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The following is a guest submission from Alysson Striner, PT, DPT, PRPC. Dr. Striner became a Certified Pelvic Rehabilitation Practitioner (PRPC) in May of 2018. She specializes in pelvic rehabilitation, general outpatient orthopedics, and aquatics. She sees patients at Carondelet St Joesph’s Hospital in the Speciality Rehab Clinic located in Tucson, Arizona.

Myofascial pain from levator ani (LA) and obturator internus (OI) and connective tissues are a frequent driver of pelvic pain. As pelvic therapists, it can often be challenging to decipher whether pain is related to muscular and/or fascial restrictions. A quick review from Pelvic Floor Level 2B; overactive muscles can become functionally short (actively held in a shortened position). These pelvic floor muscles do not fully relax or contract. An analogy for this is when one lifts a grocery bag that is too heavy. One cannot lift the bag all the way or extend the arm all the way down, instead the person often uses other muscles to elevate or lower the bag. Over time both the muscle and fascial restrictions can occur when the muscle becomes structurally short (like a contracture). Structurally short muscles will appear flat or quiet on surface electromyography (SEMG). An analogy for this is when you keep your arm bent for too long, it becomes much harder to straighten out again. Signs and symptoms for muscle and fascial pain are pain to palpation, trigger points, and local or referred pain, a positive Q tip test to the lower quadrants, and common symptoms such as urinary frequency, urgency, pain, and/or dyspareunia.

For years in the pelvic floor industry there has been notable focus on vocabulary. Encouraging all providers (researchers, MDs, and PTs) to use the same words to describe pelvic floor dysfunction allowing more efficient communication. Now that we are (hopefully) using the same words, the focus is shifting to physical assessment of pelvic floor and myofascial pain. If patients can experience the same assessment in different settings then they will likely have less fear, and the medical professionals will be able to communicate more easily.

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Upcoming Continuing Education Courses

Pelvic Floor Level 2B - Annapolis, MD Satellite Course (SOLD OUT)

Jan 29, 2022 - Jan 30, 2022
Location: Lynch Physical Therapy

Oncology of the Pelvic Floor Level 1 - Remote Course

Jan 29, 2022 - Jan 30, 2022
Location: Replacement Remote Course

Postpartum Rehabilitation - Remote Course

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Pelvic Floor Level 2B - Tampa, FL Satellite Course (SOLD OUT)

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Location: Bloom Pelvic Therapy

Pelvic Floor Level 2B - Lansdale, PA Satellite Course

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Location: Ivy Rehab (Lansdale, PA)

Pelvic Floor Level 2B - Shelby, NC Satellite Course

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Location: Ivy Rehab Physical Therapy (Shelby, NC)

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Pelvic Floor Level 2B - Tullahoma, TN Satellite Course

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Location: TOP Rehab

Pelvic Floor Level 2B - South Jordan, UT Satellite Course

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Location: South Jordan Health Center

Pelvic Floor Level 2B - Self-Hosted

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Location: Self-Hosted Course

Coccydynia and Painful Sitting - Remote Course

Feb 4, 2022
Location: Short Form Remote Course

Athletes & Pelvic Rehabilitation - Remote Course

Feb 5, 2022 - Feb 6, 2022
Location: Replacement Remote Course

Yoga for Pelvic Pain - Remote Course

Feb 5, 2022 - Feb 6, 2022
Location: Replacement Remote Course

Pudendal Neuralgia and Nerve Entrapment - Remote Course

Feb 5, 2022 - Feb 6, 2022
Location: Replacement Remote Course

Pelvic Floor Level 1 - Los Angeles, CA Satellite Location (SOLD OUT)

Feb 5, 2022 - Feb 6, 2022
Location: Origin Physical Therapy

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Feb 5, 2022 - Feb 6, 2022
Location: Hands of Hope Physical Therapy

Pelvic Floor Level 1 - Providence, RI Satellite Location (SOLD OUT)

Feb 5, 2022 - Feb 6, 2022
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Fertility Considerations for the Pelvic Therapist - Remote Course

Feb 5, 2022
Location: Short Form Remote Course

Pelvic Floor Level 1 - Chicago, IL Satellite Location (SOLD OUT)

Feb 5, 2022 - Feb 6, 2022
Location: Advocate Illinois Masonic Medical Center

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Feb 5, 2022 - Feb 6, 2022
Location: Riverside Physical Therapy - Regional Medical Center

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Feb 5, 2022 - Feb 6, 2022
Location: Enhanced Therapy Services

Pelvic Floor Level 1 - Leavenworth, KS Satellite Location

Feb 5, 2022 - Feb 6, 2022
Location: University of Saint Mary

Pelvic Floor Level 1 - Self-Hosted

Feb 5, 2022 - Feb 6, 2022
Location: Self-Hosted Course

Pelvic Floor Level 1 - San Diego, CA Satellite Location (SOLD OUT)

Feb 5, 2022 - Feb 6, 2022
Location: FunctionSmart Physical Therapy

Pelvic Floor Level 1 - Virginia Beach, VA Satellite Location

Feb 5, 2022 - Feb 6, 2022
Location: Ivy Rehab (Virginia Beach, VA)

Pelvic Floor Level 2A - Self-Hosted

Feb 12, 2022 - Feb 13, 2022
Location: Self-Hosted Course

Pregnancy Rehabilitation - Remote Course

Feb 12, 2022 - Feb 13, 2022
Location: Replacement Remote Course

Pelvic Floor Level 2A - Torrance, CA Satellite Course (SOLD OUT)

Feb 12, 2022 - Feb 13, 2022
Location: Women's Advantage Inc

Pelvic Floor Level 2A - Eagan, MN Satellite Course (SOLD OUT)

Feb 12, 2022 - Feb 13, 2022
Location: Twin Cities Orthopedics