July 18, 2025
Story by Ryan Gauthier, rjgauthier@health.missouri.edu
Sarah Miller has learned to embrace awkward conversations.
“I always joke with my patients that nothing is TMI,” Miller said. “I want them to feel comfortable advocating for themselves and having an open conversation so we can figure out solutions.”
The 2019 Doctor of Physical Therapy graduate from the University of Missouri is working at the forefront of pelvic health, helping patients deal with everything from discomfort during sex and bowel issues to painful periods and urinary leakage.
According to the National Institutes of Health, nearly 1 in 4 women will be affected by a pelvic floor disorder at some point in their life; and that risk only increases with age. While people commonly think of urinary incontinence or pelvic pain as pelvic health issues, Miller said her patients don’t always exhibit symptoms that are quite so clear cut.
“I also treat a lot of chronic low back pain and chronic hip pain that hasn’t been resolved with traditional stretches and exercises,” she said. “A lot of times that pain is stemming from the pelvic floor.”
From patient to practitioner
As is the case for many students drawn to the Mizzou Department of Physical Therapy, Miller discovered the profession after a painful basketball injury in high school.
“I knew I wanted to do something in the science field from a young age,” she said. “And then I had an ACL, MCL and meniscus injury, and I discovered physical therapy while going through the recovery process.”
After completing undergraduate degrees in biology and psychology from Northwest Missouri State, Miller connected with Mizzou PT faculty member Teresa Briedwell and immediately knew she wanted to get her doctorate here. During her third clinical rotation, Miller discovered pelvic health.
“I was like, ‘Whoa, this is such a taboo topic that women don’t want to talk about,’” she said. “I was able to be that filter and that soundboard for things that they haven’t even discussed with their other providers.”
For the past five years, Miller worked as a pelvic floor physical therapist through MU Health Care. Although the work was incredibly rewarding, Miller wanted to find a way to make a bigger difference in the lives of her clients. To get there, she just needed to take a leap of faith.
Creating a community of care
When Miller was plotting her next career move, numerous ideas were swirling around her head. But the one notion that kept rising to the top was that she wanted to connect more directly with patients and avoid administrative headaches.
Enter the cash-pay model.
Under this business model, patients cover the costs of their medical services directly rather than asking their health care provider to bill the patient’s insurance company. In April 2024, Miller embraced the cash-pay model by launching Revive Rehab and Wellness.
The cash-pay model means patients don’t have to wait for insurance approval or denied claims, Miller said, meaning they can access PT much more quickly and without a doctor’s referral.
“You can also use your HSA, FSA or any out-of-network benefits you may have for coverage,” she said. “It’s typically better access to PT and a much quicker timeline to healing.”
Revive Rehab focuses on women’s health and orthopedic conditions, offering everything from dry needling and myofascial cupping to therapeutic exercise and visceral manipulation.
While growing her physical therapy practice can be stressful at times, Miller said it has been rewarding to create relationships with women that she hopes to maintain for the rest of their lives.
“I’m seeing clients with their first baby; I’m seeing them with three kids; I’m seeing them postpartum and how they navigate that,” she said. “I get to grow with their family, and it’s so special to be able to answer questions they face along the way. It’s just creating this cool community of women that I’m happy to be part of.”