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Mobilization of Visceral Fascia for the Treatment of Pelvic Dysfunction - Level 1: The Urologic System - VTUS

Audience: This continuing education seminar is targeted to physical therapists, occupational therapists, physical therapist assistants, occupational therapist assistants, registered nurses, nurse midwives, and other rehabilitation professionals. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.
Level: Beginning level visceral treatment intended for therapists already experienced with internal pelvic floor examinations.
Contact Hours: 17.75 (CEUs vary by state)
Price: $650 (Early registrant price of $625 for registrations received one month before course start date)
Prerequisites: Pelvic Floor 1 through Herman & Wallace or prior seminar instruction in internal pelvic floor vaginal muscle examinations
Required Readings:
1. The Fascial Mechanoreceptors Article from fasciaresearch.com

2. Review the anatomy of the pelvis and perineum

3. Review of Anatomy Terms
4. Participants should bring an anatomy atlas (preferably Netter) for reference of the visceral anatomy.



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Visceral mobilization is a gentle manual therapy technique that releases restrictions between the viscera and related somatic structures such as muscles, fascia, ligaments, nerves and bones. It operates on the premise that the organs are dynamic structures that are affixed to the somatic frame through connective tissue attachments; that these structures carry a significant mass within the human body and are subject to the same laws of physics as the locomotor system. Material will be presented that includes the science of and evidence behind the use of visceral mobilization, relevant anatomical structures, clinical reasoning and extensive number of treatment techniques, both external abdominal as well as internal vaginal approaches. Course participant will be able to immediately incorporate evaluation and treatment of visceral fascia for patients with diagnoses of urinary incontinence, urgency, retention and bladder pain.



Application of visceral mobilization requires advanced palpation skills along with extensive knowledge of visceral anatomy. This continuing education course is a two-and-a-half day seminar designed to provide comprehensive knowledge concerning the relationship between the connective tissue surrounding the visceral structures of the urologic system as it relates to physical therapy treatment. This course is geared toward the experienced pelvic health therapist that wishes to integrate advanced manual therapy skills into their treatment regime.


Special Considerations:

As this course includes extensive lab work, all course attendees should come prepared to participate as both clinician and patient. Abdominal and Vaginal pelvic approaches to access visceral structures will be taught in labs. Male course attendees may participate fully in the entire course but should make arrangements in advance for a lab model for the internal approaches. Pregnant attendees may participate in a limited capacity, bringing a model for internal labs will facilitate the best learning experience as vaginal examination and internal myofascial manual therapy prior to 32 weeks gestation is not the common standard of medical practice.


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Upon completion of this continuing education seminar, participants will be able to:

1. Describe the theory and application of mobilization of visceral structures relating to proper function of the urinary system and pelvic floor
2. Cite potential causes for development of restrictions in the connective tissue of visceral structures of the urologic system, pelvis and thorax
3. Differentiate between direct and indirect release techniques and understand the proper application of each
4. Identify visceral structures with relation to the urinary system via external and internal vaginal landmarks
5. Recognize abnormal tissue mobility and motility of visceral structures
6. Apply the technique of three-dimensional fascial release to visceral structures; utilizing external body and internal vaginal approaches
7. Recognize and treat fascial restrictions throughout the abdomen and thorax as it relates to symptoms of dysfunctional voiding
8. Develop treatment sequencing with respect to global, local and focal fascial restrictions
9. Implement fascial release techniques into a comprehensive treatment program for the patient with varied urologic diagnoses to include incontinence, urgency, retention, and bladder pain as they relate to physical therapy


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Day One:
5:00 Registration
5:30 Introduction
6:00 Concepts of Visceral Mobilization and Fascial Release: Principles of Osteopathy, Fascial Anatomy, What is Visceral Manipulation? Fascial Stacking Exercise
8:00 Lab: Fascial Release Techniques for Horizontal Diaphragms
9:00 Adjourn

Day Two:
8:00 Review & Questions, Layer Palpation Exercise
9:00 Visceral Listening, (Lab II) Local Listening Technique
9:45 Bladder Lecture: Anatomical Relationships, Clinical Considerations, Mobility and Motility
10:15 Break
10:30 External Bladder Techniques: Demo and labs
Lab: Lateral Mobility Testing & Treatment, Median and Medial Umbilical Ligament (Urachus), Scar Release
Lab: Pubovesical Ligament, Seated & Quadruped
12:00 Lunch
1:00 External Bladder Techniques: Demo and lab
Lab: Obturator Foramen: Testing & Treatment, Bilateral & Motility
1:45 Kidney/Ureters Lecture: Anatomical Relationships, Clinical Considerations, Mobility and Motility
2:15 Kidney/Ureter Techniques: Demo and labs
Lab: Anterior & Posterior Approaches, Ureter Mobilization
3:15 Break
3:30 Small & Large Intestine Lecture: Anatomical Relationships, Clinical Considerations, Mobility and Motility
3:30 Small Intestine: Demo and lab
(Lab VII) Mesenteric Root, Small Intestine, Posterior Peritoneum
5:00 Adjourn

Day Three:
8:00 Review of Day 2 & Questions
8:30 Large Intestine: Demo and lab
Lab: Cecum & Sigmoid
Internal Techniques Urethra & Bladder Lecture: Anatomical Relationships, Clinical Considerations, Mobility & Motility
9:45 Break
10:00 Internal Bladder Techniques: Demo and labs
Lab: Urethra: Longitudinal, Transverse, Bi-Manual Scar, Tissue Release: Indirect/Direct
(Lab X) Perineal Membrane, Pubovesical Ligament, Trigone & Bladder: Indirect/Direct/Mobility, Bladder Motility
12:00 Lunch
1:00 Coccyx and Pelvic Floor Lecture: Anatomical Relationships, Clinical Considerations, Mobility
1:30 Coccyx/Pelvic Floor Techniques: Demo and labs
Lab: Urogenital Diaphragm, Internal Coccyx/Coccygeus, Pelvic Floor/Obturator Foramen
2:15 Thoracic Relationships: Anatomical Relationships, Clinical Considerations, Mobility
2:45 Thoracic Mobilization: Demo and Lab
Lab: Thoracic Mobility at Diaphragm, Ribs, Sternum and Costo-diaphragmatic Recess
3:30 Documentation & Case Study Presentation
4:00 Adjourn



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This is an amazing course. The manual techniques and knowledge gained will have a profound affect on how I will treat, evaluate, and think about my pelvic floor and female patients.
-Rebecca Keller PT - Pennington, NJ

The course was easy to follow, even for someone who has minimal to no background in soft tissue work. Ramona [and the TAs] were all able to guide me through the labs with so much patience. Thanks!
-Eileen Malong, DPT - Plainsboro, NJ

The pig dissection was amazing! Great way to emphasize anatomical relationships. Ramona's examples/experiences were great as well! I have been waiting for this course but it exceeded my expectations.
-Amy Friedman, PT - Mt. Prospect, WA

Just brilliant! I can't wait to start using techniques. Pig dissection was brilliant for putting everything into context.
-Susan McGovern, MISCP - Ireland

I really liked the visceral course. Ramona uses very accessible teaching techniques. I took Visceral Mobilization 1 through Barral, but when I got back to work I was not confident with my skills. After this course, I have used it every day, and I feel like I have a better appreciation for what my goals for this treatment are. I look forward to finding out when the level 2 course will be taught.
-Natalie Hickenbotham - Santa Barbara, CA

I thought the course was by far the best I've taken in my almost 12 years as a PT! My company, Marathon Physical Therapy, hosted the course. One of my colleagues, Kate Chabot, took care of setting up this course and obtaining the mailed materials from Ramona. I thought the highlights of this course were: The instructor, Ramona Horton, was fabulous, such an engaging speaker and extremely knowledgeable. Her TA's in the class (Janette and Rachel) were fantastic as well, they all worked so well together and ensured that each technique was performed on each of us so we could feel what it felt like from a patient's perspective and so we could give feedback to our partners. The course manual is one that I will reference frequently, as the basics behind visceral fascial mobilization are clear as well as step by step instructions for each technique. I have taken other courses that were "hands on" but there was no place in the manual to reference back to and I found that very frustrating. The class ran according to schedule and I feel that the techniques I learned will be a great addition to my women's health treatments.
- Jessica Keaney, MSPT - Norton, MA

Ramona was informative and attentive during lab sessions. Class size was key to learning objectives
- Vanessa Barrett, DPT - Sicklerville, NJ

Great Course with much needed NEW techniques and information.
- Claire Maguire, PT - Durham, NC

I have been trying to get to a visceral course for many years and am so glad that this one was available. I loved Ramona's instruction style and feel I learned techniques that will be applicable in the clinic immediately.
- Anne Duch, MPT - Wilmington, DE

I can't wait to go back to the clinic this week and work with my patients - I have learned some truly valuable techniques for my patients as well as an insight into some sagging symptoms of my own! Thanks Ramona! I will recommend this course.
(P.S. Also love to meet another "anatomy nerd")
- Sarah Talley, MSPT - Raleigh, NC

Wonderful course to take me to the next level of internal techniques done with a very directed purpose.
- Heather Strauch, MSPT - Stamford, CT

I’m excited to take it all back to my patient’s. This is a level of knowledge that has been missing in my clinical care, I’ve wondered for some time how to affect the body in this way. I’m excited to develop my skills. I’ll be back for more!
- Amy Irene Lynch, PT - Port Hadlock, WA

One of the best courses I've had the pleasure to attend! Can't wait for level 2!
- Andrea Bognar, PT – Westfield, IN

The best course I have taken in a while. The instructors were there to help us truly learn the material. I wish she presented more courses through the year on the reproductive system.
- Kathleen Novicki, PT – Cincinnati, OH

Awesome Seminar! Pig dissection was great to help visualize the anatomy.
- Sophie Geissler, PT – Fairfax, VA

Overall great class and extremely useful techniques. Can't wait to try them this week! Looking forward to taking more of Ramona's classes.
- Kathy Pesavento, MSPT, DPT, CMTPT – Vienna, VA

This connected a lot of the dots for me. Enjoyed the teaching staff!
- Ellie Trumble, MS, PT – St. Hilo, HI

Great class! Very helpful for pulling all the systems together and thinking of the whole body.
- Jerri Miller, DPT – Boulder, CO

Very comprehensive, excellent course applicable to both women’s health and many somatic dysfunctions. Thanks for sharing your knowledge and experience. Can’t wait to get home and implement my new, developed skills.
- April Nesham, PT, RCMT, BCB-PMD – Mandan, ND

Great course! Will be helpful for many of my patients. Thank you!
- Debbie Lentz – Issaquah, WA

Ramona and Janette are awesome. Great organization of course. Easy to understand and apply. Very applicable and usable techniques.
- Stacey Gayer, MSPT – Pottstown, PA

Wish more of this material could be presented during other pelvic courses to start integrating into practice earlier.
- Jamie Smith, PT – Westfield, IN

The material was presented in a way that was very usable for clinical practice.
- Marika Zandstra, PT – Merrillville, IN

Outstanding course, very well presented and assisted by Janette. Ramona used a lot of props that visually and tactilely helped to understand the details presented.

- Janine Laughlin, PT – Hudson, OH

I had heard great things about the visceral course and it lived up to my expectations! I look forward to applying new skills and improving my techniques to better help my patients.
- Nadia Ori, PT, DPT - Evanston, IL

This course makes me want to learn more & take the additional visceral mobilization and myofascial release courses.
- Amanda Schaffer, PT, MS, OCS - Winfield, IL

Thank you all for an amazing weekend. Thank you also for the pig disection demonstration. It really helped to bring everything into focus and reinforce the importance and relevance of new tools.
- Gail O'Neill, PT - NY, New York


If there are no courses listed below, we do not have any future events scheduled at this time. Please Contact Us if you want to be notified of future events, or if you would like to bring this course to your location.

Visceral Mobilization 1: The Urologic System - VTUS
Jun 05, 2015 - Jun 07, 2015
Location: Meriter Hospital
$ 650.00
Nov 06, 2015 - Nov 08, 2015
Location: University of Utah Orthopedic Center
$ 625.00