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Ramona Horton's Fascial Mobilization Series Series

Ramona Horton's Fascial Mobilization Series Series

Mobilization Series Schedule 2022

This blog includes portions of an interview with Ramona Horton. Ramona serves as the lead therapist for her clinic's pelvic dysfunction program in Medford, OR. Her practice focuses on patients with urological, gynecological, and colorectal issues. Ramona has completed advanced studies in manual therapy with an emphasis on spinal manipulation, and visceral and fascial mobilization. She developed and instructs her visceral and fascial mobilization courses for the Herman & Wallace Pelvic Rehabilitation Institute, and presents frequently at local, national, and international venues on topics relating to women’s health, pelvic floor dysfunction, and manual therapy.

How did you start in pelvic rehabilitation and visceral mobilization?

My PT training was through the Army-Baylor program, I was all in for orthopedics and sports medicine until October of 1990. I gave birth to my second child, an adorable, but behemoth, 9lb 9oz baby boy. His delivery, a VBAC (vaginal birth after cesarean) was very traumatic on my pelvis, I sustained pudendal nerve injury and muscular avulsion. When I queried the attending OB-GYN about my complete lack of bladder control his response and I quote “do a thousand Kegels a day, and when you’re 40 and want a hysterectomy, we’ll fix your bladder then.”  As for the desire to study visceral mobilization, that reflects back to my PT training through the US Army which was 30 years ago, when the MPT was just getting started. It was an accelerated program, to say the least. We received a master's in physical therapy with 15 months of schooling. Given the very limited timeline, which included affiliations and thesis, the emphasis in our training was on critical thinking and problem solving, not memorization and protocols which in 1985 was not the norm. I can still hear the words of our instructors “You have to figure it out, I am not going to give you a cookbook."

Following my initial training in the field of pelvic dysfunction in 1993 I started treating patients.  I had a problem, I could not wrap my head around how I was to effectively treat bowel and bladder dysfunction…. without treating the bowel and bladder? I knew that there was more to this anatomy than just pelvic floor muscles and the abdominal wall, but at the time that is what was being treated. Once I started learning VM principles and applying the techniques to my patients I saw a vast improvement in my outcomes. I realized that the visceral fascia is a huge missing link in this field and that somewhere along the line the physical therapy community forgot one simple fact. We are not hollow; the visceral structures attach to the somatic frame through ligaments and connective tissue and have an influence on the biomechanics of said frame.

Why is the adoption of visceral mobilization so rare amongst practitioners who aren’t pelvic specialists?

Most likely several reasons, first they do not deal with dysfunctions that have visceral structures involved the way pelvic health therapists do. The second is a paucity of higher levels of evidence on the effectiveness of VM for musculoskeletal conditions. The third and most difficult issue to deal with is the broad-based claims that VM can be an effective treatment for issues ranging from acute trauma to emotional problems. One website called VM “bloodless surgery”. The problem simply is when anyone purports their technique to be a virtual panacea for all that ails mankind, without adequate evidence to back up the claims, the clinical world raises its collective antennae. These critical remarks are coming from a practitioner, published author, and educator in the VM field. The reality of evidence-based medicine is talk is cheap, research is not.

Why do you believe fascial mobilization is such an important aspect of clinical practice?

Most importantly because fascia is ubiquitous, it is EVERYWHERE throughout the body and it contains a vast neurological network to include nociceptors, mechanoreceptors, and proprioceptors just to name a few. The fascia was that stuff that we all dissected out of the way in anatomy lab so we could learn the assigned structures that soon would have a pin with a number stuck in it that we needed to know for a lab practical. We need to move beyond the “myofascia” and understand that the fascial system has multiple layers in the body starting at the panniculus which blends with the skin, the investing fascia surrounding muscles and forming septae, the visceral fascia which is by far the most complex and the deepest layer of fascia, the dura surrounding the central nervous system. All fascial structures, regardless of layer or location have their origin in the mesoderm of early embryologic development.


Ramona Horton's Fascial Mobilization Series 2022 Course Schedule

Mobilization of the Myofascial Layer: Pelvis and Lower Extremity Satellite Lab Course

March 4-6, 2022

August 5-7, 2022

Mobilization of Visceral Fascia: The Urinary System Satellite Lab Course

February 18-20, 2022

June 10-12, 2022

October 28-30, 2022

Mobilization of Visceral Fascia: The Gastrointestinal System Satellite Lab Course

March 18-20, 2022

September 30 - October 2, 2022

Mobilization of Visceral Fascia: The Reproductive System Satellite Lab Course

May 13-15, 2022

December 2-4, 2022

 

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Stability Before Mobility, an Interview with Stacey Futterman Tauriello

In today's interview, Holly Tanner sits down with Stacey Futterman Tauriello, PT, MPT, WCS, BCB-PMD to discuss her approach to pelvic rehabilitation. Stacey received her Master’s Degree in Physical Therapy from Nova Southeastern University in South Florida in 1996. After graduation, she relocated to Chicago where she began specializing in women’s health issues including the treatment of incontinence, pelvic pain, and prenatal/postpartum musculoskeletal issues. She returned to the east coast in 2003 and is now the owner of 5 Point Physical Therapy, a specialty physical therapy clinic for male and female pelvic dysfunction in New York City.

Stacey will be instructing Pelvic Floor Level 2A on December 11-12, 2021 and Pelvic Floor Level 1 on January 22-23, 2022.

What clinical pearls do you have for practitioners working with labral tears?

Return to sport has to be discussed on day one. Figuring out what that path is. It's ok that it is slow, but the patient needs to understand that they are going to progress in a fashion to get them stronger and more stable.

You always have to have stability before you have mobility.

You need that background knowledge of getting them stronger without flaring up their pelvic floor symptoms. You have to release and restore, release and restore, release and restore. You got to understand the "why" component. Why are they having so much pain? What can you do to strengthen without flaring? I think that is huge.

What excites you about exercise approaches?

The first thing that got me excited was that I saw that I was doing a lot of things right. One of the biggest takeaways...was the neuromuscular reeducation portion of the exercise...That really task-specific brain reeducation with every exercise...I often think of neuro as Parkinson's. So a Parkinson's patient if you want them to walk and lift their leg (because they're shuffling), you would put something in front of them and say step over it.

Your daughter is 3 and a half years old now. How has going through pregnancy, birth, and postpartum changed your approach with pregnant and postpartum patients?

I did an interview in 2019 with the Today Show on postpartum motherhood and the pelvic floor, both from the patient and the practitioner's standpoint.

It's changed my perspective completely. From the process of getting pregnant, I was in my 40s, so I was an older mom, to being pregnant, having some issues during pregnancy. And then the actual delivery was...it's not great being a pelvic floor physical therapist trying to push a baby out of your vagina...but you have to go through it. Then you realize too that your postpartum experience is all about healing. As much as it's easy for somebody that's 21 to give birth and bounce back. A lot of the women who are having babies right now are in their 30s and 40s. Their bodies don't respond the same, especially not during covid. 

It's a game-changer right now, things are different. Yeah, I had incontinence after I gave birth, I still struggle. My body, within covid from not exercising and going to the gym and everything still takes a toll. I feel like it made me more empathetic to some of my pregnant patients.

Is there a clinical pearl or fun phrase that comes to mind that you use?

One of the big phrases that I use comes from Pam Downey, and it is "healthy tissue doesn't hurt."

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Short Interview Series - Episode 7 featuring Allison Ariail

A different approach to treating prostatectomy patients.

The Pelvic Rehab Report sat down with Allison Ariail, PT, DPT, CLT-LANA, BCB-PMD, PRPC to discuss her upcoming courses Rehabilitative Ultrasound Imaging - Orthopedic Topics and Rehabilitative Ultrasound Imaging: Women's Health and Orthopedic Topics scheduled for November 12-14, 2021. Allison specializes in the treatment of the pelvic ring and back using manual therapy and ultrasound imaging for instruction in a stabilization program. She also specializes in women’s and men’s health including conditions of chronic pelvic pain, bowel and bladder disorders, and coccyx pain.

 

As a pelvic floor clinician, you may have worked with patients who are suffering from urinary incontinence following prostatectomy. During a prostatectomy the prostate, seminal vesicles, prostatic urethra, and some connective tissues are removed. The extent of the removal will depend on the size of the tumor and if the tumor has spread into the surrounding tissues.  Because of the surgery, and the loss of smooth muscle surrounding the urethra, there is an inherent risk that these patients will suffer from urinary incontinence. Recently, there have been studies that examined the difference between patients who return to continence and those who do not return to continence following prostatectomy. They found that continent prostatectomy men demonstrated increased displacement of the striated urethral sphincter, bulbocavernosus, and puborectalis compared to incontinent men. They also found that continent prostatectomy patients demonstrated better puborectalis and bulbocavernosus function than controls! (1) This has made researchers conclude that continent men following prostatectomy compensate for the loss of smooth muscle by having better than normal function in their pelvic floor.

In another recent article, researchers put together recommendations for a rehabilitation program. They argue that traditional methods that have been used in pelvic floor therapy are based on applied principles for stress incontinence in women, not men. Men suffer from incontinence for a different reason than women. Thus, their treatment should be approached differently as well.  Additionally, the authors state that examining the pelvic floor muscles via a digital rectal exam does not allow the examiner to assess the underlying issue that leads to incontinence in men, the striated urethral sphincter. Instead, a digital rectal exam identifies issues in the external anal sphincter and puborectalis. They highly recommend the use of transperineal ultrasound imaging in order to view the contraction of the pelvic floor and confirm where the contraction is originating from. They also highly recommend the use of ultrasound in treatment for the use of motor re-learning(2).

We will discuss this more in-depth as well as learn how to use ultrasound imaging to help both male and female patients suffering from incontinence. We also will be learning how to use ultrasound imaging to address orthopedic conditions such as back pain, sacroiliac joint pain, and diastasis rectus. The course “Rehabilitative Ultrasound Imaging for the Pelvic Girdle” is now being offered with satellite locations as well as a limited number of self-hosted online groups and is scheduled for November 12-14, 2021. There are two courses being offered. The 2-day version, Rehabilitative Ultrasound Imaging - Orthopedic Topicsaddresses the use of ultrasound imaging to help back and lumbopelvic conditions. While the 3-day course, Rehabilitative Ultrasound Imaging: Women's Health and Orthopedic Topics, includes more pelvic floor related conditions such as prolapse and post-prostatectomy issues. The course includes ample lab time so participants leave with the clinical skills to be able to use ultrasound imaging in their practice.

 


 

  1. Stafford R.E., Couglin G., Hodges P. Comparison of dynamic features of pelvic floor muscle contraction between men with and without incontinence after prostatectomy and men with no history of prostate cancer. Neurourology and Urodynamics. 2020; 39:170-180.
  2. Hodges, PW., Stafford RE, Hall L., et al. (2020). Consideration of pelvic floor muscle training to prevent and treat incontinence after radical prostatectomy.  Urologic Oncology: Seminars and Original Investigations.  38: 354-371
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Osteoporosis Management Is For All Practitioners

An interview with Frank Ciuba.

Frank Ciuba, co-instructor of Osteoporosis Management< alongside Deb Gulbrandson, explains that practitioners need the information provided in their course. "This course is the latest up-to-date research compiled by my partner Deb Gulbrandson and myself in the management of osteoporosis for clinicians." He shares that similar to learning about the pelvic floor, "when physical therapists go to school they get only a small amount of what osteoporosis is and very little on how to treat a patient."

Frank explains that he became interested in teaching osteoporosis management when he learned "that one in four men statistically will get osteoporosis or an osteoporosis-related fracture in their lifetime and they're really not being identified." Osteoporosis Management provides an exercise-oriented approach to treating these patients and it covers specific tests for evaluation, appropriate safe exercises and dosing, basic nutrition, and ideas for marketing your osteoporosis program.

In pelvic health rehabilitation, it's seen that osteoporosis-related kyphosis (curvature of the spine) can affect pelvic organ prolapse, breathing, and digestion. Patients who go through the osteoporosis management program with Frank and Deb, are shown that they reduce the likelihood of compression fracture by 80%.

This course, Osteoporosis Management, is not just for practitioners working with osteoporosis or osteopenia patients. Frank lists the types of patients he's been able to help. "I've used this on high school backpack syndrome, whiplash injuries, adhesive capsulitis, spinal stenosis, low back pain, lumbar strain, even some hip pathologies." He concludes with "We just need to get the word out to more individuals that this a program that can help them. Not only in the short term, but in the long term. This is a program for life."

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Short Interview Series - Episode 6 feat. Sandra Gallagher

Holly Tanner Short Interview Series - Episode 6 featuring Sandra Gallagher

In today’s interview, Sandra discusses some of the intricacies of working with transitioning patients, her path in working with the LGBTQ+ community, and her new course with H&W. Transgender Patients: Pelvic Health and Orthopedic Considerations is a remote course created by Sandra Gallagher and Caitlin Smigelski. This course provides specific content aimed at teaching pelvic health therapists how to expand their skills for working with people of all gender identities.

Sandra Gallagher has served on varied committees and boards at the state and national level, most recently as the chair of the CAPP-OBC committee for the Academy of Pelvic Health of the APTA. She has presented on the role of PT in gender-affirming vaginoplasty at UCSF Transgender Health Summit, APTA Combined Sections Meeting, and at the 2018 international meeting of the World Professional Association for Transgender Health (WPATH).

In a research study that Sandra facilitated with other colleagues, it was concluded that “Pelvic floor physical therapists identify and help patients resolve pelvic floor-related problems before and after surgery. We find strong support for pelvic floor PT for patients undergoing gender-affirming vaginoplasty.”(1)

Often therapists think of genital surgeries and sexual function when contemplating work with transgender people. However, therapists have far more to offer transgender patients. For providing optimal care, knowledge of the intricacies of gender transition is essential.

Join H&W on October 30th for Transgender Patients: Pelvic Health and Orthopedic Considerations to learn more about gender-affirming genital surgeries and medical interventions that people transitioning might choose.

 


  1. David Jiang, Sandra Gallagher, Laura Burchill, Jens Berli, Daniel Dugi 3rd. Implementation of a Pelvic Floor Physical Therapy Program for Transgender Women Undergoing Gender-Affirming Vaginoplasty. Obstet Gynecol. 2019 May;133(5):1003-1011. doi: 10.1097/AOG.0000000000003236.
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Short Interview Series - Episode 5 feat Sarah Haran

Holly Tanner Short Interview Series - Episode 5 featuring Sarah Haran

This week The Pelvic Rehab Report sat down with new faculty member Sarah Haran. Sarah instructs the new Weightlifting and Functional Fitness Athletes remote course scheduled for October 16, 2021.

Who are you? Describe your clinical practice.

My name is Sarah Haran and I have been a PT in Seattle, WA since 2007. I graduated from the University of Washington and have been working in outpatient orthopedics ever since. I opened my private, cash practice, Arrow Physical Therapy in 2016 and we specialize in CrossFit athletes, weightlifters, dancers, and patients with hip impingement. I also teach courses on practice development and coach physical therapist entrepreneurs alongside Dr. Kate Blankshain through our business consulting company, Full Draw Consulting.

What made you want to create this course?

My course, Weightlifting and Functional Fitness Athletes, will begin to fill a hole in the training we have as PTs. I was unaware of how to help higher-level athletes until I became a CrossFit athlete myself. In my practice, I have learned that not only are there not enough PTs who understand weightlifting and the "sport of fitness" as CrossFit is called but that there is even some negativity around the sports. The truth is that these activities are not going anywhere and if anything are gaining popularity. We must figure out how to serve these patients and keep them just as healthy as any other patient. I am not a pelvic therapist but I do have a great interest in hip impingement which means that I refer out to pelvic floor PTs quite commonly. It is a privilege to be able to work with these therapists in this course and I look forward to learning from the students too!!

What are some pelvic health concerns with Crossfit, and what is the role of the practitioner?

Pelvic health concerns in Crossfit athletes include urinary function, hip impingement, pelvic pain, prolapse and pressure control aspects, diastasis, and pregnant/postpartum athletes. Urinary function and diastasis are especially not understood by coaches and tend to either be not addressed or referred out. The practitioner's role for these athletes is to be understanding of the language and to be respectful of the athletes. Practitioners can support the athletes by understanding the sport and the movements involved, by helping the athlete modify versus stopping the movements/exercises. This can help the athlete maximize their sports performance while demonstrating that physical therapy is appropriate for their needs.

What does it mean when people say Crossfit is the sport of fitness?

Different types of athletes belong in different categories and it is really hard to compare those categories. With Crossfit, we say we need to include all of these components, and the person that best executes all of these things is the fittest. Crossfit is essentially the sport of fitness. The 10 components of physical exercise that are included in Crossfit are coordination, strength, stamina, flexibility, power, speed, accuracy, agility, balance, and endurance (cardiovascular/respiratory).

Is Crossfit an inclusive sport?

Yes. Crossfit is considered very inclusive. While intensity is the name of the game with Crossfit. Crossfit is also a brand, a workout, and a lifestyle. Nutrition and exercise are prioritized in this community and can be scaled across the lifespan and all ability levels. When looking at Crossfit, fitness is defined as constantly varied functional movements executed at high intensity across broad time and modal domains. In this same vein, health is defined as work capacity across broad time, modal, and age domains. Essentially health is fitness measured across your lifetimE. Crossfit is very inclusive in that it is all ages, all abilities, and is supportive of LGBTQA+ positive. Competitions are inclusive with adaptive categories, And the movement is also involved in Black Lives Matter and with Veterans.

To learn more about working with this population join H&W and Sarah Haran at Weightlifting and Functional Fitness Athletes remote course scheduled for October 16, 2021.

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Short Interview Series - Episode 4 feat Brianna Durand

Holly Tanner Short Interview Series - Episode 4 featuring Brianna Durand

Inclusive Care for Gender and Sexual Minorities is a remote course created by faculty member Brianna Durand. This course is for anyone, even if you are unsure about the pronouns or the terminology to use. Brianna created this course to provide the basic foundational knowledge around inclusive and gender-affirming care. The second day of the course provides detailed physiological considerations from the pelvic health and general health standpoint for folx undergoing medical transition.

Brianna became interested in pelvic health research pertaining to the LGBTQ+ community when she was in grad school. She was struck by how the community was not mentioned in most formal education and wanted to meet this knowledge gap.

Gender-affirming care describes ideal medical, surgical, and mental health services sought by transgender, non-binary, and gender non-conforming people. This can range from hormone therapy, to top or bottom surgery, facial hair removal, modification of speech, reduction thyrochondroplasty (tracheal cartilage shave), and voice surgery (1). Also common is the practice of genital tucking or packing, and chest binding. All of which the World Professional Association for Transgender Health lists as medically necessary procedures(2).

Hormone therapy is a common medical intervention and allows for the acquisition of secondary sex characteristics which are more aligned with the individual's gender identity. Research, such as that by Gómez-Gil et al, concludes that there are psychological improvements after gender-affirming treatments such as hormone therapy and surgery (3). Likewise, the denial of access to gender-affirming care is associated with worsened psychological health and high-risk behaviors (4).

Inclusive Care for Gender and Sexual Minorities attendees can expect to be gently guided into the sometimes confusing realm of gender and sexual orientation and identity. This course will provide a safe space to ask all the questions about caring for LGBTQ+ patients and practicing the skills needed to help advance your practice.

Inclusive Care for Gender and Sexual Minorities is scheduled for October 9-10 and covers pelvic floor physical therapy specifically, however it is appropriate and useful for any medical professional as we all have patients in the LGBTQ+ community.


  1. Madeline B. Deutsch, MD, MPH. Overview of gender-affirming treatments and procedures. UCSF Transgender Care & Treatment Guidelines. June 17, 2016
  2. WPATH Clarification on Medical Necessity of Treatment, Sex Reassignment, and Insurance Coverage for Transgender and Transsexual People WorldwideWPATH. Transgender Health Information Program. [cited 2014 Jan 21].
  3. Gómez-Gil E, Zubiaurre-Elorza L, Esteva I, Guillamon A, Godás T, Cruz Almaraz M, et al. Hormone-treated transsexuals report less social distress, anxiety, and depression. Psychoneuroendocrinology. 2012 May;37(5):662-70.
  4. Sevelius JM. Gender Affirmation: A framework for conceptualizing risk behavior among transgender women of color. Sex Roles. 2013 Jun 1;68(11-12):675-89.
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Short Interview Series - Episode 3 featuring Lauren Mansell

Holly Tanner Short Interview Series - Episode 3 featuring Lauren Mansell

Lauren Mansell shares, "We're never ready to do this work. We're never ready to be perfect." Her course, Trauma Awareness for the Pelvic Therapist, is for all practitioners, not just physical therapists. Anyone licensed who works with patients can benefit from this topic. However, it can be offputting to put ourselves into a vulnerable position by registering for a course on this topic. Lauren understands this and comes prepared to teach other practitioners about trauma-informed care in the gentlest way possible.

Lauren Mansell, DPT, CLT, PRPC, CYT curated and instructs this course. Lauren worked in counseling and advocacy for sexual assault survivors before becoming a physical therapist. She also brings her experience as a 2017 Fellow of the Chicago Trauma Collective to teach trauma-informed care to medical providers. Trauma-informed care is especially important as the field of pelvic rehabilitation becomes more inclusive.

Pelvic rehabilitation and pelvic therapists really do treat the whole patient. Patients can present with pain, long-term issues, and undisclosed trauma that can be compounded when it includes sex, bladder, or bowel issues. Trauma Awareness for the Pelvic Therapist addresses several topics under this umbrella and spends time on each of the following:

  • Explaining and describing compassion fatigue, trauma-informed care as well as anatomy, neurobiology, physiology of trauma, and the polyvagal autonomic nervous system
  • Identifying risk factors and Adverse Childhood Experiences (ACEs)
  • Formulating techniques for reducing compassion fatigue, secondary trauma, and retraumatization

To learn more about trauma-informed care join H&W this weekend at Trauma Awareness for the Pelvic Therapist this September 25-26, 2021. The course will be offered again in 2022 if you are not available this weekend!

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Holly Tanner & Deb Gulbrandson Interview

Holly Tanner Short Interview Series - Episode 2 featuring Deb Gulbrandson

Holly Tanner and Deb Gulbrandson sat down to discuss the Osteoporosis Management Remote Course and why it is important for practitioners to recognize and know how to safely treat and manage osteoporosis patients in their practices.

Deb Gulbrandson shares the goal of the Osteoporosis Management remote course: "This course is based on the Meeks Method created by Sara Meeks, PT, MS, GCS...we have branched out to add information on sleep hygiene, exercise dosing, and basic nutrition for a person with low bone mass. Knowing how to recognize signs, screen for osteoporosis, and design an effective and safe program can be life-changing for these patients."

Join H&W at the Osteoporosis Management remote course, scheduled for September 18-19, 2021, to learn more about treating patients with osteoporosis.

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Faculty Interview: Kate Bailey

Faculty Interview: Kate Bailey

Kate Bailey

This week The Pelvic Rehab Report sat down with Kate Bailey, PT, DPT, MS, E-RYT 500, YACEP, Y4C, CPI to discuss her career as a physical therapist and upcoming course, Restorative Yoga for Physical Therapists, scheduled for September 11-12, 2021. Kate’s course combines live discussions and labs with pre-recorded lectures and practices that will be the basis for experiencing and integrating restorative yoga into physical therapy practice. Kate brings over 15 years of teaching movement experience to her physical therapy practice with specialties in Pilates and yoga with a focus on alignment and embodiment.

 

Who are you? Describe your clinical practice.

My name is Kate Bailey. I own a private practice in Seattle that focuses on pelvic health for all genders and ages. I work under a trauma-informed model where patient self-advocacy and embodiment are a priority. My dog, Elly, assists in my practice by providing a cute face and some calming doggy energy. My patients often joke that they come to see her just as much as to see me, which I think is great. In addition to being a physical therapist, I’ve been teaching Pilates for nearly 20 years and yoga for over 10. They are both big parts of my practice philosophy and my own personal movement practice

 

What books or articles have impacted you as a clinician?

I have a diverse library of Buddhist philosophy, emotional intelligence, trauma psychology, human behavior, breathwork/yoga, and sociology and, of course, a bunch of physical therapy pelvic floor books. I also love a children’s book on emotional regulation or inclusion, even for adults. One of my favorite finds is the Spot series that gives kiddos different ways to use their hands to help deal with different emotions. I’ve used it for adults who need physical self-soothing options. There are so many, and I find that it's the amalgamation of information that really impacts my practice the most.

 

How did you get involved in the pelvic rehabilitation field?

I have a deep interest in the human experience and how culture and dissociation create mass-disembodiment and how hands-on work can be profound in how we experience our body. Pelvic rehab allowed me the opportunity to work more closely with people on areas that bring up the most shame, disembodiment, and trauma, and therefore have some pretty amazing possibilities to make an impact not only in their lives but how they act in culture. In many ways, I see my work in pelvic rehab as a point of personal activism in creating a more embodied, empowered, and powerful culture.

 

What has your educational journey as a pelvic rehab therapist looked like?

I knew I wanted to go into pelvic health from my second year in PT school. I’ve always been at bit…well, let’s call it driven. I did an internship with great therapists in Austin and then only considered full-time pelvic floor positions once licensed. I took as many courses as I could handle in my first couple years of practice, which worked well for me, but understandably is not the right path for all those entering this field for a number of reasons. I went through the foundational series, and then into visceral work as well as continued my yoga and Pilates studies. I continued my education in trauma and emotional intelligence which is both a personal and professional practice. I found that a blend of online coursework and in-person kept me satisfied with my educational appetite.

 

What made you want to create your course, Restorative Yoga for Physical Therapists?

I was a yoga teacher long before I became a PT. When I found my way into the specialty of pelvic floor physical therapy, this particular part of my yoga teaching became incredibly useful for patients who had high anxiety, high stress, and difficulty with relaxation and/or meditation. This course was a way for me to share some of my knowledge of restorative yoga with the community of health care providers, where it could not only be used as a means of helping patients, but also as a means to start valuing rest as a primary component of wellbeing.

 

What need does your course fill in the field of pelvic rehabilitation?

Learning about yoga as a full practice and understanding that it has many components is very useful in deciding which component would be a good match for a pelvic health patient. Is it strengthening from an active practice? Is it meditation or pranayama (breath manipulation)? Or is it supported rest? This particular course focuses on the lesser-known aspects of the yoga platform: breath, restorative practice, and a bit of meditation. I have clients all the time struggle with meditation because their nervous systems aren’t ready for it. So we look at breathing and restorative yoga both as independent alternatives, but also as a way to get closer to meditation. Learning how to help people rest, the different postures, how to prop, and how to dose is an important component of this class. As a bonus, giving the clinicians another skill for their own rest practice can be useful when feeling tired, overwhelmed, or burned out. All this under a trauma-informed, neuro-regulation-focused model is a lovely way to deepen one’s physical therapy practice.

 

What demographic, would benefit from your course?

People who are stressed out or who work with people who are stressed out. In particular, clinicians who work with people who have pelvic pain or overactivity in their pelvic floors.

 

What patient population do you find most rewarding in treating and why?

I love working with female-identifying patients that struggle with sexual health or those who are hypermobile and trying to figure out movement that feels good. I love working with all genders generally and do so regularly. There’s nothing quite like helping a male-identifying patient find embodiment and understanding of their pelvis in a new way. I think for me, working to dismantle female normative structures for those identifying as female, particularly in the realm of sexual health feels inspiring to me because it combines physical, emotional, spiritual health with going against the cultural standards of how those identifying as women fit into society, and being able to sit with the trauma of all types that so many people face.

 

What do you find is the most useful resource for your practice?

A pelvic floor model is great. The most important part of my practice is a conversation about consent, not only for internal work but for everything I offer during visits and also for patients to understand that they can give or retract consent with any medical provider for just about any service. Emergency procedures are a smidge different, but I hope my patients walk away with the understanding that the medical community is here to serve their embodied experience. My newest favorite resource is a series of metal prints that depict the emotional intelligence grid used in the RULER syllabus. I have a magnet that patients can use to identify how they are feeling and help develop their language for emotional and then somatic or interoceptive knowledge.

 

What has been your favorite Herman & Wallace Course and why?

There was nothing quite like PF1. I don’t think I’ll ever forget it. The instructors were Stacey Futterman Tauriello and Susannah Haarmann. I was still in grad school prepping for my internship and ended up being the model for labs which falls squarely in line with my upbringing as a dancer who wanted to understand everything from the inside out. It was a challenging weekend on pretty much every level. I went through phases of dissociation and total connection. It made me realize that my decision to enter health care after having a career in movement was the right one.

 

What lesson have you learned from a course, instructor, colleague, or mentor that has stayed with you?

Meet the patient where they are at first and validate that they live in an incredibly intelligent body. I think sometimes it’s so exciting to see the potential that patients have because, as clinicians, we’ve seen the progress of others. In yoga, there is a practice of the beginner’s mind. It asks the student to sit with an empty cup of knowledge and experience each practice with the curiosity of someone just being introduced to yoga. I have knowledge that may be helpful to patients. Patients have so much knowledge of their own body from their life experiences, some of which are conscious and so much of which is subconscious. The fun part is seeing how my experience and their experience match (or don’t sometimes) to then assess how to craft the care plan.

 

If you could get a message out to other clinicians about pelvic rehab what would it be?

That it's so much more than pelvic rehab. We get to talk to people about things that aren’t talked about and normalize the human experience. Pelvic rehab gives safety to patients to experience their bodies in all the sensations that come from having a nervous system: from sadness to joy to relief to fear. It's all in there and when we learn about those sensations from pelvic rehab, my hope is that it can flood into other areas of life.

 

What is in store for you in the future as a clinician?

Refining, learning, and seeing what else comes. Hoping to publish a book of cartoon organs shortly. But most importantly to create a safe space for patients to feel cared for and supported in my corner of Seattle.

 

Kate Bailey (She/Her)
Pelvic Floor Physical Therapy
Yoga & Pilates

 

This email address is being protected from spambots. You need JavaScript enabled to view it.

www.kbwell.org

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Upcoming Continuing Education Courses

Pelvic Floor Level 2A - Self-Hosted (Sold out)

Dec 11, 2021 - Dec 12, 2021
Location: Self-Hosted Course

Pelvic Floor Level 2A - Little Rock, AR Satellite Location

Dec 11, 2021 - Dec 12, 2021
Location: Core Pelvic Physical Therapy

Breathing and the Diaphragm: Orthopedic Therapists - Remote Course

Dec 11, 2021 - Dec 12, 2021
Location: Replacement Remote Course

Pelvic Floor Level 2A - New York, NY Satellite Course (SOLD OUT)

Dec 11, 2021 - Dec 12, 2021
Location: KNOSIS Center for Physiotherapy & Wellness

Pelvic Floor Level 2A - Ann Arbor, MI Satellite Course (SOLD OUT)

Dec 11, 2021 - Dec 12, 2021
Location: Probility Physical Therapy/St. Joseph Mercy

Pelvic Floor Level 2A - East Norriton, PA Satellite Course (SOLD OUT)

Dec 11, 2021 - Dec 12, 2021
Location: Core 3 Physical Therapy

Pelvic Floor Level 1 - Arlington, MA Satellite Course (SOLD OUT)

Dec 11, 2021 - Dec 12, 2021
Location: Synergy Physiotherapy & Wellness

Pelvic Floor Level 1 - Asheville, NC Satellite Location (SOLD OUT)

Dec 11, 2021 - Dec 12, 2021
Location: Cornerstone Physical Therapy of North Carolina

Pelvic Floor Level 2A - Santa Cruz, CA Satellite Course

Dec 11, 2021 - Dec 12, 2021
Location: Alliance Physical Therapy and Rehabilitation Services, Inc.

Pelvic Floor Level 1 - Bismarck, ND Satellite Location

Dec 11, 2021 - Dec 12, 2021
Location: University of Mary

Pelvic Floor Level 2A - Jefferson, LA Satellite Course

Dec 11, 2021 - Dec 12, 2021
Location: Ochsner Therapy and Wellness/Ochsner Health System

Pelvic Floor Level 2A - El Paso, TX Satellite Course (CANCELED)

Dec 11, 2021 - Dec 12, 2021
Location: Border Physical Therapy

Pelvic Floor Level 1 - Milwaukee, WI Satellite Location (SOLD OUT)

Dec 11, 2021 - Dec 12, 2021
Location: Ascension - Milwaukee

Pelvic Floor Level 1 - Self-Hosted

Dec 11, 2021 - Dec 12, 2021
Location: Self-Hosted Course

Pelvic Floor Level 1 - Syracuse, NY Satellite Course (SOLD OUT)

Dec 11, 2021 - Dec 12, 2021
Location: Onondaga Physical Therapy

Pelvic Floor Level 2A - Novato, CA Satellite Course

Dec 11, 2021 - Dec 12, 2021
Location: Renew Physical Therapy of CA

Sexual Medicine in Pelvic Rehab - Remote Course

Jan 8, 2022 - Jan 9, 2022
Location: Replacement Remote Course

Pelvic Floor Level 1 - Rochester, NY Satellite Location (SOLD OUT)

Jan 8, 2022 - Jan 9, 2022
Location: Evolve Physical Therapy of Rochester

Pelvic Floor Level 1 - Concordia

Jan 8, 2022 - Jan 9, 2022

Pelvic Floor Level 1 - Salt Lake City, UT Satellite Location (SOLD OUT)

Jan 8, 2022 - Jan 9, 2022
Location: Dynamic Physical Therapy

Pelvic Floor Level 1 - Howell, MI Satellite Location (SOLD OUT)

Jan 8, 2022 - Jan 9, 2022
Location: Ivy Rehab Physical Therapy - Howell, MI

Pelvic Floor Level 1 - Cranford, NJ Satellite Location

Jan 8, 2022 - Jan 9, 2022
Location: Ivy Rehab Physical Therapy (Cranford, NJ)

Bowel Pathology and Function - Remote Course

Jan 8, 2022 - Jan 9, 2022
Location: Replacement Remote Course

Pelvic Floor Level 1 - Queens, NY Satellite Location

Jan 8, 2022 - Jan 9, 2022
Location: Hands of Hope Physical Therapy

Pelvic Floor Level 1 - Zion, IL Satellite Location

Jan 8, 2022 - Jan 9, 2022
Location: Cancer Treatment Centers of America

Pelvic Floor Level 1 - Self-Hosted

Jan 8, 2022 - Jan 9, 2022
Location: Self-Hosted Course

Pelvic Floor Level 1 - New Bern, NC Satellite Location

Jan 8, 2022 - Jan 9, 2022
Location: Peak Performance Clinics

Pelvic Floor Level 1 - Orange City, FL Satellite Location

Jan 8, 2022 - Jan 9, 2022
Location: Direct Physical Therapy - Orange City

Pelvic Floor Level 1 - Oklahoma City, OK Satellite Location

Jan 8, 2022 - Jan 9, 2022
Location: Oklahoma Physical Therapy

Pudendal Dysfunction: The Physician's Perspective - Remote Course

Jan 9, 2022
Location: Short Form Remote Course