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Mobilization of Visceral Fascia: The Urinary System Satellite Lab Course - Self-Hosted - October 28-30 2022

October 28th 1:00pm-5:30pm /October 29th 8:00am-5:45pm /October 30th 8:00am-3:00pm

*Times are listed in Pacific Time

Self hosted
  • Description

  • Schedule

  • Objectives

  • Self-Hosted Course Info

  • Instructors

  • Discounts

Price: $600 (Early Registrant 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 participants 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. It is expected that participants will only register for satellites in which they are within driving distance, and adhere to all state and local COVID guidelines, including wearing a mask at all times during the course.

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 nasopharynx 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 the presentation of relevant visceral and fascial anatomy and their embryologic origins. 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 textbook for reference of the visceral anatomy. If you need to purchase an anatomy textbook Gray's Anatomy for Students is available at a 25% Discount for Herman & Wallace registrants with promo code 70484.

 


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.

 

 "Relative" Hourly schedule of live Zoom meetings:

Day One:

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

1:15 Lab I – Three-dimensional Fascial mobilization, Horizontal diaphragms 
-Direct and indirect treatment
2:15 Review of Evaluation Concepts 
- Layer palpation exercises, Kinesthetic awareness exercises
2:45 Lab II - Palpation stations 
-
Visceral Palpation and Structure Evaluation
3:45 Bladder Lecture: External approach 
- Normal mobility of bladder
-Anatomic relationships 
-Clinical considerations
4:30 Adjourn

Day Two:

00:00 External Bladder Techniques: Demo and labs Lab III - Lateral mobility testing & treatment -Median and medial umbilical ligament (urachus) Abdominal scar mobilization
1:15 External Bladder Techniques: Demo and labs
Lab IV - Pubovesical ligament, seated & quadruped - Obturator foramen, Bladder motility
2:30 Break
2:45 Small & Large Intestine Lecture
 -Normal mobility of small intestine 
-Anatomical relationships 
-Clinical considerations
4:00 Lunch
5:00 Small Intestine: Demo and lab Lab V - Mesenteric root -Small intestine corpus mobilization Posterior peritoneal wall
6:15 Large Intestine: Demo and lab Lab VI – Cecum, Ileocecal valve, Sigmoid
7:30 Kidney/Ureters Lecture 
-Normal kidney mobility 
-Anatomic relationship -Clinical considerations
8:30 Kidney/Ureter Techniques: Demo and lab Lab VII - Anterior & Posterior Renal Fascia Ureter Mobilization 
9:45 Adjourn 

 

 

Day Three:

00:00 Review of Day 2 & Questions
00:30 Urethra & Trigone Lecture: Internal Approach
-Normal urethra mobility
-Anatomic relationships
-Clinical considerations
1:30 Internal Bladder Techniques: Demo and labs
Lab VIII - Urethra: Longitudinal, Transverse,
- Bi-Manual scar mobilization, indirect/direct
2:30 Lab IX - Perineal membrane, Pubovesical ligament
- Trigone & Bladder: Indirect/Direct bladder motility
3:30 Break
4:00 Lunch & Lecture
Thoracic Relationships
-Normal Thoracic Mobility
-Anatomic Relationships
-Clinical Considerations
4:45 Visceral anatomy, fetal pig dissection
5:30 Thoracic Mobilization: Demo and Lab
Lab X - Thoracic Mobility at Diaphragm, Ribs and Sternum
6:30 Evaluation, Documentation & Case Study Presentation
7:00 Adjourn

 

 

Notice this schedule starts each day at 0:00. The course does not start at mid-night! This schedule is meant to show the duration of each component of the course, not the actual start-time of each lecture. The actual start time of this a given day's Zoom meeting of this course will appear in the title of the remote course page on our website, as well as in the Teachable sections of the course in which you are registered.

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

This is a "self-hosted" option for attending a satellite lab course. Registrants who would like to pursue this option must:

  1. Locate another therapist or small group of therapists who would like to register together as a unit
  2. Find a suitable location from which the pair/group can all view the zoom lectures together
  3. Practice hands-on lab techniques on the other therapists in their pair/group without a lab assistant or instructor physically present at their self-hosted location. The instructor will provide remote direction via zoom.

Those who wish to take this course, but cannot meet the above requirements should register for a satellite location or in-person version of this course


What to have on hand for self-hosted labs

Your partner! You will need at least one person to work with during labs. This person must be a licensed professional who is also registered for the course.
The printable portion of your manual from Teachable if you choose to print. * You are not required to print your full manual, please check for any sections specifically asking you to print prior to the event.
Your Mask- Please wear a mask while participating in this course to keep your colleagues safe.
A computer with a Wifi connection that your group will be using to view the course.
The following supplies:
Non Latex, Non-Powder Vinyl Gloves MEDIUM (box of 100)
Hand Sanitizer (8 fl. Oz.)
Lube for labs

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.

Attention: We are unable to offer "retro-active" discounts (i.e. applying a discount to a transaction after the transaction takes place), so if you are interested in exploring discount options and you are unsure if your transactions is eligible for a discount, please contact us to inquire.


Multi-Course Discount

This 10% discount is available for a single registrant who wishes to enroll in 3 or more courses, and pay in one transaction. Registrants wishing to enroll in 5 or more courses should contact us for a customized quote. We can also apply this discount if 2 therapists from a single clinic/hospital enroll in 3 or more courses (ie Registrant A enrolls in Course X and Course Y, Registrant B enrolls in Course X, and Registrants A and B both work at Clinic Z). This discount cannot be used in combination with any other discounts. Registration and payment must be received at the same time in one credit card payment, one check or one envelop with multiple checks. This type of registration cannot be completed online, if you are wishing to receive the Multi-Course discount please call or email us directly for assistance.


Group Discount

This discount is available for a group of three or more registrants, who all work at the same clinic/hospital, enroll in a single course, and pay in a single transaction or mail in multiple checks in a single envelope. This discount cannot be used in combination with any other discounts.

Groups of 3-5 receive a 10% discount off the combined price of their group's registrations.
Groups of 6 or more should call or Contact Us so that we can properly create an invoice for your registration.


Student Discount

This 10% discount is available to current students who have yet to earn a license to practice at the time of course registration. This discount is not available to those therapists who have previously held a license, and are currently enrolled in a doctoral, or other post-graduate, program. This discount cannot be used in combination with any other discounts.

 

To get this discount when checking out online, use the code Student2021. (Note, this code is only valid for non-licensed students. The H&W admin team will verify that registrants signed up with this code are, indeed, current students prior to their attendance of the course).


First-Time Registrant Discount

This $50.00 discount is available to any therapist who has never before taken a Herman & Wallace course (no previous registrations) and can be used towards the registrant's first Herman & Wallace course (not applicable to Pelvic Floor Level 1/2A/2B or Capstone).

To apply this discount, please use the code FirstTimer2020 during check out. (H&W will check records to verify past attendance.)


Referral Credit/Discount

Any therapist who has already taken a Herman & Wallace course will earn a $50.00 "referral credit" if:

1. A therapist who has never taken a Herman & Wallace course successfully registers for his or her first course(s); AND
2. In the registration process, the first-time registrant gives the name and clinic/hospital of the therapist who referred them to Herman & Wallace.

A therapist who has earned a $50.00 "referral credit" may use this credit toward any course that is eligible for a "referral discount".


Guest Blogger Credit/Discount

Any therapist who completes a qualifying guest blog post on the Herman & Wallace blog will earn a $50.00 "guest blogger credit". This credit may be applied toward any course eligible for a "guest blogger discount".