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Episode 281 - Di Wu, Part 2: A Link Between

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DI “WOODY” WU

Canada | MD, PT, Cert. MDT

In episode 281 I conclude my conversation with Dr. Di Wu of Montreal, Quebec Canada. He discusses his practice treating pelvic pain and pelvic associated disorders using a mechanical assessment and treatment approach. He shares about examining, treating and educating his patients, resources and more. This week on MCF!

SHOW NOTES

(by Jayla Hall)


Professional Background

Di Wu trained as a medical doctor and completed his orthopedic residency in Beijing, China. He practiced as an Orthopedic Surgeon for several years before establishing himself in Montreal, Canada. He attended McGill University and obtained a Master's degree in physical therapy. Having developed a strong interest in the link between spinal conditions and pelvic pain syndrome, Di innovatively used Mechanical Diagnosis and Therapy as a screening tool to rule out spinal sources of pelvic pain and dysfunction. He described this approach in a case study published in the journal Physiotherapy Theory and Practice. Di is now a physical therapist and director of the V-Active clinic, where he provides services for a wide range of health conditions, including musculoskeletal disorders and male pelvic-related issues (The McKenzie Institute International 2024). 


(4:12)

A Man’s Search for Meaning

While studying at McGill University, Wu discovered a pelvic floor rehabilitation course in which he anticipated investigating his inquiries concerning the link between the lumbar spine and pelvic floor dysfunction. Given the internal practice involved within the course, the course’s enrollment was restricted to female students. Wu became the exception to the rule, after presenting his observation of the link and his intrigue in the matter. Wu’s exploration subsequently galvanized him into specializing in the field of pelvic health. 


Quotes:

“It’s not common [to see a male physiotherapist] practicing in the field [of pelvic health], but I do see [that] there’s a need.”

 “We need more and more male physiotherapists who treat [male pelvic health issues].”


Barriers Between Patient and Therapist

Ward mentions Stephanie Lowery PT, DPT, Dip. MDT who also sees patients presenting with pelvic floor dysfunction. Referring to a previous discussion with Stephanie concerning pelvic health care, Ward discloses the hesitance that female patients experience when met with a male clinician, given the sensitive nature of the field.


Wu acknowledges this sentiment, agreeing that a barrier does exist between the patient and a therapist who is of the opposite sex. 


Quote:

“[The clinician] needs to understand [the patient’s] concerns and symptoms.”


Regarding the barrier, Wu stresses that it is no question of the clinician’s ability to see and treat the patient. Rather, the concern pertains to the clinician’s ability to (1) develop and maintain a rapport with a patient of the opposite sex and (2) possess the capacity to empathetically understand the patient’s complaint.


(10:48)

Prevalence of Pelvic Floor Conditions in the General Pop.

Relative to variance across studies, the prevalence of pelvic pain syndrome (i.e., pain in the pelvic region often associated with urinary, GI, or sexual dysfunctions) is 8-24% in men and women in the USA.

“We see more patients in the clinic with general MSK pain, but the majority of patients don’t have access to information to see a physiotherapist about [pelvic pain syndrome].”


(12:05)

The MDT Assessment Applied to Pelvic Health Care

Wu discusses two parts to the physical examination of which he informs his patients. 

Plan A concerns the physical examination unique to the MDT assessment (i.e., observation of symptomatic responses to postural change and repeated, end-range movements in forward bending, backbending, and side-gliding directions). If the patient’s complaint is proven to be nonmechanical, then Wu communicates Plan B to the patient (i.e., internal examination).


“Most [patients] dislike being examined internally, [given prior, negative experience with providers involved in pelvic health care]. [Patients] feel afraid of being examined.”


Wu expresses to Ward the benefit of the MDT assessment as the first measure of understanding the patient’s condition, provided that the patient’s condition is proven to be mechanical:


“[With regard to] the physical exam, for most of my patients I do not have to do an internal examination.”


(18:05)

A Memorable Patient Story


(22:22)

Are there other symptoms, besides pain, that you have seen change and respond well to MDT treatment?

  • Lower urinary tract symptoms (LUTS)


Wu refers to a case report of which he was the primary investigator of MDT’s application to patients with LUTS:


Wu, D., & Rosedale, R. (2018). The use of Mechanical Diagnosis and Therapy (MDT) in patients with lower urinary tract symptoms (LUTS): case series. Physiotherapy Theory and Practice, 35(4), 383–391. https://doi.org/10.1080/09593985.2018.1443359


(26:20)

Wu’s Resources

  • CEUs;

  • Research literature


Di Wu also references a book for the clinician who is interested in the area of male pelvic health and wants to read about men’s self-management of pelvic pain:

Gronski, S. (2020). Pelvic Pain The Ultimate Cock Block: A no-bullshit guide for men navigating through pelvic pain. Dr. Susie Gronski, Inc. 


You may purchase the book here (embed link in “here”).


(27:45)

Wu’s Advice

Wu suggests that clinicians inquire about urinary, sexual, or GI dysfunctions with the patient.

Do not feel afraid to pose such questions; and neither avoid nor neglect such symptoms during the patient’s history. If the clinician is not adept at treating such conditions, then he/she should refer the patient to the appropriate provider.




“[With regard to] the physical exam, for most of my patients I do not have to do an internal examination.”


(18:05)

A Memorable Patient Story


(22:22)

Are there other symptoms, besides pain, that you have seen change and respond well to MDT treatment?

  • Lower urinary tract symptoms (LUTS)


Wu refers to a case report of which he was the primary investigator of MDT’s application to patients with LUTS:


Wu, D., & Rosedale, R. (2018). The use of Mechanical Diagnosis and Therapy (MDT) in patients with lower urinary tract symptoms (LUTS): case series. Physiotherapy Theory and Practice, 35(4), 383–391. https://doi.org/10.1080/09593985.2018.1443359


(26:20)

Wu’s Resources

  • CEUs;

  • Research literature


Di Wu also references a book for the clinician who is interested in the area of male pelvic health and wants to read about men’s self-management of pelvic pain:

Gronski, S. (2020). Pelvic Pain The Ultimate Cock Block: A no-bullshit guide for men navigating through pelvic pain. Dr. Susie Gronski, Inc. 

You may purchase the book here.


(27:45)

Wu’s Advice

Wu suggests that clinicians inquire about urinary, sexual, or GI dysfunctions with the patient.

Do not feel afraid to pose such questions; and neither avoid nor neglect said symptoms during the patient’s history. If the clinician is not adept at treating these conditions, then he/she should refer the patient to the appropriate provider.





References

The McKenzie Institute International 2024, McKenzie Institute, accessed 24 July 2024, <https://mckenzieinstitute.org/ottawa-2024/speaker-information/di-wu/>.



For clinicians desiring to begin their career in the area of male pelvic health, refer to Integrated Pelvic Care’s free resources: https://www.ipc.health/freeresources.

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