🚨 Are we still using the biceps analogy for the pelvic floor? It’s time for an upgrade.

When explaining pelvic floor strength, many of us were taught to compare it to a bicep—contracting, strengthening, and controlling movement in a straightforward way. But this analogy doesn’t quite capture the full picture.

This is one of our favorite episodes from the past 500+ we’ve recorded! While I’m out on maternity leave, we’re replaying some of the most impactful conversations we’ve had on the podcast over the years.

Instead, I teach the trampoline analogy in my Essential Pelvic Strengthening: Not Your Mama’s Kegels course.

Here’s why it works better:
✅ Explains resting tone – The pelvic floor isn’t just about contraction; it has a natural resting position.
✅ Shows how surrounding structures matter – Just like a trampoline depends on its frame, the pelvic floor is influenced by the core, glutes, and breath.
✅ Highlights involuntary movement – The pelvic floor reacts automatically to forces like pressure and movement, just like a trampoline responding to weight.

This analogy helps patients better understand their bodies, making it easier to explain treatment and exercises in a way that actually clicks.

Tune in to hear why I think the trampoline analogy should replace the old-school biceps analogy—for both clinicians and patients!

Essential Pelvic Strengthening

If you're looking for more information on how to strengthen the pelvic floor without relying on Kegel exercises and how to make this more functional for patients, make sure to check out the Not Your Mama's Kegels course! www.pelvicptrising.com/kegels

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

Are you holding your business back by NOT hiring an admin?

We were way too late in hiring a front desk team at PelvicSanity, and it’s one of the biggest mistakes we see practice owners make.

If you’re unsure whether you need an admin, ask yourself:
👉 What aren’t you able to do for your business because you don’t have time?
If you have answers to that question, it’s time to start looking for help.

In this episode, we break down:
✅ Why an admin is necessary if you want to grow beyond yourself
✅ How a front desk team actually adds value (not just “costs” money)
✅ Why hiring an in-person admin is the gold standard over a virtual one
✅ The mistake of having clinicians do admin work (it’s a waste of their skills!)
✅ Why you’ll need more admin hours than you think

Whether you’re a solopreneur or planning to expand, bringing on admin help is one of the smartest investments you can make.

If you’re still trying to do it all yourself, tune in and find out why that needs to change!

Business Accelerator Program

If you're looking to grow as a business owner and meet your business goals faster, make sure to join us for the next cohort of the Business Accelerator Program! You can find all the details and submit an application at www.pelvicptrising.com/accelerator

We've now had more than 350+ business owners through the program - check out all the results and apply now to reserve a spot!

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

Still starting your evals with strength testing? It’s time to rethink that.

Most pelvic health pros are trained to assess isolated pelvic floor strength first—and then jump straight into isolated strengthening. But we believe that’s backwards.

In this episode, we’re talking about why you should start with function first—because it leads to better patient buy-in, faster results, and helps your patients actually connect their symptoms to real-life movement and function.

We also dive into:
✅ Why pelvic floor therapists often overlook orthopedic factors
✅ Why ortho therapists often miss the specialized pelvic floor knowledge
✅ How combining both orthopedic and pelvic assessments gives you the full picture
✅ The importance of standing and dynamic assessments to see how the pelvic floor works in the system
✅ Our mantra: Assess, Don’t Guess!

If you want to bridge the gap between orthopedic and pelvic health—and stop wasting time on isolated strength tests—this episode is for you!

Not Your Mama's Kegel Course - Cohort #3

Registration is now open for Cohort #3 of Not Your Mama’s Kegels! (www.pelvicptrising.com/kegels). Learn how to strengthen more functionally and in the system. Registration closes Wednesday—don’t miss out!

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

Still writing blog posts to grow your practice? Stop.

For years, we were told that blogging was the way to rank on Google and get new patients. And after building one of the largest pelvic health blogs in the world (with 130,000 visitors per year!), we can tell you firsthand… it doesn’t work.

Here’s why:
🚫 Google prioritizes local SEO – Your blog won’t really help you rank for local searches.
🚫 AI-generated content dominates search results – People aren’t even clicking blogs anymore.
🚫 The internet is flooded with AI-written blogs – You can’t compete with mass-produced content.
🚫 Blog readers aren’t local – They’re searching for information, not a pelvic health provider.

So what should you focus on instead?
✅ A website that converts visitors into patients
✅ Optimizing your Google Business Profile
✅ Getting patient reviews
✅ Building a strong FAQ page that sells your services
✅ Listing your practice in local directories and social platforms
✅ Real, local marketing—networking, events, and partnerships

Don’t waste your time (or money) writing blog posts no one will read! Tune in to learn what actually works to grow your practice.

Business Accelerator Program

If you're looking to grow as a business owner and meet your business goals faster, make sure to join us for the next cohort of the Business Accelerator Program! You can find all the details and submit an application at www.pelvicptrising.com/accelerator

We've now had more than 350+ business owners through the program - check out all the results and apply now to reserve a spot!

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

Isolated pelvic floor strength isn’t the key to pelvic health.

In Part 2 of the Great Kegel Debate, we dive deeper into why we come down firmly on the anti-Kegel side—and why we believe pelvic health is about so much more than isolated strength.

The single biggest reason? Strength has no reliable correlation with symptoms.

👉 We’ve all seen patients with objectively weak pelvic floors who have no symptoms at all.
👉 And others with strong pelvic floors who are dealing with significant dysfunction.

If isolated strength doesn’t predict symptoms, why would it be the primary focus of treatment?

We also share why we aren’t blindly rejecting Kegels—we understand both their pros and cons. In fact, we hold these two ideas at the same time:
💡 Someone could need pelvic floor strengthening… AND it’s not the most important thing to do right now.
💡 You can have weak pelvic floor muscles… AND be totally symptom-free.
💡 A muscle can have volitional control… AND still work primarily involuntarily.
💡 Something can be proven in the literature...AND there can still be a better way to do it.
💡 We can value what research says....AND realize research always lags behind (often by decades) clinical practice.
💡 There are times when Kegel exercises are incredibly important and the most effective tool for a patient...AND recognize these times are rare and the exception that proves the rule.

We also explain how testing voluntary muscle strength at the initial evaluation can lead us down the wrong treatment path—and what to focus on instead.

This is a must-listen for anyone rethinking how we approach pelvic floor strength in our evaluations and treatment!

Not Your Mama's Kegels Course - Cohort #3

We're opening up Cohort #3 of Essential Pelvic Strengthening: Not Your Mama's Kegels course, starting next Monday (3/10)! We've already had nearly 600 pelvic rehab providers go through it and get more practical and functional with their strengthening for patients.

Starting next Monday it's open for registration - get $50 off and access to an exclusive Q&A when you join this cohort! All the details at www.pelvicptrising.com/kegels

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

Are packages really the best way to sell pelvic health services?

At first glance, packages sound like a great idea. They give patients commitment, help cash flow, and make sales "easier," right?

Not so fast.

In this episode, we break down why we’re opposed to selling packages in pelvic health and the major issues that come with them:
❌ Unrealistic patient expectations – Patients assume they’ll be “done” when the package ends (even if they’re not).
❌ You’re putting limits on care – We hated when insurance dictated treatment plans, so why are we doing it to ourselves?
❌ Cash flow challenges – You get paid upfront, but then have to deliver care without ongoing revenue.
❌ Hiring headaches – Most great clinicians don’t want to be salespeople, and training them to sell packages is hard.

At the end, we share what to do if you’re committed to selling packages and how to structure them for the best results. But after working with over 650+ practices, we’ve seen very few do it well.

If you’ve been debating packages, this is the episode you need to hear first!

Business Accelerator Program

If you're looking to grow as a business owner and meet your business goals faster, make sure to join us for the next cohort of the Business Accelerator Program! You can find all the details and submit an application at www.pelvicptrising.com/accelerator

We've now had more than 350+ business owners through the program - check out all the results and apply now to reserve a spot!

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

The Kegel debate is heating up… but what are we really disagreeing about?

Over the past few years, the conversation around Kegels has shifted big time. We’ve seen an explosion of “no-Kegel” content, frustration from those pushing back, and even research articles challenging each other in the literature.

In this episode, we break down the three major camps in the Kegel conversation:
🔥 Pro-Kegel – Kegels are the most researched pelvic health tool and should be used for almost everyone.
🔥 Anti-Kegel – There are better, more functional ways to strengthen the pelvic floor. Kegels shouldn’t be a blanket prescription.
🔥 Anti-Anti-Kegel – Stop telling people not to do Kegels! They have limitations but are a valid part of treatment.

But here’s the thing… we actually agree on way more than we disagree on! We all know:
✅ Kegels can be useful—but they’re not for everyone.
✅ Pelvic floor therapy is so much more than Kegels.
✅ Kegels should never be blindly prescribed without assessment.
✅ Movement and functional training are critical for success.

So why all the controversy? A lot of it comes down to how we talk about this on social media—and whether we should be the "Instagram police" calling out others’ content.

Let’s get into the real conversation and find the common ground in the Great Kegel Debate!

Read the Article

Check out the full article referenced in this podcast in the POPG here! https://thepogp.co.uk/_userfiles/pages/files/journals/135/06_solomon_et_al_with_appendix.pdf

PelviCon Live Virtual

Now Open! Live Virtual tickets on sale this week - your only chance for $50 off and reserve your spot. Find all the details at www.pelvicon.com/virtual

Not Your Mama's Kegels

Cohort #3 of the Not Your Mama's Kegels course is opening up in just a few weeks! It's going to be the 3-year anniversary of the groundbreaking course in pelvic health - if you haven't joined us yet, make sure to check your email as we open up spots!

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!

If you’ve gone cash-based, why are you still acting like you work for insurance?

Too many practice owners break up with insurance companies… but then keep trying to keep them happy. It’s like staying in touch with a toxic ex—you don’t owe them anything!

In this episode, we’re putting a stop to the madness. Here’s what we cover:
🚫 No more calling insurance companies—Not for denials, pre-auths, or patient questions. That’s not your job anymore.
🚫 No more fighting on their behalf—If a patient wants to submit for reimbursement, we’re happy to provide documentation—but we’re not playing insurance games.
🚫 No more worrying about what they say—Our obligation is to our patients, not insurance companies. Period.

If you’ve committed to running a cash-based practice, it’s time to fully step into that role. No more answering insurance calls. No more trying to “play nice.”

You’re free—now act like it!

Business Accelerator Program

If you're looking to grow as a business owner and meet your business goals faster, make sure to join us for the next cohort of the Business Accelerator Program! You can find all the details and submit an application at www.pelvicptrising.com/accelerator

We've now had more than 350+ business owners through the program - check out all the results and apply now to reserve a spot!

About Us

Nicole and Jesse Cozean founded Pelvic PT Rising to provide clinical and business resources to physical therapists to change the way we treat pelvic health. PelvicSanity Physical Therapy (www.pelvicsanity.com) together in 2016. It grew quickly into one of the largest cash-based physical therapy practices in the country.

Through Pelvic PT Rising, Nicole has created clinical courses (www.pelvicptrising.com/clinical) to help pelvic health providers gain confidence in their skills and provide frameworks to get better patient outcomes. Together, Jesse and Nicole have helped 600+ pelvic practices start and grow through the Pelvic PT Rising Business Programs (www.pelvicptrising.com/business) to build a practice that works for them!

Get in Touch!

Learn more at www.pelvicptrising.com, follow Nicole @nicolecozeandpt (www.instagram.com/nicolecozeandpt) or reach out via email (nicole@pelvicsanity.com).

Check out our Clinical Courses, Business Resources and learn more about us at Pelvic PT Rising...Let's Continue to Rise!