Electrostimulation is a conservative treatment of improving bladder function. This can be performed parasacrally, intravaginally or by stimulation of the tibial nerve (Wang and Liu, 2022, Jacomo et al, 2020, Bhide et al 2019, Padilha et al., 2020).

There are faculty members who teach courses, and then there are faculty members who help define the standard of education in an entire specialty. Pamela A. Downey, PT, DPT, WCS, BCB-PMD, PRPC, is the latter. A Senior Faculty member at Herman & Wallace since 2006, Dr. Downey has spent nearly two decades shaping how clinicians learn to assess and treat pelvic floor dysfunction, and she shows no signs of slowing down.

We are proud to spotlight one of the longest-serving and most accomplished educators in our institute.

A Clinician and Educator Since 1991

Half the world's population experiences a menstrual cycle, yet social stigma, clinical discomfort, and gaps in provider training often leave patients without the information, tools, or permission they need to manage it well. Pelvic rehab clinicians frequently find themselves on the receiving end of questions no one else has been willing to answer. What is a normal period? Why does my cycle affect my pelvic floor symptoms so much? What products actually work, and how do I choose the right one? Is this amount of pain something I should just live with?

These are the questions Nicholas Gaffga, MD, MPH, FAAFP and Amy Meehan, PT, DPT, MTC set out to address when they built the Herman & Wallace remote course Menstruation and Pelvic Health. The course is designed for pelvic rehab providers who want to go beyond treating isolated symptoms and instead help patients reshape the menstrual experience itself through non-hormonal, non-prescription, and non-surgical interventions.

What the Course Covers

Few modalities have generated as much clinical conversation in the last five years as low-intensity extracorporeal shockwave therapy. Once reserved for kidney stones and elite sports medicine clinics, shockwave has now crossed into pelvic health, with growing applications for chronic pelvic pain, erectile dysfunction, genitourinary syndrome of menopause, and stress urinary incontinence. For clinicians considering whether to add this tool to their practice, the first question is always the same. Does the research support what the marketing claims?

Stacey Roberts, PT, RN, MSN has built her teaching career around answering that question with rigor. Her Herman & Wallace remote course, Shockwave Treatment, gives pelvic rehab clinicians a clear-eyed look at the evidence, the device landscape, and the clinical protocols that actually work.

From Home Care to Pelvic Health: A Journey Guided by Faith, Mentorship, and Resilience

Sometimes the most meaningful career paths aren’t the ones we plan. For Herman & Wallace faculty member Carole High Gross, PT, MS, DPT, PRPC, the road to becoming a leader in pelvic health rehabilitation was shaped by unexpected challenges, pivotal relationships, and a willingness to trust the journey even when the destination wasn’t yet visible.

We recently sat down with Carole to talk about her career, her calling, and the work that drives her. What unfolded was one of the most compelling stories of resilience and purpose we’ve heard.

A new peer-reviewed publication in the Journal of Women’s & Pelvic Health Physical Therapy expands the evidence base for non-surgical, patient-centered care.

By Rachna Mehta, PT, DPT, CIMT, OCS, PRPC, RYT 200

Herman & Wallace Faculty Member  

Anorectal balloon catheter training is one of the most underrated but helpful treatments for people with pelvic floor symptoms related to bowel dysfunction. This is a tool that many clinicians don’t know about or are afraid to initiate with their clients. Clinicians wonder if clients will be receptive, how to use an anorectal balloon catheter efficiently, and frequently wonder what cases are appropriate for this specific modality. Anorectal balloon catheter training is a versatile treatment helping patients with pelvic floor conditions that stem from hyposensitivity or hypersensitivity in the rectal canal.

Rehab clinicians can use anorectal balloon catheters to help with defecation training, anorectal sensory training, coordination training, and resistance training that can improve symptoms for individuals with fecal incontinence, fecal urgency, and chronic constipation as well as other colorectal diagnoses. This modality can be used to improve the coordination between the pelvic floor muscles and the abdominal muscles to assist in defecation training. It also can help a patient learn what the urge to have a bowel movement should feel like, especially if they have altered sensation in the anal canal. 

Pelvic rehabilitation is a constantly evolving specialty, and your ability to offer high-quality care grows when you have access to a diverse set of tools. Modalities play a significant role in strengthening clinical precision, improving neuromuscular learning, enhancing patient engagement, and expanding treatment possibilities. When you integrate evidence-based modalities into your practice, you elevate the effectiveness and individualization of your patient care.

Here are the top five reasons modalities matter in pelvic rehabilitation, along with examples of tools that can support your work

1. Modalities Improve Your Clinical Precision

Pelvic health presentations often involve complex relationships between muscle tone, coordination, pain, biomechanics, breathing patterns, and emotional factors. Modalities help you see these interactions more clearly and treat them more effectively.

Are you a clinician passionate about pelvic rehabilitation and ready to take your expertise to the next level? The Pelvic Rehabilitation Practitioner Certification (PRPC) from Herman & Wallace is designed to recognize advanced practitioners who provide comprehensive pelvic health care to patients of all genders and ages.

Whether you’re a physical therapist, occupational therapist, nurse, or physician, PRPC sets you apart as a leader in the field—backed by rigorous standards and national recognition.

🗓 Upcoming Exam Window: November 1–15, 2025

Application Deadline: October 1, 2025
👉 Apply Now