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Carolyn Vandyken: Embracing Change in Physiotherapy

"The significant problems we face cannot be solved at the same level of thinking we were at when we created them." - Albert Einstein

This is most certainly true in the physiotherapy industry, and healthcare as a whole. In this blog, Carolyn Vandyken, an international speaker, physiotherapist and the co-founder of Pelvic Health Solutions (PHS), provides her insights and advice to physiotherapists and physiotherapy students.


1. What's One Article You Would Recommend?

"Pelvic Floor Muscle Training versus no treatment for urinary incontinence in women", Cochrane Collaboration 2014 so that I could have prevented my personal pelvic floor dysfunction that started with the birth of my son in 1989.

Stress incontinence is the involuntary leakage of urine with physical activity including coughing and sneezing. Urgency leakage occurs with a strong need to urinate, but the person cannot make it to the toilet in time. A combination of stress and urgency leakage is called mixed incontinence. This Cochrane review found that pelvic floor muscle training helps women cure and improve stress urinary incontinence.


 2. What's your favorite book?

The Gift of Pain by Dr. Paul Brand so that I could challenge my thoughts and beliefs about pain from the beginning of my career. Pain is not something that most of us would count as a blessing. However, Dr. Paul Brand's work with leprosy patients in India and the US convinced him that pain truly is one of God's great gifts to us. In this account of his 50-year career as a healer, Dr. Brand probes the mystery of pain and reveals its importance. As an indicator that lets us know something is wrong, the pain has a value that becomes clearest in its absence. Pain is a gift that none of us want and yet none of us can do without.

A WORLD WITHOUT PAIN? Can such a place exist? It not only can―it does. But it’s no utopia. It’s a colony for leprosy patients: a world where people literally feel no pain and reap horrifying consequences. His work with leprosy patients in India and the United States convinced Dr. Paul Brand that pain truly is one of God’s great gifts to us. In this inspiring story of his fifty-year career as a healer, Dr. Brand probes the mystery of pain and reveals its importance. As an indicator that lets us know something is wrong, the pain has a value that becomes clearest in its absence. The Gift of Pain looks at what pain is and why we need it. Together, the renowned surgeon and award-winning writer Philip Yancey shed fresh light on a gift that none of us want and none of us can do without.


3. What's your favorite blog, podcast or online resource?

I have two favorite online resources that I check in with frequently.  The first is HealthSkills Weblog by Dr. Bronwyn Thompson.  Bronwyn has done a fabulous job of increasing our understanding of the psychosocial pieces of health care that we as physiotherapists often feel much less comfortable tackling.  Her insights are evidence-based, thought-provoking and challenging, although I don't agree with everything that she states; however, that makes for excellent reflection, digging deeper and further research on my part.    This has helped me tremendously in embracing a true biopsychosocial-spiritual perspective with my patients. 

The second is TED talks.  Random topics from teaching, shame, vulnerability, pain, originality, you name it.  I listen to it.  What a great way to get an eclectic, entertaining, expert-based introduction to so many topics that challenge what I think and believe.  I am at the stage in my career where I am drawn to conferences, theoretical discussions and things that cause me to think differently.  We all have our confirmation bias' but what we know and understand reflects just a sliver of the information/knowledge that is available to us.  TED talks represent a challenge to that knowledge base. So do conferences vs. courses.  I don't think that learning a new technique is going to change my outcomes with my patients; however, expanding and challenging my paradigm certainly will.  I love it!

HealthSkills Weblog by Dr. Bronwyn Thompson - Health professionals supporting chronic pain self-management

TED Talks  -  TED is a nonpartisan nonprofit devoted to spreading ideas, usually in the form of short, powerful talks. TED began in 1984 as a conference where Technology, Entertainment, and Design converged, and today covers almost all topics — from science to business to global issues — in more than 110 languages.


4. What advice would you give to your 25-year-old self?

Approach your career with high levels of intellectual curiosity. Think critically for yourself. 

Your mentors and preceptors were biased by their own experiences when they taught you "evidence-based" practice. It is hard to undo years of learning for all of us who have been in physiotherapy for a while, but you are at the brink of a new age in physiotherapy.  Don't become part of the "old guard" by accepting everything that you hear and see from the experienced clinicians in your new place of employment.  Ask good questions.  What is the evidence? Are you taking a biopsychosocial-spiritual perspective with each patient?  Do you have a good understanding of what that means after graduating with your Masters in Physiotherapy?  If not, read, read, read. 

Read work by Lorimer Moseley, David Butler, Peter O'Sullivan, Jo Nijs, Adriaan Louw and others who are leading the charge to change our practice.

Change is needed, and new grads are at the forefront of change.  Be that change.  Embrace the change.  It will make you a happier, more well-rounded and engaged clinician.


5. What's something you've recently learned that you're really excited to implement?

I am fascinated by visceral inputs into the nervous system.  I loved, loved, loved Ramona Horton's course on the visceral components of pelvic pain.  I am also looking forward to Jessica Drummond's approach to Functional Nutrition.  Looking at the gut aspect of pain and healing fascinates me, and physiotherapists have a role to play in understanding this piece as it relates to generalized pain, pelvic pain, and low back pain.


6. Why did you decide to join the Embodia Academy Instructor Community?

Joining Embodia has been such a pleasure. I resisted it partly because of my own discomfort with the digital age, social media, etc.  However, Maggie and Elie have made it so easy to make the transition to the digital sharing of exercises (for patients) and knowledge for clinicians.  Not everyone will learn through e-learning.  However, it is another avenue to access high-quality course material from the comfort of your home at your own pace.  The nice part about online learning is the ability to go back and review lectures/concepts that you didn't really get the first time.  E-learning also has the advantage of being more cost-effective with less time lost from work, travel and the expense of hosting courses at a physical location.  However, you do miss the face-to-face interaction of the community of learners and instructors around you.  As well, I have personally found it more challenging to set aside time in my busy schedule to complete an online course.  I would highly recommend that people write it into their calendar and make a date with themselves to go through the material. When you take a "live" course you set aside the time to do it; online learning has to be the same way.

The second part of joining Embodia which has been a real eye-opener for me was the enthusiastic embracing of digital exercise prescription by my patients.  My patients LOVE having an exercise video to follow and reminders on their phone to tell them to do their exercises.  This has been very well received by my patients.  No more paper handouts!! The trees in beautiful Huntsville, my new hometown, are also saying "Thank you" :)


Learn Online with Carolyn

Carolyn Vandyken

Carolyn has practiced in orthopaedics and pelvic health for the past 33 years.She is a McKenzie Credentialed physiotherapist (1999), certified in acupuncture (2002), and obtained a certificate in Cognitive Behavioural Therapy (CBT) in 2017.

Carolyn received the YWCA Woman of Distinction award (2004) and the OPA Distinguished Education Award (2015). She has been heavily involved in post-graduate pelvic health education, research in lumbopelvic pain, speaking at numerous international conferences and writing books and chapters for the past twelve years in pelvic health, orthopaedics and pain science.

Her passion is to break down the silos that we live in as clinicians. She is the Co-Founder of Reframe Rehab:

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