Lonny Green (left) and Amanda Miller Avila Photo by Sarah Walor
Lonny Green: I had been searching for a group of physical therapists that really understood the pelvic floor anatomy and understood the patients, and did it in a way that sort of brought the art of medicine into alignment with the science of medicine. One of my partners told me about Progress, so we met over lunch, and it really just seemed to click. Amanda Miller Avila: What I address is the whole-body dysfunction, but I come at it from a pelvic-floor-muscle standpoint, looking at core muscles, and how the pelvic floor and the bladder, and the respiratory diaphragm and the pelvic floor, are working together — and the rest of the core muscles too, of course — and how that affects [patients]. LG: I saw someone not long ago, [where] there was an issue of frequency of urination and discomfort, but she also had not been able to have intercourse with her husband for a couple of years because it was so painful. The frequency and urgency got under control relatively early on with some of the things I did, but I think it was — I don't want to say "life-changing" but just about, to go from a relationship where she could not enjoy sexual activity with her husband to, after working with Progress PT, she now is back to having a normal sex life. AMA: That patient also had chronic SI [sacroiliac] joint dysfunction [pelvic joint pain], and she had been to physical therapists and orthopedics, and nobody could touch her pain. When we started working on the pelvic floor, we also got rid of her SI joint pain, which was just amazing to her. LG: Maybe the reason this works so well is we both look at the whole patient — and not all doctors or physical therapists do that. Though I'm looking for medicines for the bladder, I'm also open to dietary, behavioral and stress things. [At Progress], they're not just focused on the pelvic floor musculature; they talk about dietary [issues], stress and all the other things, and they bring to the table the things that frankly I just [didn't] learn in medical school. AMA: [Patients] get the benefits of the medical aspect from Dr. Green; they get the benefits of the musculoskeletal aspects from us at Progress. It's a great resource for [them]. LG: It's like the sum is more than just the parts. I think the added benefit is that the patient understands and feels like we are looking at them much more holistically and in an integrated manner — it's not just simply writing a prescription and sending them on their way. AMA: For me and everybody at Progress, we see Dr. Green and his team as a great resource. Dr. Green's group is really great at staying up to date with the different diet and medical options, and we really learn a lot from him in that regard. LG: A lot of patients come to me who've been to many other doctors, and sometimes get put off as having chronic bladder infections or that it's in their head, so even if I don't know exactly what's going on with the pelvic floor, I've got to present to the patient the [physical therapy] option. Often [Progress' therapists] find things wrong that both the patient and I are not aware of. AMA: [I value] Dr. Green's open-mindedness, that he and his group [are] willing to send us so many people and recognize the benefit of [that].