A pessary is a device that is placed in the vaginal canal to support the pelvic organs. They can be worn only during an activity that typically provokes symptoms, such as running, or used almost continuously with periodic cleaning. People looking to avoid or delay pelvic organ prolapse surgery, such as those planning to give birth, may especially benefit from pessary use. Many transgender and nonbinary people with a front canal also find pessary use helpful for reducing POP symptoms.

Pessaries have additional benefits beyond improving prolapse symptoms. For example, some pessaries are designed to mitigate urinary incontinence by applying pressure to the urethra (1). A 2024 study even indicated that they may improve sexual wellness in people with pelvic organ prolapse (2). One case study series suggests that intersex people who have undergone vaginoplasty or neovaginoplasty may also benefit from pessary use for maintaining the patency of the canal (5).

Traditionally in the United States, pessaries have been placed by medical professionals rather than rehabilitation professionals (although some PTs at the Veterans Affairs were involved in fitting pessaries under the guidance of urogynecologists). In 2021, the American Physical Therapy Association’s Academy of Pelvic Health convened a Pessary Task Force to look at the feasibility of physical therapists fitting and managing pessaries. In 2022, the Academy of Pelvic Health released its position statement to include pessary fitting and management in the scope of practice of pelvic health physical therapists in the United States and its five territories. By the end of 2022, the Academy of Pelvic Health hosted its first pessary fitting course. Several more courses have been offered since then. Physical therapists specialize in showing clients how to tend to and support their bodies. Active participation in pessary fitting and management is a way to help the nearly 40% of people with vaginal canals who are expected to develop pelvic organ prolapse. 

Did you know that Ramona Horton is going to be speaking at HWConnect in March? Her lecture is titled, “The Do Not Miss List: What many pelvic rehab therapists overlook." I don’t know about you, but we’re pretty excited to hear what she has to say and to learn from the best!

So, who is Ramona C. Horton MPT, DPT?
Ramona completed her graduate training in the US Army–Baylor University Program in Physical Therapy in San Antonio, TX. She exited the army at the rank of Captain and applied her experience with the military orthopedic population in the civilian sector as she developed a growing interest in the field of pelvic dysfunction and received her post-professional Doctorate in Physical Therapy from A.T. Still University in Mesa, AZ. In 2020, Ramona received the prestigious Academy of Pelvic Health Elizabeth Noble Award for her contributions to the field of pelvic health.

Ramona is the lead therapist for her clinic's pelvic dysfunction program in Medford, OR where her practice focuses on the treatment of urological, gynecological, and colorectal issues. Ramona has completed advanced studies in manual therapy with an emphasis on spinal manipulation, and visceral and fascial mobilization.

As the holiday season approaches, it’s the perfect time to prioritize what truly matters. Join us March 28-30 at HWConnect in Seattle, WA to discover the power of networking, learning, and growth as we come together to celebrate the gift of connecting to one another. At Herman & Wallace, we believe that connection is the heart and soul of meaningful relationships, personal growth, and professional opportunities.

Networking opportunities throughout the event allow attendees to connect with like-minded individuals, share ideas, and build lasting relationships. Through structured networking sessions, informal social gatherings, and interactive activities, attendees will be able to expand their professional network and form meaningful connections with others in their industry. These networking opportunities are a highlight of HWConnect and create a supportive and collaborative environment where new friendships are formed, and partnerships can be forged.

Keynote speakers and topics include Dawn Sandalcidi, PT, RCMT, BCB-PMD lecturing on the “Development of Continence Through The Lens of The Diaphragm, Ribcage, and Pelvic Floor;” Nancy Norton, RN discussing “The Power of Humor for Pelvic Healers,” and Leticia Nieto, PsyD, LMFT, TEP who will be delving into “Trauma Responsive Care for Those We Work With and for Us.”

Pessaries and Pelvic Rehab includes 6 hours of pre-course video lectures that cover relevant pelvic anatomy, types of prolapse, indications and contraindications for prolapse, and medical-legal considerations for pessary fitting. The in-person portion will include labs on advanced POP assessment and assessment of vaginal dimensions, as well as provide participants the opportunity to fit various pessary types under the supervision of an instructor.

This two-day in-person course is targeted to pelvic therapists who are interested in adding pessary fitting to their clinical practice and have completed Pelvic Function Level 1 and Level 2B.

Attendees will:

If you haven’t registered yet then consider this your personal invitation to join us at HWConnect 2025 in beautiful Seattle, Washington. Take advantage of this golden opportunity to network, learn, and expand your toolkit. The conference will be here before you realize it – and tickets are limited! PLUS, if you register now, you can reserve your room at a special discounted rate. 

FRIDAY  SPEAKER LINEUP
Ramona Horton, MPT, DPT - "The Do Not Miss List: What many pelvic rehab therapists overlook"
Ramona Horton, MPT, DPT developed and instructs the visceral and fascial mobilization courses for HW and frequently presents at local, national, and international venues – including International Pelvic Pain Society, CSM and HWConnect- on topics relating to women’s health, pelvic floor dysfunction, and manual therapy.

Discover Inclusive Care for Gender and Sexual Minorities in this interview with Brianna Durand, an expert in inclusive care for gender and sexual minorities. In this insightful video, Durand discusses the importance of tailored and compassionate healthcare for individuals who identify as LGBTQ+.

Gain valuable insights as Durand shares her extensive knowledge on the unique challenges faced by these communities and how to provide comprehensive and inclusive care. With a focus on creating safe and welcoming spaces for all individuals, this video provides valuable information for healthcare professionals and anyone looking to support the LGBTQ+ community.

Are you looking to improve your knowledge and understanding of inclusive care for the LGBTQ+ community? Look no further! Our remote course on Inclusive Care for Gender and Sexual Minorities is here to guide you through the most important principles and best practices in providing compassionate and equitable care for individuals of all gender identities and sexual orientations.

At Herman & Wallace, we’re committed to providing practitioners with the knowledge and skills they need to offer the best care possible. We’ve heard your feedback regarding the lack of familiarity with rectal balloon catheters, and we’re excited to announce a new remote course: Anorectal Balloon Catheters: Introduction and Practical Application.

Course Overview
This short but comprehensive course offers 5.5 contact hours dedicated to the essential aspects of using rectal balloon catheters in treating patients experiencing defecatory dysfunction. It is designed for those who have completed Pelvic Function Level 1.

While this course will be conducted remotely, participants are required to register with another clinician to facilitate hands-on lab practice.

HWConnect is scheduled for March 28-30, 2025 in Seattle Washington. HWConnect tickets include all speakers, breakout sessions, labs, mixers, vendor hall time, and reception.

The HW admin team has been hard at work filling speaker spots, building breakout sessions, and creating fun new experience ideas for the upcoming 2025 conference.

If you're into pelvic health then this is the conference for you. HWConnect was created to provide a top-tier networking event for pelvic rehabilitation practitioners that focuses on providing a safe environment for professional development, exposure to new products, and sharing inspiration for all things pelvic health.

HWConnect features keynote speakers, breakouts, labs, and educational sessions. Topics range from pediatrics with Dawn Sandalcidi to gender-affirming care with Ken McGee. HWConnect is all about connection - the name says it all. Network. Learn. Grow. Repeat.

We are preparing for a busy second half of the year, and are seeking hosts for our satellite and in-person course offerings. If you'd like to cut down on travel and earn a free course registration, consider hosting a course with us this year! Satellites require a minimum space for 16 attendees, and in-person courses need to be able to accommodate 30+.

We always want to hear from those interested in hosting our courses. We work with healthcare organizations of all types, sizes, and locations. Please, Contact us about hosting Pelvic Function Level 1 or any other course!

There are two formats of course which you can host, and they are described below.