Allison Ariail, PT, DPT, CLT-LAANA, BCB-PMD is one of the creators of the Herman & Wallace Oncology of the Pelvic Floor Course Series. Allison Ariail is a physical therapist who started working in oncology in 2007 when she became certified as a lymphatic therapist. She worked with breast cancer, lymphedema patients, head and neck cancer patients, and the overall oncology team to work with the whole patient to help them get better. When writing these courses, Allison was part of a knowledgeable team that included Amy Sides and Nicole Dugan among others.

June is National Cancer Survivor Month. When individuals talk about “survivorship,” they are referring to the process of navigating their life experiences and the difficulties that they have as a result of their cancer diagnosis. Survivorship begins at the time of diagnosis and includes those individuals that are undergoing treatment, those after treatment with no signs of cancer, those undergoing extended treatment to control the cancer, those undergoing extended treatment to reduce the risk of the return of cancer, and those individuals with advanced cancer. According to cancer.net, there were 18 million people in the United States living with a history of cancer.¹ Considering the number of people surviving cancer, and the degree of medical treatment can vary for each of them, there will be a wide range of needs from cancer survivors.  Rehabilitation professionals are in a unique position where we can help patients in many different ways to help improve their function, ability to participate in activities that they enjoy and improve their quality of life. 

There are multiple studies that show how rehabilitation can help cancer survivors. The research varies in its focus; it could be examining specific side effects such as chemotherapy-induced peripheral neuropathy, looking at the effects of fatigue after treatment, or to sexual health after cancer diagnoses. In January of this year, a study came out that showed a physical rehabilitation program of moderate intensity promoted a relief of general and physical fatigue.² This is huge for cancer patients! Fatigue is an immense problem that survivors suffer from. Another study from 2019 showed that a 12-week exercise-based training program can negate some of the deficits that occur in strength and physical function that occur from the medical treatment of cancer.³ The exercise program, which included both aerobic and resistance training, helped both middle-aged and older adults improve their physical function and strength. In 2018 Dennet et al performed a qualitative study of cancer survivors’ experiences of an exercise-based rehabilitation program. They determined that an exercise-based cancer rehabilitation program was important in facilitating a ‘return to normal’ and helped patients increase their ability to participate in physical activities.⁴ 

Herman & Wallace is celebrating Memorial Day Weekend! 

Herman & Wallace is offering *for a limited time only* a $50 coupon code for online registration of any specialty course! The special code to use during checkout is 𝗛𝗢𝗡𝗢𝗥. 

What are the top 3 takeaways a practitioner could hope to gain from this class?

NC - 1. Better self-care in and out of the clinic. 2. A more effective and less taxing way to interact with clients, share responsibility, and communicate in more helpful ways for both practitioner and patient. 3. enjoying their life and having more energy for their life outside of work.

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.

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 . . .

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.

The official Herman & Wallace blog. New blogs post every Friday on topics relating to the field of pelvic floor dysfunction.

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.

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.

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.