is the co-owner and founder of Embody Physiotherapy and Wellness, LLC. Susan is active in teaching and research as an adjunct instructor for the University of Pittsburgh and Chatham University. Additionally, she is an international instructor and presenter of post-professional education in women’s health and orthopedic manual therapy and a certified Total Control® Instructor. Her research activities include publications on chronic pelvic pain and clinical practice guidelines for the APTA Section on Women’s Health and Orthopedic Section. Susan is active with the American Physical Therapy Association, serving in governance as a local delegate and alternate delegate, and as the Chair of the Clinical Practice Guidelines steering committee for the Section on Women’s Health. She is the past secretary on the Section on Women’s Health Board of Directors and the former President of the Performing Arts Special Interest Group of the Orthopedic Section of the APTA. She has served as an item writer and case reviewer for the WCS board certification examination and is a member of the credentialing committee with ABPTRFE. Susan is proud to serve as an inaugural board member of the Women’s Global Health Imitative (GWHI) and she concurrently serves on the board for the Association of Pelvic Organ Prolapse Support (APOPS). Susan has received awards for outstanding research in pelvic girdle by AAOMPT and Outstanding Clinical Educator by Chatham University. She is the 2016 winner of the Elizabeth Noble Award from the Section on Women’s Health.

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