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Meet Nicole Cozean of PelvicSanity Pelvic Health & Wellness

Today we’d like to introduce you to Nicole Cozean.

So, before we jump into specific questions about the business, why don’t you give us some details about you and your story.
Well, I had known that I wanted to be a physical therapist since I hurt my knee and had surgery at the age of 13 … but I certainly I never planned to be a pelvic physical therapist. If I had known at the beginning of my career that I’d be talking about peeing, pooping, sex, and pain in the nether regions I would have either laughed or cried! I thought I wanted to work with elite athletes and sports injuries.

My first introduction to the pelvic floor came by accident. In my doctoral program, we were each assigned a specific part of the body to dissect and analyze. I ended up having the last choice – after all the ‘interesting’ things like the knee, ankle, and shoulder had been selected – and got stuck with the pelvis.

To my surprise, I found it fascinating! It’s such a complex area of the body, with connections to so many other muscles and structures. I’m grateful to have gotten the chance for such a thorough understanding of the pelvic anatomy, which I feel is missing from the education of both physicians and physical therapists.

However, I returned to focusing on orthopedic injuries and didn’t think about the pelvis again until I was working at Hoag Hospital. They asked me to build a pelvic health program. I hesitated at first, but they essentially bribed me with an almost unlimited budget for continuing education. In retrospect it was another fortunate moment in my career, giving me the opportunity to learn directly from some of the most influential leaders in the field.

I distinctly remember the decision to focus full-time on the pelvic floor and throw myself into the field. I was splitting time between orthopedic patients and those with pelvic issues, and treating a 17-year old with a sprained ankle. He did none of the exercises I recommended and made no effort with his home program at all – and he still was getting rapidly better!

Later that day, I was treating a woman for painful intercourse she had been dealing with her entire adult life. We had been working together for several weeks and through tears told me she had just had pain-free intercourse with her husband for the first time in five years. She credited the physical therapy she had received with saving her relationship and giving her the chance to start a family.

At that moment, it became clear where I could have the biggest impact on the lives of my patients, and I’ve been focusing exclusively on pelvic health and wellness for almost 15 years.

Has it been a smooth road?
Yes and no! I’ve been fortunate to work and learn at some amazing facilities, but I always felt that there was more we could be doing for our patients. After starting and growing the program at Hoag Hospital, I saw the limitations of a hospital program. With any insurance-based program (either out-patient or in a hospital), the amount of time we could spend with patients was limited, and insurance concerns often dictated treatment.

I left the hospital setting to manage an outpatient pelvic health facility and grew that over the next several years. That setting gave me more time with patients, but I still felt there was a lot missing for my personal and professional growth. I wanted to create a place where patients got the best possible care and also reach out to help those beyond the walls of my own clinic. I feel that each step of the way brings new challenges, peaks, and valleys, but its all worth it because I get to positively impact people’s lives and pelvic health all around the world!

So, as you know, we’re impressed with PelvicSanity Pelvic Health & Wellness – tell our readers more, for example, what you’re most proud of as a company and what sets you apart from others.
Just under three years ago, I founded PelvicSanity physical therapy for pelvic health and wellness in Orange County, CA. So many of our patients had been through an insane gauntlet of doctor visits, failed treatments, and misdiagnosis, so we wanted to help them find pelvic sanity again.

From the beginning, we said that providing the absolute best patient care would be our highest priority. That framework guides all of our decisions. I believe that an hour-long appointment is necessary for complex pelvic health conditions, which allows us to address both the internal and external components of treatment and find the underlying ‘why’ of their symptoms.

Hands-on, manual physical therapy – not simply being told to do exercises or to Kegel – is crucial for patients. We wanted to create a peaceful, positive environment that looked nothing like a hospital waiting room and were able to renovate a space to fit our vision.

We specialize in treating complex pelvic and core pain and other symptoms in both women and men (Yes, men have pelvic floors too!). That encompasses all kinds of pain in the pelvic region, including low back, hip, groin, tailbone, and pelvic pain. Many of our patients have been struggling with pain for years and travel for long distances to see us for treatment.

We work with mothers, making pregnancy more comfortable and preventing many of the common – but not normal! – post-natal symptoms that occur after a baby. Urinary and bowel symptoms, like incontinence, urinary urgency, and constipation, can all be addressed with pelvic PT.

Sexual function in both women and men is controlled by the pelvic floor muscles, so we can also treat painful intercourse, erectile dysfunction, and a variety of other sexual issues. We aid in recovery after pelvic, abdominal and gynecological surgeries, making sure everything gets back to working properly. Basically, if you have issues you wouldn’t want to discuss at a dinner party, we can help!

We deal with a lot of difficult cases. In fact, more than 70% of our patients have been to other physical therapists before finding relief with us. We have people travel to the clinic for treatment from all over the world; in just the last few years we’ve treated patients from five different continents and more than 20 US states.

When we started, it was just me, treating in a space that had three separate treatment rooms (we worried it was too large when we signed our lease!). My husband, who worked from home, came in to run the business side and answer the phones. My book, The Interstitial Cystitis Solution, came out around that same time and became an Amazon best-seller, which also increased our national profile.

Fast forward, and today there are three other physical therapists working full-time with another currently in training, along with a fantastic massage therapist and front desk staff at the clinic. Two and a half years after founding PelvicSanity, my husband and I were even able to take a vacation! Overall what I am most proud of is the growth – both personally and professionally – that we have been able to make in such a short period of time. It makes me excited to go to work everyday with some amazing women by my side and help our patients.

How do you, personally, define success? What’s your criteria, the markers you’re looking out for, etc.?
One of the great things about being a physical therapist – and especially working in pelvic health – is that you get to experience the success of your patients on a daily basis. Women who couldn’t have intercourse due to pelvic pain come back in for care after having a baby.

Men who couldn’t play golf due to incontinence following a prostate surgery send us photos of their hole-in-one. Patients with chronic low back pain see their symptoms resolve and avoid unnecessary surgeries after years of unsuccessful treatment. We also find success in the team and the culture we’ve created.

Every physical therapist we train has the potential to impact thousands of lives over the course of their career. In addition to our team here at PelvicSanity, we teach continuing education courses for other physical therapists, mentor younger therapists in the field, and have created an online community of more than 2,000 pelvic PTs who can collaborate from across the world.

Ultimately, our goal is to change the way our entire culture and medical system treats pelvic health. There remains an unfortunate stigma around pelvic symptoms, and so many patients are misdiagnosed and mistreated for years before finding help. We want patients to know about how pelvic physical therapy can help and feel comfortable seeking out care instead of continuing to struggle with their symptoms.

I’m amazed by how quickly we’ve grown, and we try to focus on the process rather than the results. Our biggest successes have come from concentrating on meeting the needs of patients – whether in the clinic or across the world – and we look forward to where that will lead us in the coming years.

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Getting in touch: VoyageLA is built on recommendations from the community; it’s how we uncover hidden gems, so if you know someone who deserves recognition please let us know here.

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