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Mobilization of the Visceral Fascia - The Urinary System October 2-4, 2020 Satellite Locations

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Mobilization of Visceral Fascia: The Urinary System Satellite Lab Course - October 2-4, 2020

Oct 2nd: 1:30pm-7:00pm / Oct 3rd: 8:00am-5:30pm / Oct 4th: 8:00am-4:00pm
*Times are listed in Pacific Time

  • Description

  • Schedule

  • Objectives

  • Remote Course Info

  • Instructors

Price: $575
Format: Remote Course
Experience Level: Intermediate
Contact Hours: 17.75

This is a satellite offering of our course, Mobilization of Visceral Fascia Level 1: The Urinary System.  A satellite means that participnts will be gathering in a given location and watching the instructor present remotely on the same screen. During labs, participants will pair up and be guided by the local lab assistants at the satellite course location.

This course is designed to provide comprehensive knowledge concerning the relationship between the connective tissue surrounding the visceral structures of the urologic system as it relates to the musculoskeletal system. 

This course is geared toward the experienced pelvic health therapist who wishes to integrate advanced manual therapy skills into their treatment regime.

  • The fascial system consists of four concentric layers, with the visceral layer, which is the most complex, beginning at the naso-pharynx and ending at the anal aperture  (1)
  • The abdominopelvic canister is “A functional and anatomical construct based on the components of the abdominal and pelvic cavities that work together synergistically” (2)
  • The walls of the canister, although part of the musculoskeletal system, are intimately connected to the visceral structures found within via fascial and ligamentous connections (3).
  • In order to function optimally the viscera must be able to move, not only in relationship to one another, but with respect to their surrounding container (4).
  • Most importantly, the viscera are subject to the same laws of physics as the remainder of the locomotor system with solid structures such as the kidney are particularly affected by blunt force trauma (5, 6).

Material will be presented that includes the science of and evidence behind the use of fascial based manual therapy with presentation of relevant visceral and fascial anatomy and their embryologic oragins. Emphasis will be placed on clinical reasoning with the goal of immediate implementation of the techniques learned following this introductory course. Students will be instructed in an extensive number of treatment techniques, both external abdominal as well as internal vaginal approaches. Course participants will be able to immediately incorporate evaluation and treatment of visceral fascia for patients with a variety of urinary dysfunction diagnoses.

 

Audience:

This continuing education seminar is targeted to physical therapists, occupational therapists, physical therapist assistants, occupational therapist assistants, registered nurses, nurse midwives, and other rehabilitation professionals. Content is not intended for use outside the scope of the learner's license or regulation. Physical therapy continuing education courses should not be taken by individuals who are not licensed or otherwise regulated, except, as they are involved in a specific plan of care.


Prerequisites:

Pelvic Floor Level 1 through Herman & Wallace or prior seminar instruction in internal pelvic floor vaginal muscle examinations

 

Required Readings:


1. Horton (2015) Clinical Review: Visceral mobilization for pelvic dysfunction

2. Review of Anatomy Terms

3. Participants should bring an anatomy atlas (preferably Netter) for reference of the visceral anatomy.


References

1. Willard, F. H. (2012) Visceral fascia. In: Schleip R, Findley TW, Chaitow L, Huijing P (Eds.) Fascia-The Tensional Network of The Human Body. (pp. 53-56). Elsevier, Edinburgh.

2. Lee, D., Lee, L., McLaughlin, L. (2008). Stability, continence and breathing: The role of fascia following pregnancy and delivery. Journal of Bodywork and Movement Therapies, 12(4), 333-348.

3. Bordoni, B. & Zanier, E. (2013). Anatomic connections of the diaphragm: influence of respiration on the body system. Journal of Multidisciplinary Healthcare, 6, 281–291.

4. Uberoi, R., D'Costa, H., Brown, C., & Dubbins, P. (1995). Visceral slide for intraperitoneal adhesions? A prospective study in 48 patients with surgical correlation. Journal of clinical ultrasound, 23(6), 363-366.

5. Cheynel, N., Serre, T., Arnoux, P-J, Ortega-Deballon P., Benoit L. ,Brunet, C. (2009). Comparison of the biomechanical behavior of the liver during frontal and lateral deceleration.

6. Cox, E. (1984). Blunt abdominal trauma. A 5-year analysis of 870 patients requiring celiotomy. Annals of Surgery. 199(4), 467-474The Journal of Trauma, 67(1), 40-44 Physical Therapy, 68(7), 1082-1086.

Recorded video lectures to be viewed in-full prior to the course: 

    Three hours of pre-recorded lectures and additional anatomy study will be sent to participants prior to the course and should be completed prior to the course.

 

 Hourly schedule of live Zoom meetings. All times are in Pacifc Time:

Day One:

1:00 Registration, welcome and Zoom review
1:30 Review and questions of recorded lectures
- Comcepst of Visceral Mobilization
- Concepts of Visceral and Fascial Mobilization

2:15 Lab I – Three-dimensional Fascial mobilization, Horizontal diaphragms 
-Direct and indirect treatment
3:15 Review of Evaluation Concepts 
- Layer palpation exercises, Kinesthetic awareness exercises
3:45 Lab II - Palpation stations 
-
Visceral Palpation and Structure Evaluation
4:45 Bladder Lecture: External approach 
- Normal mobility of bladder
-Anatomic relationships 
-Clinical considerations
5:30 Adjourn

Day Two:

8:00 External Bladder Techniques: Demo and labs Lab III - Lateral mobility testing & treatment -Median and medial umbilical ligament (urachus) Abdominal scar mobilization
9:15 External Bladder Techniques: Demo and labs
Lab IV - Pubovesical ligament, seated & quadruped - Obturator foramen, Bladder motility
10:30 Break
10:45 Small & Large Intestine Lecture
 -Normal mobility of small intestine 
-Anatomical relationships 
-Clinical considerations
12:00 Lunch
1:00 Small Intestine: Demo and lab Lab V - Mesenteric root -Small intestine corpus mobilization Posterior peritoneal wall
2:15 Large Intestine: Demo and lab Lab VI – Cecum, Ileocecal valve, Sigmoid
3:30Kidney/Ureters Lecture 
-Normal kidney mobility 
-Anatomic relationship -Clinical considerations
4:30 Kidney/Ureter Techniques: Demo and lab Lab VII - Anterior & Posterior Renal Fascia Ureter Mobilization 
5:45 Adjourn 

 

Day Two:

8:00 Review of Day 2 & Questions
8:30 Urethra & Trigone Lecture: Internal Approach
-Normal urethra mobility
-Anatomic relationships
-Clinical considerations
9:30 Internal Bladder Techniques: Demo and labs
Lab VIII - Urethra: Longitudinal, Transverse,
- Bi-Manual scar mobilization, indirect/direct
10:30 Lab IX - Perineal membrane, Pubovesical ligament
- Trigone & Bladder: Indirect/Direct bladder motility
11:30 Break
12:00 Lunch & Lecture
Thoracic Relationships
-Normal Thoracic Mobility
-Anatomic Relationships
-Clinical Considerations
12:00 Lunch
12:45 Visceral anatomy, fetal pig dissection
1:30 Thoracic Mobilization: Demo and Lab
Lab X - Thoracic Mobility at Diaphragm, Ribs and Sternum
2:30 Evaluation, Documentation & Case Study Presentation
3:00 Adjourn

 

 

Upon completion of this continuing education seminar, participants will be able to:

 

1. Describe the theory and application of mobilization of visceral fascial structures relating to optimal function of the urinary system and pelvic floor.

2. Understand the biological plausibility of how alteration of the normal mobility of visceral fascial structures can contribute to pelvic dysfunction

3. Describe the role of neurologic mechanisms in altering the tone and tension of fascia with respect to manual therapy

4. Cite potential causes for development of restrictions in the visceral fascia of the urologic system, pelvis, abdomen and thorax

5. Describe the influence of somatic and autonomic function, to include respiration, on the normal mobility of the visceral structures within the urinary system

6. Differentiate between direct and indirect manual therapy techniques and understand the proper application of each

7. Identify visceral structures with relation to the urinary system via external and internal vaginal landmarks

8. Recognize abnormal tissue mobility of visceral fascial structures.

9. Apply the technique of three-dimensional fascial mobilization to visceral fascia utilizing external body and internal vaginal approaches

10. Recognize and treat fascial restrictions throughout the pelvis, abdomen and thorax as they may relate to diagnoses of dysfunction within the urinary system

11. Develop treatment sequencing with respect to global, local and focal fascial restrictions

12. . Implement visceral fascia mobilization techniques into a comprehensive treatment program for the patient with urologic dysfunctions to include incontinence, urgency/frequency, retention, and bladder pain as they relate to physical therapy

Attending a remote course is easy and safe, and you can do it entirely from the security and comfort of your own home or clinic without having to find a lab partner.

 

Important thing to note: 

- To attend a remote Herman & Wallace course, registrants will need Zoom video conferencing software. This is a requirement. One can create an account and download the software to their computer at https://zoom.us/

- We use the Pacific Time Zone for all of our remote course start and end times (this is not the case for in-person and satellite lab locations). Please make a note of this and set your calendar accordingly.

- A Zoom account is free to create. Before the meeting, we recommend having a practice Zoom session with a friend or colleague so you can test your microphone, video, and internet connection. You can participate in any remote course from the comfort of your home, but will need a stable internet connection in order to participate. We recommend downloading the software and practicing a call with a friend or colleague prior to your course with us. Zoom also offers video tutorials on their website at https://support.zoom.us/hc/en-us/articles/206618765-Zoom-Video-Tutorials.

- Still have questions about Remote Courses? Check out our Frequently Asked Questions on Remote Courses

Ramona Horton, MPT, DPT

Ramona Horton

Ramona C. Horton MPT, DPT 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. A desire to expand her knowledge of evidence-based practice and research was the impetus to further her academic pursuits, receiving a 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 serves as the lead therapist for her clinics pelvic dysfunction program in Medford, OR. Her practice focuses on the treatment of men, women, and children 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 the visceral and fascial mobilization courses for the Herman & Wallace Pelvic Rehabilitation Institute, presenting frequently at local, national, and international venues on topics relating to women’s health, pelvic floor dysfunction, and manual therapy.