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Mobilization of Visceral Fascia: The Urinary System - Remote Course - May 15-17, 2020

Ramona
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Price: $495
Format: Remote Course
Experience Level: Intermediate
Contact Hours: 17.75

This continuing education course is a two-and-a-half day remote seminar 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. In order to be safe during the COVID outbreak, the course taking place in Medford, OR will be live-streamed. A designated teaching assistant will be monitoring the Zoom meeting and asnwering questions while the instructor lectures. Thereapists who wish to participant will need to follow these guidelines for participating in labs. (Click to download and review).

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.

Day One:
3:30 Registration, Introduction (arrive and log on early for Zoom basics and troubleshooting) 
4:30 Concepts of Visceral Mobilization: Biological Plausibility, Clinical Reasoning, Principles of Osteopathy
6:15 Break
6:45Concepts of Visceral and Fascial Mobilization, Fascial Morphology, Fascial Based Manual Therapy, Fascial Stacking Exercise
8:00 Direct & Indirect Treatment (Lab I) Three Dimensional Fascial Mobilization: Horizontal Diaphragms
9:00 Adjourn

Day Two:
8:00 Review of Fascial Concepts, Layer Palpation Exercises, kinesthetic awareness exercises
9:00 Visceral Palpation and Evaluation, (Lab II) Palpation Stations, Local Listening Technique
10:00 Break
10:15 Bladder Lecture: External Approach, Normal Mobility of Bladder, Anatomic Relationships, Clinical Considerations
11:00 External Bladder Techniques: Demo and labs (Lab III) Lateral Mobility Testing & Treatment, Median and Medial Umbilical Ligament (Urachus), Abdominal Scar Mobilization
12:00Lunch
1:00 External Bladder Techniques: Demo and labs (Lab IV) Pubovesical Ligament, Seated Quadruped, Obturator Foramen & Bladder Motility
2:00 Small & Large Intestine Lecture Normal Mobility of Small Intestine Anatomical Relationships Clinical Considerations
3:00 Break
3:15 mall Intestine: Demo and lab (Lab V) Mesenteric Root Posterior Peritoneal Wall
4:15 Large Intestine: Demo and lab (Lab VI) Cecum & Sigmoid
5:30 Adjourn

Day Three:
8:00 Review of Day 2 & Questions
8:30 Kidney/Ureters Lecture, Normal Kidney Mobility, Anatomic Relationships, and Clinical Considerations
9:00 Kidney/Ureter Techniques: Demo and lab (Lab VII) Anterior & Posterior Renal Fascia Ureter Mobilization
9:45 Break
10:00Urethra & Trigone Lecture: Internal Approach, Normal Urethra Mobility, Anatomic Relationships, and Clinical Considerations
10:30 Internal Bladder Techniques: Demo and labs (Lab VIII) Urethra: Longitudinal, Transverse, Bi-Manual Scar Tissue Mobilization: Indirect/Direct (Lab IX) Perineal Membrane, Pubovesical Ligament Trigone & Bladder: Indirect/Direct Bladder Motility
12:00 Lunch
1:00 Visceral anatomy, fetal pig dissection
1:45 Thoracic Relationships, Normal Thoracic Mobility, Anatomic Relationships, and Clinical Considerations
2:15 Thoracic Mobilization: Demo and Lab (Lab X) Thoracic Mobility at Diaphragm, Ribs and Sternum
3:15 Evaluation, Documentation & Case Study Presentation
4:00 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

Remote courses require Zoom video conferencing software. You can create an account and download the software to your computer at https://zoom.us/

We use the Pacific Time Zone for all of our start and end times. 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.

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 2020Student. (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".