We caught up with the brilliant and insightful Jess Hund a few weeks ago and have shared our conversation below.

Jess, thanks for joining us, excited to have you contributing your stories and insights. We’d love to hear the backstory of how you established your own practice.

I never wanted to be a clinic owner. From what I had seen in the field – it was a difficult role that caused a lot of individuals to flirt with not being ethical in billing practice and I wasn’t willing to compromise quality of care for monetary gain.

But when I needed pelvic therapy I couldn’t find care (not enough providers) and everything involved lying on a table and just squeezing (ie a kegel) and somehow this was going to be make me not have pain during sex or leakage while running. In any other realm of Physical Therapy what we choose for patients to do is “task specific” but apparently this was not what was occurring in the pelvic health space. It was in that moment that I realized I would need to start a practice and find a way to not only provide an environment for my DPTs to be paid fairly but where patients would receive 1:1 hour long treatment sessions with the highest evidence of care we have available. That’s when I decided to start The Floor PDX.

I found mentors who weren’t necessarily PT’s who are incredible business owners and I interviewed them. I wanted to replicate strong business foundations for scaling down the line. Some of these individuals are still my mentors. I tell those who are looking to start their own business – make sure you’re the smallest standing among giants and absorbing all of their knowledge. The moment you think you know it all (this is the same for clinical practice) – then you clearly aren’t learning and have become stagnant.

We started small as a mobile clinic and quickly recognized that this didn’t work from a scaling perspective as traffic often dictated 3 hr blocks of time for treating one patient. Often our patients needed barbells or heavier weights that I wasn’t going to just pop into the back of my car. So we found a partnership with a local crossfit gym and we dreamed of how we would build this out to both benefit their members as well as ours in creating a symbiotic community. We are still coming up with ideas to implement down the line!

Awesome – so before we get into the rest of our questions, can you briefly introduce yourself to our readers.

My name is Jessica Hund – I have my doctorate in Physical Therapy and specialize in pelvic health.
I went to school wanting to be an orthopedic sports PT who understood loading of muscles, length tension relationships, and the interaction of the body in space. So I did just that and in the process fell in love with this realm. It wasn’t until I had my first baby who “tore her way” into the world that I became interested by pelvic health therapy. (As a disclaimer you don’t have to have had a baby to experience pelvic floor problems — I would say 1/2 of our clients have never had a baby — but this was my story!)

The care I fought to receive after having her was arduous. I couldn’t find a pelvic health practitioner when I needed help 9 months postpartum and once I had found one she determined that my pain was most likely from my liver (which is not something that is related nor something a PT would be able to “treat” or feel). I was incredibly frustrated and a light bulb went off in that moment. How are these muscles any different than the ones I understand intimately in the rest of the body. They are made of the same contractile units and respond to force the same way. Arguably they are just cooler in that they have the urethra, vagina, and rectum passing through. This instigated the long journey of entering the pelvic floor realm and discovering how we could treat differently than lying down and kegeling the whole time.

In our practice we spend a good period of time listening to your story. Then we educate educate educate. I never want our patients to feel that we are the saviors but rather want to place them in the drivers seat of their journey as they are the ones taking the tools we provide to create change.

I’m really proud of what we are building and how we are pushing the boundaries of pelvic floor care. Our plan this year is to begin initiating force plates into treatment sessions so we can find the exact force production that is the tipping point for your symptoms and then build from there. We dont just stare at the pelvic floor intravaginally — we are looking at it’s integration throughout the body as you do the tasks that cause the problems.

We are also investing in a translabial ultrasound so we are able to see and discuss with providers findings for prolapse and accurate pessary fitting within the clinic. This will improve our communication with referring providers to further collaborative care within the community.

We do standing assessments with clients intravaginally. What this looks like is someone who might feel heaviness in their pelvic floor with lifting things overhead, we glove up and place you with a sheet wrapped around like a Grecian goddess – and feel intravaginally what happens when you lift that weight overhead. Then we go from there.

As you can see – how we treat is very different than “pelvic rehab” but this is what we believe pelvic rehab should look like.

Putting training and knowledge aside, what else do you think really matters in terms of succeeding in your field?

Being anti-fragile. What do I mean by this? Bone is anti fragile. When stress is applied to it, instead of breaking it responds and lays down more matrix to be stronger than before to better withstand the stress. I want to be like this. Whatever comes down the line in business with the stressors that occur, I want to be able to respond and become stronger to that which presents itself – ever evolving and adapting.

Any stories or insights that might help us understand how you’ve built such a strong reputation?

We treat so massively differently from anyone else in the area. The stereo typical pelvic health clinic in the area you arrive, the PT is with you for maybe 23 minutes and then an aide (a rotating individual who doesn’t have education in the pelvic health realm) finishes your treatment. Most of the time is looks like lying down and kegeling, sitting and kegeling, bridging, standing and kegeling, clamshells and kegels.

We spend 60 minutes every single treatment session with the same Doctor of PT on whatever the presentation is doing most often the opposite of kegels. We look at the integration of the hips rotator muscles with the pelvic floor and how this influences the body’s ability to absorb force. We make you do the thing that makes you leak/have urgency/have heaviness. We do standing internal assessments. We use mirror therapy for desensitizing the hyper sensitive structures. We bring you out to the gym where we have weights (not just bands). Its just completely different. This is what has helped us build our reputation. Our patients tell their friends who have “failed” traditional pelvic PT.

Contact Info:

• Website: https://www.thefloorpdx.com
• Instagram: @thefloorpdx
• Linkedin: https://www.linkedin.com/company/91171607/admin/dashboard/

Image Credits

Eric Doolan
Haley Graham