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

Theresa, appreciate you joining us today. Can you open up about a risk you’ve taken – what it was like taking that risk, why you took the risk and how it turned out?

In 2014, I was working as a hospital-based physical therapist at Sharp Healthcare, 50% focused on rehabilitation for post-operative patients and those recovering from strokes or severe injuries and 50% Pelvic Floor patients. The work was demanding but rewarding. I had built strong relationships with my patients, colleagues, and mentors. But as time went on, I began to feel a pull in a different direction. I had been reading more and more about pelvic floor physical therapy, a niche that I noticed wasn’t getting enough attention in traditional hospital settings. By 2020, I had already been treating pelvic floor patients 100% of the time for the past 6 years.

My interest was piqued in graduate school during a seminar that focused on pelvic health, and I realized how deeply this specialty could impact quality of life, especially for women. Pelvic floor issues, from postpartum recovery to chronic pain, urinary incontinence, and pelvic organ prolapse, often went under the radar in traditional healthcare settings. These problems weren’t being fully addressed, and I could feel the untapped potential in that area. The more I learned, the more I knew this was where I wanted to make my mark.

The thought of leaving the comfort of a large hospital system was intimidating. Sharp Healthcare offered me stability, a steady paycheck, health benefits, and a reliable structure for professional development. But the autonomy of private practice beckoned. I dreamed of creating a space where I could focus solely on pelvic health, take my time with patients, and not be rushed by the limitations of hospital policies or insurance-driven treatment quotas.

The decision wasn’t easy. I didn’t have a business background, and I knew running a practice in San Diego, especially in a community like Pacific Beach, would have its challenges. But after months of internal debate and encouragement from a close circle of colleagues and family, I took the plunge.

The first step was setting up a website and leasing a small office in Pacific Beach. I had saved up for months to cover rent and initial costs. I also knew that I wanted to create a calming, welcoming space that didn’t feel clinical—so I rented my space with like minded holistic professional building that focuses in making the environment warm and soothing, with soft lighting and minimalistic décor. It was a risk because this venture was self-funded, and and I had to dip into my savings, hoping I could build a sustainable client base.

At first, it was terrifying. There were days when no patients would book, and I questioned if I had made the right choice. I had to learn about marketing, social media, and managing administrative tasks on the fly. But slowly, word began to spread. I connected with local doulas, OBGYNs, and midwives who started referring patients to me. Each client who came through the door was treated with care and personalized attention, and I made it my mission to spend more time with them than they’d get in a hospital setting. That’s when I started seeing the transformations. Women who had suffered from pelvic pain for years began to regain their strength and confidence. Mothers who thought they’d never recover from childbirth injuries found relief. The one-on-one attention I could provide in a private setting was making a tangible difference.

Within a year, my practice grew steadily. I invested in additional certifications, expanded my knowledge, and even hired a part-time assistant to help with the admin work so I could focus more on patient care. My biggest reward came in the form of patient stories—women who were able to return to their daily lives without pain, who could exercise again, or who regained intimacy in their relationships after years of suffering.

It wasn’t just a financial or professional success; it was deeply personal. The risk I took in stepping away from the comfort of a hospital system allowed me to fully align my work with my passion. Now, I’ve expanded my practice and offer workshops and classes to educate women on pelvic health before issues arise. The risk was big, but the reward was bigger. Not just for me, but for the many lives that have been changed through this often-overlooked specialty.

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

I’m not your typical clinician. My career began in pediatrics, particularly working with children who suffered from severe neurological impairments, and over time, I’ve carved out a unique and meaningful path in healthcare. Today, my expertise spans beyond the traditional, as I now specialize in musculoskeletal injuries and, most notably, Pelvic Floor and Abdominal Dysfunction.

My passion lies in pelvic health, where I offer a variety of services to a diverse group of patients. This includes fertility patients, pregnant and postpartum parents. What sets me apart is my ability to blend Eastern and Western medicine in a way that enhances my patients’ healing. I’m not limited by traditional approaches, and this has allowed me to create highly personalized treatment plans that address both the body and the mind.

From internal pelvic floor assessments to uterine massage, I cater to a wide range of needs. My toolkit includes everything from cranial sacral therapy and yoga to advanced methods like kinesiology taping and myofascial decompression (cupping). I also offer more unique therapies like pelvic steaming, visceral manipulation, and the use of an amethyst bio-mat.

One of my core values is ensuring that my practice is welcoming to everyone. I’ve designed my clinic to be a diverse, inclusive, and accepting space—where all patients, regardless of their background, can feel safe and supported. For busy parents, I offer the option to bring their children to appointments to make their experience as convenient as possible.

My ultimate goal is simple: helping my patients return to a pain-free, healthy lifestyle. Many of them start with a specific treatment plan but continue with wellness follow-up visits to ensure they have long-term support on their healing journey. For me, holistic health isn’t just an option—it’s an ongoing partnership in wellness.

As healthcare evolves, I remain committed to staying at the forefront, offering a comprehensive, compassionate, and inclusive approach that breaks barriers in pelvic health.

Training and knowledge matter of course, but beyond that what do you think matters most in terms of succeeding in your field?

Pelvic floor therapy often deals with deeply personal and sensitive issues such as incontinence, pain during intercourse, or postpartum recovery. Patients may feel vulnerable or embarrassed. Being empathetic, compassionate, and non-judgmental helps build trust and comfort, which is essential for effective treatment.

Clear and open communication is crucial. Many patients may not fully understand pelvic floor dysfunction or may struggle to articulate their symptoms. As a therapist, the ability to explain complex medical concepts in an approachable way, actively listen, and ask the right questions ensures that the patient feels heard and understood. This also helps set realistic expectations and keeps patients motivated throughout their recovery process.

Pelvic floor issues can take time to resolve, and progress may be slow or nonlinear. Having patience and flexibility with treatment plans allows for adjusting to the patient’s unique needs and responses to therapy. Therapists must adapt to setbacks or changes in a patient’s condition, especially when dealing with chronic issues.

Many patients who seek pelvic floor therapy may already feel a sense of shame or fear due to the nature of their issues. Creating a safe, welcoming, and inclusive space for patients of all genders, sexual orientations, and backgrounds is essential. Sensitivity to cultural and personal differences helps foster a sense of security and trust.

Pelvic floor therapy involves detailed assessments of muscle function, posture, movement patterns, and internal examinations. A keen eye for detail and a thorough approach to both the evaluation and treatment process ensures that no contributing factor is overlooked. This precision is critical for developing effective, individualized treatment plans.

Successful pelvic floor therapists often collaborate with other healthcare professionals, such as gynecologists, urologists, pain specialists, or midwives. Having the ability to work well within a multidisciplinary team ensures that patients receive holistic and coordinated care.

Pelvic floor therapy can be physically demanding due to the manual techniques often required, such as soft tissue mobilization or internal pelvic assessments. It can also be emotionally taxing, especially when working with patients recovering from trauma or chronic pain. Maintaining your own physical and emotional resilience, along with self-care, is essential to avoid burnout and continue providing high-quality care.

The field of pelvic floor therapy is constantly evolving with new research, techniques, and technologies. Having a genuine passion for learning and staying current with advancements is key to providing the best care. Continuing education not only enhances your skills but also ensures that your practice remains evidence-based and innovative.

Many patients need encouragement to stay committed to their treatment plans, which often include exercises or lifestyle changes outside of therapy sessions. Having the ability to motivate patients, celebrate small wins, and keep them engaged throughout the treatment process is important for long-term success.

Given the intimate nature of pelvic floor therapy, maintaining professionalism and patient confidentiality is crucial. Patients need to trust that their therapist will handle their information and treatment with the highest standards of privacy and respect.

By integrating these qualities with solid clinical expertise, a pelvic floor physical therapist can create a positive impact on their patients’ lives and achieve success in this specialized field.

Do you have any insights you can share related to maintaining high team morale?

Maintaining high morale as a small business practice pelvic floor physical therapist can be challenging, especially when you’re balancing patient care with the demands of running a business.

Having a clear vision for your practice keeps you focused and motivated. Celebrate small wins along the way to keep your momentum.

Set goals that reflect both your personal and professional aspirations. Achieving harmony between business success and personal fulfillment will help you stay energized.

Surround yourself with other professionals, either within your specialty or in complementary fields, to share advice, challenges, and successes. This can provide inspiration and make you feel less isolated, especially as a small business owner.

As a pelvic floor therapist, you understand the importance of health. Apply those principles to yourself by engaging in regular exercise, yoga, or mindfulness practices to manage stress. Burnout is real in small business ownership, and taking care of your own well-being should be a priority.

The nature of running a small practice means that things may not always go as planned. Flexibility in how you manage unexpected challenges, whether financial, patient-related, or personal, will help maintain morale. Being able to pivot and adapt without stressing over every bump in the road can sustain your energy and enthusiasm.

Consider building flexibility into your schedule. Offering virtual sessions or modifying clinic hours can help reduce pressure on you, especially if you’re juggling family or personal responsibilities.

Your clinic is your sanctuary. Keep it organized, warm, and positive—not just for your patients but for yourself. An inviting environment can uplift your mood and keep you excited about coming to work each day.

Building strong relationships with your patients can increase your sense of purpose and fulfillment. When you see the positive impact your care has on others, it can boost your morale and remind you why you entered this field in the first place.

The field of pelvic floor therapy is constantly evolving, and continuing education can reinvigorate your passion for your work. Attending workshops, learning new techniques, or even expanding your services (such as incorporating yoga or alternative therapies) can spark new enthusiasm.

Develop New Skills: Learning new business skills, such as marketing or practice management, can also keep your practice growing and successful, helping you feel more confident and motivated as a business owner.

Create a practice that aligns with your personal values and passions. Whether it’s focusing on women’s health, supporting gender confirmation patients, or integrating holistic health approaches, when your work aligns with your deeper values, it’s easier to stay motivated and positive.

Giving back to the community through workshops, education, or volunteer work can help you feel more connected and impactful. Community engagement also builds a sense of purpose and fulfillment.

By focusing on these strategies, you can maintain high morale, continue to find joy in your work, and cultivate long-term success as a pelvic floor physical therapist and small business owner.

Contact Info:

• Website: https://www.holisticPTsandiego.com
• Instagram: Pelvic_Floor_Wellness
• Other: https://drtheresapulickaldptholisticapproachtherapy.setmore.com