The Pelvic Rehab Report recently caught up with Katie Woolf, DPT, in order to hear a bit about her recent experience at H&W's Pudendal Neuralgia course in Salt Lake City. The Pudendal Neuralgia course was developed and is instructed by faculty members Loretta Robertson and Tracy Sher. Katie had this to say about her experience in the course:

I recently attended the Pudendal Neuralgia course in Salt Lake City, Ut. It was a fabulous experience! The instructors were Tracy and Lorretta. They are such darling ladies. They have a contagious passion and endless knowledge of pelvic rehabilitation. This was my second Herman and Wallace course and I have never been disappointed. The facilities for the course were perfect as well.

This course opened my eyes to pelvic pain, pudendal neuralgia (PN), pelvic dysfunction, and how to recognize and manage it. The instructors gave an evidence based practice review and personal testimony of PN and how they treat patients with PN. The instructors were knowledgeable about anatomy, treatment interventions, and surgical interventions for to PN. Most of all they made it a fun course.

Update: Please note that this course is now only offered online through the instructor's website. For more information visit https://pelvicpainrelief.com/laser/

Herman & Wallace is announcing a new course on laser therapy for pelvic pain! The Pelvic Rehab Report caught up with the instructor, Isa Herrera.

Low-Level Laser Therapy for Female Pelvic Pain Conditions will be taking place in New York City, NY on October 3-4, 2015

Laser Therapy For Female Pelvic Pain was developed by Isa Herrera MSPT, CSCS for Herman and Wallace specifically for women’s health clinicians. Ms. Herrera is the author of 4 books, including the breakthrough book, Ending Female Pain, A Woman’s Manual, now in its 2nd Edition. Ms. Herrera has appeared on several national TV and radios shows including on MTV True Life, The Regis and Kelly Show and NBC’s Today Show. She lectures nationally on the topic of women’s health and has been a passionate advocate about pelvic health for over 10 years.

Patients who suffer severe bladder damage or bladder disease such as invasive cancer may have the entire bladder removed in a cystectomy procedure. Once the bladder is removed, a surgeon can use a portion of the patient's ileum (the final part of the small intestines) or other part of the intestine to create a pouch or reservoir to hold urine. This procedure can be done using an open surgical approach or a laparoscopic approach. Once this new pouch is attached to the ureters and to the urethra, the "new bladder" can fill and stretch to accommodate the urine. As the neobladder cannot contract, a person will use abdominal muscle contractions along with pelvic floor relaxation to empty. If a person cannot empty the bladder adequately, a catheter may need to be utilized. (A prior blog post reported on potential complications of and resources for learning about neobladder surgery.)

During the recovery from surgery, patients will wear a catheter for a few weeks while the tissues heal. Once the catheter has been removed, patients may be instructed to urinate every 2 hours, both during the day and at night. Because patients will not have the same neurological supply to alert them of bladder filling, it will be necessary to void on a timed schedule. The time between voids can be lengthened to every 3-4 hours. Night time emptying may still occur up to two times/evening. Patient recommendations following the procedure may include that patients drink plenty of fluids, eat a healthy diet, and gradually return to normal activities. Adequate fluid is important in helping to flush mucous that is in the urine. This mucous is caused by the bowel tissue used to create the neobladder, and will reduce over time.

Urinary leakage is more common at night in patients who have had the procedure, and this often improves over a period of time, even a year or two after the surgery. As pelvic rehabilitation providers, we may be offering education about healthy diet and fluid intake, pelvic and abdominal muscle health and coordination, function retraining and instruction in return to activities. In addition to having gone through a major surgical procedure, patients may also have experienced a period of radiation, other treatments, or debility that may limit their activity levels. The Pelvic Rehabilitation Institute is pleased to offer courses by faculty member Michelle Lyons in Oncology and the Pelvic Floor, Part A: Female Reproductive and Gynecologic Cancers, and Part B: Male Reproductive, Bladder, and Colorectal Cancers. If you would like to explore pelvic rehabilitation in relation to oncology issues, there is still time to register for the Part A course taking place in Torrance, California in May! If you would like to host either of these courses at your facility, let us know!

In our weekly feature section, Pelvic Rehab Report is proud to present this interview with Herman & Wallace instructor Michelle Lyons, PT, MISCP

How did you get started in pelvic rehab?

Like a lot of therapists whom I talk to when I travel and teach, it was after the birth of my daughter, when I realized what an under-served population postpartum women are! After childbirth, the focus almost entirely shifts to the baby, and poor old Mum is left, by and large, to fend for herself. Now, more than ever, when we are looking at shorter hospital stays and the lack of maternity leave, we as pelvic therapists need to grow awareness of the needs of women throughout the life cycle and what we have to offer. Pelvic rehab is a high touch, low risk, cost effective and highly effective (yet under used) treatment option. I am passionate about spreading the Pelvic Rehab Gospel!

In our weekly feature section, Pelvic Rehab Report is proud to present this interview with Herman & Wallace instructor Jennafer Vande Vegte, MSPT, BCB-PMD, PRPC

How did you get started in pelvic rehab?

A supervisor of mine suggested that I go to a course and develop a pelvic floor program. I thought she was nuts. As a late twenty-something, I wanted to work with athletes. Finally she convinced me to go. Imagine my surprise when I felt like a duck in the water in the Pelvic Floor Level 1 class.

An article appearing this year in Arthroscopy details a systematic review completed to determine if asymptomatic individuals show evidence on imaging of femoroacetabular impingement, or FAI. Cam, pincer, and combined lesions were included in the results. To read some basics about femoroacetabular injury, click here. Over 2100 hips (57% men, 43% women) with a mean age of 25 were studied. (Only seven of the 26 studies reported on labral tears.) The researchers found the following prevalence in this asymptomatic population:

Cam lesion: 37% (55% in athletes versus 23% in general population)

Pincer lesion: 67%

In our weekly feature section, Pelvic Rehab Report is proud to present this interview with newly certified practitioner Reeba Varghese, DPT. PRPC.

How did you get involved in the pelvic rehabilitation field?

I was asked to attend a course by my director back in 2008 because they wanted to expand pelvic rehabilitation services to a few of our company's locations. I told my director I did not think this specialty was for me but I would be willing to attend one course and see how I felt. When I attended PF1 I was immediately drawn in by the wealth of knowledge I gained. Learning the intricacies of the human anatomy, specifically the female anatomy just completely opened my eyes to one of Gods most amazing creations. Also, the passion in the instructors was contagious. When I returned to work and started to see patients with incontinence and listened to their stories my passion for supporting these individuals in their rehabilitation journey began to grow. As I continued to expand my knowledge base by attending more courses through Herman and Wallace I realized I had found my niche in the world of physical therapy.

In our weekly feature section, Pelvic Rehab Report is proud to present this interview with newly certified practitioner Amy Robinson, PT, PRPC, CLT.

What/who inspired you to become involved in the pelvic rehabilitation field?:

I first learned about pelvic rehabilitation while I was a student at the Indiana University Physical Therapy program. The instructor brought in speakers for special topics sessions and I must admit I knew at that moment that pelvic rehab was an area of interest for me. However, I was hesitant to start in the area of pelvic health as I felt I needed to gain experience as a new graduate, and I also wasn’t sure I would feel comfortable performing pelvic examinations. I chose to work in a hospital setting for one year, a long term care setting for 2 years, and then transitioned into outpatient physical therapy. There were numerous times in each of those settings that it was apparent pelvic rehabilitation was the missing link in the patients’ treatment plan. In 1998 we had a physician, Dr. Scott Miles, approach the president of the rehabilitation company that I worked for and request that they train a women’s health physical therapist. This was my opportunity and I took my first course with Kathe Wallace, PT. I remember thinking that she was a wealth of knowledge and her enthusiasm allowed me to get over the trepidation of performing pelvic examinations. She allowed me to focus on the examination process itself, how to apply critical thinking to the patient symptoms and evaluation findings, and how to pick the appropriate treatments. I was hooked! I feel very blessed to have had the opportunity to participate in several continuing education courses all over the country from so many very talented Pelvic Health Practitioners and each and every one of them have inspired me in some way to continue to learn and perfect my skills as a pelvic practitioner.

In our weekly feature section, Pelvic Rehab Report is proud to present this interview with newly certified practitioner Amy C. Sanderson, PT, OCS, PPRC.

Describe your clinical practice.:

I am a co-owner of a private physical therapy practice in the Spokane, Washington area. We currently have 3 clinics and staff 14 providers overall. I have been an Orthopaedic Certified Specialist since 1996, and our clinic is primarily an orthopedic setting. We do, however, provide several specialties, including Pelvic Rehab, Vestibular Program, and Video Gait Analysis for athletes.

In our weekly feature section, Pelvic Rehab Report is proud to present this interview with newly certified practitioner Michele Syska, PT, PRPC

Describe Your Clinic:

Orthopedic manual based.  I love figuring out how mechanical issues may be affecting the current presentation.   I would also characterize my practice as open.  I’m up for trying new ideas either from course work, other therapists or patients.  I enjoy learning from the experience of others and have an open mind to many techniques.