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It was my honor to interview Dr. Allyson Shrikhande, MD, founder of Pelvic Rehabilitation Medicine about the role of rehabilitation medicine in chronic pelvic pain.

Rehabilitation medicine includes the tools of pain and nervous system modulation medications, specific injections to improve local pain in the pelvis, including pelvic nerve pain, and management and referrals for integrative healing. At Pelvic Rehabilitation Medicine, the physicians are on the cutting edge of pain management, and are actively involved in research to develop even better tools for relieving pelvic pain.

Meet Dr.Allyson Shrikhande…

 

Do you work with patients with endometriosis or other pelvic pain conditions in your practice? Interested in deeper dive training on endometriosis and pelvic pain? Click here to learn more.

Interview Transcript:

Dr. Drummond:

Hi there, everyone. It’s Jessica Drummond here from the Integrative Women’s Health Institute. And I’m so excited to be here with Dr. Allyson Shrikhande. And she is the founder and medical director of Pelvic Rehab Medicine, which is, I primarily work with them in Manhattan, but they also have offices in New Jersey, Long Island, Miami, Detroit, Washington, DC. So they’re more and more available to our clients and patients everywhere. So welcome, Dr. Shrikhande. How are you?

Dr. Shrikhande:

Good. Thank you so much for having me, Jessica. This is great.

Dr. Drummond:

Yeah. And thank you so much for the really innovative work that you do in bringing PM&R, physical medicine and rehab from the medical standpoint to women with pelvic pain because, and men with pelvic pain, I’m assuming you’re working with men as well.

Dr. Shrikhande:

Quite a bit of men. Exactly. Yep.

Dr. Drummond:

Yeah.

Dr. Shrikhande:

Definitely.

Dr. Drummond:

So tell us a little bit more about PRM, Pelvic Rehab Medicine, your clinic, your practice, and who you do take care of.

Dr. Shrikhande:

Sure. Yeah, so Pelvic Rehabilitation Medicine or PRM. So we’re physiatrists, so we’re outpatient, musculoskeletal physicians. And we take care of men and women with pelvic pain. So we see… And pelvic floor muscle dysfunction. So we see a lot of women with underlying gynecological issues that could cause their pelvic floor muscle dysfunction and pelvic pain, such as endometriosis, adenomyosis, ovarian cysts, etc. As well as we see quite a few postpartum women who puts a lot of pressure on their pelvic floor, and men too. Men usually, they’d been diagnosed with abacterial prostititus, or chronic prostititus, and we call it now, the nomenclature has changed to urological chronic pelvic pain syndrome. So men usually have that diagnosis, and unfortunately have really seen many doctors by the time they get to us. But we do see a lot of men with similar symptoms to women, very similar.

Dr. Drummond:

And so like pelvic health, physical therapy, pelvic health and nutrition, you and I are not generally the first person that these patients see. Where do they usually, how do they usually get to you?

Dr. Shrikhande:

Oh, from all over. I’d say the majority of our female patients are referred from their OB GYNs. That’s the most common as well as pelvic floor physical therapists will send essentially… the protocol that we created, it’s essentially for patients who, you got 60% better with pelvic floor PT, but you’re plateauing, and you’re looking to be 100% better, right? You want your quality of life back. So that would be when the pelvic floor physical therapist will then send. Essentially we’re basically PT on steroids. We just help you get over that hump and get better faster essentially is what we’re doing. So they’re big referral source. Internet as well is fairly big. But really the major one is OB GYN is really our major referral source is from their local OB GYNs and gynecologists who really realize this speculum exam is painful, and they do it all day every day, and they know it’s not their technique. So they’re recognizing that, oh, maybe there is something with their pelvic floor. And then that’s when they’ll send to us.

Dr. Drummond:

Yeah, that’s really interesting. I think a lot of times just knowing whatever your subspecialty is as a clinician, whether you’re a gynecologist or a women’s health nurse practitioner, when things aren’t normal. It’s not normal for a pelvic exam to hurt. And if you do 15, 20 a day, you know when that’s not normal.

Dr. Shrikhande:

Exactly. Exactly. That’s exactly right. So the speculum exam is a big one. And then pain or discomfort with tampons is a big one too. When younger women come in and tell their OB GYN or nurse practitioner that tampons really are not that comfortable and they really hurt, that’s another key that they’ll say, ooh. And then they think of us, and that’s when they’ll send.

Dr. Drummond:

Okay, that’s perfect. So when should, so if women are seeing this interview on the internet, or men are seeing this interview on the internet, what is sort of the red flags that’s like, okay, pelvic rehab medicine can be very helpful for me directly. I don’t have to see 15 other doctors before I come to see Dr. Shrikhande and her team. What are the common symptoms that you tend to address?

Dr. Shrikhande:

Yeah, so classic symptoms would be pain with during intercourse or really post intercourse soreness. It’s even more common. Either post erection ejaculation pain, or for females, post intercourse soreness, as well as we see a lot of urinary symptoms. So one common chief complaint is a sensation of a UTI, but the workup was completely normal. And they even taken antibiotics for it, which really didn’t resolve it, so that burning, UTI urgency, frequency, very common in our patient population, as well as bowel. We see a lot of chronic constipation, straining on the toilet. Even pain with bowel movements or having a bowel movement can stimulate some pelvic pain. That’s very, very common in our patient population. So we spent a lot of time talking about bladder, bowels, intercourse.

Dr. Shrikhande:

Classically it’s all worse with sitting, so when you’re sitting on a long flight, or if you’re sitting at work for a long time, usually the pain can get worse classically. A lot of lower abdominal bloating, discomfort, referring to the hips, and then to the sacrum and low back. Also very common. Sometimes worse with menstrual cycle, sometimes not. So that’s the challenge, I think, sometimes with even with endometriosis patients. Sometimes it’s not cyclical so it can be challenging, the cyclical nature and the hormonal aspect of their pain. But those would be the most classic things that we would see. We also see a lot of concomitant lumbar sacral pathology and hip impingement and labral tears, particularly with our men. Classically pelvic pain patients are, are usually very athletic. It’s usually a repetitive microtrauma that can happen either along the ligaments or the muscles, nerves and joints, but classically particularly men, but and women, very athletic patient population that we have. And they’re always looking to get back. But just that repetitive microtrauma over time that can really cause pelvic pain, particularly if you don’t have the pelvic floor musculature to support what you’re trying to do.

Dr. Drummond:

Yeah, yeah. It’s sort of like overactive because there’s not that strength in a way. It’s like-

Dr. Shrikhande:

Totally.

Dr. Drummond:

Like that short overactive, but not really functionally strong.

Dr. Shrikhande:

Exactly. So classically, classically right with pelvic floor spasm or hypertonia, they’re short, spastic and weaker. So our protocol with pelvic floor PTs, we work closely with pelvic floor PT to really… The first part of it, we call it down regulation. We’re really trying to reset that short spastic weak muscle spindle, create space, increased blood flow around the nerve and treat that neurogenic inflammation. So calm down that inflammation. So a lot of down training, creating space, open up the pelvis. Right?

Dr. Shrikhande:

And then when we’re done with that, after about six to eight weeks, it’s that whole neuromuscular reeducation program where you really try to get that lift. You work on the hip abductor strengthening, really support the SI joints in the hips and the lumbar sacral spine better. And then we slowly progressed patients back to the cardio that they’re looking to get to.

Dr. Drummond:

Okay, great. The fitness activities, comfortable sex, all of that.

Dr. Shrikhande:

Exactly. Exactly.

Dr. Drummond:

So are there any conditions or symptoms that you have seen in your practice that come as a surprise or tend to be unexpected?

Dr. Shrikhande:

Oh, I’d say over the years now doing this for a while, I think what I’m surprised that there is quite a bit of a joint laxity in our patient population, which can be a bit of a challenge. Some mild connective tissue issues can be a bit challenging because when you have that joint laxity, you have the secondary guarding or secondary spasm in the muscles, compensatory mechanism that can really perpetuate this pelvic floor hypertonia.

Dr. Shrikhande:

The other thing that I’ve found surprising over the years, there is quite a bit of underlying autoimmune issues that I feel working with you and your team with the integrative medicine approach is key to really treating that autoimmune inflammation. That whole body approach is super important. And also over the years I feel the training that we get doesn’t really teach us to sometimes look at female patients from the gynecological perspective. So I feel sometimes we really need to consider gynecological etiology for this chronic pelvic pain, particularly in young females. So we’re doing that more and more as we go along, which I think has been a nice switch, very helpful for our patients.

Dr. Drummond:

Right. So looking to see if maybe they have not just pelvic floor dysfunction but driven by underlying endometriosis or ovarian cysts or things like that. Yeah.

Dr. Shrikhande:

Exactly. Yeah, that’s exactly right. The longer I practice, I look back seven years ago. I’m like ooh, there is quite a bit of underlying gynecological pathology that I think we need to have on the forefront of our minds and work clearly as a team. I mean, the way we treat these patients is we look at ourselves, physiatrists are used to kind of looking at the body and making connections because that’s what we do. So we don’t, which I think is a unique perspective. So we don’t really just look at one organ system. We really look at how each organ system connects to one another and how each organ system connects both to the peripheral and central nervous system, as well as the myofascial pain intention, so the musculoskeletal system. So we really do put everything together because that’s what we’ve been taught to do in training since day one. So I think we’re kind of a nice quarterback to this care. But then clearly we have to say, who do we need to build our team? Who else do we need to get this patient better? Always pelvic floor PT. We won’t even really treat patients if they don’t have one on board. But usually, we may have to bring another specialty in. But the key is to be the detective, figure out the primary pain generator, and bring in the right person. Right?

Dr. Drummond:

Yeah. And what I like about what you do is you have the ability to see all of that. Is it a myofascial pain driver? Is it a gynecologic cause pain driver. Is it more central nervous system? Is it more peripheral nervous system? Is it more of those things? Is it autoimmune? Because sometimes it’s not just one pain driver, right? Is it neural inflammation? But the other thing that you have that I think really pulls it all together is the ability to add or start to take away, start to unwind medication use because sometimes the other doctors, that’s the only tool that they have. So if you see a gynecologist, you have pelvic pain. Basically the first solution is either birth control pills or antidepressants or some other pain medication. But I think what you guys offer, which is really helpful, is really understanding the pain medicine aspect of either adding it or helping to take it away when all of the other drivers been addressed.

Dr. Shrikhande:

I completely agree. We’re definitely more of a holistic approach. And overall our patients really don’t want to be on medications. Right? So sometimes we’ll even initiate protocol with working with you and pelvic floor PT and our protocol really to get patients off their either CNS neuromodulator or valeant suppositories. I mean really a lot of times even to get pregnant, right? If you want to get pregnant, quite often our population, it seems like they’re trying to get pregnant, so they can’t be on these meds. So that is 100% our mantra. Less medication is more. Sometimes we do need to use it. We usually try to use CNS neuromodulators or valeant depositories on a short term. It’s not a longterm approach. It’s really just to kind of treat you, and then get you off. Right? It’s not really long-

Dr. Drummond:

Well, like bridge, sometimes just a bridge to be able to tolerate and move through the other therapies for sure.

Dr. Shrikhande:

100%. really just to tolerate even the pelvic floor PT and the internal work is key to getting them better. So if they need it to tolerate it, I think for a short term use, it’s excellent combined with everything else. Right? And I think acupuncture also can help a lot. And meditation where mindfulness meditation acupuncture allows us to use medications at a lower dose. So a lower dosage usually less side effects. So that’s usually our approach. We think you need a little bit of a CNS neuromodulator, but let’s do some mindfulness meditation, some acupuncture or make sure your nutrition is optimized with your pelvic floor PT. And we really think we don’t need to… We can keep you at a lower dose.

Do you work with patients with endometriosis or other pelvic pain conditions in your practice? Interested in deeper dive training on endometriosis and pelvic pain? Click here to learn more.

Dr. Drummond:

Yeah, that’s fantastic. So tell me what’s new with PRM and your practice? What’s going on with the practice?

Dr. Shrikhande:

Yeah, no it’s, so yeah, we’re growing, which is very exciting. And I’m lucky enough to have some excellent physiatrists who are joining us and really interested in pelvic pain and male female pelvic floor disorders, which is, it’s great to see the interest, which is I think, excellent for the field to have.

Dr. Shrikhande:

So yeah, we’re, you mentioned the cities we’re going to. We’re in Miami. We’re in DC. We’re in Michigan, as well as Manhattan, Long Island and Jersey. And we’ll be going to the Midwest, Chicago as well as Dallas and Houston as well, and Boston in the spring.

Dr. Drummond:

That’s great.

Dr. Shrikhande:

So yeah, we’re growing, which is great. We’re doing quite a bit of research. We just got our paper published in the, we call it the Physiatry Journal on physical medicine rehab and function on treating endometriosis patients who have, with our protocol, post excision pain. So they’ve had proper excision surgery, but they had persistent pain. So that was exciting. We got it published a couple months ago. And we also got our paper published for treating UCPPS, so urological chronic pelvic pain syndrome in male patients with, again, our protocol, and people who’ve kind of progressed or plateaued in physical therapy essentially, and also completed multiple courses of antibiotics and NSAIDs, and then still had the pain. So that was in the Journal of Neurourology and Urodynamics. So that’s, yeah, a lot of exciting things going on.

Dr. Shrikhande:

And we recently submitted a paper on something called alpha-2-Macroglobulin that we do. It’s in the realm of regenerative medicine. What it is is we draw a patient’s blood, and we centrifuge it down to something called A2M or alpha-2-Macroglobulin. It’s a protease inhibitor. So it’s essentially like a pacman that’s binding to these proinflammatory cytokines, and then carrying them out of your body because it’s a carrier protein. So yeah. So we were the first that… People are doing it for knee osteoarthritis and the shoulder and spine. But we’re the first people to really try it around the pelvic muscles and nerves. So it’s definitely not our first option. It would be for the people who are debating either sacral neuromodulator or something more invasive. Sometimes they’ll prefer to try the regenerative approach to help heal the pudendal nerve and its branches. So, yeah.

Dr. Drummond:

Oh, that’s really cool. So is it a local injection near the pudendal nerve?

Dr. Shrikhande:

Yeah.

Dr. Drummond:

Oh, fantastic.

Dr. Shrikhande:

Yeah. It’s a local injection. Yeah. I mean, the needles we use are 27 gauge, so they’re tiny.

Dr. Drummond:

That’s nice.

Dr. Shrikhande:

Very safe. I mean, it’s similar procedure really to our protocol. People go to work right away. They sit on ice in their office.

Dr. Drummond:

Oh, good.

Dr. Shrikhande:

There’s no anesthesia involved in what we do. It’s like a cold numbing spray. And then people are at, they see us at 8:30 in the morning, and they’re at their meeting by 9:30.

Dr. Drummond:

Okay.

Dr. Shrikhande:

Easy with the A2M. There’s no… That’s why we use it because it’s similar, people think, oh, is it PRP, which is more about platelet rich plasma, but we don’t use PRP because we feel our patients are very sensitized, right? They have this cool sensitization process, and the concept behind PRP is it stimulates inflammation, ultimately to promote healing, which I think is great in athletes with acute injuries, but in chronic pelvic pain, I don’t think it’s a good idea. So we don’t use that. A2M is still centrifuging your blood, but it’s more soothing. It’s more like a, almost like a natural steroid, I guess you could say, or natural sort of arnica, but it’s in your blood, so it’s soothing and it doesn’t cause a flare. So that’s why we chose to use the A2M versus PRP. We don’t do PRP.

Dr. Drummond:

That’s really fascinating and helpful because I agree with that. I think one of the biggest challenges we have in pelvic pain is the CNS kind of up regulation, the chronic nature sometimes of the pain that I love the approach of using, mindfulness meditation, using acupuncture, using nervous system down training, pain science, we use along with a physical modality like that, that is essentially anti-inflammatory, just like steroids, which have their place too because they’re so effective, but they’re effective very short term and also kind of do damage. So there’s this cost benefit that we’re always kind of dealing with with steroids.

Dr. Shrikhande:

Exactly. Well-stated. Exactly.

Dr. Drummond:

Yeah. All right, well that’s fantastic. Can you tell me just, like brief snippet, like a little more about the endometriosis protocol that you published?

Dr. Shrikhande:

Yeah, so essentially, again, we initiate the protocol always for people who have either plateaued in pelvic floor PT or just really not progressing beyond a certain point. Okay, so you try that first.

Dr. Drummond:

So you’ve had excision surgery. You’re doing pelvic floor PT.

Dr. Shrikhande:

Yeah, exactly.

Dr. Drummond:

And you’re stuck, or you’ve kind of hit what they can do. Okay.

Dr. Shrikhande:

Yeah. So you’ve maximized, right? So you’ve… Usually, we give it about eight weeks, two months. After that, we would initiate it because the longer we leave things, the harder it is for us to make it go away honestly. It becomes imprinted in the [inaudible 00:18:41]. So basically what we’re doing is external ultrasound-guided combination of peripheral hydrodissection of the pudendal nerve, its branches, as well as the posterior femoral cutaneous nerve and its branches, ilioinguinal and the genital branch of the [inaudible 00:18:58] sometimes, based on the exam, tailored to what the patient has honestly on the exam. And then concomitantly that we treat with trigger point injections to the levator ani sling. So the pubil rectalis, pubil coxidius and the iliococcygeus, and sometimes we’ll do the external rotators of the hip, particularly the operator internist and/or the quadratus femoris or piriformis. Again, depending on the patient’s exam, but it is all external ultrasound guided. We just treat one side at a time. Conceptually, we’re really creating space. I think the majority of the benefit is mechanical in nature where we’re going in and we’re at creating space in those fascial planes that are restricted. So we’re opening, we can see it on ultrasound, just opening it up, creating some space.

Dr. Shrikhande:

So I do think patients probably would get better even just use normal saline, but if you’re going to do it, I think it’s more comfortable. So we put lidocaine 1% in it, and typical protocol, the first time on the right, and the first time on the left we’ll use a little bit of a dexamethazone two cc’s. And then we transition away from the dexamethazone to something called traumeel. So the homeopathic medicine, mostly arnica, some echinacea, but with that will be our anti-inflammatory. Again, with the 1% lidocaine. So 1% lidocaine is a sodium channel blocker, right?

Dr. Shrikhande:

So it’s resetting and desensitizing those peripheral nociceptors that are really firing inappropriately. That sodium ion sodium potassium channel, that’s firing inappropriately, it’s repetitively desensitizing that and essentially chilling it out. And then the neurogenic inflammation, I think is improved both from the traumeel and a little bit of steroids, but also really just from increased blood flow from creating space. Really just those, most of it’s the fascial restrictions that are released.

Dr. Shrikhande:

And it’s subtle. I mean it’s one side at a time, front and back. It’s not like they walk out of there. It’s not like that. It’s we’re publishing our protocol on when we first meet you, we’re looking at the functional pelvic pain scale, right? Because we’re more into function than pain because we’re physiatrists. So are you able to have intercourse? How are your bowels? How are your bladder? Can you sit? Can you exercise? All those things.

Dr. Shrikhande:

And then we do the vast scale as well. But then we don’t judge it until six weeks post our protocol. So essentially you see us three times on the right, three times on the left. Each muscle’s treated one time. And then we get to the nerves eventually too. So it’s fairly subtle. And then the six weeks you have off, you’re doing the pelvic floor PT still. You don’t see us, but you’re continuing that. And then you come back, and that’s when it all just comes together. I think it’s because conceptually, we’re not really healing the nerves. All we’re doing is creating a better environment, more blood flow, less inflammation, more blood flow. And then they have to heal themselves, honestly. That’s really what we’re doing.

Dr. Drummond:

I love that because essentially from a functional nutrition standpoint, that’s how I think of pelvic PT as helping me do my job. Right? So, and if pelvic PT is not enough, what you’re saying here is now you’re creating micro space. It’s more localized, more micro right around the nerve, right to a kind of a sticky spot in the muscle that your fingers or the patient education about down training and letting go is like there’s a sticking point somewhere. You don’t have the micro space, so you’re using a little needle to kind of create that micro space.

Dr. Drummond:

And then what we do is essentially the nutrition is very anti-inflammatory in a more therapeutic dose. So we use food, but we also use supplements. But the only way to get that to the pelvic floor muscles and nerves and even the gynecologic organs is through the circulation, which is why we have to have digestion optimized and why circulation has to be optimized. But if you’re still clamped down locally, I can give you all the turmeric orally I want, but it’s not going to get to your pudendal nerve, if that makes sense.

Dr. Shrikhande:

No, it does. Yeah.

Dr. Drummond:

So I love that. I love that.

Dr. Shrikhande:

Yeah. I love what you’re doing too. It’s so cool.

Dr. Drummond:

Super cool. And you need the whole thing because, as you said, these systems, you have to have digestive system functioning. You have to have cardiovascular system functioning. And we think, we talk a lot about erectile dysfunction in men being kind of a red flag for cardiovascular disease. And I think we can think the same thing about women. If you’re clamped down in a cardiovascular way such that you don’t have blood flow, you also have to think about how’s the health of the whole cardiovascular system too.

Dr. Shrikhande:

So true. It’s so true. Are there other things you use to promote blood flow overall?

Dr. Drummond:

I don’t know that we really, I don’t necessarily promote other than kind of the vasodilation of being anti-inflammatory. So we’re kind of healing the vessels. Right?

Dr. Shrikhande:

Right. Exactly.

Dr. Drummond:

So like fish oil and phytonutrients and antioxidants and things like that. And of course, it’ll work faster and more directly in a larger vessel. But the small vessels matter a lot too because that’s what’s surrounding those peripheral nerves. And honestly, one of the other best circulation optimizers is exercise.

Dr. Shrikhande:

Totally. I mean, yes.

Dr. Drummond:

And then doing it in context of an antiinflammatory nutrition plan with sometimes more therapeutic circulation support. Basically just healing the vessels, right? So the vessels get irritated when you have too high LDL cholesterol, not high enough HDL cholesterol, too much inflammation, too high HSCRP. So the more we unwind all of that, then we can get to those very peripheral vessels. But the other thing that happens to almost create more peripheral vessels is to, of course exercise so that when, the body is super smart. Like if you have someone who has even like a left anterior descending heart attack, but they have tons of peripheral, tons of microcirculation in the heart from being a swimmer or something like that, that plaque has been building up for a long time. So the more peripheral vasculature we can promote, that happens with exercise basically over longterm.

Dr. Shrikhande:

Yeah, no, it’s so interesting, but it’s so fascinating. But conceptually it’s similar. Increasing blood flow, decreasing inflammation with whatever tools that we have to do that.

Dr. Drummond:

Yeah. And I think that combined tool approach of both the local mechanical and the more systemic is really the key.

Dr. Shrikhande:

Me too. I completely agree. I mean it’s so important to do both. I mean with without that systemic approach, that inflammation just keeps pouring into the body, and it’s very challenging no matter what you do locally.

Dr. Drummond:

Right.

Dr. Shrikhande:

It just keeps fighting us, you know?

Dr. Drummond:

Yeah. And that’s where you have people with that chronic joint pain, chronic pelvic pain. And then you get centralization, which makes it harder to unwind because the brain is now kind of like used to being in pain.

Dr. Shrikhande:

Exactly.

Dr. Drummond:

Yeah. I love like the sooner, the better approach.

Dr. Shrikhande:

100%. And we just started a course called retrain your brain actually. It’s like five session course with our pain psychologist who does a telemedicine platform.

Dr. Drummond:

Amazing.

Dr. Shrikhande:

But a lot of it is just to try and teach patients tools to reset and retrain those descending signals that clearly need to be stopped with, again, less medication.

Dr. Drummond:

Yeah, absolutely. Because then you don’t have all the side effects and addiction and all of that.

Dr. Shrikhande:

Exactly.

Dr. Drummond:

Yeah. Awesome. So to wrap up, tell me anything else you want to share about your research foundation or your practice, any new innovations that you’re excited about beyond what we just talked about, which is amazing.

Dr. Shrikhande:

Yeah, no, we’re proud that we did start a clinical research foundation called the Pelvic Rehabilitation Medicine Clinical Research Foundation, which I think is really going to help us just really help us keep working on improving patient care for these chronic pelvic pain patients and really just try to figure out how to best approach it because there’s still a lot of work to do. So we’re excited about that. And yeah, that’s really it. A lot going on, but all really exciting stuff.

Dr. Drummond:

That’s fantastic. Well, I so appreciate the work that you’re doing as do tens of thousands of women and men with pelvic pain for sure. And it’s a pleasure to see your growth. It’s a pleasure to see so many physiatrists starting to enter this field. I’ve worked with physiatrists my whole career, but normally on things like stroke and hip pain and stuff like that. So I’m glad we’ve got more on our side in pelvic pain. And I really think that integrative training that you have is really unique in this field, but so necessary. So I’m super excited to see how fast and how well is this growing.

Dr. Shrikhande:

Yeah, thank you for all the work you do, and for all the help for our patients. We really appreciate everything you do.

Dr. Drummond:

Thanks so much. All right, well thanks for being on with us today. And will anyone who has any questions about this, you can certainly connect with us. Post comments, send us messages. Where can we best, where can our practitioners and colleagues find you, Allyson?

Dr. Shrikhande:

Yeah. So our website is called pelvic rehabilitation medicine, it’s you Google that. Our email, is contact@pelvicrehabilitation.com. So if you send that email out, you can talk to me easily or anyone you want to talk to. But yeah, it’s Pelvic Rehabilitation Medicine and based out of multiple cities. So if you Google it, you’ll find us.

Dr. Drummond:

And are you active on any particular social media platform?

Dr. Shrikhande:

Yes, we have a Instagram, again, Pelvic Rehabilitation Medicine, Instagram. We have Facebook, as well as Twitter. All of them.

Dr. Drummond:

Excellent. All right. Yeah.

Dr. Shrikhande:

We do a pelvic health summit, which we featured you in last spring. So again, if you look on YouTube for Pelvic Rehabilitation Medicine, it’s really multiple experts such as yourself speaking on pelvic pain from acupuncture to nutrition to PT. So if you want to learn more, you can check out our pelvic health summit.

Dr. Drummond:

Yeah, that was a great resource. Thank you for putting that together.

Dr. Shrikhande:

Yeah.

Dr. Drummond:

All right, go follow Dr. Shrikhande and Pelvic Rehab Medicine all over the social media platforms and at their website. And thank you so much for joining us today.

Dr. Shrikhande:

Thank you, Jessica. Take care.

Dr. Drummond:

Take care. Bye, bye.

Dr. Shrikhande:

Bye.