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When to check in with a physiotherapist and how we can help. Written by Jodie Pulsifer We get this question A LOT! Currently the best answer is, it depends! When it comes to seeking out physiotherapy in pregnancy we have a dream world that takes down the barriers to accessing care and then we have the real world! In our dream world, we are a part of your healthcare team to support your obstetric care from pre-conception to long after delivery helping you to manage your health through lifestyle maintenance, practical adjustments for improving outcomes and preventative care to help reduce the risks associated with your long term health because of pregnancy and delivery injury. We don’t live in that perfect world… but strongly contemplating a PhD adventure to hope that someday we could live there. In the meantime, in this current world our recommendations for care can include reaching out for support early and helping you make a plan for moving through your pregnancy. We help to troubleshoot a number of lifestyle things: Pre-Conception: What is up with your period and what is this health optimization for conception all about?! We can support you in this phase to get a baseline understanding of your health by taking a look at sleep, nourishment, activity and lifestyle contributors to your entire neuroendocrine system. We can help consider habits and assess pelvic floor function and core function and strategies to help you feel strong, stable and resilient for conception that can carry you through pregnancy and beyond. First Trimester: This is a time where you are fully pregnant, even if you are not yet appearing it. Body changes begin immediately, including bowel changes, increased urinary frequency, fatigue +++ and insomnia, uncertainty about physical activity and possibly discovering you have loss of urine control with a sneeze or vomiting! We are here to help you make sense and manage any of these changes, get and stay physically active and think about strategies for support for the pregnancy ahead. Second Trimester: Often things smooth out here, you might have more energy to start getting back into your regular flow of life. We continue to support your activity strategies for the prevention of low back and pelvic girdle pain, gestational diabetes, preeclampsia. We can assess the pelvic floor internally to help you understand your anatomy, engagement patterns and support your body learning for prevention of stress incontinence. This is a great window of time to help you build stamina and strength for delivery. Third Trimester Early third trimester, we love to connect with you about your upcoming birth and birth choices. We can begin to discuss perineum protection strategies, including the role of perineum massage and stretching. We can discuss options and strategies for vaginal delivery, including birthing positions, pain management and things to discuss with your birth providers regarding strategies for reducing risk of severe tears. We also support questions around cesarian section delivery and recovery strategies following all forms of birth. We continue to help you stay active and comfortable right to the end of your pregnancy, including supports to manage low back and pelvic girdle pain if it arises. Other healthcare supports start to ramp up at the end of third trimester and a lot our work with you can begin to wind down. We are always happy to continue to support you right to the end if that feels right for you. Post Birth Virtual support is a great strategy to debrief birth and make a plan forwards that makes sense. If you sustain a severe tear, checking in at 2 weeks is recommended. Six weeks is not a magic window of time for recovery, you can reach us anytime you have questions or feel ready to connect and make a plan for you. We can help tailor your recovery to the experience of birth that you had and from there, decided together when seeing us in person might make sense, if a pelvic exam is beneficial for you, and support you with strategies for pain management and how to get moving again. We do this with you in a timeline and way that fits for your life and the things you are juggling. Anytime, our role is to help you look at bowel, bladder, sexual health, sleep hygiene, basic nourishment, activity demands, emotional wellbeing, life stressors and your life responsibilities. We help build strategies that make sense to you to help you feel well for where you are and as life shifts. Finally, since this isn't our dream world, we also want to note that we are always trying to consider how to give you the best support within the resources you have. We understand that jobs that allow you resources to access our services and extended health benefits are not something we can all are able to have. We try to work with you and the means you have (eg. geographical location, time, finances, life capacity) to make sure you can still get as much benefit as you can!

Jodie's Story of How We Came to Be HERE Written by Jodie Pulsifer Full Circle Physiotherapy has become much more than just a clinical practice. It has been an evolution of all of the people who have crossed paths with it, have asked what could it be and let it continue to adapt to what might be possible. One of the things I am most proud about in my own life is the self identity I have been forging, sometimes with great difficulty, is that I am allowed to grow and change and that I can give that same grace and permission to those around me. As I give myself permission to change, I have tried to build relationships and frameworks around myself that embody and support that ever evolving process. This is the story of Full Circle Physiotherapy from how my memories have been shaped and evolved over time and from own vantage point today: Full Circle Physiotherapy was the name given to my own sole proprietorship when I started out in pelvic health at Pomegranate Community Midwives in 2016. I was young, a new mom, new in my pelvic health career and excited and simultaneously entirely unsure about what life in solo private practice could be. The one thing I knew was that I wanted to be identified not by my own name but by something that could be more expansive. I wanted something that could shift with me if I took another maternity leave and to have the space for others within. I had no idea what it would become but I knew that I thrive in community and needed something that might leave room for the expansiveness of my own curiosities. MEETING MY COMMUNITY As I set down my roots in my solo pelvic health practice, I also took a job at Treloar Physiotherapy where I had the opportunity to work with other pelvic health providers. That’s where I met Jen LaRoy and learned about her work in pelvic health and the way she pushed for acceptance of pelvic health as an area and expertise in practice that was paralleled to our orthopedic colleagues in training and compensation. Treloar accepted and encouraged her to build the program there and it has expanded and had so many of us walk through and work in their space. I am eternally grateful for the connections that space allowed me to make. When I took a second surprisingly early mat leave in 2017, Jen covered part of it at Pomegranate and the expansiveness of Full Circle Physiotherapy began! As I eased back into daytime work in 2018, Jen stayed on to work a few hours in the evenings to give more options for appointments for clients. When Jen made the move back to her hometown of Chilliwack in 2019, Full Circle was able to have the framework for her to provide home visits and still care for some of her Vancouver based clients when she was in town or virtually. SHARED VISIONS COLLIDING AND EXPANDING At some point in this adventure I met Adrienne Sim and my own life and professional development expanded exponentially. Adrienne, having trained at Curtin University with a Certificate in Women’s Health, could quote research in ways I am still trying to catch up to and she inspired me to dive deeper and get smarter! In 2019, when Adrienne started thinking about working in her home community of Langley, she asked me what solo practice was like. I told her about how much I loved my own agency for my schedule, my time and for feeling like I knew where the resources were being spent and distributed. I suggested to her that I had the digital infrastructure already in place and would be more than happy to share and rebrand. Adrienne was planning on returning from her own maternity leave in 2020 to her position at Fortius where she had found her dream connection of bringing pelvic health to the sports world and then run a small solo practice from her home office in Langley. Unfortunately, Fortius was put in a really challenging position during the Covid-19 pandemic and was forced to permanently close. Adrienne found herself having to pivot what was going to be just a side hustle solo practice into her full time job and that was when Full Circle Physiotherapy needed to grow some wings. It was from there that we truly became a framework for us, as independent providers, to be networked together as a community of providers with shared vision and shared resources. LEARNING OUR OWN RESILIENCY AND ADAPTABILITY What we learned in the pandemic was that we had resiliency. We pivoted immediately as we weren’t tied to large overheads in real estate and the digital infrastructure allowed us to continue to reach our clients virtually and we could stay connected as a community over larger geographical landscapes. We’ve learned that we could support each other in our personal and professional growth and have room for others too. We’ve sat together and had hard conversations around legal contracts to keep each other safe in business and give value to each others’ time. We’ve committed to sharing in tasks and projects, to sharing costs transparently, to being open and honest with each other, to work together and to have boundaries to turn off too! We’ve provided mentorship to newer physiotherapists which turned into a model shift for our own self development. We’ve rumbled with how to add more members to our group and deepened our own understanding of who we are and the commitments we make to each other. We strive to say yes to each other’s changing lives as much as we can and we shift our framework to adapt and meet those needs but also allow for those needs to be met beyond what we can support. WHAT WE HAVE BECOME As I write this, I reflect back to my own opening paragraph about what change can be possible. Full Circle Physiotherapy has become a framework around all of us that embodies and supports us in our ever evolving lives. We have permission to stay, we have permission to grow, we have permission pause, we have permission to go. Full Circle Physiotherapy has become more than just a clinical practice. We are an evolving group of humans that try to welcome the possibility of our own growth and adaptation as healthcare changes, as new knowledge arises and as culture and society shift in our changing world. As frightening as it can be to look ahead to the unknown, I’m so honoured to have this community along for this part of the ride!

The Path To Care Is Winding Written by Jodie Pulsifer | Reviewed by Adrienne Sim The therapeutic relationship is a very important part of successful treatment. You need to feel safe in care and trust in your provider to help you in your health journey. We know that your physiotherapy care starts long before your appointment starts. It may begin when your healthcare provider recommending getting care or a friend tells you they have an awesome provider they trust. You might read our bios that we’ve made to try and reflect our personalities and style of practice so that you can get a sense of who we are and if we might be the right fit for you. You might think about care but decide it’s not the right time. You might look at our schedules and locations and it’s not the right fit. There might be finances or childcare logistics that feel challenging to overcome. We know this all too well because we experience this too. As healthcare professionals, we know all too well how difficult it is to try and reach out to get help for our own health! “BOOK” If you make it through all of those navigations and click to book an appointment with one of us. You can book a virtual or in person initial assessment depending on your location and preference. People often assume that physiotherapists have to see you and put our hands on you to understand what is happening in your body. The reality is, we are the most effective with understanding your body when we take the time to throw the net wide and capture the fuller story of your health. “INTAKE FORM” When you book an appointment, our booking system will send you an intake form to fill out. This will include detailed questions about your health history, including your social connections, life obligations, relationships, habits and patterns can help us put a number of puzzle pieces together with more clarity. It will also include an opportunity to add your insurance information if you want us to direct bill for your physiotherapy services. are. As you answer this form, we know it is long and we truly value the time you take to complete it. We have carefully put those questions together with the diversity of training that we have because it helps us get a fuller picture of your health. We also know that sometimes it feels impossible to answer more questions about your health and we can work with you wherever you are and with whatever you feel you can fill out. “APPOINTMENT” When we arrive together to your appointment, virtually or in person, we will take the time to ask you what you hope to get from your visit with us. We can briefly review your intake form and then take time to ask more probing questions and begin to dialogue about your health. We will give you space to ask questions, we can provide education and strategies for your health and discuss what options we might be able to provide to support you, including a physical assessment and treatment strategies. Together we can decide what might be the most meaningful next step in your care. If we have more time in an appointment, virtually we could watch your movement patterns and provide you movement support. In person we can put our hands on externally to assess patterns of movement and provide input to your body. If you have pelvic health concerns, we could perform a pelvic floor exam to provide feedback to your movement patterns and education about your body. “TREATMENT PLAN” As the appointment unfolds, we will check back in to make sure we are working to meet the needs and expectations that you had when you came into care. We can adjust the appointment to make sure it continues to support your needs while working with the skills of each provider. The best plan forward is one that is adaptable, where you feel safe to ask questions, where you feel you can return to care in a timeline that is appropriate for you and that your provider is adaptable to your needs.

SERVICES Individual needs. Individual services. Care for ALL. PHYSIOTHERAPY | PELVIC FLOOR | GROUP EXERCISE | CLINICAL PILATES | PERSONAL TRAINING PHYSIOTHERAPY VIRTUAL PHYSIO PHYSIOTHERAPY IN-PERSON & VIRTUAL SERVICES: Care personalized for you At Full Circle Physiotherapy, we consider you to be whole and work with you from head to toe. We approach care in a way that considers the inter-connection of your body structures, functions and the interplay of how your individual thoughts, feelings, beliefs and social contexts influence each other. Physiotherapy services should be adaptable to you and we are thrilled to offer care in your community, in person and virtually online through BC. WHAT CAN YOU EXPECT? Read more We start with a detailed intake form including past medical history, current history, social and emotional wellbeing and beliefs about your body. We love to take time to talk with you and give you space to share what brings you into care. We may ask guided questions to learn more about you, your health and how you want to live. We may perform a physical assessment of how your body moves and feels. When speaking with you and performing assessments, our goal is to do it in collaboration with you and in a way that you feel comfortable. We can provide treatment with education, hands on support and movement based strategies to help you feel better. We consider care to be a partnership with you to bring your needs and goals together with the physiotherapists’ knowledge and resources. Together we can create a comprehensive care plan to support and empower you in your body. ​ Check out our blog series to find out more. PELVC HEALTH PELVIC HEALTH PELVIC HEALTH PHYSIOTHERAPY FOR YOUR PELVIC FLOOR: Learning and Discovering ​ One of the key skills Full Circle Physiotherapy providers are trained in is the ability to assess and treat pelvic floor conditions through interviewing and physical external and internal exams when needed. An internal examination in the context of pelvic health care may provide additional valuable information but is not a requirement for care. Pelvic floor concerns may be related to questions and challenges you may have with bowel and bladder health, sexual function, pelvic organ prolapse and pain. These conditions can present at any point in your entire lifespan. Many people seek care for low back and hip pain, prenatal and postnatal support, bladder pain and urgency, persistent pelvic or genital pain, symptoms of menopause, oncology and transgender health. WHAT CAN YOU EXPECT? Read more Just like a regular physiotherapy appointment, we understand that your pelvic health impacts you within the context of your whole body. We know how challenging it can be to seek care for intimate concerns and we try to take down barriers to provide spaces that all you to ask questions and understand your body better. We’ve made blog posts related to pelvic health care to try and answer some frequent questions and concerns people have. ​ Check out our blog series to find out more. EXERCISE CLINICAL PILATES EXERCISE MOVEMENT MADE TO MEET YOU WHERE YOU ARE We believe that movement and exercise have the power to transform our health and wellbeing. A number of our providers offer clinical pilates, physiotherapist led group exercise classes and personal training to support your treatment goals. Exercise support with our providers can be tailored to consider the diversity of your health needs, including emotional wellbeing, sleep health, sexual health, cardiovascular health, muscle function, bone health and overall metabolic health. CLINICAL PILATES Locations: Langley, Chilliwack, Burnaby, Comox Valley Read more Adrienne, Jen, Hayley and Mikaela are physiotherapists who offer clinical pilates as a compliment to your physiotherapy care. Clinical Pilates can be done virtually using a mat or in person with more equipment including mat, reformer and chair. PERSONAL TRAINING Locations: North Vancouver, Vancouver, Port Mo ody Read more Lisa is our incredible team personal trainer. She offers in person and virtually supported training through her platform BeStrongTraining. Lisa also works as a support person for the physiotherapy team to compliment your treatment needs. We love to support our clients to transition from physiotherapy care into longstanding exercise support that feels fun and sustainable for them! GROUP EXERCISE Locations: East Vancouver, Langley Read more Jodie and Adrienne offer group exercise classes to help you find movement that is fun, social and supporting your unique treatment goals. Group based care can help people to regularly complete their therapy exercise and improve their pelvic health symptoms alongside the added wonderful impact to many other systems of your body. We particularly love to laugh, have fun and slip in some pelvic floor humour while we move with you! Group classes can be joined following a 1:1 appointment to determine your needs and what class might fit best for you. ​ Check out our blog series to find out more. PERSONAL TRAINING GROUP EXERCISE

PREVENT. RESTORE. THRIVE. PHYSIOTHERAPY AND PELVIC HE ALTH SERVICES IN BC. At Full Circle Physiotherapy we believe that every human deserves to feel empowered to take control of their health. We strive to consider ways that support you to prevent challenges, restore function and maintain your wellbeing. We love working with people across all spans of life to make small changes for the largest impact. We want to support you to thrive in the life you are living. INDIVIDUAL NEEDS. INDIVIDUAL SERVICES. We know that accessing comprehensive healthcare that takes our unique lived experience into consideration can be hard to find. At Full Circle Physiotherapy we have the gift of time and the opportunity to work with you to more deeply understand your health and what is important to you. Partnered with a provider that feels right for you, we offer physiotherapy, pelvic health and exercise services that help you consider the longevity of your health. PHYSIOTHERAPY PELVIC HEALTH EXERCISE We are committed to providing high quality, evidence-based healthcare backed by our own commitment to regular continuing education and professional development. We approach care through an inclusive biopsychosocial, trauma and violence informed lens which we understand requires continuous and ongoing self-reflection, learning and action. We commit to monthly team meetings, case reviews, collective knowledge translation projects and most of all keep each other accountable in our personal and professional growth. INDIVIDUAL PROVIDERS. INDIVIDUAL LOCATIONS. We are a collective of independent and value aligned healthcare providers spread across beautiful British Columbia. We come together to share resources and infrastructure to provide virtual support to anybody living in BC and in person services in our local communities. Because of this reach and access to more minds (and hearts) our collective is able to bring a breadth of knowledge and skills to best support you. OUR LOCATIONS vancouver langley coquitlam chilliwack burnaby comox valley virtual in b.c. OUR PROVIDERS jodie pulsifer adrienne sim jessica adaszynski jen laroy susannah britnell mikaela barnes hayley alexander lisa lethbridge WHAT CLIENTS SAY "I sought out Jodie for post natal care. There are more and more pelvic floor specialized physio coming into the Fraser Valley but I didn't want just anyone if I could have a trusted referral. Jodie did not disssapoint! She's caring, easy to talk to and gives practical break down of what to expect. Got me back to running with confidence post C section. Also helped with scar comfort and massage as well as what I could expect. I hope to see Adrienne out in langley when we hope to expand our family in the future. Would highly recommend!" ​ Jessica C.

JESSICA ADASZYNSKI she/her BHK, MPT | Registered Physiotherapist Pelvic Health, Persistent Pain, Biopsychosocial Model of Care COQUITLAM, BC • CONTACT JESSICA I know that pelvic health care relies on clients sharing sensitive information about their bodies and lives; to be trusted with this information and your care is an incredibly humbling experience. I seek first to understand, as you are the expert of your own body. BOOK WITH JESSICA ABOUT JESSICA Read more I’ve been a registered physiotherapist practicing since 2011. My early career was mostly in adult neurological rehabilitation in public healthcare, however since 2018 my clinical focus has been on pelvic health and persistent pain treatment. I work in a number of public and private healthcare settings. My private practice is located in Coquitlam, B.C. I believe strongly in pelvic floor care being accessible throughout the healthcare continuum which is why I have a hybrid public and private practice. One of the things I love to do is mentor physiotherapy students and new graduates; I support labs at UBC and Pelvic Health Solutions as well as taking students from UBC Master of Physical Therapy Program and UBC Midwifery Program. Outside of work, you can find me with my family and friends exploring everything beautiful British Columbia has to share with us. Hiking, swimming, gardening and cooking are some of my favorite things to do. PHYSIOTHERAPY RATES $170 / hour $145 / 45 min $95/ 30 min Direct Billing to Extended Benefits Direct Billing to ICBC (Core Kinesis) Sliding Scale available BOOK WITH JESSICA WHERE TO FIND JESSICA: COQUITLAM, BC Tri-City Midwives Book Appointment Core Kinesis Book Appointment WHAT CLIENTS SAY "Jessica is a compassionate professional who is very knowledgeable in pelvic floor health. Her experience as a mother makes her relatable and easy to open up to. She is very conscientious about the delicate nature of pelvic floor physio and always works to make sure those in her care are comfortable with the treatment provided. She is able to provide easy to understand education and ensures clients leave with a better understanding of their condition and the planned course of treatment then when they arrive. I would highly recommend her if you are in need of pelvic floor physio!" ​ RELEVANT POST GRAD EDUCATION Read more Level I: The Physical Therapy Approach to Female and Male Urinary Incontinence – Pelvic Health Solutions Level II: Female and Male Pelvic Pain – Pelvic Health Solutions Level III: Clinical Skills For Treating Pain – Pelvic Health Solutions Relieving sacro-iliac and pubic pain during and after pregnancy – Rost Therapy Diastasis Rectus Abdominis and the Implications for Low back and Pelvic Health - What's the Solution? - Pelvic Health Solutions Introductory Electrical Stimulation for Pelvic Health - Pelvic Health Solutions Pelvic Floor Therapy & Sex: What is Our Role? - Pelvic Health Solutions Unhappy Bladder Reframed Rehab MEMBERSHIPS & AFFILIATIONS Read more CPTBC Provider Registration: College of Physiotherapists of British Columbia Physiotherapy Association of British Columbia SPEAKING ENGAGEMENTS, PUBLICATIONS & KNOWLEDGE TRANSLATION Read more CONNECT WITH JESSICA For all bookings please click HERE for Tri-City Midwives and HERE for Core Kenesis to select an appointment time that works for you. ​ For all other inquiries for Jessica, please fill out the form. First Name Last Name Email Let Jessica know how she can better support you: SUBMIT Thanks for submitting!