Fertility At Inside Out Physical Therapy, our specialized fertility and pelvic health physical therapy program is designed to address the unique needs of individuals seeking to optimize their reproductive health and manage conditions impacting the pelvic region. Caroline offers personalized assessments and evidence-based treatment techniques to support your journey towards improved pelvic wellness and fertility. Whether you are preparing for pregnancy, experiencing challenges with conception, or seeking to address pelvic health concerns, IOPT’s comprehensive approach aims to enhance your overall well-being and quality of life. Partner with IOPT to discover the benefits of tailored physical therapy interventions in promoting fertility and pelvic health. HOME / SERVICES / WHAT WE TREAT / FERTILITY / Get Started Today Caroline's expertise and personalized approach to therapy ensure that you receive top-notch care tailored to your needs. Contact us today to book your session with Caroline and take the first step towards a healthier, more active lifestyle. CONTACT Qualified Physical Therapist ​ With years of experience and extensive training in pelvic floor rehabilitation, she is dedicated to helping her clients overcome fertility issues. Compassionate Care for Fertility ​ We are dedicated to delivering compassionate care to individuals seeking support and solutions for fertility-related concerns. Holistic and Comprehensive Approach ​ We offer assessments and evidence-based treatment techniques to support your fertility journey.

Bowel Health A healthy bowel will fill and empty within a range of norms, comfortably, and with easy and regular control. If you are, or have at any point in your life, had problems with constipation or diarrhea, IBS, difficulty emptying, leaking/incontinence, flatulence, bloating, abdominal pain, or rectal pain, we can help. These issues can be caused by a complex multitude of factors, including diet, breath mechanics, emotional and muscular holding patterns, and many abdominal surgeries. ​ Feel like your bowels have never quite been right, either your whole life or after an incident like a fall, surgery, infection or childbirth? Healthy bowels work well, filling and emptying easily and regularly. If you have constipation, diarrhea, IBS, trouble emptying, leaks, gas, bloating, or belly/rectal pain, we can help you manage and resolve issues like this. These concerns may be linked to diet, breathing habits, fascial restrictions, scar tissue, emotions and stress response, compensatory movement patterns, or prior abdominal surgeries. ​ Due to the complexity and inter-relatedness of your gut health to the rest of your body as well as the brain, improving gut issues can also positively impact bladder problems, mental health, and back pain. Yes, you too can become regular, are you ready to let us show you how? HOME / SERVICES / WHAT WE TREAT / BOWEL HEALTH / Get Started Today Caroline's expertise and personalized approach to therapy ensure that you receive top-notch care tailored to your needs. Contact us today to book your session with Caroline and take the first step towards a healthier, more active lifestyle. CONTACT Qualified Physical Therapist ​ With years of experience and extensive training in pelvic floor rehabilitation, she is dedicated to helping her clients overcome bowel issues and regain control over their health. Compassionate Care for Bowel Health ​ We are dedicated to delivering compassionate care to individuals seeking support and treatment for bowel-related concerns. Importance of Bowel Health ​ Understanding the importance of bowel health is crucial for overall well-being and quality of life.

Frequently Asked Questions Do I need a doctor's referral to see you? The short answer is no. In North Carolina, we have what’s called “direct access” to physical therapy. That means we can work with you without a referral. After your initial evaluation, if your concerns are musculoskeletal in nature (that is, they fall within the scope of physical therapy), then we can continue working together towards your goals. If you have medical needs, we’ll make sure to send you in the right direction to get those addressed. ​ Even though a doctor’s referral isn’t necessary, we always support you sharing your PT plan and results with your physician and their information with us. In addition, if you will be submitting your bills to insurance, they may require a referral, you will need to ask your insurance company. Do you think PT can really help me? The entire driving force behind our clinic is to help people. We wouldn’t be doing this work if we didn’t think it could make a difference and help you get back to the activities and life you want to lead. You deserve to feel better, and pelvic PT has a proven track record of helping people recover, feel better in their body, and achieve their health goals. I see the proof of this every day with current clients. When is the best time to make a PT appointment? Is it too late for me? It is never too late to get started on your recovery. The best time to make a PT appointment is whenever you are ready — whether that’s today, next week, or in three years. We want you to be ready to participate in the work so that you can find success and meet your goals. ​ That said? The sooner the better. The longer you wait, and your body integrates what becomes a long standing problem, the longer it will take to resolve, and the longer you are living with frustration and limitations. ​ Success isn't found by following your "should's." It is found by following your "can's." Let us show you what's possible. Are you going to tell me to stop drinking coffee? It depends on what you’ve got going on, and what your goals are! ​ But seriously? We can’t “make” you do anything, and will not try. Instead, we act as a guide, a teacher, a health “consultant.” In this role, we provide education and coach you through making the changes that support your goals. We will always work together on your goals in a way that helps you feel comfortable, understood, and supported. ​ Anything you do — including drinking coffee — is ultimately up to you. Just know that what you choose to do (or not do) can impact your progress and recovery journey. ​ Full transparency? For me, I drink 2-3 cups of coffee a day. At your appointment, I’ll share my secret for how I still drink coffee and stay symptom-free. How long will it be until I get better? How long your plan of care lasts depends on three things: where you currently stand, where you want to be, and what resources (time, energy, finances, support at home, education etc) you can bring to the table . With our approach, your symptoms will decrease significantly and often totally disappear in the first phase of PT, which tends to be 6-10 sessions, based on the above factors. ​ One of the most impactful of these is your ability to extend the benefit of each session with a home program crafted uniquely for you. Sometimes the most a client can do is make it to their appointment once a week. Yes, they do get better, it just takes a bit longer. ​ The second phase, which usually takes another 6-10 sessions, involves directly addressing whatever is influencing your problems. This is where we do a deep dive into fascial mobility, alignment and motor control. At the end of this phase, you will have a good understanding of your pelvic floor and how to use it, and you’ll notice a significant difference in your strength and connection to your body. ​ The third phase is as long as you want it to be, based on your goals and resources. Some clients prefer to see me on an ongoing basis, with progression towards more and more core strength and functionality as they are able to do so. This is where we can fully integrate your gains into whatever activity you participate in for fitness. Do you take insurance? Inside Out Physical Therapy practices as a direct care model provider. As an out-of-network provider, we will provide superbills as requested and you can submit to your insurance company if you wish. We will not bill your insurance company directly. As so many Pelvic Health PT’s are practicing under this model, more insurers are becoming open to this. ​ Practicing under this model gives you and your therapist so much more freedom to customize your treatment plan and make sure you’re actually getting the care you need and deserve. It allows us to spend 100% of your appointment time meeting your individual needs and goals, rather than addressing an insurance company's requirements. ​ This can significantly shorten the length of time it takes to meet your goals, as we can be more efficient in your treatment plan. ​ I understand that recovery requires a resource challenge for many people, and I want to make your goals accessible. Please schedule a consult so that we can discuss all the options you have with us. ​ In the meantime, we recommend you call your insurance company to determine what your deductible, copay, and out-of-packet max are. Then call a PT clinic that accepts your insurance, and ask them these questions: ​ How often you might be expected to come in? What their average total visits are for a case like yours? How long it might take to reach your goals? ​ When you see how those numbers aren't much different from going to a cash-based practice, I invite you to book an appointment with us so that you can get started on your path to recovery as soon as possible. We look forward to the opportunity to help you in a way that helps you best. What payment methods do you accept? Payment is due at the time of service. We accept payment via cash, check, credit/debit card, or HSA/FSA card.

Postpartum Health Not surprisingly, the orthopedic impact of pregnancy and childbirth on the female body have been equated in the research to running a marathon. These physical demands can subject women to unique problems postpartum, including prolapse, pain with intercourse, urinary incontinence, straining with bowel movements, vulvar varicosities, pelvic and spinal pain, as well as diastasis recti (yes, you’re saying it right!) ​ Frequently, postpartum women will come to us without pelvic symptoms, but with fear around how to protect their pelvic floor from injury and prolapse during exercise and play with their children after birth. Even in those without symptoms, we usually find, on assessment, mild weaknesses and issues that are easily resolved when addressed soon after birth. ​ We strongly recommend an assessment to make sure you’re body is recovering well from the delivery and make sure you are on a safe path to reaching your postpartum goals. Specific interventions can address things such as education in comfortable positions, use of birth control, and appropriate use of lubrication during intercourse, as well as recommendations for a pessary as your pelvic floor is recovering from birth. Through tailored exercises and personalized strategies, IOPT works towards facilitating recovery and enhancing the overall well-being of women not just during the immediate postpartum phase but also throughout the lifespan. HOME / SERVICES / WHAT WE TREAT / POSTPARTUM HEALTH / Get Started Today Caroline's expertise and personalized approach to therapy ensure that you receive top-notch care tailored to your needs. Contact us today to book your session with Caroline and take the first step towards a healthier, more active lifestyle. CONTACT Qualified Physical Therapist ​ With years of experience and extensive training in pelvic floor rehabilitation, she is dedicated to helping her clients recover following labor and delivery. Compassionate Postpartum Care ​ We are dedicated to delivering compassionate care to individuals seeking support and postpartum care. Importance of Postpartum Care ​ Understanding the importance of postpartum care and pelvic health is crucial for your recovery and long term well-being.

Menopause If you are born with female reproductive organs, namely ovaries, you are guaranteed to go through “the Menopause” at some point in your life. If you’re lucky. Think about that. ​ From the second decade of life to around the fifth, women are hormonally influenced (this is a nice way of putting it,) on a monthly basis by hormonal changes that are programmed, in a healthy body, to facilitate fertility. As we grow out of the childbearing years, hormone levels fluctuate and then decline, until there is very little of that cycle left. ​ This can occur naturally in your fifth decade, as the ovaries stop producing viable eggs, and therefore endometrial tissue stops building and then shedding in the menstrual cycle. As this “change” occurs, chaos can, and often does, ensue. On either end of the spectrum, we have the extremes. On one end, we have the women who barely even notice this has happened, and on the other, the women who are overwhelmed by every possible symptom of menopause. The majority of women will experience something in the middle. ​ Surgical and medical menopause results in the same outcome, the cessation of ovulation and menstruation. Surgical removal of the uterus, a hysterectomy, can induce early menopause, and the symptoms can be more extreme with the immediate loss of hormonal messengers in the system. Even if the ovaries are spared in a hysterectomy, menopause will still occur earlier than it might have naturally, and the symptoms may tend to be more extreme. Undergoing chemotherapy can also induce menopause. Some women experience an early menopause before forty. ​ Menopause can bring about various changes in a woman's body, including those affecting pelvic health. Symptoms such as urinary incontinence, vaginal dryness, joint pain, changes in the sexual experience, and pelvic pain, to name just a few, are common during this time. Others include brain fog, mental health struggles, sleep disturbances, memory issues, cardiac changes and bone density impacts. ​ The good news here, is that, unlike what you may have been led to fear by your mother and her mother, menopause isn’t always something to live in fear of. Instead, it can be a welcome change that gives you a new opportunity to thrive in life, if well prepared for and managed. IOPT distinctly focuses on menopause care and is ideally positioned to help you navigate this change with confidence and understanding. ​ Pelvic health physical therapy offers specialized treatments to address all of these, and often collaborates with other providers to offer you a full spectrum approach to management. Through education, goal setting, lifestyle changes, nervous system management, soft tissue management, as well as targeted and integrated exercise programs, your personal physical therapist can help you manage menopause-related pelvic health concerns, improve muscle function, and enhance overall quality of life throughout the health span you envision for yourself. Your best approach to navigating this time with ease is to educate and prepare yourself. ​ Partnering with IOPT for personalized care and support as you approach and progress through this shift will ensure the best experience possible. We look forward to helping you change the rest of your life! HOME / SERVICES / WHAT WE TREAT / MENOPAUSE / Get Started Today Caroline's expertise and personalized approach to therapy ensure that you receive top-notch care tailored to your needs. Contact us today to book your session with Caroline and take the first step towards a healthier, more active lifestyle. CONTACT Qualified Physical Therapist ​ With years of experience and extensive training in pelvic floor rehabilitation, she is dedicated to helping her clients manage menopause-related pelvic health concerns. Compassionate Menopause Care ​ We are dedicated to delivering compassionate care to individuals seeking support and treatment for menopause-related concerns. Importance of Menopause Care ​ Understanding the importance of menopause care is crucial for overall well-being and quality of life.

What We Treat Get Connected HOME / SERVICES / WHAT WE TREAT / PELVIC HEALTH MENOPAUSE FERTILITY PRENATAL POSTPARTUM POST SURGICAL MEDICAL BLADDER HEALTH BOWEL HEALTH REPRODUCTIVE HEALTH SEXUAL HEALTH SPORTS, FITNESS + PLAY ORTHOPEDIC HEALTH Do I need a doctor's referral to see you? No. In North Carolina, we have what’s called “direct access” to physical therapy. That means you do not need a doctor’s note or referral to make an appointment with me. ​ After your initial evaluation, if your concerns are musculoskeletal in nature (that is, they fall within the scope of physical therapy), then we can continue working together towards your goals. If you have medical needs, we’ll make sure to send you in the right direction to get those addressed. ​ Even though a doctor’s referral isn’t needed, I always support you sharing your PT plan and results with your physician and their information with me. Do you think PT can really help me? Absolutely. I wouldn’t be doing this if I didn’t think it could make a difference and help you get back to the activities and life you want to lead. You deserve to feel better, and pelvic PT has a proven track record of helping people recover, feel better in their body, and achieve their health goals. I see the proof in this every day with current clients. When is the best time to make a PT appointment? Is it too late for me? It’s NEVER too late to get started on your recovery! The best time to make a PT appointment is whenever you are ready — whether that’s today, next week, or in three years. I want you to be ready to participate in the work so that you can find success and meet your goals. Success with seeing a PT isn’t a “should” situation; it needs to be an “I CAN” situation. Are you going to tell me to stop drinking coffee? It depends on what you’ve got going on, and what your goals are! ​ I can’t “make” you do anything, and will not try. Instead, I am a guide, a helper, a health “consultant.” In this role, I provide education and coach you through making the changes that support your goals. We will always work together on your goals in a way that helps you feel comfortable, understood, and supported. ​ Anything you do — including drinking coffee — is ultimately up to you. Just know that what you choose to do (or not do) can impact your progress and recovery journey. ​ Full transparency? For me, I drink 2-3 cups of coffee a day. At your appointment, I’ll share my secret for how I still drink coffee and stay symptom-free. How long will it be until I get better? How long your plan of care lasts depends on three things: where you currently stand, where you want to be, and what resources (time, energy, finances, support at home, education etc) you have to bring to the table. With my approach, symptoms will decrease significantly and often totally disappear in the first phase of PT, which tends to be 6-10 sessions, based on the factors above. One of the most impactful of these is your ability to extend the benefit of each session through your unique-to-you home program I send you with each week. ​ I have had some clients who cannot do anything except make it to their appointment once a week. And YES, they DO get better; it just takes longer. ​ The second phase, which usually takes another 6-10 sessions, involves directly addressing whatever is influencing your problems (such as strength, breath, coordination, etc.). At the end of this phase, you will have a good understanding of your pelvic floor and how to use it, and you’ll notice a significant difference in your strength and connection to your body. ​ The third phase is as long as you want it to be, based on your goals and resources. Some clients prefer to see me on an ongoing basis, with progression towards more and more core strength and functionality as they are able to do so. This is where we can fully integrate your gains into whatever activity you participate in for fitness. Do you take insurance? Inside Out Physical Therapy provides care as an out-of-network provider and uses a pay for service model of care. We will provide superbills as requested and you can submit to your insurance company if you wish. As so many Pelvic Health PT’s are practicing under this model, more insurers are becoming open to this. ​ Not accepting insurance gives us WAY more freedom to customize your treatment plan and make sure you’re actually getting the care you need and deserve. It allows us to spend 100% of your appointment time meeting your individual needs and goals, rather than addressing an insurance company's requirements. ​ This can significantly shorten the length of time it takes to meet your goals, as we can be more efficient in your treatment plan. ​ I understand that recovery requires a resource challenge for many people, and I want to make your goals accessible. Please schedule a free consult so that we can discuss all the options you have. ​ In the meantime, I recommend you call your insurance company and find out what your deductible, copay, and out-of-packet max are. Then call a PT clinic that accepts your insurance, and ask them these questions: How often you might be expected to come in? What their average total visits are for a case like yours? How long it might take to reach your goals? ​ When you see how those numbers aren't much different from going to a cash-based practice, I invite you to book an appointment with me so that you can get started on your path to recovery as soon as possible. What payment methods do you accept? Payment is due at the time of service. I accept payment via cash, credit/debit card, or HSA/FSA card. FAQs More FAQs

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Pelvic Health This field began as Women’s Health, based around women in childbearing and geriatric seasons of life, and the problems that showed up with the bladder. Once it became evident that men, in fact, had some of the same problems with their pelvic organs and musculature, it transitioned to Pelvic Health. And, maybe finally, we can call it Abdominopelvic Health. When you can see all of the areas of impact with the pelvic floor and abdominal organs, it becomes clear that this is a very complex field. Not only do we now address all of these areas of challenge, but we see clients in all phases of life and physical capacity. ​ Are you having back, or SI pain? Pelvic floor pressure, pain, or prolapse? Digestive difficulties? Lack of pleasure or difficulty with orgasm? Fertility challenges? Urinary leakage or stream struggles? Issues in pregnancy? Concerns around birth? Pelvic health involves different parts of the pelvic floor, impacting and causing issues that are interconnected throughout the systems. A thorough understanding of the muscles, nerves, bones, and blood vessels is essential for effective treatment. A comprehensive and multi-faceted approach that addresses all of the systems is vital to manage your specific pelvic health challenges. At IOPT, this is the practice platform we use to help you change your life. HOME / SERVICES / WHAT WE TREAT / PELVIC HEALTH / Get Started Today Caroline's expertise and personalized approach to therapy ensure that you receive top-notch care tailored to your needs. Contact us today to book your session with Caroline and take the first step towards a healthier, more active lifestyle. CONTACT Qualified Physical Therapist ​ With years of experience and extensive training in pelvic floor rehabilitation, she is dedicated to helping her clients overcome pelvic health issues and regain control over their health. Compassionate Care for Pelvic Health ​ We are dedicated to delivering compassionate care to individuals seeking support and treatment for pelvic-related concerns. Importance of Pelvic Health ​ Understanding the importance of pelvic health is crucial for overall well-being and quality of life.

Inside Out Physical Therapy is uniquely positioned to help you change your life. We start with the basics you have likely never known even mattered, and build on those to help you develop a healthy, optimally functioning body. ​ As the first direct care Pelvic Health clinic in Wilmington, since 2017 IOPT has offered a boutique style practice that brings a uniquely integrated and holistic approach to your recovery. Here, you will experience the benefit of interacting directly with one therapist regarding your personal questions, goals, scheduling needs and individual treatment plan. ​ We appreciate the opportunity to help you feel heard and understood, and to walk you through realistic and actionable steps towards your goals, whatever they may be. About Inside Out HOW WE TREAT Our Values Education At IOPT, we believe many of the problems you are experiencing would not be an issue if there was better education around them to begin with. Therefore, education is a primary, integral, and ongoing approach in helping you resolve these problems in our practice. Here, you will learn about your nervous system, and how stress can impact your symptoms. You will learn tools to manage your stress reaction, so as to help manage those symptoms. You will learn how your bladder, bowel and reproductive systems work, and how to keep them healthy. Knowledge will help you progress more quickly and have less need for therapy in the future. Trauma Sensitive Practice The research has shown that experiencing stress or threat, and therefore the activation of the flight, fight or freeze reaction, can have a strong influence on the pelvic floor. At IOPT we recognize the likelihood that many of our clients have experienced some type of stress/trauma/situation that impacts their symptoms, and that walking in our door can be a huge act of courage. In order for healing to occur, we recognize that privacy, safety, choice, consent, collaboration, trust, and empowerment must be integral concepts in the care we provide. In support of this, we strive to provide the best therapeutic landscape for you that supports this. Mind, Body, Spirit At IOPT, we recognize and help you identify that your symptoms may be sourced in any or all of these areas, and most likely a combination of them. In our approach to healing, we use practices that integrate your mind, body and spirit, and you will be surprised at the improvements in all the related areas of your being. Accountability, Growth, Responsibility At IOPT, we are here to help you regain control, confidence and joy in your body. We believe in the power of understanding and taking responsibility for your own health. We understand that sometimes this can feel overwhelming, and we are here to meet you wherever you are and guide you to wherever you want to be. We can be your accountability partner, until you grow into the strength to be your own. WE know you can do this, and soon you will, too. We look forward to witnessing you grow into your best self. Our Vision At IOPT, we look forward to a world in which the future generations will be as comfortable with, and as knowledgeable of, their pelvic health as they are the rest of their body. They will live lives free of the limitations we see in today’s adults around bladder, bowel, reproductive and sexual health. We pursue this goal by replacing limiting stigma and shame with education, support and celebration. It begins with you. Let us help. Meet Your Physical Therapist To make a VERY long story as short as possible, I have been practicing as a Physical Therapist since 1991. My initial specialty was in what we call neuro. where I worked with patients with severe head injuries, strokes, MS, Parkinson’s, and children with multiple diagnoses. I transitioned to geriatric based home care in order to be flexible to raise and partially homeschool my daughter as a single parent, and to support my community. ​ Working in these two spaces has given me a unique lens into Pelvic Health and your experience. The neurological specialty created the foundation from which all my current work evolves. The body and pelvic floor can only move at the direction of the nervous system, and that’s my first area of expertise. Working with the elderly, and hearing stories of long standing urinary issues, bowel issues, and back problems especially after birth, I wanted to change the story of the aging population in this country. Being in their homes and seeing their specific and unique challenges gave me the incentive. ​ After experiencing my own problems in pregnancy and birth trauma, as well as long standing problems as a result, I wanted there to be a different answer than “it’s just because you’re pregnant or had a child.” I took my first course in Pre-natal and Post Partum Exercise in 1994, and have been pursuing further knowledge and developing extensive skills ever since, to better help you change your story too. One of my favorite opportunities to impact a paradigm change in this culture has been an invitation to speak with the OB/GYN residents at the local hospital about the support we can offer their patients. My goal is that they never use that phrase again. ​ Along the way, I learned that so many of the things I experienced before and after pregnancy also had an impact on my symptoms, as well as stressors and basic physiological health. And finally, after years of banging my head against the wall of treating my patients’ symptoms, instead of addressing the actual problem from an integrative and holistic standpoint, I had had enough. ​ I was no longer willing to treat people according to the insurance companies’ dictates. In 2017, I moved out from under the insurance umbrella with all its restrictions and antiquated policies and requirements, and opened the first direct care Pelvic Health Physical Therapy clinic in Wilmington NC. Under this model of care, I can help you meet your goals more efficiently and thoroughly. We will follow a plan that you and I develop together, based on your needs, resources, and my professional expertise. ​ Personally, I have a lifetime of information and interests and stories, that I would need a whole other site for. I’m sure when you come to work with me, you will hear some of them! OUR SERVICES DISCOVER MORE | @insideoutpt

Orthopedic Health If you are experiencing pain in the low back, hips, tailbone and joints of the pelvic girdle, you might be surprised to know the pelvic floor is very often involved. “My hips are always out” is one of our most often heard complaints. Fun fact is that much of the pelvic floor musculature is literally attached to the bottom of your spine at the tailbone, as well as having an impact on the hip, and so, very often when people come to us for bladder issues? Their back, hip, knee and foot issues resolve right along with their bladder. We can help you understand this impact and resolve those long standing back and “hip” issues that traditional therapy may not have been able to address. ​ There is an extremely high correlation between back pain and urinary incontinence. If you have either one, or both, come see us. ​ If you have had an injury and/or surgery to one of your legs, you can develop pelvic floor dysfunction, depending on the degree and impact of the injury. HOME / SERVICES / WHAT WE TREAT / ORTHOPEDIC HEALTH / Get Started Today Caroline's expertise and personalized approach to therapy ensure that you receive top-notch care tailored to your needs. Contact us today to book your session with Caroline and take the first step towards a healthier, more active lifestyle. CONTACT Qualified Physical Therapist ​ With years of experience and extensive training in pelvic floor rehabilitation, she is dedicated to helping her clients overcome orthopedic issues and regain control over their health. Compassionate Care for Orthopedic Health ​ We are dedicated to delivering compassionate care to individuals seeking support and treatment for orthopedic-related concerns. Importance of Orthopedic Health ​ Understanding the importance of orthopedic health is crucial for overall well-being and quality of life.