William Klein is a Brooklyn-based physical therapist specializing in treating men’s health and pelvic floor. His background as a yoga instructor and passion for learning have helped inform his clinical practice. He can be reached at @willkdpt Instagram, and is currently working on posting educational content on that account.
What’s covered in this episode?
- What barriers to care are there for men needing pelvic floor physical therapy?
- What common conditions do men struggle with that can be addressed by pelvic floor physical therapy?
- What difficulties do our current insurance billing procedures cause in providing pelvic floor physical therapy to men?
- What challenges do men face when becoming pelvic floor physical therapists?
- What progress has been made in making pelvic floor physical therapy a standard practice of care for childbirth and prostate removal recovery?
Episode Transcript
Caitlin: Welcome back to the Practice Human Podcast. I’m your host, Caitlin Casella. Before we dive into my interview with William Klein, I wanted to catch you up on a few events coming up in the new year at Practice Human. For those of you that like to plan your schedules in advance, I’ve got just a few save the dates for you and not to be missed courses that You’ll see here in our space in Midtown Manhattan, some of them happening in person, some of them happening online.
My good friend Elizabeth Wipff and veteran strength coach is back for another series of True Strength Academy. It was really exciting to see the incredible group of people that she brought into our space this past fall. Many of them Our yoga teachers who are looking to add strength, strength training, heavy strength training to their movement repertoire.
And it was really such an honor to have Elizabeth here teaching and to see how much this group got out of being here in person, in a small group, in a space that might feel perhaps for some a little bit less intimidating than your typical gym environment. She was teaching True Strength Academy. It’s really great for anybody who wants to get started with strength training, but doesn’t know where to start.
So many people that were here in her group on Wednesdays wanted to join and do it again. They were that enthusiastic about it. So we have a group continuing on Wednesday afternoons, as we start back in the new year and she’s. adding a second group on Monday afternoons for people who are brand new. So there’s a little bit of space left in the Wednesday group.
As far as I know, there’s still a couple of spots available in the Monday group, but this is limited to only six participants. So it’s going to fill up really quick. And if it’s something that you’re interested in. Doing with Elizabeth here in person, definitely check out the details and get yourself signed up as soon as possible before it fills up.
You can find all the details for Elizabeth’s True Strength Academy on our website, practicehuman.com/events. I am also in the new year bringing in just some small, short workshops on sustaining robust activity with hip arthritis and with knee arthritis. This is something that I get requests for a lot.
It’s something that I work with on my patients who are transitioning from a physical therapy plan of care into more robust exercise that they can do independently, especially if they want to start playing around with a little bit heavier strength training in the gym and some impact activities. So as many of you listed, I’m super passionate about getting people jumping at any age and any level of experience.
So some of what we’ll cover in these courses has to do with, you know, upping your level activity even to the point of jogging or jumping or doing some kind of impact work with knee arthritis and with hip arthritis. So if you’d like to learn just some self assessment and self treatment tools and have a little overview of, I think really just, just getting an idea of what’s possible with severe or any level, even up to severe hip and knee arthritis, I just think society makes us think that there’s, there’s a lot less that we can do when really I want to deliver the message that there’s much, much more.
that anyone can do with even severe levels of hip and knee arthritis. Because one of the things we know about arthritis is the severity of the changes, joint changes on x-ray or on MRI really don’t correlate with level of pain and level of function. And someone can improve, significantly improve their function and decrease pain with exercise with a little bit heavier, more robust loading of the joints and, even impact activities with the joint.
So if that interests you, you can also check out the details for that at practicehuman.com/events. In February, my good friend Laurel Beversdorf will be here with her Yoga with Resistance Bands teacher training. I had Laurel on the podcast recently. I’m going to have an episode coming out next.
where we chat about a little bit more on what to expect and some of the benefits of adding resistance bands into your yoga asana practice. And then this is still a little bit in the works, but I’m super excited to have Brian Nevison here in March. I did an interview with Brian a couple of months ago and I got so much positive response from the episode that we put out on balancing discipline and play.
Brian is one of the most playful people I know. And, actually that I know from social media, but I’ve never met in person, and I am just really delighted and honored to have Brian here in person, partly so I can meet him in person, but also he has just such valuable content to share for athletes on strategies for self assessment and mobility work and active recovery.
And he’s going to be sharing treatment tools specifically for the hip and low back as it relates to So there’s a bit of preliminary information on that also on the website that you can take a look at, and, and, just a post there so you can save the date for March 2nd for Brian Nevison, if that’s something that you’d be interested in.
I highly recommend getting to that if possible. We may open up a hybrid component for online. So if that’s something that you, you’re like, yes, definitely, please. I can’t come in person, but you want to be a part of that workshop. Just shoot us an email and let us know if there’s interest for that also being presented simultaneously online, live on zoom with the recording, there’s potential for that as well.
So you can email us here. Anytime at hello at PracticeHuman. com, we reply to all emails and would love to hear from you. I just wanted to give you that quick rundown as we’re nearing the end of the year and about to start 2024 so that you can plan the early part of your year if you are interested in learning with any of these incredible teachers that are coming to present at Practice Human.
And now I am delighted to bring you my interview with William Klein. We talked about a lesser covered area of pelvic floor physical therapy, specifically, treating pelvic health for men by a male. physical therapist. William Klein is a Brooklyn based physical therapist specializing in treating men’s health and pelvic floor.
His background as a yoga instructor and passion for learning have helped inform his clinical practice. If you want to get in touch with Will, if you’re interested in working with him, the best way to reach him is through Instagram @WILLKDPT. That’s @WILLKDPT. and he’s currently working on posting a little bit more educational content over there on that account.
I want to thank Will for coming on to speak with me. This was a really thought provoking talk, kind of from all angles, from the practitioner side, from the patient side, from the insurance. and the billing side about, as I said, just a lesser covered territory here and a place where there’s quite a lot of barriers for care for men, men getting help that they need when it comes to pelvic floor PT or pelvic health.
So I hope you enjoy my interview with Will. podcast today. I’m really Looking forward to getting into a deeper conversation with you about your treatment and your work. Thanks for being here.
William: Thank you so much for having me.
Caitlin: So the little bit that I know about you, I think we have sort of a similar background coming from teaching yoga and then going to school for physical therapy.
And then your path led you to pelvic PT. And I’d love for you to start by sharing with the listeners just a little bit more about Initially, what led you to pursue, pursue your DPT and then any experiences or relevant interests along the way that made you choose pelvic health or pelvic PT?
William: Yeah, totally.
I mean, I could get really granular here, but I suppose in broad strokes, you know, as a kid, I was definitely like an unwilling athlete. I was much more of an indoor kid, more, more interested in video games and like Magic the Gathering and drawing pictures. but my parents were like, no, physical activity is important.
You need to go and we’re signing up for soccer. We’re signing up for swim team. We’re doing all those things. And of course I hated every minute of it as a kid. and you know, was completely ready to just. Like never doing any sort of physical activity ever again. Once I got, you know, out of my parents house as a child.
Right. Then, when I was a senior in high school, a friend of mine, who was a journalist for the high school newspaper, invited me to do a yoga class with him because he was writing an article on yoga. This is like mid aughts when yoga was first kind of becoming more of a thing that more people were doing.
And so I was like, all right, why not? I’ll go with you. And I remember I was wearing jeans and I think I had mono at the time. and I remember being in the yoga class and it was like one of the first times where I was like, wow. I’m moving my body. I’m exercising and I’m actually enjoying this. And that was a really revelatory experience for me, no, I don’t have to be on a team.
I don’t have a coach or my other teammates yelling at me. I don’t have to, like, do anything I don’t want to do and I can take it at my own pace. And I was, I was hooked from that moment on. Eventually that kind of led me into other forms of physical exercise. I started, you know, biking more, weightlifting more.
I actually enjoyed playing sports from time to time with friends once that happened. And then, you know, when I was after high school and going through college, I was about to graduate and I thought, well, what am I going to do with my life? I graduated, you know, when the recession was happening in 2008, I graduated a little bit after that and there weren’t a lot of jobs.
So I figured, you know what, let me get my yoga teaching degree. Certification. It’s always something I wanted to do and I’ll figure it out from there. So I, you know, did that and then I started teaching and I taught full time for a while. I was lucky enough to get a regular class schedule and be able to support myself on it pretty soon on, which I know is a hard thing for a lot of yoga teachers.
but after a couple of years of that, I, you know, started to, okay, I’m teaching four or five classes a day. I’m biking all over the place throughout the city. I’m really tired. and I don’t even know if what I’m doing is really helping people. You know, I didn’t ever really take any science or anatomy or physiology or anything in undergrad.
And I realized that there was a huge gap in my knowledge. So I thought, well, I should probably learn, you know, this stuff a little bit more so I can really tailor my yoga classes to help my students and myself. And, that kind of got me back to taking classes at Hunter. And I was, you know, kind of toying with the idea of like, well, what’s sustainable here?
and I started looking into physical therapy more and that sort of became this idea of, well, this looks like what I really want. so I go through the application process. I get all my prereqs in, I go to PT school and I go through PT school. The very last lecture I had, in PT school before. all my final exams and all my clinicals was a pelvic floor physical therapist.
and she came to speak to my neuromuscular PT course and she was so cool and so impressive. And just, I forget her name and I really, I hope I remember it at some point in this interview, but she was, she really inspired me to pursue this. I realized during the course of her lecture that like, you know, I was peeing way more than I was supposed to be.
And I always thought, well, that’s just how it is. I have a small bladder. I drank a lot of water and I found out none of those things were true. so I immediately signed up for the course, right after that weekend. And she was like, yes, there’s so few men who do this. It’s a really good idea. And then, COVID hit and I had to forgo doing that for several years, this lockdown thing happened.
So finally I got to do the trainings and I’ve been doing it ever since. Wow.
Caitlin: Yeah. what, just, just for a timeline for me because we have such a similar path of teaching yoga and going to PT school, what year did you graduate from PT
William: school? I graduated in 2021. I haven’t been practicing
Caitlin: for that long.
Oh, okay. I did also. Okay. Okay. Mm hmm. I hadn’t realized that we were, yeah, right. Because I also did my yoga teacher trainings here in New York in 2007 and 2008. So I also kind of hit that wave of like huge expansion of yoga in New York City. And like you were saying that just, just the, the opportunities for new yoga teachers to have classes at that time and lots of classes.
And like, if you want to teach, you’re going to teach a lot. I also had that experience at that time. So I think we’re like, Totally on the same timeline here. It’s wild. Yeah. yeah. And that’s, that’s so interesting that you went through all of, all of. Three years of PT school until the very last lecture, and then that kind of drew you toward pelvic PT.
William: amazing. Yeah, no, I had no idea it existed until this woman came. You know, I always knew what it was. I knew what it was loosely, I just assumed it had something to do with pregnancy and childbirth. Right. And that was all I knew.
Caitlin: Right. And that actually is a great lead in to my next question because I think a lot of people have the perception that pelvic PT is for females, it’s for people with uteruses, it’s for people who go through childbirth, and You, from what I understand, focus quite a bit on pelvic PT for men.
Is that correct?
William: Yeah, that’s right. That’s pretty much my treatment population. I pretty much have only treated cis men since I started. Yeah, mostly for necessity, but also Yeah, there’s just a huge They’re not very well represented in this field.
Caitlin: Right. Right. Exactly. I, I would love to hear a little bit more about representation, from the, I guess, from the practitioner side with you as a male pelvic PT, and then also from the patient side in terms of access, because one thing that I understand is it’s quite difficult for men to get access to pelvic PT for a number of reasons.
We can talk, go into some of the, the barriers there, but, I’d love to hear more just about your perspective as a man in your field and the patients that you treat, kind of primarily the population you work with.
William: Yeah, no, definitely. This is, I think, One of the most important things about what I do now is how few of us there are out there.
and how much of a need there is for this type of physical therapy for, you know, penis and prostate owning individuals. Then I remember I was, you know, the night before I went to go do my very first training. I went to go see a movie with some friends and a friend of mine who’s a woman, she was like, Oh, Will, wait, do men have pelvic floors?
And I said, Yes, everyone
Caitlin: does. Right. But that’s like, I think that’s just kind of the general perception out there. Yeah. Yeah,
William: totally. Well, yeah, I mean, it’s like, so Herman and Wallace, which is the company that I did my pelvic training at, there’s also the APTA has their own, but I can’t comment on that cause I don’t have any experience with it.
Herman and Wallace didn’t even used to let men in. That was a relatively recent thing. I don’t know when they started, but I did my training about two years ago and it was not. As far as I’m aware, I think it was shortly before that that they started even allowing it because they realized that, yes, not only do, does everyone have a pelvic floor, but everyone can have issues related to those pelvic floor muscles.
so there are, you know, I, my, most of my, the people I treat. tend to have, you know, urinary frequency, urinary urgency, urinary hesitancy, fecal incontinence, constipation, pelvic and perineal pain, non infectious, non bacterial prostatitis, testicular pain, and, you know, all sorts of things that kind of stem from those issues, and so there’s very specific things that people who have penis and prostates, that they deal with that people who their counterparts don’t.
And then there’s issues that everyone deals with that I also treat. but I tend to focus on, CIS men historically, number one, that’s, that’s who I am. I identify as such. And, you know, I think there are a lot of pelvic floor providers in the city. Most of them as far as I’m aware are women. I think the vast majority of them identify as women and of those people, very few of them, treat men as well, or treat both genders and sexes.
So I, when I first started doing the training, I was, I, meeting with the head of the pelvic program at the company that I work for because we did have quite a robust pelvic program, but I am the only man who was in that program at that time. And she and I decided that when I was going to, you know, start treating, I would start treating men and then I would maybe expand my, the client that.
Population that treated once I got a little more comfortable and then it just sort of became this thing where I would just get so many requests for patients, all of whom are men that that just sort of filled up my schedule. and then I think, you know, there is a certain inherent, you know, power dynamic and liability, minefields and ethical minefield of just being a man who treats pelvic floor.
In people who are not men that I want to be mindful of. and so the place where I work now, the resources, we just don’t have the setup for me to be able to provide that. but who knows, maybe I’m, I’m not saying no, I will never do it. It’s just something I’m not currently doing.
Caitlin: Okay. Thanks for sharing that.
Yeah. I, um. I, it’s interesting just backtracking to one thing you said about the Herman and Wallace training. I think when I was initially looking into doing one of those trainings, because I had some, some interest in it when I was finishing up PT school, I remember reading, some details about male participants in the courses and even participating as a male seemed like a bit of a barrier to take those trainings because there was something about having to bring your own lab partner that challenging, right?
To like work out all the logistics of that. So I feel like there are so many steps along the way. There’s just kind of a lot of walls set up that make it a little bit harder for male practitioners to move into this field and, and then also for, for patients to find care. What, let’s talk a little bit about what your intake process is like, or your history taking process when you start to work with a new patient.
William: Yeah, that’s a really good question. I feel like it’s evolved so much since I’ve started doing this. You know, where I work right now, it’s an outpatient facility, primarily orthopedic historically. And, you know, they do have quite a good pelvic program, but it’s still sort of scheduled as though it’s an orthopedic practice.
And we do take commercial insurance. So that also does kind of set certain barriers in terms of timing and volume of patients. But, you know, we kind of need to see due to reimbursement rates, as I’m sure your listeners, many of whom are physical therapists, all know. And love. So yeah, my intake process, you know, it’s, I usually have an hour with people and we find that when we get started, there’s always so much to discuss.
So I usually tell people, Hey, we may not get to everything today because there’s just so much to talk about and so much to do, you know, if we don’t get to everything today, that’s fine. You know, we’ll get up. and then we’ll get into more broad strokes, and we’ll get more specific as we need to.
And at the very least, they’ll, you know, determine whether or not someone’s a candidate for my services and what if anything, I’d like to get them started with. but most of the thing is, you know, it’s it’s I know the subjective is really, really important. You know, I really like to dig into the details when I can, just in terms of lifestyle habits and when this all started, what they attribute it to.
And, you know, there’s, there’s some detail that might seem really small and minute that may be really, really important. So I like to kind of try to leave no stone unturned when I can. so, you know, it’s a lot of setting expectations. You know, I always tell people because we are talking about really intimate things that a lot of people may not want to share with a lot of people that I always say, Hey, you know, I’ll asking you, I’ll be asking you questions related to bowel, bladder and sexual function, but if you feel like you don’t want to answer some of those questions for me, then we can move on and come back to it.
Another point. If never, most people will tell me that they’re an open book and they’re ready to, they’re ready to go. And anything that I need to do, they’re ready for it. But there’s other people who may not want to Talk about their sexual life or their oral habits, even in front of me. So, you know, you want to get as detailed as possible, but also respect that person’s privacy and, you know, their willingness to be forthright.
with you over time that may grow as they develop trust in, trust is, I think the most important thing of what I do right now is building that and making someone feel safe and making someone feel like, Hey, if I can’t help you, at least I can figure out someone who can, or somewhere you should go or something like that.
so that’s sort of, you know how it’s been broadly. That’s how it’s been lately. but yeah, like, you know, obviously these questions will depend upon, you know, that person’s chief complaint. So if I see someone who is going to get their prostate removed because they have prostate cancer, then we’ll talk about, you know, that we’ll talk about their goals, how they’re thinking about everything.
And we’ll talk about sort of. What continents look like, and what to expect if it’s someone who has a hard time peeing. Then we talk about sort of what’s, what’s your stress level, like what’s yours, and that applies to everyone, honestly, but that’s, that’s something that’s very important for those people.
Same thing with my people who have a lot of urinary frequency and urgency. There’s a lot of stuff that goes into it from, you know, how much sleep are you getting a night to what’s your diet like to, what’s your work life like? Yeah. These are things that I think are really, I ask about when my orthopedic patients too, but they just become that much more important to get really detailed.
Caitlin: Yeah, yeah. Well, I think there’s so much also that’s beneficial in just, not just the information that you’re gathering from the person, but that patient having a little bit more in depth kind of thought process around some of those factors in their life just starts to make them more informed.
look at them differently, maybe see them in a different light, pay a little bit more attention throughout the day and night, to what’s going on. So I think some of that too is just bringing, bringing to mind for someone just a few other, I don’t know, potential, potential lifestyle factors that could be contributing to what they’re experiencing or that they can maybe have some control over multiple areas of their life in a, small way, you know, so that it doesn’t feel maybe that makes it feel like I think sometimes patients feel less overwhelmed if it’s like, well, you can have just like a little bit of control over several things.
You don’t have to totally do a total overhaul on any, you know, aspect of your life all at once. So I think even just that history taking process can help. Maybe patients feel more empowered that they have a little more control or insider awareness over multiple factors in their day to day.
William: I totally agree.
And it’s also interesting because you get, by asking these questions, you can get them thinking about sort of how certain behaviors, certain things going on in their life, certain things that may not necessarily be in their control, or they may perceive it that way, would be affecting, you know, their chief complaint.
And, you know, it may not require them to do a bunch of happy babies in order to pee more easily, right? Like it may just be that they need to change one small thing and
Caitlin: That will help. Yeah, yeah, exactly. Oh, that’s so great. I’ve always thought a thorough, thorough interview history taking like that, at the start of working with a new patient, is beneficial in those ways, in so many ways.
What are some of the things that you encounter with your patients in terms of their struggles in their personal lives or also, things that might come up that are challenging within the course of pelvic PT treatment?
William: Yeah, this I think we were kind of touching on her. You actually brought this up when we’re chatting just now in the last question about just sort of like the small details, but like the overwhelming ness of it all, that can continue to be a factor as people kind of go through it.
I’m thinking specifically about a few patients I’ve had who have just chronic pelvic pain. You know, they may have been misdiagnosed with bacterial prostatitis and undergone many, many different courses of antibiotics and been through the ringer of specialists and providers and urologists.
And other people and, you know, they may be going to four or five people before someone even suggests to them that they should try physical therapy about it. And so at the time I see a lot of those people, they really don’t believe that anything can get them better. And breaking through that can be super challenging.
You know, you have to, and even when you start a course of treatment, you know, sometimes let’s say I give someone three exercises to do at an intake for their home exercise program. And let’s say that I want to give them, you know, diaphragmatic breathing. Cat cow, an adductor stretch, a squat stretch, or happy baby, whatever’s feasible to them.
You know, I usually will preface it by saying, hey, you need to be doing these pretty regularly before you may even notice any difference, and it may take several weeks, and you may not feel like anything is changing for you, but I’m still going to encourage you to keep practicing. and that sort of thing.
Just setting that expectation, I find, has been really helpful because people will come in to see me, you know, for several weeks and say, Hey, I don’t know, know anything. Nothing is different. Everything’s the same. I still have pain. I still have all these issues. And, you know, it’s, it’s sort of like, I know that you probably don’t feel any difference now, but let’s keep going.
Let’s keep practicing. Let’s keep working. That can help. at least motivate me in the beginning. And then when they reach that first milestone where something starts to feel a little easier, that’s really the sweet spot is like when I can get someone there, then they take over that motivation and then they really start to say, Oh, okay.
I see how this is working for me. It’s often joked in the pelvic floor world, at least among my colleagues, most of whom are women, that they’re. The ones who treat men say, Oh, my male patients are the most compliant patients I’ve ever had because they’ve been through it and they’ve been through so much and they’re just ready to, to, to do it.
I don’t know why that is, but they always tell me that, well, you know, I guess women are more used to dealing with pain and suffering in silence and men are not. And so they’ll, they’ll complain about it. I can’t speak to that, I, I’m not a woman, but, it, it’s certainly my experience with my patients.
Caitlin: Yeah. I wonder, I mean, I think there’s probably a few layers to that as you’ve got the wheels turning in my head. Like, I wonder if some of it is there that males are less likely to be referred to pelvic PT. So they’re bounced around to a lot of other things first, whereas women might be more likely to come across a provider that will refer them to pelvic PT.
Mm hmm. Um. Yeah, and I wonder if, too, it’s, I don’t know, like, I, I know there’s some kind of, like, reporting biases that show up in research, of, I don’t know, this would be kind of the opposite of what you said, though, my, my mind is going to, like, how a lot of things get reported less, tend to potentially be reported less by males than by females, And sometimes I wonder if due to just kind of, I don’t know, stigma or something, there might be something in there, for males needing care with pelvic health, but I don’t know.
William: I don’t know. I also think there’s a point to that. No, I, I think that you have something there, with regards to stigma or less, getting less likely referred to pelvic PT, those are all issues that, the patient population I treat faces, have. You know, in a major way, stigma for sure. I don’t know about the statistics about more or less likely, but it just anecdotally, it makes sense to me.
just cause again, there’s so few of us out there. I’m, how many people I’m trying to think I know of two others for sure. And I think it may be in New York City.
Caitlin: This is in New York City. It’s amazing, in New York City.
William: Yeah, and I think there may be two more. I think there’s one person at NYU, one person at some private outpatient practice, and then the other two I know of are cash based and run their own businesses.
but I, yeah, those are the only ones I, the only men I know who treat Pelvic Floor.
Caitlin: Are there other things you see from your perspective in terms of barriers? I know one of the things that I’ve heard a little bit about through our, mutual colleagues, so, so Will and I know someone who said that they’re comfortable with me mentioning that we, we know someone, I won’t say who, but we know someone who’s been, seeing you for physical therapy and, One of the things that, that I know the two of you have discussed that I’ve also discussed with this person is, the, some of the barriers with insurance, specifically like diagnostic codes with insurance and getting services, PT services covered for males that is a little bit of a challenge.
More of a challenge potentially than diagnostic coding for females. Is that correct?
William: Yeah. Yeah. That is certainly a thing. And I also know that, so dyspareunia is a specific code that I often get denied for, when billing insurance companies for, with patients who have penises and prostates, which, for your listeners, if you don’t know, is painful sexual, intercourseupon insertion.
I know, well I’ve heard, that if you are a woman or you have a vulva and a vagina and you are being seen for this as a chief complaint, that insurance companies typically, they may cover it, but not all of them do. And of the people I have spoken to about this, they often say, well, you know, you should bill it for what, like, right about, like, painful, exams at the gynecologist, because that is a similar type of thing.
Like, there’s something going inside of you and it may be very painful, but an insurance company will care more about that than they will about, you know, your sexual life. If you are a person with a penis or a prostate and you are, let’s say someone who has receptive anal sex, then that is not something an insurance company will ever, in my experience, will ever say, yeah, we’re going to cover that.
I have been denied multiple times. I have written letters of medical necessity to insurance companies, and the subcontractors that they hire out to do their authorization processes. And they never have gone, gone in and said, yes, we’re going to cover this. I always have to be very, very specific about different types of billing codes that I can then say, this is what we’re doing.
And obviously I’m not lying to the insurance company, but it is just sort of. Okay, well, how can I play by their rules and still get the treatment that my patient needs? so it is a really frustrating thing and, you know, very homophobic in my opinion. But yeah, that’s the reality of where we’re at right now.
Caitlin: Yeah, yeah, yes, it is, it is a struggle for all and especially in that context that, I think our, just our healthcare systems have not, I don’t know, I want to say like not caught up, but this is something, you know. Anal sex is something that’s been happening always, it’s not a new thing, and this is like, it’s like, really, this is, just a, normal and known thing, and, yeah, it’s, it’s kind of surprising and not surprising all at the same time, you know?
William: Yeah, and I think, like, given, like, the, you know, the, the general cultural shames around sex. That we’ve had for so long and the stigmas that come up about it and, you know, the lack of education that so many people have about these types of things that, you know, consenting adults do behind closed doors, leads to these sorts of things and these stigmas and these inability to say, well, no, I’m not going to cover that.
That’s not medically necessary, because who are you to make that determination? someone you don’t know, someone you are not, they’re just a number to you and name and a number and that’s it. And that’s a justification to not. Yeah. You know, give them care that they may very well need for their well being.
Yeah,
Caitlin: Yeah, absolutely. I mean, we’re talking about pain with sex in any kind of context. There’s a lot of ways that that happens. And yes, yeah. Um. A thousand percent. you mentioned, education. And again, you keep leading me so perfectly into my next question. So I wanted to talk a little bit about the therapist role as an educator, because as PTs, we know that’s a, that’s a huge part of our job, to be sort of a teacher in the clinic.
And I feel like, especially in what you do, I can imagine that so Much time spent in your sessions must come down to education. Educating people. We already talked a little bit about that, in the intake process in terms of lifestyle factors, but also just educating people on their own self care, to complement your treatment that you’re doing in the clinic.
And then so that people can manage their symptoms long term once they finish a plan of care. tell us a little bit more about what What your education for the patients looks
William: like. Oh man, that’s like, it’s, it’s such a, it’s going to be like a very simple but complicated answer, but like something I, I love doing.
I’m really, my, my challenge with this right now is trying to figure out. You know, how can I use being an educator as a therapist in the clinic as a tool of empowerment for my patients to be able to manage themselves? I think you, you sort of mentioned that in the question and not be paternalistic about, yes, do this.
No, don’t do that. Yes, if you have that second cup of coffee a day, you’re going to be peeing every 30 minutes and you’re going to hate it. Like, don’t do that anymore. I wouldn’t be doing my job if I was just telling people what to do and how to do it. because I have sort of the idea of like, well, We have, let’s say, if you are coming in to see me and you are someone who has a lot of urgency and frequency around urination and, I’m You know, may say, well, there may be some lifestyle factors we’ll need to change, you know, I’m not gonna, you know, let’s say someone’s, well, let me, let me step back for a second.
I, when someone comes to see me for that condition, we often do what’s called a bladder diary. And this is where for 72 hours, I will have them record everything they eat and drink, how much they eat and drink, and when they tend to go to the bathroom. and how often they go. How much urgency was there?
Was there any leakage? All sorts of things about that. And then we sort of get together and we look at the data together. And then we try to come up with some patterns. at which point I’ll then pull up a list of known bladder irritants. And I’ll just sort of look at this with the patient now. I’ll see if I can get them to come to their own conclusions.
But just kind of by pointing out some certain trends that we see in the 72 hour snapshot of their life. And it’s very interesting because, you know, on the one hand, I can say, Hey, you know, like, maybe don’t have that third cup of coffee. maybe limit your alcohol intake, maybe instead of drinking that can of seltzer, then have a glass of water instead.
but that doesn’t usually stick until you kind of point out the patterns. Cause I could make those assertions without really knowing what their lifestyle was like, and maybe they don’t drink coffee. Maybe they’ve never had a seltzer. Maybe they haven’t had a drop of alcohol in 20 years. and so.
You want to kind of point out things and lead them in certain ways that are going to get them to arrive at those conclusions themselves. At least this is what I find to be most beneficial and most empowering. Because at any, every opportunity, I really want to give that person as much control over their own life as possible.
And even if we do notice trends. Let’s say I’m speaking specifically about urinary frequency because I feel like they, those patients of mine typically need the most sort of lifestyle change. Well, everybody does, but theirs is the most present to me for some reason. they’re I could I then say, Hey, you know, I’m not going to sit up here and say, don’t drink a beer.
Don’t have coffee. Don’t have seltzer. Don’t eat a spicy meal because those are all known bladder irritants. But what I will say is, you know, this is always a negotiation with yourself. You know, you’re welcome to continue. Your diet in this way, but just know that this may happen and if this happens This is what we can do about it And if this becomes significantly disruptive to you in such a way that you’re here You know in my clinical treatment room talking to me about this then maybe we can make some changes and see if well, maybe we can live without that second cup of coffee or maybe instead of Drinking a seltzer will try water, or maybe if you’re peeing a lot at night, we can try tapering liquids two to three hours before bed, see if that helps.
so it’s always about, you know, the, the, what underscores it all for me is, is empowerment. but the, the, you want to know the biggest change I make in someone’s life though, is I do tell them, let’s say this, I’m still talking about urinary frequency. If. That person is like, you know, peeing a lot. I’ll say, all right, do you, before you leave the house to run an errand, do you go pee?
Almost always they’ll say yes. And I’ll say, all right, don’t do that anymore. That’ll be like the first thing I will say, hey, don’t do this. And then I’ll say, hey, that sounds really scary. You know, then don’t worry about it if you’re going on a long car rip, car trip. But maybe if you’re going to the deli or the grocery store, try not to pee before you leave the house.
Of course, if you have to pee, then pee. But if you don’t feel the urge at that moment, don’t do it. And probably about 80 percent of the time, those people will come back and say, I can’t believe what a difference that made. I suddenly just didn’t have the urge to go. And I’m like, well, yeah. A lot of it is, especially with urinary frequency.
So much of it is habit focused and how the nervous system responds to the habits that we set around using the bathroom. that when we start to break those habits, sometimes the nervous system will resist you, but sometimes it will say, oh yeah, maybe I didn’t need to pee. And that is also a big step forward.
Yeah,
Caitlin: yeah, that’s huge, and it’s, yeah, and those habits are kind of, yeah, attached to those little triggers that people might not be aware of at all, right, like leaving the house or getting in the car or whatever, or even just sitting down to like Watch a movie or, you know, all those, all those moments where subconsciously your mind is going to be like, Oh, I better go pee first, but yeah, that you probably don’t have to or might.
William: Yeah. And I used to be doing that all the time. And then when I first heard this phrase from that pelvic floor therapist who gave us that lecture that inspired me back in PT school, I stopped doing that. And then almost immediately I was like, wait. It doesn’t feel like an emergency when I have to go.
Caitlin: Yeah. Yeah. I mean, I’ve certainly gone through cycles like that before. I mean, it’s just kind of a universal experience that most people at times in their life have gone through. I don’t know. Oh, definitely. I think so. I remember learning to and I, I, I, I’d be interested in hearing your thoughts on this, because I, I’m certainly not the expert on it.
But something about how you have an initial urgency that comes on, that if you ignore it and move past it, you probably have like two hours still or so before you actually have to urinate.
William: Yeah, I think you’re right. Oh,
Caitlin: sorry. Go ahead. Yeah, no, go ahead. I just, I’ve started to notice that like first impulse and then ignore it, get past it, and then wait and be astonished by how long I can go.
Without feeling like I have to go at all, you know? Yeah,
William: go ahead . That’s, that’s so, you know, we have like several dipped in types of incontinence and that is often sort of what we might refer to as an urge incontinence, where if someone is not able to ignore that initial message, it grows and grows and grows until it’s like, oh my god, my bladder is totally full and I have to pee right now.
we usually, I, I remember this. from Herman and Wallace, we usually get that urge when our bladder is around 30 percent full or often if we’re like this often happens with people coming home from doing errands, right? Like right when the key gets into the keyhole, they’re like, Oh my God, I gotta pee. Or for those, you know, of my patients who have you.
Live in Manhattan or parts of Brooklyn. They have elevators in their building. It’s like when they’re in the elevator. That’s when it strikes and Yeah, very often. So what happens is, you know, whether there’s a habit you’ve associated like coming home with needing to pee That sometimes is when you get that message and yes to your point if you let’s say you have your groceries You’re like wait, I’m not gonna pee yet I’m gonna put my groceries away then I’m gonna pee and you start putting your groceries away and you may realize wait I don’t have to pee now
Caitlin: Just forget about it.
Yeah, just be like, Oh, what happened? I guess I don’t. And then, and then like, yeah, I’ve experienced that where then it’ll be two or three hours later. I’m like, Oh, I never went in that moment. And I was just fine that whole time.
William: Yeah, I remember going into hot yoga classes. And they would be like, all right, we’re going to shut the door.
Please try to keep the heat in. If you don’t have to pee, don’t pee. And of course, initially, immediately, I’m like, I’m going to have to pee in this class. and then of course I forget about it cause I’m doing the yoga and then it doesn’t happen. but the fizzy, physiologically what. Also can go on like when your bladder is about 30 percent full is when the trigone, which is the portion of your bladder that has a nerve supply to it, responds to stretch when that trigger first senses that stretch sensation.
That’s when you first get that urge to pee. But at that time, the bladder is only about 30 percent full. So, you know, a human bladder has the capacity to hold urine such that you, what we Often described as a healthy amount of peeing is once every two to four hours. so often, you know, yeah, you can go a lot longer than that first urge.
Two, three
Caitlin: hours, four hours. Yeah. Yeah. Oh. Well, thank you for reviewing that with me. See, there we go. Perfect example of education right there for all of our listeners. I think that will probably help a lot of people, Will. Thank you. I hope so. I think that things like that are just so helpful to understand.
Like, just. Well, just understanding the physiology, right? It makes it so much less like kind of amorphous or mysterious or you know, people are afraid of things they don’t understand or stressed out about things they don’t understand. And just having a little bit more knowledge of the actual physiology with that education component, I think that’s just so key for like kind helping people be more at ease or maybe a little bit more kind of.
observant in a relaxed way, of what’s going on, because that, with a little more understanding of it.
William: Yeah. I really like being sort of the person who can say to someone, especially someone who’s been through a lot or seen a lot of people, says, hey, you know, like, we’re going to sit together, we’re going to talk about what’s going on, we’re going to figure out what’s going on.
And if I can’t figure out what’s going on, then I’m going to try to point you to someone who can help. Or I’m going to do a little bit more research to see how I can better assist you. And sometimes just giving people that sort of moment that let’s listen to what’s going on. Let’s dig into it.
Let’s try to figure out what’s happening. Let’s see. What do I know that you might not that I can help you with? Because getting someone to understand how something is happening is a huge step forward in helping them get over it.
Caitlin: Mm hmm. Yeah. Well, another topic that I wanted to cover that you had mentioned when we were speaking earlier was treating patients with chronic pelvic pain.
I’m wondering if you can delve a little bit deeper into that area.
William: Yeah. Well, so there’s like a lot of, We’re kind of on the fringes right now, in terms of like pelvic floor physical therapy, you know, we, it’s relatively, it’s a new subset of a new field that hasn’t been around for all that long. And as we’ve sort of talked about earlier for a long time, many people didn’t even know that men had pelvic floors, let alone issues related to those.
and so what we do, what we, of all the research I’ve seen for pelvic floor physical therapy in a number of different conditions, you know, everything is promising, but we still need to know so much more. And, you know, with my patients who have chronic pelvic pain or a lot of these things, you know, what the general treatment recommendations right now is this like a multi pronged, multifactorial approach.
And so I, as a pelvic floor physical therapist, I’m playing like one role, but I’m on a team of people. And so oftentimes I’ll be working with, you know, urologists or other, you know, pain management specialists to try and like, you know, address an issue. So it’s, it’s, Often for these people, you know, it can take a village to say the very least, and it can take some time.
and so I’m currently, you know, there’s, there’s doctors actually, in the city who also administer injections into the pelvic floor. Some are Botox and some do a combination of dexamethasone and lidocaine. And I’ll be seeing those people, throughout their course of treatment. but what I, One, I just kind of like hammer home for your listeners is just, you know, there are so many people out there and maybe there’s one of you listening who’s like this, where you might just be walking around and think that nobody else has this issue.
and there’s so many people out there. I, I, those who are living with this suffering from it. And, you know, they’re, they’re, I just wanted those people who may be listening to let you know that you’re not alone. And there are treatments for it, you know, pelvic floor, physical therapy plays a role. These injections play a role.
We sort of talked a little earlier about education and lifestyle habits. You know, psychotherapy certainly plays a role here. and, you know, a lot of people who’ve gone into looking at like, what is this? You know, generally, there’s, there’s a book that I’m reading right now called A Headache in the Pelvis.
And, it’s written by an MD and I believe, Psychiatrist, maybe a physiologist. I’ll have to, I’ll have to look at the title afterwards. but they have taken sort of like a number of different diagnoses. Chronic pelvic pain syndrome, acute prostate, or noninfectious prostatitis. There’s a whole piriformis syndrome even.
And a whole bunch of other host of conditions. And they have sort of, the authors of this book have looked on it and they’re like, Well We look at all these conditions and we think that it’s, you could equate it to a bunch of blind men around the elephant describing it in different ways, but they’re all talking about the same thing and they have developed this sort of protocol where they’re looking at it in terms of, well, what is different?
What is similar about a migraine? To chronic pelvic pain, let’s call it that for a moment, and yeah, it’s really fascinating I’ve sort of started thinking about this in terms of my, the pelvic patients who I have who have like chronic pain Because often the way that they feel better is similar to someone who has a migraine who needs to lie down for the rest of the day and they can’t really do much else.
and the authors of this book have also developed this protocol where it’s a lot of just stretches and relaxation based exercises. And, I don’t know, I find it very interesting. but I also see these people as they’re undergoing injections for this thing. And they’ll, they’ll. Do them over the course of several weeks very often and, you know, I’ll sort of be treating them and work on their muscle function afterwards.
And, you know, it’s physical therapy that plays one role. and there’s many different routes, but I’m often sort of working. I’m communicating, coordinating with a bunch of different people.
Caitlin: Yeah, yeah, that’s interesting. I wonder a lot too, as somebody who treats a lot of low back and hip pain. Mm hmm. I often wonder how much of that is related to pelvic pain Completely, you know, I mean, it’s just like these body regions lumbopelvic hip complex and kind of muscular musculoskeletal terms But with the pelvis being kind of right there in the center of it all, so often, I, I find that a referral to pelvic PT for someone with chronic low back pain or chronic hip pain can be really valuable and maybe vice versa to work with someone for hip and low back pain, but it’s all so intimately connected in that body region that, like, do you find that you often get patients who have kind of been through.
some courses of treatment with various providers for low back pain, for hip pain, and then they land in your office to be treated for pelvic pain, and then see that low back and hip stuff starts to resolve in certain ways. Yeah.
William: That happens a lot. And on the flip side of that, sometimes I start doing hip and low back exercises with my pelvic patients and they start to get better too.
Yeah. I’m sure. Because, you know, it’s, both of those things happen. you know, pelvic floor, you know, there’s a lot of load transfer that happens through the pelvic floor. Totally. Totally. You know, one of its functions is to support your organs and to help transfer load from your legs into your trunk.
and so a lot of, let’s say of my patients, who have maybe when talking very stereotypically about, you know, just like penis and prostate owning individuals that who may have very like tight hips and tight, low backs and oh, yeah, they’re their left testicle is really painful and they have, they go on a run or something like that.
There’s a lot of connection between those. And, one thing I do is to educate other PTs who may not be doing pelvic floor work or know much about it. There are some screening questions you can also ask your patients if you feel comfortable asking them. if you suspect. That, you know, Hey, you’re showing up with low back or hip pain or something like that.
And maybe I’m suspecting, or just want to rule out any, any involvement of the pelvic floor if you can ask them about their, their bowel and their bladder habits and their sexual function. Of course, you know, this does, I understand, require a certain level of comfort with asking those questions and, assuming a comfort and a rapport with the patient.
that they will be opening, willing to open up to you. But it’s part of my standard. Now I do treat orthopedic patients, non pelvic orthopedic patients as well. And it’s part of my line of questioning, you know, I always ask them that as well, because that is definitely a connection there. and even part of my pelvic exam.
I do look at patients’ hips. I do look at their posture. I do look at how they walk, what a straight leg raises like for them and things like that. Just to kind of see sort of, you know, do we need to strengthen these muscles? Do we need to relax them first and then strengthen them? Do they just need to relax them and or to coordinate them better so that they can work with all of these other muscles?
I’ll give you one example. I had one patient who I was treating for a condition called hard flaccid syndrome, which is still pretty poorly understood, but it’s understood to be a neurological condition in which the penis can feel retracted, but the glands of the penis can be very large or vice versa.
Sometimes the testes hang very low as though there’s no tone in the cremaster muscle. and this. One of the patients for whom I was treating this shared with me that he had had a surgery, after I’d been working with him for a while, he never, we never talked about this before, he had had a surgery, to repair a varicocele, which, for those of you who don’t know, is a sort of a swelling of the veins in the testes, when he was much younger.
And, ever since then, he’d sort of avoided doing anything to strengthen or use his obliques. And this is someone who had a very physically demanding job. and the minute we started, you know, poking and prodding around the iliacus muscle around the hip, it was insanely sensitive and tight and painful.
But, you know, he would stretch that would just set his symptoms off into a whole tailspin. And so we found that doing a lot of eccentrics and isometrics and just very light, you know, marches with a kettlebell and things like that were actually really helpful. because he hadn’t worked that muscle at all and they were, those things were related to a whole cluster of other symptoms that were very distressing.
Caitlin: Yeah. I mean, you take a part of the body that’s responsible for load management and then just don’t put any loads through it in a certain way for a long period of time. It’s going to be like, yeah, yeah, that’s so interesting. Well, and I, I’ve experienced that too with a lot of my hip and low back pain patients who, a lot of people I treat come from the yoga world and have been sort of just like a lot of end range joint type of practice.
Not any external loading and just being like generally under loaded, just not letting all that musculature that’s responsible for kind of supporting and uplifting against load or going through a full breadth of contraction and lengthening and against resistance, like just getting all of that. I wanted to finish up by asking you about, where you see the future of pelvic PT going, you had mentioned that you are one of very few male practitioners here in New York City.
I feel like this is a niche that has grown tremendously over the last probably five to ten years, at least here in like a major metropolis. I’m wondering if you see it continuing to grow, do you think it will slow down, do you think it will grow more on the side of male Practitioners and male patients, what do you see happening?
William: This is, like, such an important question. Yes, pelvic floor physical therapy is something that has grown tremendously in the last few years. Yeah. And as I think it is a necessity, people are realizing, oh, all these issues that we were suffering with didn’t even know they could be fixed or addressed.
Now, you know, they’re there. well, currently, I think there’s still a lot of hurdles for us to go over, but I see this field is doing nothing but expanding and continuing to grow in the next, couple of years, my hope, I hope I’m wrong that I am one of very few providers in New York who treat men who are men.
I, I. If those of you who are listening who may be doing this type of work in New York City or anywhere else, please get in contact with me. But, the thing I want to see most is that pelvic floor physical therapy being more of a standard care, a practice or just a referral from urologist. from gynecologists from obstetricians from, you know, for women who are, or people who are undergoing pregnancy and getting ready to deliver a child, you know, that the pelvic floor physical therapy is not currently, as far as I’m aware, in the standard practice of care for most people.
And obviously the research shows that it’s very important for continents, for pain, for all of these functions that we’ve spoken about both pre and postpartum for the population of patients that I treat. Again, like I’ve seen so many people who’ve been through it and they’ve seen four urologists, five urologists, pain management specialists, and nobody has talked to them about pelvic floor physical therapy until like the fourth or fifth person.
So people are becoming more aware of it. And, I just, Hope that that continues to grow because there’s clearly a need for it, and there’s clearly research behind a lot of not everything that we do yet. There’s a lot more that needs to be done, but there’s clearly a lot. Research behind it indicates, hey, this is super promising.
We just need more sample sizes. Like right now, I’m, I’m actually going to be participating in a study next year where I’ll be working with Memorial Sloan Kettering, and among a team of therapists at the. Company I work for where we’re going to be working with patients who are with prostate cancer who will be undergoing a radical prostatectomy For those listeners who may not know it’s when you get the entire prostate removed and that can severely impact your ability to be Continent urinary at a urinary way as well as your sexual function and I’ll be working with you know doing biofeedback training to basically implement a protocol That of, that’s going to look at the, should this be part of a standard of care for people undergoing radical prostatectomies and does this help their continents and what the preliminary studies have shown is that, you know, their continents has, come back way faster and way better, excuse me, and it will significantly improve quality of life on any sort of like patient reporting or questionnaires that we have, and so I’m going to be participating in that.
this coming year. and my hope is that that will also become part of the standard practice of care because I have seen people who have had their entire prostates removed who don’t get this kind of counseling, don’t really get any kind of education beforehand, and then are incredibly distraught. whether or not they’re going to be able to, you know, not soil their pants again, whether they’re going to be able to, be intimate with a partner again, in the way that they’re used to.
and so I think that there needs to be a lot more of it and my hope, and my optimism say that that is going to continue to grow and become more and more a part of the standard practices for people with those conditions and probably others that we may not be aware of yet. Yeah.
Caitlin: Yeah. I hope so, too. I mean, I hope that more and more of these conditions will just automatically get a referral to pelvic PT.
Yeah. yeah. Cause I, I know you, you had mentioned, for birth parents just that it’s, it’s not even typical after birth here. And I, I. Have some colleagues that have worked over in France and it’s kind of become known as a school standard in health care for, for, pelvic care after giving birth.
And, and I would love to see, I would love to see the U. S. get a little closer to something like that. You and I both. Right, where people are actually getting pelvic care when they need it.
William: yeah. Yeah, no, absolutely. It’s very important. And I, I think it will. We’re just, you know, a little slower sometimes.
Caitlin: I always like to end these interviews because we do so much clinical talk And we, I know as clinicians, spend a lot of our time, researching and in continuing education and learning and working with our patients I always like to end by having you Talk a little bit about what you do for fun or personal interests, things that kind of light you up and turn you on outside of your work as a physical therapist.
William: Yeah. That’s a great question. I have, it’s harder for me to say what I’m interested in. Like, I am interested in everything. Like, the list of things I’m not interested in is very short, but most of the time, I think these days, I really, I love reading science fiction, Ursula K. Le Guin is my favorite author, I love cooking, you know, I’m always whipping up something, I love, you know, hanging out with friends, but I, you know, I grew up as a very arty, nerdy kid, and I, at the end of the day, that’s still who I am.
and that’s what I kind of like to spend my time doing. So I always like to tell people that physical therapy is full of nerdy jocks and jockey nerds. And I definitely like that. Thank you. I definitely think I’m more in the latter category, but these days I mostly spend my time reading, puzzling, going to the gym and cooking.
Yeah,
Caitlin: cool. Yeah, I can totally relate. I know you mentioned Magic the Gathering when we first started talking and that took me way back because that was like so big when I was in high school and And I knew a lot of I didn’t I didn’t really like play but I knew a lot of people who did in my just Definitely my like nerdy theater kid kind of friend group that I hung out with Totally.
Yeah, I can totally relate to that. Yeah, I have a box
William: of like a thousand cards somewhere that I think maybe one of my friends has, I don’t know, some babysitter I had when I was in like elementary school gave them to me and then I was hooked ever since.
Caitlin: Yeah, yeah. The cards are so fun to look at. I mean, I, yeah, that just when you mentioned it, it is like total nostalgia for me.
All of a sudden I was like, oh yeah, these cards.
Well, thanks so much, Will. If people want to get in touch with you, or they want to work with you, what is the best way for them to reach out and find you? Yeah.
William: So I have a DPT Instagram, but I have zero content on it. It’s sort of an account I created a little while ago that I keep meaning to say, I’m going to start creating educational content for this and I have yet to get around to it.
So, if you want to follow me there, it’s at will K D P T. you can reach out to me there. you stay tuned for some things I will eventually get around to putting up, but I do check it periodically. and yeah, you can find me there. I also work at Spear. If you’re looking to work with me, I work at a company called Spear.
and, but the clinic I work at is in Williamsburg, right on North seventh street between Kent and YC.
Caitlin: Awesome. Thanks so much, Will. And I’ll link your Instagram and the show notes for everybody so they can find it there. And it was such a pleasure talking to you and getting to know you a little bit more.
Thanks so much for your time. Well, thank
William: you so much for having me. I really appreciate the opportunity to come on and you ask me really good questions and any chance I get to plug in, to be an advocate and plug for a pelvic floor PT, I’ll take it. So thank you.
Caitlin: It’s so important. Thank you. Yeah.
Yeah. I mean, I feel like. All PTs, we just got to talk about what we do as much as possible. Because right? I mean just educate, educate, educate the population on what we do. The giant breadth of. I think it’s so important to spread the word as much as possible, so thank you for that.
William: Absolutely. Thanks for having me.
Caitlin: Thank you so much for listening to my talk with William Klein. Again, if you have any thoughts or observations or questions for us here at Practice Human, please shoot us an email at hello at practicehuman. com. And again, if you’re interested in getting inspired, Staying in touch with Will, follow him on Instagram @WILLKDPT, and I’m looking forward to continuing this conversation with Will and staying connected to him.
I think he’s such a valuable resource here in New York City and if anyone listening has any thoughts on other practitioners who treat men for pelvic health. Please reach out to me and let me know. I want to gather a little bit more resources where possible so that I have, kind of all the, all the referral sources that I might need in my own practice because I think this work is valuable, hard to come by and, and super, super important.
So thank you so much for listening and I will talk to you again soon.
