Nicole Muriel, OTR/L, PCES, is a pelvic floor occupational therapist and the founder of PivOTal Performance in Rockland County, NY. She built her practice on a truth she lived herself: being dismissed with "it's all normal" when you're in pain is a failure of care.

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After six years of being misdiagnosed and told her debilitating symptoms were "in her head," Nicole used her own expertise to discover and heal the root cause—levator ani dysfunction. Now symptom-free for years, she guides others from confusion to recovery.

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Her Philosophy: Whole-Person, Root-Cause Care

Nicole believes healing requires seeing the whole you. She connects symptoms to their source by looking beyond the pelvis to your nervous system, movement patterns, scars, and history. In her trauma-informed space, you are heard, safe, and in control.

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A Recognized Leader in the Field

Nicole is proud to have co-authored the landmark New York State Occupational Therapy Association (NYSOTA) statement on pelvic health, which formally establishes OT's vital role in this specialty. This commitment to advancing best practices is a testament to her expertise and dedication to exceptional care. Link for pelvic health statement: Statement on Occupational Therapy's Role in Pelvic Health - New York State Occupational Therapy Association

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Why Clients Choose Nicole

With 12 years of experience in neurology/orthopedics and 6 years in pelvic health, she solves complex cases that others overlook. She specializes in pelvic pain, incontinence, prolapse, diastasis recti, C-section recovery, constipation, and pediatric bowel/bladder issues.