Prolapse, Levator Avulsions & Pessaries: What’s Actually Happening (Part 2) — with MELISSA DAVIDSON, PT

Send us Fan MailIn Part 2 of this conversation, I’m joined again by Melissa Davidson, specialist pelvic health physiotherapist, clinical educator, and PhD, to go deeper into the clinical realities of pelvic organ prolapse, levator ani avulsions, and pessary use.This episode moves beyond definitions and into what actually matters in practice: clinical decision-making, patient education, and navigating an evolving pelvic health landscape where access is expanding—but not always with the training to support it.We talk about how to explain complex diagnoses in a way patients can actually understand, why accurate assessment matters, and how clinicians can balance symptom management with long-term capacity building.We also unpack the growing conversation around pessaries—including types, fitting considerations, complications, and the rise of over-the-counter options—and what that means for both patients and providers.This is a nuanced conversation about where pelvic health care is right now… and where it still needs to go.In this episode, we discuss: Different types of pessaries and how they’re used  What levator avulsions are (and why they matter)  Clinical decision-making in prolapse care  Potential complications and limitations of pessary use  The importance of provider training and ongoing education  What “high tone” actually means (and why it’s often misunderstood)  The role of mental health and psychological support in pelvic floor conditionsTime Stamps1:00 avulsions explained7:05 proper diagnoses of pelvic floor issues14:00 over-the-counter pessaries20:55 cutting through the marketing29:33 expanding access while preserving quality care33:33 what we don’t know40:26 how the research changes clinical practiceCONNECT WITH CARRIEIG: https://www.instagram.com/carriepagliano/Website: https://carriepagliano.comCONNECT WITH MELISSA:Instagram: https://www.instagram.com/drmelissapelvicphysio/Website: https://www.drmelissadavidson.com/The Active Mom Podcast is A Real Moms' Guide to pregnancy, postpartum, perimenopause & beyond for active moms & the professionals who help them in their journey.  This show has been a long time in the making!   You can expect conversation with moms and professionals from all aspects of the industry.   If you're like me, you don't have a lot of free time (heck, you're probably listening at 1.5x speed), so theses interviews will be quick hits to get your the pertinent information FAST!  If you love what you hear, share the podcast with a friend and leave us a 5 ⭐⭐⭐⭐⭐ rating and review. It helps us become more visible in the search algorithm! (Helps us get seen by more moms that need to hear these stories!!!!)