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187. Your Pelvic Floor Needs More Than Kegels with Dr. Charlotte Lange · Dr. Danielle Difference

• 0:00
  You've tried doing all the right things.
• 0:02
  Let's get to what actually makes a difference.
• 0:05
  Welcome to The Dr.
• 0:07
  Danielle Difference.
• 0:10
  Dr. Danielle Hofer: Hi, friends.
• 0:11
  Dr. Danielle Hofer: I have a treat for you today.
• 0:13
  Dr. Danielle Hofer: I am so excited to bring to you someone that has been very pivotal in my own health journey.
• 0:18
  Dr. Danielle Hofer: I say journey because there's never a before and after.
• 0:21
  Dr. Danielle Hofer: If you've been here a long time, you know there's a before I'm going to take radical responsibility and an after knowing, and I continue to take radical responsibility.
• 0:28
  Dr. Danielle Hofer: So I wanted to introduce you to one of my favorite people in the whole wide world that has truly saved my life and is, uh, like, in the background of my brain every single time I'm working out.
• 0:39
  Dr. Danielle Hofer: Oh my I didn't think I was gonna get emotional.
• 0:40
  Dr. Danielle Hofer: You better make me laugh, Charlotte.
• 0:42
  Dr. Danielle Hofer: Um, I wanna introduce you to Dr.
• 0:43
  Dr. Danielle Hofer: Charlotte Lang.
• 0:44
  Dr. Danielle Hofer: She is a physical therapist.
• 0:46
  Dr. Danielle Hofer: She has a doctorate of physical therapy, she has multiple specializations that I think it's very important that you all get to know who this is and kind of, like, why in my clinic that I am consistently referring out
• 0:59
  Dr. Danielle Hofer: to Hands on PT.
• 1:00
  Dr. Danielle Hofer: And so I wanna talk with her today and introduce you.
• 1:03
  Dr. Danielle Hofer: So Charlotte, can you introduce yourself?
• 1:05
  Dr. Danielle Hofer: Welcome here.
• 1:06
  Dr. Charlotte Lange PT, DPT: Hi, I'm, uh, Dr.
• 1:08
  Dr. Charlotte Lange PT, DPT: Charlotte Lang.
• 1:09
  Dr. Charlotte Lange PT, DPT: I'm a physical therapist, started in orthopedics, branched into pelvic health about five years ago, I think.
• 1:19
  Dr. Charlotte Lange PT, DPT: Five years ago, yeah.
• 1:20
  Dr. Charlotte Lange PT, DPT: That's a long time.
• 1:21
  Dr. Charlotte Lange PT, DPT: I've known you for five years.
• 1:22
  Dr. Charlotte Lange PT, DPT: Danielle was one of my very first pelvic floor patients when I was still being mentored.
• 1:27
  Dr. Charlotte Lange PT, DPT: Um, I sat in on her eval, and I absorbed this super complex case that I learned I was not prepared for, and I've learned a lot about her and from her, and she's taught me a lot of things.
• 1:38
  Dr. Charlotte Lange PT, DPT: Um, and really, she's like became my ideal patient.
• 1:43
  Dr. Charlotte Lange PT, DPT: Um, so Danielle and I have been on this journey for five years together.
• 1:48
  Dr. Charlotte Lange PT, DPT: Um, she's seen me grow.
• 1:49
  Dr. Charlotte Lange PT, DPT: I bridge a lot of orthopedics and pelvic floor together in my practice.
• 1:54
  Dr. Charlotte Lange PT, DPT: So Danielle being a CrossFitter, Danielle being active, Danielle having pelvic floor dysfunction was like my ideal gal
• 2:03
  Dr. Danielle Hofer: Yes.
• 2:04
  Dr. Danielle Hofer: And so this episode, even if you are not someone that does CrossFit, you're not someone who is into athletics at all, that's totally fine.
• 2:10
  Dr. Danielle Hofer: You still need to listen because it- all of this can transfer into your realm and, um, in your life because all we're talking about today, all Charlotte and I really care about is your functional wealth, or, I mean,
• 2:21
  Dr. Danielle Hofer: sorry, functional health.
• 2:22
  Dr. Danielle Hofer: Maybe functional wealth too, but your functional health, right?
• 2:25
  Dr. Danielle Hofer: Like, that's what we care, like, really ultimately to see is our patients walk out and just function well, right?
• 2:32
  Dr. Danielle Hofer: Like, that's where we're at.
• 2:34
  Dr. Danielle Hofer: So I thought we would start this episode a little bit about my story and why.
• 2:39
  Dr. Danielle Hofer: I think it's important to know the why behind what I do and how I do things.
• 2:44
  Dr. Danielle Hofer: And so let me...
• 2:45
  Dr. Danielle Hofer: I'm gonna be very vulnerable in this episode, not that I'm not normally, but I'm going to share more of who I am and, like, my struggles and things I had going on.
• 2:55
  Dr. Danielle Hofer: So let me take you back to about 20- about 2017.
• 3:02
  Dr. Danielle Hofer: had...
• 3:02
  Dr. Danielle Hofer: It was about a year, almost a year postpartum from my third child, I was having trouble, um, like normal po- I say quote unquote "normal" postpartum things.
• 3:13
  Dr. Danielle Hofer: I was, like, leaking.
• 3:14
  Dr. Danielle Hofer: I was having stool problems.
• 3:15
  Dr. Danielle Hofer: Um, I
• 3:16
  Dr. Charlotte Lange PT, DPT: Common.
• 3:16
  Dr. Charlotte Lange PT, DPT: Common, not normal.
• 3:18
  Dr. Danielle Hofer: Yes, common.
• 3:19
  Dr. Danielle Hofer: Yes.
• 3:19
  Dr. Danielle Hofer: Thank you.
• 3:20
  Dr. Danielle Hofer: Common, not normal, problems when it came to just everyday living.
• 3:25
  Dr. Danielle Hofer: Um, I love running.
• 3:26
  Dr. Danielle Hofer: Running is something that really, especially postpartum, that running, there's nothing like that just...
• 3:32
  Dr. Danielle Hofer: brain would just, um...
• 3:33
  Dr. Danielle Hofer: And it still does.
• 3:34
  Dr. Danielle Hofer: Like, running is what makes my brain go blank, and I don't have all these weird thoughts and this stuff just constantly spinning in my head, and it makes me just focus on my breath.
• 3:43
  Dr. Danielle Hofer: It makes me just, like, hear nothing, and that's there, that's not normal in my everyday life unless I'm running.
• 3:49
  Dr. Danielle Hofer: And it's usually about that mile two, mile two and a half that, uh, that it finally goes blank.
• 3:53
  Dr. Danielle Hofer: Um, and so I would...
• 3:55
  Dr. Danielle Hofer: That's what I did postpartum, and of course, I was lifting and things too, but I was starting to be affected in that I was not just, not just the annoying leaking when you're laughing, coughing, jumping, that kind of
• 4:07
  Dr. Danielle Hofer: stuff.
• 4:09
  Dr. Danielle Hofer: As the years progressed, about 2018, I started noticing I was having these weird spasms, and I thought that they were cramps, and I thought that they were o- ovulation cramping.
• 4:19
  Dr. Danielle Hofer: I couldn't quite pinpoint it to that time of the month, right?
• 4:23
  Dr. Danielle Hofer: Like, I couldn't pinpoint these, this cramping.
• 4:26
  Dr. Danielle Hofer: Had never experienced it before.
• 4:28
  Dr. Danielle Hofer: Meanwhile, I have a special needs child.
• 4:29
  Dr. Danielle Hofer: I have a baby that's very high needs, and I'm like, "I'm spent."
• 4:32
  Dr. Danielle Hofer: My marriage was sucking.
• 4:33
  Dr. Danielle Hofer: Like, it just- everything sucked in my life.
• 4:35
  Dr. Danielle Hofer: And so I'm like, "Okay, like, I don't know what this is, but I'm just gonna push through.
• 4:38
  Dr. Danielle Hofer: No big deal."
• 4:40
  Dr. Danielle Hofer: And then that ignoring it, to live my life, continuing to exercise and work out and, and take care of all the things, spasms kept coming more and more frequently.
• 4:49
  Dr. Danielle Hofer: What I then learned were bladder spasms.
• 4:52
  Dr. Danielle Hofer: It hit a head when I was having...
• 4:55
  Dr. Danielle Hofer: thought I had urgency, and it was painful urgency when I was jump roping or when I was, um, even doing squats.
• 5:01
  Dr. Danielle Hofer: I would have this painful urgency that I felt like I had to go to the bathroom and there was nothing there.
• 5:05
  Dr. Danielle Hofer: Nothing in my bladder.
• 5:06
  Dr. Danielle Hofer: W- it would not release.
• 5:08
  Dr. Danielle Hofer: then I was at a Pet Supplies Plus or something.
• 5:11
  Dr. Danielle Hofer: I don't know why.
• 5:12
  Dr. Danielle Hofer: I, I do know why I remember this.
• 5:14
  Dr. Danielle Hofer: I was in the...
• 5:15
  Dr. Danielle Hofer: I was pushing the cart, thinking nothing of it, and then all of a sudden, a spasm hit, and I was keeled over on the disgusting floor of Pet Supplies Plus.
• 5:23
  Dr. Danielle Hofer: I could not get my bladder to stop spasming.
• 5:27
  Dr. Danielle Hofer: I was crying.
• 5:28
  Dr. Danielle Hofer: I couldn't stand up.
• 5:29
  Dr. Danielle Hofer: I had to crawl out the flipping front door of this nasty...
• 5:33
  Dr. Danielle Hofer: All these dogs and all these pets.
• 5:34
  Dr. Danielle Hofer: You don't know how many people peed and pooped and all this stuff on this floor.
• 5:37
  Dr. Danielle Hofer: I was embarrassed.
• 5:38
  Dr. Danielle Hofer: I was so embarrassed.
• 5:40
  Dr. Danielle Hofer: So, at that time, I still was very stubborn, and Charlotte knows.
• 5:43
  Dr. Danielle Hofer: Like, s- stubbornness, she can get- she can hack me and, like, get me to be stubborn in the right ways that are good for me, but I was so stubborn that I was like, "Oh, maybe it's just coffee."
• 5:52
  Dr. Danielle Hofer: I wasn't drinking a ton of coffee.
• 5:53
  Dr. Danielle Hofer: So I stopped drinking coffee, and it kind of helped some, but it came to a head when it was happening then at Kroger, and then it was happening, um, at the h- at home.
• 6:03
  Dr. Danielle Hofer: It was pushing me.
• 6:04
  Dr. Danielle Hofer: I was late to church.
• 6:05
  Dr. Danielle Hofer: It was so bad.
• 6:06
  Dr. Danielle Hofer: I could not do anything but crawl myself to a toilet and sit on it and let my bladder just...
• 6:11
  Dr. Danielle Hofer: Had to breathe through the pain.
• 6:12
  Dr. Danielle Hofer: It was worse than labor pains.
• 6:13
  Dr. Danielle Hofer: It was just awful.
• 6:16
  Dr. Danielle Hofer: I think w- the last time it lasted two and a half hours, and I was sitting there on the toilet, like, just crying.
• 6:22
  Dr. Danielle Hofer: So that's when I knew that I needed some- something, something needed done.
• 6:25
  Dr. Danielle Hofer: So I went to a urogyne, and then I knew before that,
• 6:29
  Dr. Charlotte Lange PT, DPT: did you get to UroGyne?
• 6:31
  Dr. Danielle Hofer: I, oh, that's a good question because that's not easy, is it?
• 6:34
  Dr. Charlotte Lange PT, DPT: Mm-hmm.
• 6:35
  Dr. Charlotte Lange PT, DPT: And if that's a story for another podcast, that's okay.
• 6:38
  Dr. Charlotte Lange PT, DPT: But
• 6:38
  Dr. Danielle Hofer: but we can talk about that though, because getting to a urogyne really isn't easy.
• 6:42
  Dr. Danielle Hofer: And I will say that my OBGYN, I adore him, but he, um, told me I probably didn't need a urogyne at the time
• 6:49
  Dr. Charlotte Lange PT, DPT: And for those of you that don't know, a urogyne is
• 6:51
  Dr. Danielle Hofer: Oh,
• 6:52
  Dr. Charlotte Lange PT, DPT: a urogynecologist.
• 6:53
  Dr. Charlotte Lange PT, DPT: So they go to, um, residency for gynecology and then fellowship in urology gynecology.
• 6:59
  Dr. Charlotte Lange PT, DPT: Um, so they specialize in gynecological and urology bridge because there is a lot of overlap.
• 7:05
  Dr. Charlotte Lange PT, DPT: So urologists don't under-understand everything, and OBGYNs don't understand everything
• 7:09
  Dr. Danielle Hofer: Yes, and thank you for that.
• 7:11
  Dr. Danielle Hofer: Like, thank you for that education because it's, I did not know either.
• 7:14
  Dr. Danielle Hofer: I thought that they just did, what is it?
• 7:16
  Dr. Danielle Hofer: Vaginoplasties?
• 7:17
  Dr. Danielle Hofer: I thought that that's what they did.
• 7:18
  Dr. Danielle Hofer: I really didn't know what they did.
• 7:20
  Dr. Danielle Hofer: Um, and I thought that they just made everything look younger and youthful down there.
• 7:25
  Dr. Danielle Hofer: Um, I really did not know that they were functional for, like, the way that the body structurally works.
• 7:31
  Dr. Danielle Hofer: So I got to this place because I was desperate, and I started asking around, and then I just l- happened to luck upon, I truly th- it wasn't luck.
• 7:40
  Dr. Danielle Hofer: It was clearly, like, God, like, intervening for me, but I got one of the top u- urogyns in our area, he was fantastic.
• 7:49
  Dr. Danielle Hofer: And so I walked in there, and I was, like, the youngest one in the, in the room, which is unfortunate because you know, Charlotte, like, you know how many of us struggle, um, in our 30s and our 40s,
• 8:02
  Dr. Danielle Hofer: and it's like, how, why is it that I'm the youngest one in here?
• 8:05
  Dr. Danielle Hofer: Um, but I went in, and he was so gentle, so kind, so...
• 8:10
  Dr. Danielle Hofer: Like, when I say gentle, I mean his bedside mannerisms and his bedside, what is it called?
• 8:15
  Dr. Danielle Hofer: Bedside behavior was just so accepting and comforting and didn't make me feel like I was nuts, that my problems were just like a Kegel could fix it.
• 8:26
  Dr. Danielle Hofer: Um, he did a thorough assessment, and he, uh, he assessed vaginally, he assessed rectally, he assessed my, he actually filled my bladder.
• 8:33
  Dr. Danielle Hofer: Um, he cathed me and then, like, wanted to see and then filled my bladder, and he did it all right there in the office.
• 8:38
  Dr. Danielle Hofer: It was so fast, so easy.
• 8:40
  Dr. Danielle Hofer: Nothing was painful at all.
• 8:42
  Dr. Danielle Hofer: And on that first visit, I knew what was wrong with me, and it was something I could never have fixed.
• 8:48
  Dr. Danielle Hofer: It was something that I was able to link back to when I was a young girl and having trouble with my urinary system, and it was that my urethra was, for lack of better terms, it was loose.
• 8:58
  Dr. Danielle Hofer: It was prolapsed.
• 8:59
  Dr. Danielle Hofer: It was not able to stay firm, so every time I jumped, sneezed, walked, and then, like, picking up dog food at the, at the dog st- at the pet store, any, like, bending, picking up my kids, all of
• 9:11
  Dr. Danielle Hofer: that, it was m- causing my urethra to move, thus signaling nerves into my bladder like, "Hey, you need to go pee.
• 9:19
  Dr. Danielle Hofer: Like, that's, that's what we need to do."
• 9:21
  Dr. Danielle Hofer: And it was overreacting and then causing the spasms.
• 9:25
  Dr. Danielle Hofer: And when he talked to me about how we fix this, I was like, all I heard was restriction, restriction, restriction All I heard was that you're no longer gonna be able to lift heavy things.
• 9:38
  Dr. Danielle Hofer: no longer gonna be able to run.
• 9:40
  Dr. Danielle Hofer: You're gonna have to go find new ways to work out.
• 9:42
  Dr. Danielle Hofer: You're gonna have to go find new hobbies, new lifestyle, all of that, and I demanded better.
• 9:48
  Dr. Danielle Hofer: And I'm so grateful to me back then that was demanding better.
• 9:52
  Dr. Danielle Hofer: So I started prehabbing with a personal trainer, and once I And I had the surgery, and after the surgery, the, the personal trainer was like, "I've hit you as far as I can.
• 10:00
  Dr. Danielle Hofer: You need to go see I've heard of this girl named Ch- uh, Charlotte.
• 10:04
  Dr. Danielle Hofer: She's a physical therapist.
• 10:05
  Dr. Danielle Hofer: I really think she understands what's going on."
• 10:08
  Dr. Danielle Hofer: And I, scared, I'd never been to anything like this before.
• 10:11
  Dr. Danielle Hofer: I'd never been to hands-on physical therapy.
• 10:13
  Dr. Danielle Hofer: I'd only been to, like, the, you call them?
• 10:15
  Dr. Danielle Hofer: Like, chains or, like, the hospital versions of physical therapy where they are with you for maybe 15 minutes.
• 10:21
  Dr. Danielle Hofer: They want you to do the exercises, and that's it.
• 10:23
  Dr. Danielle Hofer: Um, and so I got a rude awakening when I met Charlotte.
• 10:28
  Dr. Danielle Hofer: And so Charlotte, I want you to kind of pick up on this story and talk about I, why it was a rude awakening for me.
• 10:35
  Dr. Danielle Hofer: Like, why, why would that be?
• 10:36
  Dr. Danielle Hofer: 'Cause it's so different, right?
• 10:38
  Dr. Danielle Hofer: Like, what you do is so completely different than
• 10:40
  Dr. Charlotte Lange PT, DPT: Mm-hmm.
• 10:40
  Dr. Danielle Hofer: we think of physical therapy.
• 10:42
  Dr. Danielle Hofer: And then kind of pick up on, like, where, like, some missing pieces that I, that maybe you hear other people talking about and things like that when they go to or they have some kind of pelvic surgery or
• 10:52
  Dr. Danielle Hofer: pelvic concern.
• 10:53
  Dr. Charlotte Lange PT, DPT: Sure.
• 10:54
  Dr. Charlotte Lange PT, DPT: So there's a lot to unpack there.
• 10:57
  Dr. Charlotte Lange PT, DPT: Um, with physical therapy and the way in which I treat, um, specifically, and then to Danielle, there is so much that goes into the human body.
• 11:08
  Dr. Charlotte Lange PT, DPT: So you have these...
• 11:10
  Dr. Charlotte Lange PT, DPT: She'd had three deliveries, um, trauma with each of her deliveries, which she didn't touch on, but that was there, which probably also contributed to some of her symptoms.
• 11:19
  Dr. Charlotte Lange PT, DPT: Physical trauma, maybe emotional, I don't know.
• 11:21
  Dr. Charlotte Lange PT, DPT: I'm not gonna speak, speak to that.
• 11:23
  Dr. Charlotte Lange PT, DPT: But tearing, um, is kind of what I'm referencing.
• 11:26
  Dr. Charlotte Lange PT, DPT: So if there's vaginal tearing, if you have a C-section, anything like that disrupts the way in which your body functions.
• 11:31
  Dr. Charlotte Lange PT, DPT: Um, and as you heal and as you recover, your body develops this scar tissue and develops change in movement patterns and compensations and all of this stuff.
• 11:41
  Dr. Charlotte Lange PT, DPT: And you can have surgery and it could fix the problem, but you're not fixing the underlying root causes, which should sound familiar in what Danielle has, preaches, right?
• 11:50
  Dr. Charlotte Lange PT, DPT: Um, so she had this pelvic floor reconstruction.
• 11:54
  Dr. Charlotte Lange PT, DPT: Um, there was some other reconstruction, I think also along in your surgery, not just through, with the urethra.
• 12:00
  Dr. Danielle Hofer: Yep
• 12:01
  Dr. Charlotte Lange PT, DPT: so you fix the structure, but if you're not fixing the underlying issues, the mechanical, the biomechanical things, the way she's moving, um, and getting her tissue ready to accept load, which is life.
• 12:14
  Dr. Charlotte Lange PT, DPT: Life is load.
• 12:15
  Dr. Charlotte Lange PT, DPT: You have to carry laundry.
• 12:16
  Dr. Charlotte Lange PT, DPT: You have to pick up your kids.
• 12:17
  Dr. Charlotte Lange PT, DPT: You have to carry the dog food.
• 12:18
  Dr. Charlotte Lange PT, DPT: You have to push the grocery cart that has all the water and food, and it's heavy.
• 12:22
  Dr. Charlotte Lange PT, DPT: You have to be able to do these things.
• 12:24
  Dr. Charlotte Lange PT, DPT: Um- If your body's not ready to accept that, you're not going to heal, you're not gonna recover, and you're gonna end up with the same issues, whether it's a year later or whether it's 10 years later.
• 12:34
  Dr. Charlotte Lange PT, DPT: Um, so where I come in is I help to restore this function in your body.
• 12:38
  Dr. Charlotte Lange PT, DPT: Um, and a lot of people hear physical therapy, they think pain and torture.
• 12:42
  Dr. Charlotte Lange PT, DPT: Sometimes, yes, um, but with the best of intentions.
• 12:46
  Dr. Charlotte Lange PT, DPT: Um, I think I made Danielle cry on several occasions,
• 12:50
  Dr. Danielle Hofer: Yep.
• 12:51
  Dr. Charlotte Lange PT, DPT: and she still loves me.
• 12:52
  Dr. Danielle Hofer: Yes
• 12:54
  Dr. Charlotte Lange PT, DPT: um, we start with...
• 12:59
  Dr. Charlotte Lange PT, DPT: And my approach has changed a lot through the years, too.
• 13:01
  Dr. Charlotte Lange PT, DPT: As I've said, Danielle was one of my very first pelvic floor patients, and I think if I could go back and treat her now, I would treat her differently early on than I did later on.
• 13:08
  Dr. Charlotte Lange PT, DPT: But hands-on care.
• 13:11
  Dr. Charlotte Lange PT, DPT: You need hands-on care.
• 13:12
  Dr. Charlotte Lange PT, DPT: I don't care what your injury is, I don't care what your surgery is, I don't care what it is.
• 13:15
  Dr. Charlotte Lange PT, DPT: You need somebody to touch your body.
• 13:17
  Dr. Danielle Hofer: Yes
• 13:19
  Dr. Charlotte Lange PT, DPT: feeling for what is tight, what is restriction, what is your fascia doing, what are your muscles doing, um, what, uh, it, what is your scar tissue like?
• 13:27
  Dr. Charlotte Lange PT, DPT: Is it, is it there?
• 13:29
  Dr. Charlotte Lange PT, DPT: Is it mobile?
• 13:29
  Dr. Charlotte Lange PT, DPT: Is it restricted in this direction or that direction?
• 13:33
  Dr. Charlotte Lange PT, DPT: Um, so that's a lot of what we start with, is restoring normal function in that tissue.
• 13:39
  Dr. Charlotte Lange PT, DPT: Because if your muscle's not doing something, if your fascia's not doing something, you're compensating.
• 13:44
  Dr. Charlotte Lange PT, DPT: Um, I remember distinctly putting a cup on Danielle's, I think, right, I don't, one of her lats, and then she had full shoulder motion.
• 13:54
  Dr. Charlotte Lange PT, DPT: Like, hadn't had it in a long time.
• 13:57
  Dr. Charlotte Lange PT, DPT: Um, and that's not even, like, a direct...
• 13:59
  Dr. Charlotte Lange PT, DPT: There's a correlation there, but it was cross-body.
• 14:02
  Dr. Charlotte Lange PT, DPT: Um, so there's connections in ways that I don't even always understand, but something happens.
• 14:07
  Dr. Charlotte Lange PT, DPT: Um- So we start with that.
• 14:12
  Dr. Charlotte Lange PT, DPT: We learn to load the tissue, we learn to load the tissue appropriately.
• 14:15
  Dr. Charlotte Lange PT, DPT: Um, it is not all Kegels.
• 14:17
  Dr. Charlotte Lange PT, DPT: I don't...
• 14:18
  Dr. Charlotte Lange PT, DPT: We probably did some Kegels as far as like can you coordinate this, but you...
• 14:23
  Dr. Danielle Hofer: can I, can I interrupt real
• 14:24
  Dr. Charlotte Lange PT, DPT: Uh-huh
• 14:25
  Dr. Danielle Hofer: Um, one of the things I remember happening is that I didn't realize that...
• 14:31
  Dr. Danielle Hofer: Okay, first, uh, and I wanna talk to this too, like, um, I didn't realize I was tight down there.
• 14:35
  Dr. Danielle Hofer: I didn't realize that my muscles were exhaustedly tight, right?
• 14:39
  Dr. Danielle Hofer: Um, but there was a time that you asked me, you were just checking to see if I c- had the coordination and all of that with the tissues, and I went to do a Kegel, and all of a
• 14:48
  Dr. Danielle Hofer: sudden it seized up on you, and it hurt like the dickens.
• 14:51
  Dr. Danielle Hofer: And I'm so grateful, because just that hands-on piece was even able to relate- to release it.
• 14:56
  Dr. Danielle Hofer: Like, me to breathe, yeah, maybe.
• 15:00
  Dr. Danielle Hofer: But, like, it was a muscle that was having a spasm, and you were able to release it, and I don't think we think of, like, our, our pelvic sling is nothing but full of muscles and full of ligaments
• 15:12
  Dr. Danielle Hofer: and full of all these things that need the support.
• 15:14
  Dr. Danielle Hofer: We will, if, I think if our pelvic floors had abs and everybody could see the abs, like, we would focus on it more.
• 15:20
  Dr. Charlotte Lange PT, DPT: 100%.
• 15:22
  Dr. Danielle Hofer: but it's like that, I, I just wanted to speak into that idea of, like, the Kegel.
• 15:27
  Dr. Danielle Hofer: The Kegels were not great for me, it was already so tight,
• 15:31
  Dr. Charlotte Lange PT, DPT: The Kegels are not great for most of my patients
• 15:34
  Dr. Danielle Hofer: Yeah.
• 15:35
  Dr. Danielle Hofer: And can you talk about why?
• 15:36
  Dr. Charlotte Lange PT, DPT: Yes.
• 15:36
  Dr. Charlotte Lange PT, DPT: So if you think of...
• 15:40
  Dr. Charlotte Lange PT, DPT: Let me grab my pelvis for those of you that may end up seeing a clip of this.
• 15:43
  Dr. Charlotte Lange PT, DPT: Um
• 15:44
  Dr. Danielle Hofer: are going to possibly have this live, uh, or like some pieces of this on YouTube and my Instagram, and I will tag Sharla as well.
• 15:51
  Dr. Danielle Hofer: So if you are watching the video or you're...
• 15:54
  Dr. Danielle Hofer: or I'm sorry, if you're just listening to this, sure you head to one of our accounts.
• 15:57
  Dr. Danielle Hofer: The information will be in the show notes, um, and you'll be able to see her grab the pelvis and talk
• 16:02
  Dr. Charlotte Lange PT, DPT: So this is your pelvis.
• 16:03
  Dr. Charlotte Lange PT, DPT: This is the front, this is the back, and then this is if you're looking up the bottom.
• 16:07
  Dr. Charlotte Lange PT, DPT: So anything red here that you see, this is inside your pelvis.
• 16:11
  Dr. Charlotte Lange PT, DPT: This is all muscle.
• 16:12
  Dr. Charlotte Lange PT, DPT: Um, and if you think of a, of a, like a pop can, you have your diaphragm at the top, you have your pelvic floor at the bottom, and then your core muscles encapsulate this or circle this.
• 16:21
  Dr. Charlotte Lange PT, DPT: Um, and your core and your pelvic floor work directly together.
• 16:25
  Dr. Charlotte Lange PT, DPT: Um, everyone thinks core, they think six-pack muscles.
• 16:30
  Dr. Charlotte Lange PT, DPT: Not wrong, not ideal, that I very rarely are training.
• 16:33
  Dr. Charlotte Lange PT, DPT: Your rectus abdominis is what that's called.
• 16:35
  Dr. Charlotte Lange PT, DPT: Um, but we're working transverse abdominis, which Danielle and I have worked a ton on, and we're working pelvic floor.
• 16:40
  Dr. Charlotte Lange PT, DPT: So when these muscles here are weak, weak muscle becomes tight muscle, and they, they tighten and they spasm.
• 16:48
  Dr. Charlotte Lange PT, DPT: So if your hamstrings are tight, they're probably weak.
• 16:51
  Dr. Charlotte Lange PT, DPT: Um, same with your pelvic floor.
• 16:53
  Dr. Charlotte Lange PT, DPT: So a lot of my women come in and their pelvic floors are weak.
• 16:56
  Dr. Charlotte Lange PT, DPT: You're trying to find stability from somewhere.
• 16:58
  Dr. Charlotte Lange PT, DPT: Um, you've had babies.
• 17:00
  Dr. Charlotte Lange PT, DPT: You've, um, you know, you've had all these things, and what do you do when something is tired?
• 17:04
  Dr. Charlotte Lange PT, DPT: It tenses up.
• 17:05
  Dr. Charlotte Lange PT, DPT: Or if you feel threat to, for any reason, it tenses up.
• 17:08
  Dr. Charlotte Lange PT, DPT: So you, you, h- you're holding all of this tension there.
• 17:11
  Dr. Charlotte Lange PT, DPT: Um, so where manual therapy comes in is it releases that.
• 17:16
  Dr. Charlotte Lange PT, DPT: Your pelvic floor should be like a trampoline.
• 17:17
  Dr. Charlotte Lange PT, DPT: It should produce force, and it should absorb force, and when you're stuck up here, you're not able to lengthen.
• 17:23
  Dr. Charlotte Lange PT, DPT: You're not able to get that full contraction to stop yourself from leaking, to, um, sneeze, um, without leaking, for sexual function.
• 17:32
  Dr. Charlotte Lange PT, DPT: All of these things come back to what is the baseline of your pelvic floor?
• 17:37
  Dr. Charlotte Lange PT, DPT: Um, so manually, I'm assessing w- what...
• 17:41
  Dr. Charlotte Lange PT, DPT: Are these muscles tight?
• 17:42
  Dr. Charlotte Lange PT, DPT: Are they weak?
• 17:43
  Dr. Charlotte Lange PT, DPT: Um, h- what's your contraction quality like?
• 17:46
  Dr. Charlotte Lange PT, DPT: What's your endurance like?
• 17:48
  Dr. Charlotte Lange PT, DPT: And then we're, we're loading that tissue.
• 17:50
  Dr. Charlotte Lange PT, DPT: Um, I mean, Danielle and I did deadlifts and squats and band walks and, um, we changed her shoes at one point.
• 18:00
  Dr. Danielle Hofer: Yes.
• 18:01
  Dr. Danielle Hofer: Like, huge.
• 18:01
  Dr. Danielle Hofer: It changed everything for me.
• 18:03
  Dr. Charlotte Lange PT, DPT: Yeah.
• 18:05
  Dr. Charlotte Lange PT, DPT: Uh, and go ahead
• 18:06
  Dr. Danielle Hofer: oh, and I was just gonna say, and that's, like, a piece of where many insurance-covered places, this is unfortunate, but they are forced to only focus on one area of your concern.
• 18:18
  Dr. Danielle Hofer: So if you come in complaining of your back hurting, they have to work on your back, not your pelvic floor, where that source, that foundation of the, of, of, uh, uh, where the source of the actual pain is
• 18:28
  Dr. Danielle Hofer: coming from, they cannot get the pelvic floor.
• 18:31
  Dr. Danielle Hofer: Or let's say you come in for a shoulder, but with the, but Charlotte notices, oh, you have pelvic floor, or something's going on with your adductor, or, you know, something like that.
• 18:40
  Dr. Danielle Hofer: It, they can only work on one part of your body, whereas Charlotte was able to make the connections of my pelvic floor, uh, previous surgeries I'd had that were probably connecting scar tissue things and causing restrictions, and then
• 18:53
  Dr. Danielle Hofer: she also connected it to my foot, like, to my feet.
• 18:57
  Dr. Danielle Hofer: And so, like, I am able to lift and go through life and actually have more, I guess it's called the three-point thing, um, but, like, I'm actually able to hold the floor better than I've ever been able to
• 19:09
  Dr. Danielle Hofer: do, and it's like ortho piece is like, oh, I didn't even know that was connect...
• 19:14
  Dr. Danielle Hofer: You know what I'm saying?
• 19:14
  Dr. Danielle Hofer: Like, opening that door of how the body is actually intertwined and how everything is...
• 19:21
  Dr. Danielle Hofer: Again, specialists, I love them.
• 19:23
  Dr. Danielle Hofer: Specialists are really good at what they do, but they f- don't have the whole picture of the whole system in mind, and Charlotte does that and does that so stinking well.
• 19:33
  Dr. Danielle Hofer: But go
• 19:33
  Dr. Charlotte Lange PT, DPT: Thanks.
• 19:34
  Dr. Danielle Hofer: I did
• 19:34
  Dr. Charlotte Lange PT, DPT: Yeah.
• 19:35
  Dr. Charlotte Lange PT, DPT: No, you're fine.
• 19:36
  Dr. Charlotte Lange PT, DPT: Um, so I'm, I'm looking at all of these things, and I, like Danielle said, I'm connecting what is happening in your shoulder to what is happening in your abdomen to what is happening in your pelvic floor.
• 19:45
  Dr. Charlotte Lange PT, DPT: Um, and we're loading, we're strengthening.
• 19:48
  Dr. Charlotte Lange PT, DPT: We did so many mobility things.
• 19:50
  Dr. Charlotte Lange PT, DPT: Um, Danielle really struggled with internal rotation of her hips, and we did so many I did manual mobilizations.
• 19:58
  Dr. Charlotte Lange PT, DPT: I gave her all these different exercises.
• 20:00
  Dr. Charlotte Lange PT, DPT: We would always do, um...
• 20:01
  Dr. Charlotte Lange PT, DPT: I want you all to sit there and think about SpongeBob, and our test retest would be the bring it around town.
• 20:08
  Dr. Charlotte Lange PT, DPT: And Danielle gets up off the table and, you know, she brings it around town and, um, that was how we assessed how we were doing.
• 20:16
  Dr. Danielle Hofer: Yeah
• 20:18
  Dr. Charlotte Lange PT, DPT: so it's not all serious.
• 20:18
  Dr. Charlotte Lange PT, DPT: We li- I like to have a lot of fun within my sessions too.
• 20:22
  Dr. Danielle Hofer: Yes
• 20:23
  Dr. Charlotte Lange PT, DPT: but it's my goal is your goal.
• 20:26
  Dr. Charlotte Lange PT, DPT: So if you want to run, if you want to lift, we're gonna make that happen, and I'm going to have you continue to move in some capacity in, in that interim period.
• 20:35
  Dr. Charlotte Lange PT, DPT: You may not be running.
• 20:36
  Dr. Charlotte Lange PT, DPT: You may be walking briskly.
• 20:38
  Dr. Charlotte Lange PT, DPT: We may have to load you to be able to do that appropriately, but I want to keep you moving.
• 20:43
  Dr. Charlotte Lange PT, DPT: And there are PTs out there that don't.
• 20:45
  Dr. Charlotte Lange PT, DPT: There are PTs that say, "Don't do anything."
• 20:47
  Dr. Charlotte Lange PT, DPT: There are PTs out there that will only give you exercise, and they're not working on the scar tissue and just the general tension and all of that.
• 20:55
  Dr. Charlotte Lange PT, DPT: I mean, I'm sometimes working in people's necks to work on, to improve their pelvic floor, like working on vagus nerve and following that all the way down the body, working on your diaphragm.
• 21:04
  Dr. Charlotte Lange PT, DPT: Everything is connected.
• 21:07
  Dr. Charlotte Lange PT, DPT: Um, and again, that's where Danielle alluded to this, like insurance practices can be very limited on what, what they can do and how they can do things, and you have to play a game.
• 21:16
  Dr. Charlotte Lange PT, DPT: And, um, this isn't the soapbox for insurance versus cash, but what I can do is I, I can treat what I find.
• 21:23
  Dr. Charlotte Lange PT, DPT: Um, I mean, I had a guy in here earlier today, he's not pelvic floor, he's orthopedics, but, you know, we're doing his back, and then I, you know, got the side of his back, and I was like, "Well,
• 21:31
  Dr. Charlotte Lange PT, DPT: your ribs are really stiff."
• 21:32
  Dr. Charlotte Lange PT, DPT: And then we moved to his tricep and his bicep and we're, we're doing all of these things.
• 21:37
  Dr. Charlotte Lange PT, DPT: My husband was in here earlier, and I needled, like, his whole shoulder region, um-
• 21:41
  Dr. Danielle Hofer: Yep
• 21:44
  Dr. Charlotte Lange PT, DPT: And the way that his back moved better after that, and his motion was better, and his neck was feeling better.
• 21:50
  Dr. Charlotte Lange PT, DPT: Um, there is so much to be said about manual, manual therapy.
• 21:54
  Dr. Charlotte Lange PT, DPT: I mean, that's all I did with the both of them today.
• 21:55
  Dr. Charlotte Lange PT, DPT: I talked through exercises, one of them.
• 21:57
  Dr. Charlotte Lange PT, DPT: Um, depending on your exercise...
• 22:01
  Dr. Charlotte Lange PT, DPT: What is the word here?
• 22:03
  Dr. Charlotte Lange PT, DPT: Experience, knowledge.
• 22:05
  Dr. Charlotte Lange PT, DPT: Um, I will go through exercise with people in session, um, especially if I wanna make sure like, "Okay, how are you using your core?
• 22:12
  Dr. Charlotte Lange PT, DPT: What are you doing?"
• 22:13
  Dr. Charlotte Lange PT, DPT: There's other people that, like the one I work out with, well, my husband and,
• 22:18
  Dr. Danielle Hofer: Yeah
• 22:18
  Dr. Charlotte Lange PT, DPT: other friend, but I see them move in real life all the time, so I kind of know what, what they do, and we can talk through like, "All right, do this exercise, do this exercise.
• 22:26
  Dr. Charlotte Lange PT, DPT: Focus on this when you do this."
• 22:28
  Dr. Charlotte Lange PT, DPT: And then when I see them at the gym I'm like, "Well, try this instead," or, "Do this."
• 22:31
  Dr. Charlotte Lange PT, DPT: Um, I really try to meet you where you at.
• 22:33
  Dr. Charlotte Lange PT, DPT: I...
• 22:34
  Dr. Charlotte Lange PT, DPT: You need to do exercise.
• 22:35
  Dr. Charlotte Lange PT, DPT: You need to move your body.
• 22:36
  Dr. Charlotte Lange PT, DPT: Um, and we're always doing something, but sometimes that is sitting on, sitting on the floor with your feet up the wall and breathing.
• 22:42
  Dr. Charlotte Lange PT, DPT: And that
• 22:43
  Dr. Danielle Hofer: That
• 22:44
  Dr. Charlotte Lange PT, DPT: is usually the number one piece of information I give people.
• 22:47
  Dr. Danielle Hofer: Yes.
• 22:48
  Dr. Charlotte Lange PT, DPT: scan your body.
• 22:48
  Dr. Charlotte Lange PT, DPT: Are you squeezing your butt cheeks during the day?
• 22:50
  Dr. Charlotte Lange PT, DPT: Are you clenching your jaw?
• 22:51
  Dr. Charlotte Lange PT, DPT: Are your shoulders up?
• 22:52
  Dr. Charlotte Lange PT, DPT: Relax that.
• 22:54
  Dr. Charlotte Lange PT, DPT: And that is an exercise, whether you think it is or not.
• 22:56
  Dr. Charlotte Lange PT, DPT: Your br- that is an exercise for your brain, and your brain has to be just as exercised as your body
• 23:01
  Dr. Danielle Hofer: Yeah, and then reconnected to how the body moves.
• 23:05
  Dr. Danielle Hofer: And, I think one of the, one of the biggest things that I still...
• 23:08
  Dr. Danielle Hofer: Like, there are multiple things that I still do every single day or at least four days a week, um, that I still do the exercise, I still do the mobility stuff that you have given me over the years
• 23:17
  Dr. Danielle Hofer: because I'm like, "It works."
• 23:18
  Dr. Danielle Hofer: Um, but one of the things that was so pivotal was throwing my legs on the air with my butt against a wall and breathing.
• 23:25
  Dr. Danielle Hofer: Like, when I've had a very stressful day, I'm just like, Like, we take it for granted that we breathe, but if you're breathing and your back is arched and your ribcage is pointed forward and your butt is, like,
• 23:37
  Dr. Danielle Hofer: like twerking backwards and you're actually not in alignment over the top of your hips with your ribcage, you are actually going to cause me a slow reco- like, slow work with the foundational medicine that I do.
• 23:49
  Dr. Danielle Hofer: Um, and that is, like, that is a piece.
• 23:51
  Dr. Danielle Hofer: Like, we have to relearn how to breathe.
• 23:53
  Dr. Danielle Hofer: If you cannot breathe and feel like you can feel it in your...
• 23:55
  Dr. Danielle Hofer: I always say it feels like you're breathing into your butthole.
• 23:58
  Dr. Danielle Hofer: it's like it is, and that's why I say this, and I know it's very crass for some of you, and I'm sorry.
• 24:02
  Dr. Danielle Hofer: Um, but it's the truth.
• 24:03
  Dr. Danielle Hofer: It's like you need to be bre- your breath needs to be in alignment and going straight down.
• 24:07
  Dr. Danielle Hofer: When you inhale, it's like you're...
• 24:09
  Dr. Danielle Hofer: It's almost like you're pushing a fart out with your breath.
• 24:11
  Dr. Danielle Hofer: And then, like, when you inhale, it just kinda goes, whoo, it just kinda, like, comes up.
• 24:16
  Dr. Danielle Hofer: And, like, every single day, if that's not happening...
• 24:18
  Dr. Danielle Hofer: I was in the room when, uh, Charlotte's husband was getting needled and whatever, and, like, he was doing some kinda stretch, and, like, I felt my pelvic floor, like, tighten when he was doing something.
• 24:27
  Dr. Danielle Hofer: I'm like, "Ooh, I need to breathe."
• 24:28
  Dr. Danielle Hofer: Like, I had to get myself back into alignment because I'm so aware now.
• 24:31
  Dr. Danielle Hofer: Like she said, like, the brain being connected to the body is, like, a whole...
• 24:35
  Dr. Danielle Hofer: Like, it's part of all of this.
• 24:36
  Dr. Danielle Hofer: You have to exercise and practice it, or we don't think about it.
• 24:41
  Dr. Danielle Hofer: And
• 24:41
  Dr. Charlotte Lange PT, DPT: And awareness is, like, such a big factor to life in general, but especially pelvic floor therapy because we d- generally don't have awareness in general.
• 24:49
  Dr. Charlotte Lange PT, DPT: Um, so I'm trying to bring awareness to that, and my goal is not to change who you are.
• 24:53
  Dr. Charlotte Lange PT, DPT: I want to change your awareness of who you are and how your body responds to different stressors because those stressors will cause pelvic floor tension, will cause dysfunction, will cause breath issues if you're breathing up here instead of
• 25:04
  Dr. Charlotte Lange PT, DPT: in your diaphragm and your pelvic floor.
• 25:06
  Dr. Charlotte Lange PT, DPT: And again, that's just where the awareness comes.
• 25:08
  Dr. Charlotte Lange PT, DPT: I don't expect you to be perfect.
• 25:10
  Dr. Charlotte Lange PT, DPT: I don't expect every breath to be into your pelvic floor and into the diaphragm every day because mine sure h- sure as heck are not.
• 25:17
  Dr. Charlotte Lange PT, DPT: The number of times I have to unclench my butt cheeks in the day is insane and this is my whole job.
• 25:22
  Dr. Danielle Hofer: Yep
• 25:22
  Dr. Charlotte Lange PT, DPT: Um, but that awareness component is j- is, is just k- where it starts
• 25:27
  Dr. Danielle Hofer: Yeah.
• 25:28
  Dr. Danielle Hofer: And then awareness is like the same here, is like I want you to be aware that, that any twinge, that any, um, any sneeze, any...
• 25:36
  Dr. Danielle Hofer: I want you questioning things.
• 25:37
  Dr. Danielle Hofer: Not obsessively, like, right?
• 25:38
  Dr. Danielle Hofer: Like Charlotte was talking about, like we're not obsessive about having to be perfect in everything that we do, but I want you thinking about where am I like, "Ooh, it made me like differently," or, "Ooh, needed to go
• 25:50
  Dr. Danielle Hofer: to the bathroom like immediately after I ate that thing," or, "Ooh, I'm a little bloated," or, "Ooh, like this is..."
• 25:56
  Dr. Danielle Hofer: I'm, I'm trying to like...
• 25:57
  Dr. Danielle Hofer: I want you to start paying attention 'cause it's trends, the more that we are aware of our trends and our typical trends, the more that we can combat that.
• 26:07
  Dr. Danielle Hofer: And that's part of this, the, the rewiring of the brain.
• 26:10
  Dr. Danielle Hofer: I'm so glad you brought that up, but it's like it's part of that rewiring of the brain and that foundational medicine and the type of PT that like Charlotte does, it, it coexists together because, uh, for example, we
• 26:23
  Dr. Danielle Hofer: have a shared patient she has osteoporosis, and she was freshly with it, and she came to me first.
• 26:30
  Dr. Danielle Hofer: I said to her, I'm like, "Cool.
• 26:32
  Dr. Danielle Hofer: We can get your bones to remodel.
• 26:33
  Dr. Danielle Hofer: We can get this to go.
• 26:34
  Dr. Danielle Hofer: Like, it's not that big of a deal for us.
• 26:36
  Dr. Danielle Hofer: It's just gonna take some consistent work," I said, "but what I'm gonna need you to do," as I said, "I need you to build a posterior chain."
• 26:41
  Dr. Danielle Hofer: A posterior chain is just the muscles on the backside of your body.
• 26:44
  Dr. Danielle Hofer: At age 40, we start to lose about 10% of our access to the posterior chain.
• 26:49
  Dr. Danielle Hofer: It's when people start plopping on the toilet.
• 26:52
  Dr. Danielle Hofer: It's when people start plopping on the couch, and people can't sit down, straight down, and get back up again.
• 26:57
  Dr. Danielle Hofer: It typically starts at about 40.
• 26:59
  Dr. Danielle Hofer: Sometimes a little sooner for dudes.
• 27:01
  Dr. Danielle Hofer: I'm not sure why it does that with dudes, but whatever.
• 27:04
  Dr. Danielle Hofer: Um, especially b- but if we're not paying attention, we already know that if the posterior chain is not engaged and you're plopping on things, that you're not having the opportunity to remodel bones.
• 27:14
  Dr. Danielle Hofer: You're not getting enough nutrition.
• 27:15
  Dr. Danielle Hofer: You're actually pulling proteins and nutritions out of your bones to take the place of what your muscles are supposed to be doing.
• 27:22
  Dr. Danielle Hofer: You're running on all of that, and then you wonder why we have immune system problems.
• 27:27
  Dr. Danielle Hofer: that a certain population, the people with osteoporosis, are more susceptible to viruses and autoimmune disorders and all of these things because they're, the immune system is actually built inside the bones.
• 27:37
  Dr. Danielle Hofer: It...
• 27:38
  Dr. Danielle Hofer: Everyone thinks it's all in the gut, and yeah, there's some im- immune stuff in the gut, but it s- actually starts in the bones.
• 27:42
  Dr. Danielle Hofer: And so what I needed her to do is to get in with Charlotte to start with that piece of remodeling and getting her to actually move functionally so that she can start adding muscle tissue.
• 27:55
  Dr. Danielle Hofer: And I think it was like after a month and a half or maybe a month of working with both of us, she came in and she's like, "I'm losing weight and I'm feeling great," but she's like, "I'm so
• 28:03
  Dr. Danielle Hofer: ravenously hungry."
• 28:04
  Dr. Danielle Hofer: I'm like, "Yay!
• 28:05
  Dr. Danielle Hofer: We're making progress because that means that you're actually n- you're actually absorbing all the nutrients from your food, and it's telling me that you're actually building tissues on your body again.
• 28:14
  Dr. Charlotte Lange PT, DPT: that have more energy demand
• 28:16
  Dr. Danielle Hofer: Yes, and it's so exci- I'm sorry, I got like so freaking excited because I'm like, "This is what progress looks like.
• 28:22
  Dr. Danielle Hofer: This is what functional, um, functional medicine or foundational medicine like I do," and then this foundational piece of how hands-on actual physical therapy that is ortho whole body related and thinking about your functional longevity.
• 28:38
  Dr. Danielle Hofer: And I think of longevity as not just living longer.
• 28:40
  Dr. Danielle Hofer: I think of longevity as climbing mountains when I'm 80.
• 28:43
  Dr. Danielle Hofer: I think of being 90 years old and still speaking on stage and still lifting as heavy as I can.
• 28:49
  Dr. Danielle Hofer: I don't f- want to be a frail older woman.
• 28:54
  Dr. Danielle Hofer: And if, if there's anything I can do to do that, I will be doing it, and one of those things is making sure that I don't get fascial restrictions that are causing me to be like, "Ooh, I'm feeling
• 29:03
  Dr. Danielle Hofer: a little something in my knee when I go up the stairs."
• 29:05
  Dr. Danielle Hofer: And then
• 29:05
  Dr. Charlotte Lange PT, DPT: Or you know those old ladies that are hunched over, or my grandma was one.
• 29:09
  Dr. Charlotte Lange PT, DPT: She had frozen shoulder bilaterally.
• 29:11
  Dr. Charlotte Lange PT, DPT: She couldn't reach overhead, and she was already short.
• 29:14
  Dr. Charlotte Lange PT, DPT: She was like 4'11".
• 29:15
  Dr. Charlotte Lange PT, DPT: Poor girl already couldn't reach the second shelf in the cabinet.
• 29:17
  Dr. Danielle Hofer: Yep
• 29:19
  Dr. Charlotte Lange PT, DPT: and if you manage those things when you're younger and take care of your body, you're going to have a better quality of life as you age, and that's where I come in is I...
• 29:28
  Dr. Danielle Hofer: Yeah
• 29:29
  Dr. Charlotte Lange PT, DPT: We can manage the acute issue.
• 29:30
  Dr. Charlotte Lange PT, DPT: We can manage the chronic issue.
• 29:32
  Dr. Charlotte Lange PT, DPT: I have several people, the two guys that I alluded to this morning are bo- well, one of, again, one of them is my husband.
• 29:37
  Dr. Charlotte Lange PT, DPT: He's a chron- he's a lifer.
• 29:38
  Dr. Charlotte Lange PT, DPT: But, um, they both are maintenance.
• 29:42
  Dr. Charlotte Lange PT, DPT: I, I maintain their bodies at this point so that they can continue to do what they love and build strength and move their bodies.
• 29:49
  Dr. Charlotte Lange PT, DPT: Um, the one, um, we treat something different almost every time he's in, which I look as, look at as a win.
• 29:57
  Dr. Charlotte Lange PT, DPT: He's not chronically having the same issue every single month.
• 30:00
  Dr. Charlotte Lange PT, DPT: We do his elbow, we do his knee, we do his back, we've done his neck.
• 30:03
  Dr. Charlotte Lange PT, DPT: Um, I think I've done his foot at one point.
• 30:06
  Dr. Charlotte Lange PT, DPT: Like, we, we treat a little bit of everything, um, because he wants to maintain his body.
• 30:11
  Dr. Charlotte Lange PT, DPT: You only get one.
• 30:12
  Dr. Charlotte Lange PT, DPT: You can replace joints.
• 30:14
  Dr. Charlotte Lange PT, DPT: That gets you some time, but you build scar tissue.
• 30:17
  Dr. Charlotte Lange PT, DPT: You're nothing, nothing is ever the same once you've had surgery.
• 30:20
  Dr. Charlotte Lange PT, DPT: Anatomically, things are different.
• 30:22
  Dr. Danielle Hofer: Yep
• 30:22
  Dr. Charlotte Lange PT, DPT: if we can avoid that and we can prolong that, that is, that is the goal.
• 30:26
  Dr. Charlotte Lange PT, DPT: And my goal, my goal is to help you meet your goals
• 30:30
  Dr. Danielle Hofer: Yeah, and that's, and that's, I think something that you mentioned maintenance.
• 30:36
  Dr. Danielle Hofer: Um, PT is for life.
• 30:39
  Dr. Danielle Hofer: proper PT is for life.
• 30:41
  Dr. Danielle Hofer: It's not six to eight weeks.
• 30:42
  Dr. Danielle Hofer: You're not better.
• 30:44
  Dr. Danielle Hofer: I think what really annoys the ever-living snot out of me is when someone has surgery, and they're like, "I got released from PT."
• 30:49
  Dr. Danielle Hofer: I'm like, "Oh, cool.
• 30:50
  Dr. Danielle Hofer: What is your range?"
• 30:51
  Dr. Danielle Hofer: "Well, I made it to, like, n-" whatever, whatever the degree is, and I'm like, "Can you go further?"
• 30:55
  Dr. Danielle Hofer: no."
• 30:56
  Dr. Danielle Hofer: And I'm like, you need some more support.
• 30:59
  Dr. Danielle Hofer: Like, that's not okay.
• 31:00
  Dr. Danielle Hofer: Like, going back to what you were before you were in pain is actually not, like, not a good assessment.
• 31:07
  Dr. Charlotte Lange PT, DPT: Mm-hmm.
• 31:08
  Dr. Danielle Hofer: Like, that is not fair to you, and they're actually restricting you on how well you can function and operate, and I do believe I'm not speaking for Charlotte by any means, but I do believe that the insurance companies
• 31:18
  Dr. Danielle Hofer: are vested in keeping you just healthy enough that they know that you're gonna be back and c- and be able to make them more money.
• 31:26
  Dr. Danielle Hofer: I really do believe that.
• 31:27
  Dr. Danielle Hofer: I don't believe that physicians go into their, into, um, into their field and, and are money hu- money hungry because, uh, they would not go into the field to be money hungry.
• 31:37
  Dr. Danielle Hofer: I really think that they wanna make a change, and they're, like, nerdy and nerdy, not like we do over the body, and I think that that's a thing.
• 31:43
  Dr. Danielle Hofer: But we have a system, in my opinion, that is controlling just how healthy you can get physically with your movement and your function of, of your physical structure of your body and chemically and structurally of your actual organs
• 31:59
  Dr. Danielle Hofer: and the way that they function.
• 32:01
  Dr. Danielle Hofer: And so there's always this piece of maintenance.
• 32:04
  Dr. Danielle Hofer: Like, I wanna talk about how Charlotte got me to a point where she was like, "I really think you need to go and get injections now."
• 32:10
  Dr. Danielle Hofer: And so there's this beautiful doctor.
• 32:13
  Dr. Danielle Hofer: I'm just gonna s- I'm just gonna say her name 'cause I don't know.
• 32:15
  Dr. Danielle Hofer: Should I?
• 32:15
  Dr. Danielle Hofer: Should I not?
• 32:16
  Dr. Danielle Hofer: I don't know
• 32:17
  Dr. Charlotte Lange PT, DPT: I don't know.
• 32:17
  Dr. Charlotte Lange PT, DPT: She doesn't treat in the state, so,
• 32:19
  Dr. Danielle Hofer: That's
• 32:19
  Dr. Charlotte Lange PT, DPT: or do this type of work anymore right now
• 32:22
  Dr. Danielle Hofer: doesn't...
• 32:22
  Dr. Danielle Hofer: Okay, so this doctor that, that practiced a few, I don't know, like, what, 40 minutes down south of me, and, um, I would go to her every week, and she was injecting me with, um, dextrose and lidocaine.
• 32:33
  Dr. Danielle Hofer: the idea behind dextrose as a pain...
• 32:36
  Dr. Danielle Hofer: And I was not getting pain management, like what you would think of pain management.
• 32:39
  Dr. Danielle Hofer: Um, the idea behind dextrose with the lidocaine is that
• 32:42
  Dr. Charlotte Lange PT, DPT: And this is, this is called a trigger point injection
• 32:45
  Dr. Danielle Hofer: Okay,
• 32:45
  Dr. Charlotte Lange PT, DPT: for those of you that are unfamiliar or wanting to go to your doctor to request something
• 32:50
  Dr. Danielle Hofer: Yes.
• 32:50
  Dr. Danielle Hofer: Um, so okay, trigger point injection, and what she would do is she would actually do them intravaginally, and so she would take a What is that tube thing called?
• 33:03
  Dr. Danielle Hofer: Okay, there was this tube thing that this very long needle would sit, like sit
• 33:07
  Dr. Charlotte Lange PT, DPT: Kind of like a guide tube
• 33:08
  Dr. Danielle Hofer: yes, it was like a guide tube.
• 33:09
  Dr. Danielle Hofer: And there was actually a name that she would be like, "Okay."
• 33:11
  Dr. Danielle Hofer: Like, she would just press, that I was able to tell her where I wanted the injection.
• 33:16
  Dr. Danielle Hofer: So she would just like, of all, she would examine and make sure, like, the area, so she was not going in blind, right?
• 33:22
  Dr. Danielle Hofer: But she would start pressing.
• 33:23
  Dr. Danielle Hofer: She's like, "There?"
• 33:23
  Dr. Danielle Hofer: And I'm like, "No, down a little bit more."
• 33:25
  Dr. Danielle Hofer: And I'd be, "Right there.
• 33:26
  Dr. Danielle Hofer: It feels like a knot.
• 33:27
  Dr. Danielle Hofer: It feels like a knot in your shoulder or a knot in your arm."
• 33:29
  Dr. Danielle Hofer: Like, whatever, and so she would inject.
• 33:31
  Dr. Danielle Hofer: And the idea behind the dextrose is giving energy to those cells right there locally and allowing that sugar, the sh- the pure sugar, which everyone's so scared of sugar, right?
• 33:43
  Dr. Danielle Hofer: Like, the pure dextrose would give energy to those cells that are in that area to then bring some healing nutrients and all of that to the area, and I'm telling you, like, it helped break up my scar...
• 33:53
  Dr. Danielle Hofer: I still have a lot of scar tissue, don't get me wrong, but it was enough to kinda help.
• 33:57
  Dr. Danielle Hofer: And before she moved, I would probably still be seeing her, like, once a month or once every quarter or something.
• 34:01
  Dr. Danielle Hofer: But it was enough to help break up that scar tissue and actually bring movement back to that area.
• 34:07
  Dr. Charlotte Lange PT, DPT: You probably also benefited because it's a needle.
• 34:10
  Dr. Danielle Hofer: yes, I...
• 34:11
  Dr. Charlotte Lange PT, DPT: Because the needle, it's s-
• 34:13
  Dr. Danielle Hofer: do you wanna go here?
• 34:14
  Dr. Danielle Hofer: Like, about dry needling in, like, internally?
• 34:17
  Dr. Charlotte Lange PT, DPT: you have more to say about that, about your injections with her?
• 34:20
  Dr. Danielle Hofer: this piece of...
• 34:22
  Dr. Danielle Hofer: Okay, so that was, we were talking about maintenance, and for me, that was where I was on, ooh, on my next level of maintenance.
• 34:28
  Dr. Danielle Hofer: And I think that we think maintenance just means, like, we associate it with a dieting protocol.
• 34:33
  Dr. Danielle Hofer: Like, "Oh, I'm on ma- maintenance.
• 34:35
  Dr. Danielle Hofer: These are my macros, blah, blah, blah."
• 34:37
  Dr. Danielle Hofer: Or maintenance with, like, the gym.
• 34:38
  Dr. Danielle Hofer: Like, "I'm just gonna lift.
• 34:39
  Dr. Danielle Hofer: Like, this is just kinda my working zone of, of weights."
• 34:43
  Dr. Danielle Hofer: Or we look at maintenance of, like, "Well, I'm not dying anymore," you know, and we just kinda move on.
• 34:48
  Dr. Danielle Hofer: But maintenance is active.
• 34:49
  Dr. Danielle Hofer: Maintenance is actively being aware and preparing and going to the next levels, and I'll introduce that, what I want, uh, Charlotte to talk about next.
• 34:58
  Dr. Danielle Hofer: But, um, I, I love dry needling.
• 35:01
  Dr. Danielle Hofer: I have a love-hate relationship with it.
• 35:03
  Dr. Danielle Hofer: It is amazing, and I will be breathing really heavy.
• 35:07
  Dr. Danielle Hofer: Um, but I love it because when I'm done, it's like I've had a deep tissue massage.
• 35:15
  Dr. Danielle Hofer: I...
• 35:15
  Dr. Danielle Hofer: Like, an itch I couldn't scratch myself.
• 35:17
  Dr. Danielle Hofer: Like, it, it finally got to the right spot, and it was that, I don't know, I don't even know how to describe it, but it, it's a hurt so good.
• 35:26
  Dr. Danielle Hofer: And I remember we had, we've had tons and tons of needles in me at, at one time, and we've had fun.
• 35:30
  Dr. Danielle Hofer: Uh, we have a lot of fun.
• 35:32
  Dr. Danielle Hofer: I wanna talk to you real quick about this, though.
• 35:35
  Dr. Danielle Hofer: If you're someone that listens to me and have autoimmune disorders, and, um, you inflame fast, dry needling will cause you to be very tired, typically within 30 minutes of leaving the office.
• 35:48
  Dr. Danielle Hofer: And unless you've been doing it for a hot minute, like, after about, I don't know, three weeks of doing dry needling once a week, I'm okay.
• 35:55
  Dr. Danielle Hofer: But it's that first three weeks of a new system of bringing that inflammation, 'cause inflammation's healing, but it can actually bring you down and make you take a nap.
• 36:03
  Dr. Danielle Hofer: Go take the nap and then go do what you gotta do.
• 36:04
  Dr. Danielle Hofer: Like, actually schedule time to take that nap because that's the time for your body to heal.
• 36:08
  Dr. Danielle Hofer: So I just wanted to introduce that.
• 36:09
  Dr. Danielle Hofer: But speaking of dry needling, I am still, like, actively reaching goals.
• 36:14
  Dr. Danielle Hofer: I'm setting goals for myself that are totally attainable, but it requires me to do things, and it requires me to lift heavy.
• 36:20
  Dr. Danielle Hofer: It requires me to move my body more.
• 36:21
  Dr. Danielle Hofer: It requires me to, um, do new things with my body, and I'm always wanting to challenge it, right?
• 36:26
  Dr. Danielle Hofer: I'm grateful that I can challenge my body.
• 36:28
  Dr. Danielle Hofer: thus, that being said, I still get knots in random spots, and I probably need to have this done again.
• 36:35
  Dr. Danielle Hofer: Um, but I still have trouble with my left leg internal rotation.
• 36:39
  Dr. Danielle Hofer: My right leg is much better, but my left leg, because of all that scar tissue and everything, um, it, it, whatever.
• 36:45
  Dr. Danielle Hofer: The only thing that seems to work is internal work, like internal manual work, but also internal dry needling.
• 36:51
  Dr. Danielle Hofer: So do you wanna talk about that?
• 36:53
  Dr. Charlotte Lange PT, DPT: Yeah, so dry needling is a very small needle.
• 36:58
  Dr. Charlotte Lange PT, DPT: You're not injecting anything, hence the name dry.
• 37:01
  Dr. Charlotte Lange PT, DPT: Um, and it's not hollow, it's solid.
• 37:02
  Dr. Charlotte Lange PT, DPT: Um, same needle that you would use for acupuncture, but we're needling directly into muscle that is tight, tender, achy, dysfunctional, um, scar tissue.
• 37:12
  Dr. Charlotte Lange PT, DPT: You name it, we can do it.
• 37:13
  Dr. Charlotte Lange PT, DPT: Um, you can needle anywhere in the whole body.
• 37:16
  Dr. Charlotte Lange PT, DPT: I've gone from base of skull, I've done jaws, I've done shoulders, I've done feet, I've done pelvic floors.
• 37:21
  Dr. Charlotte Lange PT, DPT: Um, what we are doing with this is, as Danielle said, like you have a itch and you can't scratch it, and that's what needling does.
• 37:29
  Dr. Charlotte Lange PT, DPT: It penetrates through all the layers of tissue that are superficial to that, to the actual problem area.
• 37:35
  Dr. Charlotte Lange PT, DPT: Um, there are some semi-standardized protocols that I follow sometimes.
• 37:40
  Dr. Charlotte Lange PT, DPT: Um, and then there's trigger point dry needling, and I kind of blend the two.
• 37:43
  Dr. Charlotte Lange PT, DPT: So we're finding the spot and we're needling that, or we're needling, you know, this series of things that will help this bigger problem.
• 37:50
  Dr. Charlotte Lange PT, DPT: Um, arthritis is one of those that has a s- a semi-standardized protocol.
• 37:54
  Dr. Charlotte Lange PT, DPT: Um, but you're bringing microtrauma to the area with the needle, so you're eliciting that inflammatory response that brings blood flow, that um, blood has all of your healing nutrients.
• 38:05
  Dr. Charlotte Lange PT, DPT: So you're restarting that inflammatory process, that healing process, as well as releasing the tissue tension.
• 38:11
  Dr. Charlotte Lange PT, DPT: Um, so you do get like a quick spasm or twitch.
• 38:14
  Dr. Charlotte Lange PT, DPT: Oftentimes I call it the money shot.
• 38:16
  Dr. Charlotte Lange PT, DPT: It's not required, but it is like, it's good.
• 38:19
  Dr. Charlotte Lange PT, DPT: Um, some people yell, some people moan, some people are silent.
• 38:25
  Dr. Charlotte Lange PT, DPT: Um, some people smack the table.
• 38:27
  Dr. Charlotte Lange PT, DPT: Some people are, you know, just chill.
• 38:28
  Dr. Charlotte Lange PT, DPT: But when you find that spot, you find that spot and you know.
• 38:32
  Dr. Charlotte Lange PT, DPT: Um, there are states where PTs cannot dry needle, um, so look into your practice act, see who can do it.
• 38:40
  Dr. Charlotte Lange PT, DPT: Um, there's different people to be trained through as well, and I've definitely noticed not all PTs needle the same.
• 38:49
  Dr. Charlotte Lange PT, DPT: Um, even those that are trained similarly don't needle the same.
• 38:54
  Dr. Charlotte Lange PT, DPT: So it, it can be hard to find somebody that's gonna needle the way you need it, but it is so, so effective.
• 39:00
  Dr. Charlotte Lange PT, DPT: My...
• 39:01
  Dr. Charlotte Lange PT, DPT: The way in which I treat has changed significantly with needling.
• 39:04
  Dr. Charlotte Lange PT, DPT: Um, the way in which my body recovers has changed significantly with needling.
• 39:07
  Dr. Charlotte Lange PT, DPT: It is just so dang good.
• 39:11
  Dr. Charlotte Lange PT, DPT: Um, we've needled, you know, Danielle's abdomen for scar tissue there.
• 39:15
  Dr. Charlotte Lange PT, DPT: We've needled, oh my gosh-
• 39:17
  Dr. Danielle Hofer: That's a trauma response that I completely forgot about.
• 39:20
  Dr. Danielle Hofer: Sorry
• 39:21
  Dr. Charlotte Lange PT, DPT: Yeah, she loved that.
• 39:22
  Dr. Charlotte Lange PT, DPT: Um, but, um, but gosh, we've done her hamstring, we've done her glutes, we've done along her tailbone, we've done her obturator internus externally.
• 39:31
  Dr. Charlotte Lange PT, DPT: So for those of you looking, that's this muscle here, which is the same as this muscle here that comes out and attaches to...
• 39:37
  Dr. Charlotte Lange PT, DPT: Let me get on camera.
• 39:38
  Dr. Charlotte Lange PT, DPT: Um, to your greater trochanter and your femur.
• 39:43
  Dr. Charlotte Lange PT, DPT: Um- I mean, we did your calf.
• 39:48
  Dr. Charlotte Lange PT, DPT: Like, you were having all that, like, calf and foot stuff, and, like, of follow, following a nerve distribution.
• 39:53
  Dr. Charlotte Lange PT, DPT: Um, but the relief that it provides is unlike anything else.
• 39:58
  Dr. Charlotte Lange PT, DPT: And there's people that don't like needles and don't ever wanna be needled, and that's okay.
• 40:01
  Dr. Charlotte Lange PT, DPT: It's gonna take us longer to get there.
• 40:02
  Dr. Charlotte Lange PT, DPT: We can get there, it's just gonna take a lot longer.
• 40:05
  Dr. Charlotte Lange PT, DPT: Um, but that's, that's a lot of the, a lot of treatment, a lot of maintenance.
• 40:10
  Dr. Charlotte Lange PT, DPT: It's not what we do every session, um, but I use that a lot for maintenance.
• 40:14
  Dr. Charlotte Lange PT, DPT: Um, and in addition to maintenance that Danielle and I have talked about, I referred Danielle to another PT.
• 40:20
  Dr. Charlotte Lange PT, DPT: I was like, we...
• 40:22
  Dr. Charlotte Lange PT, DPT: A, a good provider, whether they're a PT, whether they're a physician, is going to recognize what their limits are and send you to somebody who knows, not more, but different.
• 40:33
  Dr. Danielle Hofer: Yeah
• 40:34
  Dr. Charlotte Lange PT, DPT: Um, and Danielle has continued to see her as well.
• 40:38
  Dr. Charlotte Lange PT, DPT: Like, it is so crucial to find your team and your tribe that can work together to meet the patient's ultimate goal
• 40:46
  Dr. Danielle Hofer: Yeah, and I think that that's, like, we need to know, um, what I don't like...
• 40:51
  Dr. Danielle Hofer: I, I want to see maintenance and, and, and I know you do too.
• 40:54
  Dr. Danielle Hofer: I wanna see maintenance where there's still growth.
• 40:56
  Dr. Charlotte Lange PT, DPT: Hmm?
• 40:57
  Dr. Danielle Hofer: I wanna see that ma- 'cause maintenance isn't, it's, it's maintaining your progress while growing And I, like, I have people, and I know that y- uh, I'm still with you, obviously, after five years.
• 41:09
  Dr. Danielle Hofer: Um, but I have people that have been with me for, I think, going on eight years, nine years now, eight or nine years, um, that are still with me, and they're in maintenance, and some of them still wanna
• 41:19
  Dr. Danielle Hofer: see me every single month just because they don't, they...
• 41:23
  Dr. Danielle Hofer: Because there's,
• 41:24
  Dr. Charlotte Lange PT, DPT: They see the value that you provide
• 41:26
  Dr. Danielle Hofer: Yeah, and same with you.
• 41:27
  Dr. Danielle Hofer: Like, you still have people, and we try, we try to put people on maintenance.
• 41:30
  Dr. Danielle Hofer: Like, "Hey, you can come back, like, in so many, like, months or whatever."
• 41:33
  Dr. Danielle Hofer: And, and then they're like, "No, you know what?
• 41:35
  Dr. Danielle Hofer: I just wanna, I just wanna keep going."
• 41:36
  Dr. Danielle Hofer: And you have those people, too, and it's
• 41:37
  Dr. Charlotte Lange PT, DPT: Oh, yeah
• 41:38
  Dr. Danielle Hofer: it's...
• 41:38
  Dr. Danielle Hofer: But it's like those people know and see the value of what maintenance...
• 41:42
  Dr. Danielle Hofer: And they know what it feels like
• 41:44
  Dr. Charlotte Lange PT, DPT: to feel good
• 41:46
  Dr. Danielle Hofer: to grow and, yeah, feel good and feel alive.
• 41:48
  Dr. Danielle Hofer: And I think that that's, we've, we as a culture have learned to settle and think that we have to do everything on our own.
• 41:55
  Dr. Danielle Hofer: Um, there's only so much that ChatGPT and Instagram and TikTok Reels can help you with.
• 42:02
  Dr. Danielle Hofer: And Charlotte and I actually had this, like, very candid conversation.
• 42:04
  Dr. Danielle Hofer: I wanted her to, like, help me out in my membership.
• 42:07
  Dr. Danielle Hofer: If you're a part of the Wilderness of Wellness, like, we're, we are pretty much a very robust community.
• 42:12
  Dr. Danielle Hofer: We have nearly everything you need.
• 42:14
  Dr. Danielle Hofer: And then we had this conversation.
• 42:15
  Dr. Danielle Hofer: I'm like, "Really, I don't have PT in there."
• 42:17
  Dr. Danielle Hofer: And I'm like, "How do I get you in here?
• 42:18
  Dr. Danielle Hofer: Like, how do we do this?"
• 42:19
  Dr. Danielle Hofer: And we had this conversation, and Charlotte's like, know if I can do this because I really believe in hands-on."
• 42:24
  Dr. Danielle Hofer: And, and, like, she was like basically calling me out.
• 42:27
  Dr. Danielle Hofer: Like, "You believe it, too.
• 42:28
  Dr. Danielle Hofer: Why are you not doing it, and why are you not recommending it?"
• 42:31
  Dr. Danielle Hofer: I'm like, "Oh, you're right.
• 42:33
  Dr. Danielle Hofer: Like, that's why it doesn't feel right."
• 42:34
  Dr. Danielle Hofer: So Charlotte, can you help us?
• 42:36
  Dr. Danielle Hofer: Like, help our listeners, and we can use this as a resource for our own patients and so forth, or people that we come in contact with.
• 42:42
  Dr. Danielle Hofer: But how can people go onto Google, or how, uh, how would you...
• 42:47
  Dr. Danielle Hofer: What would you want them googling to find someone that is acceptable to you and I?
• 42:52
  Dr. Danielle Hofer: Because Charlotte, to be honest, Charlotte and I have very, very high and specific standards when it comes to our care.
• 42:59
  Dr. Charlotte Lange PT, DPT: Yes
• 43:00
  Dr. Danielle Hofer: w- we are...
• 43:01
  Dr. Danielle Hofer: Like, we will even, like, come in and say, "Hey, this is a good place.
• 43:04
  Dr. Danielle Hofer: This is..."
• 43:05
  Dr. Danielle Hofer: Like, we will actually share, um, referrals because we know that we can talk about that, and we're on the same page with what we expect our patients to be feeling, right?
• 43:14
  Dr. Danielle Hofer: So Charlotte, can you help us out with someone that needs to be seen in person, which please do not...
• 43:19
  Dr. Danielle Hofer: And I do want you to kind of go off on the online PTs.
• 43:22
  Dr. Danielle Hofer: Um, please do, because I don't believe that online physical therapy is going to fix you, and I firmly believe that you need to have someone like Charlotte in your back pocket, um, for this growth and your functional health
• 43:36
  Dr. Danielle Hofer: and your progress forward.
• 43:38
  Dr. Danielle Hofer: So can you talk about how, A, they can find someone like you in their area, um, or how they can come see you in person?
• 43:45
  Dr. Danielle Hofer: Um, and I, I think the law is as long as you treat them here, right?
• 43:48
  Dr. Danielle Hofer: Like, 'cause we do have patients that fly in to see me.
• 43:50
  Dr. Danielle Hofer: Um, so, and she's in my office as well.
• 43:52
  Dr. Danielle Hofer: She's magical in my office.
• 43:54
  Dr. Danielle Hofer: Um, so you could come see me and her at the same time.
• 43:57
  Dr. Danielle Hofer: not the same time, the same day.
• 43:59
  Dr. Danielle Hofer: Um, but also you can, um, like find someone in your area, but I also wanna talk about why online PT does not work
• 44:08
  Dr. Charlotte Lange PT, DPT: Yeah.
• 44:09
  Dr. Charlotte Lange PT, DPT: So let's start with how to find somebody.
• 44:11
  Dr. Charlotte Lange PT, DPT: Um, there are resources out there, and I will get a list of some of these specific websites to Danielle because I cannot name them myself right now.
• 44:21
  Dr. Charlotte Lange PT, DPT: I don't remember them off the top of my head, but there are ways to look up pelvic floor therapists.
• 44:25
  Dr. Charlotte Lange PT, DPT: Um, it's not enough to just look up somebody that does pelvic floor PT.
• 44:29
  Dr. Charlotte Lange PT, DPT: They could have one certification or have taken a online course and had no hands-on manual treatment.
• 44:36
  Dr. Charlotte Lange PT, DPT: Um, so you need to find somebody that cares, um, enough to have advanced themselves in that way.
• 44:41
  Dr. Charlotte Lange PT, DPT: Um, looking at not only what is their educational background and as far as continuing education and that kind of stuff, but what is their practice like?
• 44:52
  Dr. Charlotte Lange PT, DPT: I will say 9 times out of 10, if you are paying cash, you're gonna get better care than if you're going to insurance.
• 44:58
  Dr. Charlotte Lange PT, DPT: Um, your provider can treat the way that they want to treat without the confines of, well, your shoulder hurts, but we need to do something to your hip.
• 45:07
  Dr. Charlotte Lange PT, DPT: Um, and they're gonna be very limited, and there's ways to work around it, but it is not, you know, the best.
• 45:13
  Dr. Charlotte Lange PT, DPT: So cash is oftentimes gonna be your best option.
• 45:17
  Dr. Charlotte Lange PT, DPT: Um- finding somebody that's certified in dry needling, again, they care.
• 45:22
  Dr. Charlotte Lange PT, DPT: They have that different level of expertise and education, but again, there are great PTs out there that they legally cannot needle in their state, um, which is, which is hard, but it can, again, it can be done.
• 45:35
  Dr. Charlotte Lange PT, DPT: They have great outcomes.
• 45:36
  Dr. Danielle Hofer: Yeah
• 45:40
  Dr. Charlotte Lange PT, DPT: There's another one that I'm not sure that they have a, like, resource or not, but I'll, I'll look.
• 45:46
  Dr. Charlotte Lange PT, DPT: I'll, like I said, I'll get websites to Danielle of, like, where you can look things up.
• 45:50
  Dr. Charlotte Lange PT, DPT: Or reach out to me because I have connections across the country, I have connections locally.
• 45:55
  Dr. Charlotte Lange PT, DPT: I can always put something on, like, "Hey, I have somebody looking for this," and there's, you know, people come out of the woodworks to support each other.
• 46:02
  Dr. Charlotte Lange PT, DPT: Um, 'cause again, all we want is patients to have...
• 46:06
  Dr. Charlotte Lange PT, DPT: To meet their goals, to have the outcomes to meet their goals.
• 46:08
  Dr. Charlotte Lange PT, DPT: And whether that's from me or whether that's from another PT or a physician or, you know, a personal trainer.
• 46:15
  Dr. Charlotte Lange PT, DPT: Like, there's personal trainers out there that are better exercise prescription than I am, so I will, I will refer when appropriate.
• 46:21
  Dr. Danielle Hofer: Yep
• 46:23
  Dr. Charlotte Lange PT, DPT: what was the other thing?
• 46:24
  Dr. Danielle Hofer: Um, so that, and I, by the way, I'm gonna put all of Charlotte's information in the show notes for you so you can contact her on Instagram.
• 46:32
  Dr. Danielle Hofer: You c- um, I'll get her website and everything for you there as well.
• 46:35
  Dr. Danielle Hofer: Um, but I also wanted to know how, like, how is it best to contact you or to learn more about you if they wanna come in and be treated by you.
• 46:43
  Dr. Danielle Hofer: Um, what does that look like
• 46:44
  Dr. Charlotte Lange PT, DPT: Oh, and online PTs.
• 46:46
  Dr. Charlotte Lange PT, DPT: That was the other one.
• 46:47
  Dr. Charlotte Lange PT, DPT: Yeah.
• 46:47
  Dr. Danielle Hofer: juicy stuff for last
• 46:49
  Dr. Charlotte Lange PT, DPT: boy.
• 46:49
  Dr. Charlotte Lange PT, DPT: Okay.
• 46:49
  Dr. Charlotte Lange PT, DPT: Um, yeah, so my website is...
• 46:53
  Dr. Charlotte Lange PT, DPT: I don't even think I said this when I introduced myself.
• 46:55
  Dr. Charlotte Lange PT, DPT: I own Inform Physical Therapy and Wellness.
• 46:57
  Dr. Charlotte Lange PT, DPT: I'm in Centerville, Ohio.
• 46:58
  Dr. Charlotte Lange PT, DPT: I share an office space with Danielle.
• 47:00
  Dr. Charlotte Lange PT, DPT: Um, and I treat the way I wanna treat.
• 47:04
  Dr. Charlotte Lange PT, DPT: So,
• 47:05
  Dr. Danielle Hofer: I love
• 47:06
  Dr. Charlotte Lange PT, DPT: simple as that.
• 47:07
  Dr. Danielle Hofer: Yes
• 47:08
  Dr. Charlotte Lange PT, DPT: is informphysicaltherapy.com.
• 47:10
  Dr. Charlotte Lange PT, DPT: Um, my Instagram is inform_physicaltherapy.
• 47:14
  Dr. Charlotte Lange PT, DPT: Um, reach out any one of those.
• 47:16
  Dr. Charlotte Lange PT, DPT: Would love to answer questions, help you find a therapist you need, whatever.
• 47:20
  Dr. Charlotte Lange PT, DPT: Um, online PTs
• 47:23
  Dr. Danielle Hofer: Ooh, I love this.
• 47:24
  Dr. Danielle Hofer: This is a hot button topic
• 47:28
  Dr. Charlotte Lange PT, DPT: I have a lot of thoughts overall because I believe so heavily in hands-on care.
• 47:34
  Dr. Charlotte Lange PT, DPT: I don't like online physical therapy.
• 47:36
  Dr. Charlotte Lange PT, DPT: People can tr- cheat the system, compensate in a way that cannot be picked up on camera.
• 47:43
  Dr. Charlotte Lange PT, DPT: Um, is there a time and a place for it?
• 47:46
  Dr. Charlotte Lange PT, DPT: Sure.
• 47:46
  Dr. Charlotte Lange PT, DPT: Is it a one-off?
• 47:47
  Dr. Charlotte Lange PT, DPT: Is it, you know, your kid is sick and you can't do this, and you just need something, you want coached through something, you need some education?
• 47:54
  Dr. Charlotte Lange PT, DPT: Okay.
• 47:54
  Dr. Charlotte Lange PT, DPT: I, I believe in that.
• 47:56
  Dr. Charlotte Lange PT, DPT: Um, there is a PT that has a online She doesn't call it PT, she calls it, like, training.
• 48:05
  Dr. Charlotte Lange PT, DPT: It's a program.
• 48:05
  Dr. Charlotte Lange PT, DPT: She gives a ton of education behind it.
• 48:07
  Dr. Charlotte Lange PT, DPT: She teaches you how to load.
• 48:09
  Dr. Charlotte Lange PT, DPT: I think she probably has a great program.
• 48:12
  Dr. Charlotte Lange PT, DPT: I would trust that.
• 48:13
  Dr. Charlotte Lange PT, DPT: There's a personal trainer that, um, she's been a coach, she's a trainer, she owns a whole business.
• 48:19
  Dr. Charlotte Lange PT, DPT: She has programming for that.
• 48:20
  Dr. Charlotte Lange PT, DPT: I believe in that.
• 48:21
  Dr. Charlotte Lange PT, DPT: But again, she's not saying she's providing physical therapy.
• 48:23
  Dr. Charlotte Lange PT, DPT: She is teaching you how to load your body with the awareness of what your pelvic floor and orthopedic considerations may be.
• 48:31
  Dr. Charlotte Lange PT, DPT: Um, so she's giving you cues on if you feel this, try this, if you do this, do this, and they're both very good of if you cannot overcome this, you need to go find somebody in person.
• 48:41
  Dr. Charlotte Lange PT, DPT: Because I could have treated Danielle for five years virtually, and we would not be any farther along than we were on the first visit because,
• 48:49
  Dr. Danielle Hofer: be crying
• 48:50
  Dr. Charlotte Lange PT, DPT: yeah, like we-- Her bladder spasms stopped because we released her pelvic floor.
• 48:55
  Dr. Charlotte Lange PT, DPT: Her internal rotation improved because we dry needled her, and I used a hip belt to mobilize her hip, her hip.
• 49:00
  Dr. Charlotte Lange PT, DPT: Um, her deadlifts look better because I saw them in person.
• 49:06
  Dr. Charlotte Lange PT, DPT: Um, again, some of that may have been picked up on a camera had we done things virtually, but there is so much I mean, how many times did I walk circles around you watching you do a movement?
• 49:18
  Dr. Danielle Hofer: I,
• 49:18
  Dr. Charlotte Lange PT, DPT: Like every visit.
• 49:20
  Dr. Charlotte Lange PT, DPT: Yes.
• 49:20
  Dr. Danielle Hofer: But
• 49:21
  Dr. Charlotte Lange PT, DPT: Like
• 49:22
  Dr. Danielle Hofer: picked up...
• 49:23
  Dr. Danielle Hofer: So, like, I wanna, like, also shout out my people that have a belly like I do, okay?
• 49:27
  Dr. Danielle Hofer: Like, I have an insulin resistance belly.
• 49:29
  Dr. Danielle Hofer: I'm strong everywhere.
• 49:30
  Dr. Danielle Hofer: You just can't see it in my stomach.
• 49:32
  Dr. Danielle Hofer: You can, you can feel my abs, you just don't see them.
• 49:35
  Dr. Danielle Hofer: Um, we're working on that.
• 49:36
  Dr. Danielle Hofer: But anyway, um, I, like, something that she did too was she was like...
• 49:41
  Dr. Danielle Hofer: What was it?
• 49:42
  Dr. Danielle Hofer: I was doing something prone.
• 49:43
  Dr. Danielle Hofer: I was laying down on my stomach, and you were like, "Ooh, we need to prop you up."
• 49:46
  Dr. Danielle Hofer: And it was something where I was able to get more...
• 49:49
  Dr. Danielle Hofer: And I still do.
• 49:49
  Dr. Danielle Hofer: A- anytime I'm prone, I always prop myself up on my, like, my hips.
• 49:53
  Dr. Danielle Hofer: Like, I always prop my hips up now because I'm like, I feel like I get a deeper movement, um, or a deeper, um, like, even strength, um, support.
• 50:03
  Dr. Danielle Hofer: But it's like she couldn't ma- maybe.
• 50:04
  Dr. Danielle Hofer: Maybe she could have picked that up on video, like virtually, but it's like she was able to see, like, through my leggings or through my shorts or whatever, like she was able to see what muscles were firing, what
• 50:15
  Dr. Danielle Hofer: wasn't, what, like what was actually happening first and second.
• 50:18
  Dr. Danielle Hofer: Like, she was able to adjust me in the moment because she was
• 50:23
  Dr. Charlotte Lange PT, DPT: You're not close enough on video to see that.
• 50:25
  Dr. Charlotte Lange PT, DPT: Like, I cannot, like I could get as close to the screen as I want, and I can't tell what's happening in your lumbopelvic region.
• 50:33
  Dr. Danielle Hofer: And can we
• 50:33
  Dr. Charlotte Lange PT, DPT: what is that rhythm?
• 50:34
  Dr. Danielle Hofer: can we also talk about something that I've been on a tangent, and if you've been around here for a while, y- and like you know what I'm gonna say probably.
• 50:41
  Dr. Danielle Hofer: But rise of AI, you cannot even trust that the person that's talking to you is actually a person.
• 50:48
  Dr. Danielle Hofer: And it's getting so good that there are providers using bots to coach you.
• 50:55
  Dr. Danielle Hofer: And maybe one day it will be helpful, maybe one day.
• 50:59
  Dr. Danielle Hofer: But what you cannot replace is the hands-on.
• 51:02
  Dr. Danielle Hofer: You cannot replace the, um, cannot replace my brain with AI.
• 51:08
  Dr. Danielle Hofer: I can't.
• 51:09
  Dr. Danielle Hofer: I cannot replace you telling me your whole story and then me asking you a question.
• 51:14
  Dr. Danielle Hofer: You're like, "How did you know I had that happen when I was eight?"
• 51:16
  Dr. Danielle Hofer: And I'm like, "Because this and this and this."
• 51:18
  Dr. Danielle Hofer: AI cannot do that.
• 51:20
  Dr. Danielle Hofer: AI does not know the human experience.
• 51:22
  Dr. Danielle Hofer: AI cannot know that I had three births, two miscarriages, pelvic floor trauma, and what muscles actually were in- like, uh, messed with, where my scar tissue actually sits.
• 51:34
  Dr. Danielle Hofer: Yes, I have scar tissue all over, but also did that scar tissue c- it, it wouldn't have asked me, "Did you have any other surgeries?"
• 51:41
  Dr. Danielle Hofer: It wouldn't have asked, like, "Do you
• 51:42
  Dr. Charlotte Lange PT, DPT: And even, even if it did, what the patient explains is not the same as what the therapist finds
• 51:48
  Dr. Danielle Hofer: Exactly.
• 51:49
  Dr. Danielle Hofer: Exactly.
• 51:51
  Dr. Danielle Hofer: while I do run an online membership, my online membership is very in, in depth and very in detail for my piece, because a lot of my piece has to do with watching...
• 52:02
  Dr. Danielle Hofer: Yes, I can, um, watch you.
• 52:04
  Dr. Danielle Hofer: I do form h- correction and stuff on there, but I'm like, "I think you need pel- I think you need therapy.
• 52:09
  Dr. Danielle Hofer: I think you need to get to a physical therapist, or you need to get a personal trainer, and here's ways that you can get that."
• 52:12
  Dr. Danielle Hofer: But, like, that piece, like sharing your story with me online or in person or virtual, like that's fine.
• 52:19
  Dr. Danielle Hofer: Ooh, whoops.
• 52:20
  Dr. Danielle Hofer: But for physical therapy, we have to have hands-on.
• 52:23
  Dr. Danielle Hofer: There is no other alternative.
• 52:25
  Dr. Danielle Hofer: Even if you have all the tools, even if you have all the things at home, there is nothing like an outside source that is not biased based on what you think, and that they can take, you can tell
• 52:35
  Dr. Danielle Hofer: them the story of all the things, and then they can internalize and, and figure out, how do I, how do I fix this?
• 52:42
  Dr. Danielle Hofer: You cannot do, and I'm just gonna blanketly say it, you cannot do physical th- like proper physical therapy in six weeks, and you cannot do it virtually
• 52:53
  Dr. Charlotte Lange PT, DPT: I agree.
• 52:54
  Dr. Charlotte Lange PT, DPT: I think my, my ultimate conclusion to that is you can be trained online.
• 53:01
  Dr. Charlotte Lange PT, DPT: You can be given an exercise prescription.
• 53:03
  Dr. Charlotte Lange PT, DPT: You can be personally trained.
• 53:07
  Dr. Charlotte Lange PT, DPT: Danielle has an online program that she follows for exercise.
• 53:11
  Dr. Charlotte Lange PT, DPT: Someone tells her what exercises to do, and you can give that to anybody through the computer.
• 53:15
  Dr. Charlotte Lange PT, DPT: But no one is watching her do these movements.
• 53:17
  Dr. Danielle Hofer: Yep
• 53:17
  Dr. Charlotte Lange PT, DPT: Even if they are, they can't make appropriate cues, and the people that create that stuff don't always have the education behind it and understand the mechanics of, well, if you change this a little bit and this a little
• 53:25
  Dr. Charlotte Lange PT, DPT: bit, and then you're gonna be better for your pelvic floor.
• 53:28
  Dr. Charlotte Lange PT, DPT: Um, and AI can't do that.
• 53:31
  Dr. Charlotte Lange PT, DPT: So if you wanna find an exercise program, and if that's your only option, please move your body, find an online program.
• 53:37
  Dr. Charlotte Lange PT, DPT: Find a good online program.
• 53:39
  Dr. Charlotte Lange PT, DPT: If you need help, let me know.
• 53:40
  Dr. Danielle Hofer: Yep
• 53:42
  Dr. Charlotte Lange PT, DPT: but if you need physical therapy, if you need more than that, if you're still having pain while you're working out or you're still having symptoms of whatever they are, find a physical therapist to put their hands on you
• 53:53
  Dr. Danielle Hofer: Yeah, and I will say too, like you said, you know, they can't give you the cues.
• 53:57
  Dr. Danielle Hofer: I think something that Charlotte has done that is, that has, uh, this is where I'm gonna get emotional, is that has changed my life quite frankly, is she gives me permission to modify And I think because I am
• 54:12
  Dr. Danielle Hofer: a perfectionist, I'm a Type A, I literally have tears in my eyes, but I'm a Type A, I'm a perfectionist.
• 54:17
  Dr. Danielle Hofer: I wanna Rx everything.
• 54:19
  Dr. Danielle Hofer: Can I?
• 54:19
  Dr. Danielle Hofer: Absolutely.
• 54:20
  Dr. Danielle Hofer: Isolated, I can R- Rx probably everything.
• 54:23
  Dr. Danielle Hofer: Okay?
• 54:24
  Dr. Danielle Hofer: Probably not the run times, but I can, I can
• 54:27
  Dr. Charlotte Lange PT, DPT: Same
• 54:27
  Dr. Danielle Hofer: no, and um, a- and pull-ups.
• 54:29
  Dr. Danielle Hofer: I cannot Rx those.
• 54:30
  Dr. Danielle Hofer: Those are always gonna be banded.
• 54:31
  Dr. Danielle Hofer: Well, for now they're gonna be banded.
• 54:32
  Dr. Danielle Hofer: But, um, I want to Rx everything, and what I realize is just because I have, um, a wall ball that's ca- like not catching me but is my target so that I don't go too far of what my
• 54:46
  Dr. Danielle Hofer: pelvic floor load can hold at that time, um, that's still getting around.
• 54:51
  Dr. Danielle Hofer: Like, I'm still making progress.
• 54:53
  Dr. Danielle Hofer: If I, if ab mat sit-ups are the thing and like wrapping a...
• 54:57
  Dr. Danielle Hofer: And I, I've already done a ton of load on my pelvic floor, I can always grab a band and have assisted pull-ups, or I-m sorry, assisted sit-ups, and like still get in my reps and still get in the
• 55:09
  Dr. Danielle Hofer: time and really pay attention to my, like what muscle groups are going, and I'm still doing it, but it's okay to ask for help.
• 55:16
  Dr. Danielle Hofer: And I think that that's something that Charlotte would only know by knowing how my body works and by knowing the mechanics with hands-on and just,
• 55:24
  Dr. Charlotte Lange PT, DPT: And what is your capacity?
• 55:26
  Dr. Danielle Hofer: Yes.
• 55:27
  Dr. Charlotte Lange PT, DPT: "What is, what is your priority within this workout, and what is your capacity?"
• 55:31
  Dr. Charlotte Lange PT, DPT: All right, let's do step-ups instead of box jumps so that you can do, you know, something else.
• 55:37
  Dr. Danielle Hofer: Yeah.
• 55:38
  Dr. Charlotte Lange PT, DPT: Deadlifts,
• 55:38
  Dr. Danielle Hofer: has, and it's emotional because it's freeing.
• 55:43
  Dr. Danielle Hofer: It's emotional because it allows me to get stronger, and that's my goal, is like I wanna be as strong outside as I am on the inside.
• 55:51
  Dr. Danielle Hofer: Like, I want people to, like when I walk into the room, I want people to notice.
• 55:55
  Dr. Danielle Hofer: I mean, they already do, but I want them to notice, like, man, she really is strong.
• 55:58
  Dr. Danielle Hofer: Like, she's not just saying things, but she actually is doing the...
• 56:02
  Dr. Danielle Hofer: It's, there's evidence that she's doing the things.
• 56:04
  Dr. Danielle Hofer: And I'm like, you can't do that without time under tension, and I don't want to lose that.
• 56:09
  Dr. Danielle Hofer: And so that has been so freeing to build relationship with my PT and with my team, and having your team around you to actually get to know you.
• 56:19
  Dr. Danielle Hofer: So as we wrap up, is there anything that you want to, um, say f- we wrap this up?
• 56:27
  Dr. Danielle Hofer: Um, this has been really fun.
• 56:29
  Dr. Charlotte Lange PT, DPT: It has.
• 56:30
  Dr. Charlotte Lange PT, DPT: Um I hope that you prioritize yourself and the needs of your body, whether it is movement, whether it's PT, whether it's nutrition, whether it's hydration.
• 56:46
  Dr. Charlotte Lange PT, DPT: Um, be introspective and figure out what your body needs, and take the appropriate steps to do that, and give yourself grace as you do all of these things.
• 56:57
  Dr. Charlotte Lange PT, DPT: No one is gonna be perfect.
• 56:59
  Dr. Charlotte Lange PT, DPT: I'm not perfect.
• 56:59
  Dr. Charlotte Lange PT, DPT: Danielle's not perfect.
• 57:01
  Dr. Charlotte Lange PT, DPT: We laugh about our imperfections all the time in here Um, and we celebrate our wins so big
• 57:07
  Dr. Danielle Hofer: And we do, we come in and we like share them.
• 57:09
  Dr. Danielle Hofer: Like we have high five
• 57:10
  Dr. Charlotte Lange PT, DPT: Yeah.
• 57:10
  Dr. Danielle Hofer: parties
• 57:11
  Dr. Charlotte Lange PT, DPT: I'm like, "Look at this squat.
• 57:12
  Dr. Charlotte Lange PT, DPT: Check out the shoulder motion."
• 57:13
  Dr. Charlotte Lange PT, DPT: She's like, "I squatted this much weight."
• 57:16
  Dr. Danielle Hofer: Yep
• 57:17
  Dr. Charlotte Lange PT, DPT: find somebody that celebrates all of those things with you as well, because it, it makes the journey even more fun
• 57:24
  Dr. Danielle Hofer: It does, and I just wanna say that the reason why we even put this podcast episode together because I want you to understand that real foundational medicine is also looking at how your body moves.
• 57:38
  Dr. Danielle Hofer: It's how your body, how you are functioning throughout the day, and I really firmly believe...
• 57:43
  Dr. Danielle Hofer: Like, I'm always talking about blood sugar.
• 57:44
  Dr. Danielle Hofer: You know, I'm always gonna talk about blood sugar.
• 57:46
  Dr. Danielle Hofer: I'm always gonna talk about your stress, like, all of that kinda stuff.
• 57:48
  Dr. Danielle Hofer: what I want you to know is that even if you...
• 57:51
  Dr. Danielle Hofer: You could do all the parasite cleanses, you could do all the fun stuff, you could do all the biohacking, but if your body can't move right and it's not pain-free, you got a problem, and it needs to be
• 57:58
  Dr. Danielle Hofer: taken care of.
• 57:59
  Dr. Danielle Hofer: You have...
• 58:00
  Dr. Danielle Hofer: And it's going to actually create even more stress and blood sugar dysregulation and insulin, high insulin numbers, high, high C-peptide numbers, high cholesterol numbers.
• 58:07
  Dr. Danielle Hofer: It's going to cause all of that if you're in pain all the time.
• 58:10
  Dr. Danielle Hofer: You, this is a both/and situation.
• 58:12
  Dr. Danielle Hofer: This is not an either/or.
• 58:14
  Dr. Danielle Hofer: And foundational medicine is found in you thriving and being able to show up in the world where you wanna show up without restriction, period.
• 58:22
  Dr. Danielle Hofer: So with that said, I just wanna thank you all for listening.
• 58:25
  Dr. Danielle Hofer: Charlotte, thank you so much for joining me.
• 58:27
  Dr. Danielle Hofer: I don't
• 58:27
  Dr. Charlotte Lange PT, DPT: Thanks for having me.
• 58:28
  Dr. Danielle Hofer: Have you?
• 58:29
  Dr. Charlotte Lange PT, DPT: Um, yeah, like five years ago, also about pelvic floor.
• 58:34
  Dr. Danielle Hofer: Awesome.
• 58:34
  Dr. Charlotte Lange PT, DPT: is way less stressful.
• 58:36
  Dr. Charlotte Lange PT, DPT: I felt, I feel more, um, not even prepared, experienced.
• 58:42
  Dr. Charlotte Lange PT, DPT: I was a pretty fresh PT, PT in general and pelvic floor PT then.
• 58:45
  Dr. Charlotte Lange PT, DPT: So I've learned a lot from you, from everybody else.
• 58:49
  Dr. Danielle Hofer: Yep
• 58:49
  Dr. Charlotte Lange PT, DPT: It's a lot of fun
• 58:51
  Dr. Danielle Hofer: All right, guys, until next episode, we will see you later
• 58:56
  Be sure to subscribe to the Dr.
• 58:58
  Danielle Difference so we can keep this conversation going check the show notes for resources and ways to join me and share this episode with someone who needs to hear it let's lock shields and move forward together.
• 59:08
  I'll talk to you next week