At least 1 in 4 US women live with a pelvic floor disorder, and patients with urinary incontinence have up to a 2.5x higher likelihood of low back pain. Yet, most orthopedic patients will never volunteer their bowel, bladder, or pelvic symptoms on a standard intake sheet.

In this episode of In The Mind Of, host Dr. Robert Shapiro sits down with dual board-certified clinical specialist Dr. Kinjal Markana, PT, DPT, OCS, WCS (Professional Physical Therapy).

Dr. Markana breaks down why reflexively instructing orthopedic patients to "do Kegels" can often worsen symptoms, how intra-abdominal pressure mechanics link the respiratory diaphragm directly to lumbar stability, and what external screening tests every orthopedic clinician can implement immediately without performing internal exams.

• 00:00 – The Silent Caseload: Why pelvic health symptoms hide in orthopedic clinics

• 02:15 – Defining the Scope: Women's health vs. comprehensive pelvic floor health

• 04:30 – The LBP & Incontinence Correlation: Understanding the staggering research data

• 07:10 – The Clinical Conversation: How orthopedic clinicians should ask about bladder issues

• 09:45 – Ortho-Pelvic Overlap: FAI, adductor strains, tailbone pain, and diastasis recti

• 11:20 – "Pelvic Heaviness" in Runners: Differential diagnosis between POP and hypertonicity

• 13:20 – Bowel Dysfunction & Outlet Constipation: GI and colorectal referral pathways

• 16:05 – The Canister Model: Coordinating the respiratory diaphragm with the pelvic floor

• 19:30 – The Kegel Fallacy: Why 49% fail verbal cues & 25% perform a Valsalva bear-down

• 22:50 – Internal vs. External Treatment: What orthopedic PTs can treat through external cues

• 26:15 – Shattering Clinical Silence: Navigating the biopsychosocial aspect of pelvic health

Dr. Kinjal Markana, PT, DPT, OCS, WCS is a physical therapist at Professional Physical Therapy, holding dual board certifications as an Orthopedic Clinical Specialist (OCS) and Women's Clinical Specialist (WCS). She specializes in pelvic floor dysfunction, complex lumbopelvic pain, and integrating pelvic health with sports orthopedic rehabilitation.

• Find a Pelvic Rehabilitation Provider: Herman & Wallace Directory (https://hermanwallace.com/)

• Professional Physical Therapy Continuing Education: Professional Seminars (https://www.professionalseminars.com/)

• Clinical Practice Guidelines & Resources: APTA Academy of Pelvic Health Physical Therapy (https://aptapelvichealth.org/)

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Disclaimer: This podcast is produced for educational and informational purposes only and does not constitute medical advice. Clinicians should apply clinical judgment to individual patient care, and patients should consult a licensed healthcare provider.