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Herman & Wallace faculty member Dr. Heather Rader has created an all-inclusive pelvic rehabilitation course for physical and occupational therapists who treat patients in the home health setting Home Health and Pelvic Rehab - External Skills for the Home Environment.

61% of females and 38% of males over the age of 65 have some form of urinary and fecal incontinence, and nearly half of the patients receiving home health care have incontinence1. Despite these statistics, bladder and bowel symptoms are relegated to being part of the medical history rather than treatable impairments.

Home health therapists are required to ask about the presence of urinary and fecal incontinence as part of the admittance form, known as the OASIS. That’s typically where the conversation ends. This course will teach therapists how to quickly screen for the type of urinary incontinence, constipation, and pelvic pain conditions with simple and unintimidating interview skills. This can open the door to meaningful treatment interventions.

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Darla Cathcart, PT, DPT, WCS, CLT  graduated from Louisiana State University (Shreveport, LA) with her physical therapy degree, performed residency training in Women’s Health PT at Duke University, and received her Ph.D. from the University of Arkansas Medical Sciences. Her dissertation research focus was on using non-invasive brain stimulation to augment behavioral interventions for women with lifelong vaginismus, and her ongoing line of research will continue to center around pain with intercourse. Darla is part of Herman & Wallace's core faculty and instructs Pelvic Floor Level 1, Level 2A, and Level 2B, the Pregnancy & Postpartum Series, and recently launched her own course Vaginismus and Vulvovaginal Dyspareunia.

How is this class different from the information in Pelvic Floor 2B?
The main difference is in the questions that these two courses answer: "what treatments can I use" versus "how can I use those treatments effectively?" In Pelvic Floor Level 2B, participants are told about various methods for addressing pain with intercourse (such as using vaginal trainers/dilators and manual therapy techniques), with brief descriptions of how to use some of these tools. In this Vaginismus and Vulvovaginal Dyspareunia course, we go into depth on how to use these treatments specifically based on a patient's examination findings and goals.

What are the top 5 takeaways a practitioner could hope to gain from this class?
1. Vaginal Trainers (dilators) can be more effective when going beyond "just sticking them in."Traditionally, patients have been taught to just insert "dilators" to a point of stretching and discomfort, and to hold that stretch, maybe even distract themselves from the activity by watching TV or reading a book. As with other areas of the body, using active methods to increase tissue flexibility, such as incorporating contract-relax and breathing techniques, can really enhance the treatment! During the labs in this 100% remote course (a combination of self-paced preview videos and live online instruction), participants will be guided through step-by-step instructions for using and progressing through vaginal trainers and other treatments (the same step-by-step instructions you can use with your patients on Monday morning!). Additionally, as in other areas of the body, focusing on the body part that is being worked on is beneficial for increasing motor control, which is also desirable for addressing pelvic floor muscles that have too much tone and tenderness or pain with attempts at insertion. Participants will also be walked through activities that increase the brain's connection with and control of the pelvic floor and genitals, thus tapping into contemporary pain science concepts as well. And speaking of pain science . . .

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Hello Practitioners!

This Monday I would like to share a very special invitation with you. Join us in Seattle, WA for HWConnect 2023 - the first-ever conference from Herman & Wallace, the leading provider of continuing education to pelvic rehabilitation professionals. HWConnect 2023 will run Friday, October 6 - Sunday, October 8 and comprises 10+ contact hours of continuing education.

The Saturday night Keynote Presentation will be given by Diane Lee, an internationally-recognized expert with 40 years of clinical experience in thoracic, lumbar, and pelvic disability and pain. Diane will be delivering our Saturday night keynote address and will be presenting her latest research on diastasis rectus abdominis.

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Nicholas Gaffga, MD, MPH, FAAFP sat down with The Pelvic Rehab Report this week to discuss himself and how he came to TA (and teach) for Herman & Wallace. Niko is scheduled to TA next in Birmingham, AL for Pelvic Floor Level 1 scheduled March 4-5 2023, and will be instructing Menstruation and Pelvic Health on February 25-26 2023.

 

Who are you?
Describe your clinical practice. My name is Niko Gaffga, and I am a family medicine physician seeing patients in Atlanta, GA. Over the 20 years I have been practicing medicine, I have worked in a number of settings: pediatrics, gerontology, emergency room, ICU, HIV prevention in Africa for 4 years, occupational medicine, travel medicine, and obstetrics and gynecology. As I look back over these memories, the area of work where I most feel connected with my patients is women’s health and outpatient gynecology.

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Ziya Altug, PT, DPT, MS, OCS is a board-certified doctor of physical therapy with 32 years of clinical experience treating musculoskeletal injuries. Z currently provides outpatient physical therapy in the home setting in Los Angeles, California, and serves as a continuing education instructor. He received his Bachelor of Science in Physical Therapy at the University of Pittsburgh in 1989, a Master of Science in Sport and Exercise Studies in 1985, a Bachelor of Science in Physical Education in 1983 from West Virginia University, and a Doctor of Physical Therapy from the College of St. Scholastica in 2015. Z is a long-standing member of the American Physical Therapy Association and a member of the American College of Lifestyle Medicine. He has attended workshops in yoga, tai chi, qigong, Pilates, Feldenkrais Method, and the Alexander Technique.

Dr. Altug is the author of the books Integrative Healing: Developing Wellness in the Mind and Body (2018), The Anti-Aging Fitness Prescription (2006), and Manual of Clinical Exercise Testing, Prescription, and Rehabilitation (1993). In 2020, he published the chapter Exercise, Dance, Tai Chi, Pilates, and Alexander Technique in The Handbook of Wellness Medicine. In 2021, he published the article Lifestyle Medicine for Chronic Lower Back Pain: An Evidence-Based Approach in the American Journal of Lifestyle Medicine. Z joins the H&W faculty and is presenting his personally curated course Integrative and Lifestyle Medicine Toolbox for Rehab and Pain Management. This week he sat down with The Pelvic Rehab Report to discuss his course.

 

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Janet Drake Whalen, PT, DPT sat down with The Pelvic Rehab Report this week to discuss herself and how she came to TA for Herman & Wallace. Janet is scheduled to TA next at the Doylestown PA for Pelvic Floor Level 1 scheduled January 7-8 2023.

 

Hi Janet, can you tell us a little bit about yourself and your clinical practice?
I am a physical therapist with 36 years of experience who has spent 34 years of my career in women’s health physical therapy. Over my career, I have been an advocate and continue to promote abdominal and pelvic health for all.  My career led me to become a Lamaze-educated childbirth educator, certified neuroscience practitioner, women’s health coach, and professional yoga therapist. My clinical practice now is in a hospital setting where I am educating outpatient therapy staff, healthcare providers, and physicians on pelvic health.  I am heading the start of a 4th-trimester program and a sexual health program.

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Tara Sullivan, PT, DPT, PRPC, WCS, IF sat down with Holly Tanner and The Pelvic Rehab Report to discuss her course, Sexual Medicine in Pelvic Rehab. Tara started in the healthcare field as a massage therapist, practicing for over ten years including three years of teaching massage and anatomy, and physiology. Tara has specialized exclusively in Pelvic Floor Dysfunction treating bowel, bladder, sexual dysfunctions, and pelvic pain since 2012. 

 

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Aparna Rajagopal, PT, Mhs, PRPC, and Leeann Taptich, PT, DPT are the authors and instructors of the Breathing and the Diaphragm remote course. Aparna and Leeann bring a wealth of experience to this course. 

Aparna: About 10-plus years ago I had a patient who had a large para esophageal hernia which had been surgically repaired. She had been referred to therapy because of general debility and weakness and she couldn't do endurance-based things like gardening or walking for long periods of time. She was in her mid-sixties. She had seen 2 or 3 therapists and they couldn’t figure things out. She had the same complaint that she couldn’t breathe and every time she said she couldn’t breathe the therapist would obviously refer her back to the doctor who would run cardiac tests, and all kinds of other tests and say she was cleared from a medical standpoint and then send her back to therapy. So in this process, the patient came to me and one of the first things she said was that she had difficulty taking in a breath of air -that she felt like she couldn’t expand - not that she couldn’t breathe.

Based on that complaint, I started my assessment. I started looking at the thoracic spine and found that she actually couldn’t expand from the rib cage at all because of her surgery to fix her large para esophageal hernia. One of the things we know about para esophageal hernias is also that it can be associated with increased intraabdominal pressure - related to things like chronic severe constipation, chronic cough, etc. She got better. She healed, and I realized that this was something that patients needed. In the process of treating her, my interest in breathing and the diaphragm developed.

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Kelley Kukis, DPT, PRPC sat down with The Pelvic Rehab Report this week to discuss herself and how she came to TA for Herman & Wallace.

Who are you? Describe your clinical practice.
I’m Kelley Kukis, DPT, PRPC, and I’m a pelvic PT at East Sacramento Physical Therapy, or East Sac PT as we are referred to locally. East Sac PT has been a pelvic health clinic for over 30 years, and early on the owners, Risa and Jim MacDonald had to educate other medical providers about what pelvic PT was and how it would help their patients. Now the clinic treats adult and pediatric patients of all genders with pelvic dysfunction as well as adult patients with orthopedic conditions.

I also organize the Sacramento Pelvic and Sexual Health Professionals Network (Sac PuSHPiN), which is a network of PTs, MDs, mental health therapists, sex educators, and more, who meet quarterly and share ideas about pelvic and sexual health.

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Today The Pelvic Rehab Report is featuring two short interviews with instructor teams Alyson Lowrey & Tara Sulivan who teach Pain Science for the Chronic Pelvic Pain Population, and Sandra Gallagher & Caitlin Smigelski who teach Transgender Patients: Pelvic Health and Orthopedic Considerations.

 

The Pain Science for the Chronic Pelvic Pain Population instructors Alyson N Lowrey, PT, DPT, OCS &Tara Sullivan, PT, DPT, PRPC, WCS, IF answered the following two questions:

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