Pelvic PT Rising
Helping pelvic physical therapists improve as clinicians, in their careers or business, and their lives. Hosted by Dr. Nicole Cozean and Jesse Cozean, the founders of PelvicSanity physical therapy and the Pelvic PT Huddle, the podcast explores all aspects of pelvic physical therapy. You'll find the clinical pearls that Dr. Nicole teaches in her continuing education courses, the business and career advice that catapulted PelvicSanity into one of the largest cash-based physical therapy practices in the country, and living life as business owners and pelvic health advocates. And we'll be keeping it 100% real - and having some fun - along...
Preventing the December Slowdown in Business
Every year, pelvic health business owners start dreading the same thing: the dreaded December slowdown. 🎄
Patients are traveling. Family commitments pile up. People cancel or reschedule appointments. And sometimes we're closing our own doors for the holidays!
But here's the question: Does December actually have to be a bad month for your business?
We don't think so!
Every month has its challenges AND its opportunities. And December has some pretty big advantages: patients want to reach their goals before the new year, use up their FSA dollars, and...
26 Years of Pelvic Health Lessons: An Interview with Tracy Sher
What does 26 years of treating complex pelvic pain teach you? And what happens when you decide it's time to step away from patient care?
We're joined by Tracy Sher, founder and CEO of Pelvic Global (formerly Pelvic Guru), international educator, and one of the pioneers who helped shape how our field approaches complex pelvic pain.
This conversation is packed with clinical pearls, honest reflections, and some incredible stories about building a business (including a VERY expensive picture of a uterus 😳).
We dive into:
⏳ "How long until I get better?" — Tracy's brilliant framewo...
You Built the Business. Now Can You Step Away?
What happens when you hit the financial goals…but realize you still can't slow down?
This episode was sparked by a business owner who had been in practice for five years, was financially successful, but felt like she still couldn't step back, stop grinding or really enjoy what she'd built.
It got us thinking about the three very different seasons of PelvicSanity over the last 10 years—and how our definition of a successful business has changed along the way.
In this episode, we talk about:
🚀 Season 1: Growth<...
Does Your Business Get Easier Each Year? Nicole vs. Jesse Debate!
The longer you own a business…the easier it should get, right?
Well, Nicole and Jesse aren't so sure they agree. 😂
So we're debating it!
📈 On one hand, YOU get better every year. You know more. You've made mistakes. You've survived hard things. Problems that would have sent you spiraling five years ago barely register anymore.
But…
🔥 Your problems get bigger.
😬 You fall into bad habits.
🏃♀️ It gets harder to maintain momentum.
🤯 And as the business grows, you encounter entirely new challenges you never had whe...
5 Business Lessons From 5 Years of PelviCon
PelviCon is officially here! 🎉
Five years ago, PelviCon was basically an audacious idea: What if we built the pelvic health conference we always wished existed?
Since then, we've sold out five years in a row, grown to more than 600 in-person attendees, built an incredible Live Virtual experience—and learned a LOT about business along the way.
So we're pulling back the curtain on some of the biggest lessons PelviCon has taught us:
💡 Build what you wish existed. Don't just make something slightly better. Ask whether you can create s...
There’s No Such Thing as a Simple Pelvic Health Patient: An Interview with Michelle Lyons
There’s no such thing as a simple pelvic health patient.
Even the patient who walks in with “just a little stress incontinence” brings a history, a body, hormones, sleep, stress, previous injuries, bowel function, activity goals—and a whole lot more.
And that's exactly why being a great pelvic health clinician requires so much more than memorizing protocols.
We're joined by Michelle Lyons for one of those wide-ranging, thought-provoking conversations we always love having with her.
Michelle has been part of PelviCon from the very beginning. She's ou...
Your Business Doesn't Have to Grow
More revenue. More patients. More clinicians. More locations.
We're constantly told that a "successful" business should always be getting bigger.
But what if you don't actually want it to? 🤔
There are plenty of GREAT reasons not to grow.
👨👩👧👦 You're in a season where family needs more of you.
✈️ You want to travel or prioritize life outside the practice.
💰 You're already making enough money.
🙅♀️ You have absolutely zero desire to manage employees.
❤️ Or maybe you're just…happy with what you've built!
And sometimes growth stalls for reasons y...
How to Actually Be an Evidence-Based Clinician: An Interview with Taryn Hallam
Reading research and actually understanding what it means for the patient in front of you are two VERY different things.
And there may be nobody in pelvic health better at bridging that gap than Taryn Hallam.
Taryn has essentially made research translation her full-time job—reading the enormous amount of pelvic health research being published and asking:
What does this actually mean in the clinic?
Because the abstract doesn't always tell the whole story.
As Taryn puts it, the abstract is...
What’s the Point If You Hate Your Business?
You can make great money. You can have control of your schedule.
But…do you actually like the business you've created? 😬
In Part 3 of our Make the Business Work for You series, we're talking about the third major piece of upside you traded for when you became a business owner: satisfaction & impact. 🙌
Ideally, as your business grows, your role should get BETTER.
✨ More time doing things you're great at.
❤️ More of the work you genuinely enjoy.
💰 More time spent on things that actually cre...
Are We Really Providing Whole-Person Care If We Ignore Spirituality? With Sinéad Dufour
We talk a lot about providing “whole-person care.” But are we actually doing it?
And if we leave spirituality completely out of the conversation...can we really call our care whole-person?
This is exactly the kind of question we love exploring with Dr. Sinéad Dufour.
Sinéad is one of the researchers and educators we respect most because she's constantly willing to examine the evidence, challenge her own assumptions and change her mind when the science takes her somewhere new.
So naturally, when she decided to go bac...
Make the Business Work For You - Time Freedom
You started your business for more freedom.
So…why are you working more hours, answering messages on vacation, staying late for the one patient who "can only do 5pm," and feeling guilty anytime you need to change your schedule? 😬
In Part 2 of our Make the Business Work for You series, we're talking about TIME FREEDOM 🙌
⏰ How much time does your business actually require from you?
📅 Are you working the schedule you want—or the schedule your patients have created for you?
🧹 How much timesucking nonsense is quietly stealin...
Disrupting Sexual Health with Dr. Rachel Rubin
Dr. Rachel Rubin is changing the landscape of women’s health—and she’s not waiting around for permission.
In this fiery conversation, we talk about why sexual medicine has been ignored for so long, the massive education gap around menopause and hormones, and Rachel’s work fighting to remove the FDA boxed warning from vaginal estrogen.
We also get into why pelvic PTs and OTs need to own our role in recognizing hormonal and vulvar changes, why the future of women’s healthcare requires a multidisciplinary “pit crew,” and Rachel’s philosophy that no grown...
Make the Business Work For You - Financial Success
When you leave a job to start your own practice, you're making a pretty massive trade:
You're trading consistency for upside.
Gone is the predictable paycheck, the regular schedule, the structure someone else created for you, and the relative certainty of knowing what you're going to make.
In exchange? You get upside.
And in this first episode of our Making Your Business Work for You series, we're talking about the most obvious kind: money.
Because we all know the fantasy math.
"...
You Know His Research. But Do You Know Paul Hodges?
You might not immediately recognize the name Paul Hodges. But we can almost guarantee you've been taught his work.
And if you're attending PelviCon (either in-person or with our Live Virtual option) you'll get the chance to learn from him directly!
If you've learned that...
👉 The pelvic floor and diaphragm work together
👉 The pelvic floor is part of a larger pressure-management system
👉 Timing and coordination matter—not just strength
👉 The abdominals and pelvic floor don't function independently
👉 Intra-abdominal pressure isn't inherently bad
👉 Pain is far m...
Do You Actually Need a CRM? Fight for Simplicity.
When does a cash-based pelvic health practice actually need a fancy CRM?
For most of us? Never.
And yes—we've made this mistake ourselves. 😬
In this episode, we're breaking down what a CRM actually is, how it's different from your EMR and email platform, and why adding more technology often creates more problems instead of solving them.
We get into:
👉 Why you probably already have a CRM (even if it's just a Google Sheet!)
👉 The difference between your CRM, EMR and email pl...
Maternal Mortality, a Whole-Body Approach and Using Data: An Interview with Katherine Sylvester
How can we help save the lives of our pregnant and post-partum patients? What about doing more than just resolving their reported symptoms?
We can't wait for you to hear this conversation with Katherine Sylvester - she has spent her entire career challenging the status quo and pushing for better results for her patients.
After experiencing postpartum preeclampsia herself, Katherine began asking how wearable data could help women recognize problems earlier, advocate for themselves and make better decisions during pregnancy and postpartum. That eventually grew into Operation M.I.S.T. and her work helping wo...
The Hardest Part of Hiring Your First Clinician
What if the first clinician you hire isn't as good as you?
It's one of the biggest fears we hear from successful solopreneurs—and it's exactly what Nicole struggled with when we started growing PelvicSanity.
Because hiring your first clinician isn't just adding another person to the schedule.
It's changing your entire role.
Suddenly, you have to trust someone else with your patients, your reputation, your culture and something you've worked incredibly hard to build.
And yes...Nicole struggled with this enough that she eventually went to th...
Rethinking Compression Garments & Diastasis: An Interview with Gráinne Donnelly
How do you challenge long-held beliefs in pelvic health? You ask better questions.
This week, we're joined by Gráinne Donnelly—pelvic health physiotherapist, researcher, educator, editor-in-chief of the Journal of Pelvic, Obstetric and Gynaecological Physiotherapy, and one of this year's featured PelviCon 2026 speakers.
Gráinne has built a career around asking questions that matter, from postpartum return to sport and diastasis recti to compression garments and pelvic floor function. In this conversation, she shares what she's learning through her PhD research, why clinical curiosity should drive research, and how our profes...
The Biggest Mistake We Make with Downtraining
If you've ever felt like you've "tried downtraining" and your patient still isn't getting better... this episode is for you.
We're also wrapping up our recent series on internal exams, the gold standard, and access to quality care before shifting back into one of our favorite clinical topics: downtraining.
The biggest mistake we see?
Thinking of downtraining as a single intervention.
In this episode, we introduce the updated framework from our completely re-recorded Downtraining Masterclass, including the three different "levers" of downtraining and how they help you...
What's Changing in Endo Care? An Interview with Amy Stein
PelviCon '26 speaker Amy Stein has been one of the pioneers of modern pelvic health.
She founded Beyond Basics Physical Therapy, one of the largest cash-based pelvic health practices in the country, authored the groundbreaking books Heal Pelvic Pain and Beating Endo, and has spent more than two decades helping shape the future of pelvic rehabilitation.
In this conversation, we talk about how far our profession has come—from a time when there were only a handful of pelvic health courses available to today, where thousands of clinicians are entering the field every yea...
The 5 Levels of Care in Pelvic Health: What Is The Gold Standard?
Let's cut through the noise....If someone you loved needed pelvic floor therapy tomorrow, where would you send them?
🤔 Are there actually different levels of pelvic health care?
We believe the answer is yes.
The interesting part? Most pelvic therapists already act as though these different levels exist—we've just never had a common language to describe them.
Think about it...
If your spouse, your parent, or your child developed pelvic floor dysfunction tomorrow, who would you recommend?
Most of us wouldn't say:
...
What Do We Actually Gain From an Internal Pelvic Floor Evaluation?
To be honest, we never imagined we'd need to explain this.
Fair warning: this episode gets a little nerdy.
Over the last two episodes, we've talked about why we believe internal pelvic floor evaluation remains the gold standard in pelvic rehabilitation. This week, we're answering the obvious follow-up question:
What do we actually gain from performing one?
For those of us who were trained to perform internal evaluations—and who use them every day in practice—the value seems almost self-evident. It's become such a fundamental part of how w...
What We're Getting Wrong About "Access to Care"
"Access to care" sounds like something everyone should support.
So why do we think it's become one of the most misleading phrases in pelvic health?
In this episode, we argue that we've been solving the wrong problem.
Because the goal isn't access to care. The goal is access to quality care.
We discuss:
Why lowering the standard of care isn't the same as increasing access The difference between access and quality Why patients are still falling through the cracks despite having "access" The six...Is Internal Evaluation + Treatment Still the Gold Standard?
Is internal evaluation the gold standard in pelvic health? We believe the answer is yes.
Lately, we've seen more clinicians claiming that internal pelvic floor evaluation isn't necessary—or isn't the gold standard of pelvic rehab. We don't think this is just another social media debate.
We think it's one of the most important conversations our profession needs to have.
We're going to be diving deep into this topic. But for Part 1, we discuss:
Why this issue matters so much for the future of pelvic health What the pioneers of our pro...Is an Online Business Really the Future?
"Everyone" seems to be saying the future is online. Create a course. Sell a membership. Telehealth in your pajamas.
Stop trading your time for money. Retire on a beach.
As owners of both a thriving brick-and-mortar practice and a successful online business, we wanted to share a reality check.
In this episode, we discuss:
✅ Why most pelvic PTs are looking at online business for the wrong reasons
✅ Why building an online business is often harder than building a local practice
✅ The biggest mistakes we see clinicians make before they...
Endometriosis Is a Team Sport: An Interview with Excision Specialist Dr. Stuparich
Endometriosis care is about so much more than surgery.
In this episode, Nicole sits down with endometriosis excision surgeon Dr. Mallory Stuparich for a wide-ranging conversation on what it really takes to care for patients living with endometriosis.
We discuss:
The role of pelvic PT before and after surgery Setting realistic expectations for recovery Central sensitization and persistent pain Imaging, inflammation, and recurrence Why multidisciplinary care leads to better outcomesBut one message stood above everything else:
Our first job is to rebuild trust.
Many patients w...
Building a Business That Stands for Something: An Interview with Joy Noble
What if the biggest key to business success isn't strategy... but confidence?
In this episode, we bring on Joy Noble, founder of Pelvic Pride, to talk about building a business with purpose, creating an incredible team culture, and having the courage to do things differently.
A coach in our Rising Mentorship Program, Joy shares the journey from opening her practice just before the pandemic to growing into two locations, expanding her team, and creating one of the most recognizable brands in pelvic health.
We discuss:
✅ Why community is one of...
Scaling Your Practice: An Interview with Hannah Strom
What does it really take to grow from a single treatment room into a thriving multi-location practice?
In this episode, we sit down with Hannah Strom, founder of Awake Pelvic Health, to talk about the mindset, leadership, and intentional decisions that fueled her incredible growth.
Hannah shares how she started in a tiny room at the back of a yoga studio and, just five years later, has built a practice with ten clinicians. But this conversation isn't just about growth—it's about becoming the leader your business needs.
We discuss:
...
Grace, Boundaries & Burnout - Real Story of Leaving a Job
Leaving a job is one of the trickiest moments in your career.
Whether you're the employee or the employer, emotions run high, plans change quickly, and patients are caught in the middle.
In this episode, we discuss a question that came up in the Pelvic PT Huddle and use it to explore what it really means to leave a position professionally and gracefully.
We cover:
✅ Why giving notice is so emotionally complex for both sides
✅ The difference between a poor business decision and an unethical one
✅ Why it's n...
How Your Money Mindset Issues Are Holding You Back
You have money mindset issues.
We do too. Every business owner does.
The question isn't whether you have them...
It's how much they're quietly holding your business back.
In this episode, we unpack how money mindset shows up in pricing, hiring, investing, patient care, and even the recommendations you make in the treatment room.
We discuss:
Why money mindset affects far more than your finances The subtle ways it shows up in your business every day How it impacts pricing, confidence, and patient care Why awareness alone is...Why PelvicSanity Doesn't Have a Gym
Wait...you don't have a gym? It's a question we get all the time.
Especially because when we redesigned our clinic from the ground up, we could have built anything we wanted.
A dedicated gym space. Fancy equipment. Treadmills. Squat racks. All the toys.
Instead?
We made our treatment rooms bigger.
In this episode, we discuss how to think strategically about clinic space, equipment, and designing a practice around your actual patients—not what your last employer had, what you see on social media, or what everyone else s...
5 Principles for Long-Term Business Success
After working with more than 900 pelvic rehab business owners, we've noticed something:
The people who have long-term success aren't necessarily the most talented, charismatic, or the best clinicians.
They're the most consistent.
In this episode, we break down the five biggest principles we've seen separate thriving business owners from everyone else.
We discuss:
✅ Why you're a different business every six months
✅ Why consistency beats talent every time
✅ The surprising power of community and support
✅ How to embrace the seasons of business and life
✅ Why financial confidence...
Why Running Late Isn't Being Nice or Valuable to Your Patient
Do you run late with your patients? Most clinicians do. And almost all of them think it's either helping or 'not that big a deal'.
It's not.
In this episode, we break down why running late is one of the most damaging habits in clinical practice—for you, your patients, and your business.
We discuss:
Why running late doesn't earn gratitude or loyalty How it quietly poisons patient expectations The biggest reasons clinicians fall behind schedule Why insecurity often shows up as "doing too much" How poor session planning creates chaos The i...Converting Leads to Paying Patients - Your Conversion System
Getting leads is only the first step. The next part is turning those leads into paying patients. And this is where many of us struggle.
In this episode, we break down the conversion system that takes someone from "I'm interested" to actually showing up for an evaluation.
We cover:
Why scripts are only a small part of conversion The biggest follow-up mistakes practice owners make Why texting isn't enough The power of getting people on the phone How systems reduce mental load and improve consistency Why most people aren't losing patients to competitors—they're losing them to i...Complex Patients Need Simple Interventions
What if the answer for your most complex patient...was actually simpler than you think?
In this episode, we share a favorite clinical principle and one that we train on at PelvicSanity...
The more complex the patient, the simpler the intervention.
Because when someone has seen multiple providers, tried countless treatments, and feels completely overwhelmed by their symptoms...
The last thing they usually need is a more complicated plan.
We discuss:
✅ Why newer clinicians shouldn't be shielded from complex patients
✅ The foundational interventions most clin...
The 10 Marketing Mistakes Costing You Patients
Why isn't your schedule full?
The first place to look is whether we are getting enough leads.
We break down the 10 biggest marketing and sales mistakes pelvic rehab business owners make—and how to fix them.
From not tracking your numbers to relying too heavily on social media, these mistakes quietly sabotage growth and leave owners feeling frustrated, overwhelmed, and stuck.
You'll learn:
✅ Why most owners don't actually know how many leads they need
✅ The hidden cost of inconsistent marketing
✅ Why relying on one marketing strategy is dangerous
The Great Kegel Debate (Part 3): With Michelle Lyons
Should we be anti-Kegel? Has the pendulum swung too far?
We brought on the one and only Michelle Lyons to continue the conversation. It deserved a Part 3, and there's no one else we'd rather deep dive into the topic with than Michelle. We cover:
Why Kegels and pelvic floor muscle training are NOT the same thing The history of Dr. Kegel (and why we may have misunderstood him) Why pelvic floor rehab is far more sophisticated than "squeeze and lift" The role of strength, timing, coordination, endurance, and movement Why social media has made this debate more confus...How to Unlock the Hidden Potential in Your Business
Many of us have the feeling there’s more potential in the business…we just don't know how to unlock it.
What got us to this level of success isn't enough to take us to the next.
We start to feel stuck, or wonder 'is this it?'
Working harder than ever. Stressing about the business. Trying to do 'all the right things'.
And yet:
You’re not hitting your financial goals You don’t feel the freedom you expected And you know your business could be doing moreThat's what we t...
Birth Prep Isn't Birth Education: An Interview with Gina Conley of Mamaste Fit
Are we trying to do too much as pelvic rehab providers?
That might be an uncomfortable question.
Because when it comes to birth prep, many of us genuinely want to help our patients have the best experience possible.
But where does our expertise end?
And where does someone else's begin?
In this episode, Nicole sits down with Gina Conley of MamasteFit—perinatal fitness provider, birth doula, educator, and someone who has attended hundreds of births—to talk about the role pelvic PTs actually play in preg...
When the Dream of Time Freedom Turns to a Nightmare
One of the biggest reasons people start a business…
is freedom. Freedom to:
Work the hours you want Pick your kids up from school Travel Control your scheduleBut somewhere along the way…
the dream turns into a nightmare.
You started the business for freedom, but...
👉 You’re working constantly
👉 Thinking about the business all the time
👉 Feeling trapped by your schedule
👉 And wondering why you somehow have less freedom than before
Because you cannot truly feel successful if you don’t control your time.
The B...
