Continuing Education Courses > Pelvic Floor Level 2A
|Price: $695 ($725 within one month of the course)
Experience Level: Intermediate
Contact Hours: 22.5
This continuing education course is a three-day intermediate-level seminar designed as a next step in completing the clinicians’ ability to more comprehensively evaluate and treat the female and male pelvic floor. The participant will have the opportunity to learn about two common bowel dysfunctions, fecal incontinence and constipation, and how the pelvic rehabilitation provider can play a crucial role in overcoming these issues that affect quality of life so dramatically. In the US, adult estimates of fecal incontinence is over 8%, and greater than 15% in people over age 70. (Whitehead, 2010) According to the National Institutes of Health, constipation affects up to 15% of people, and is one of the most common gastrointestinal complaints that affects 42 million people. (Constipation, 2013) Pelvic rehabilitation providers are able to teach patients how to significantly improve quality of life through simple behavioral techniques and approaches that optimize abdominopelvic health.
Participants will learn how to evaluate the patient who presents with bowel dysfunction including fecal incontinence and constipation, and also with defecation disorders such as paroxysmal puborectalis, irritable bowel syndrome (IBS), and fecal urgency. Knowledge of pelvic anatomy expands into the gastrointestinal system with detailed instruction about the rectum and anal canal, anal sphincters, and with instruction in important physiologic principles such as the gastrocolic reflex, sampling response, and intrinsic defecation reflex. There are other conditions that can cause pain or bleeding such as hemorrhoids, fistulas, fissures, and proctalgia fugax; the clinician will learn how to apply skills of external and internal pelvic muscle assessement (via the anorectal canal) for these conditions.
Many pelvic rehabilitation providers attend this course to learn clinical skills for coccyx pain and for pudendal neuralgia, two conditions that are included on Day 2 of this continuing education course. As either condition can contribute to chronic pelvic pain, this course provides significant lab time so that participants will have the opportunity to practice any new skills. Day 3 of the course introduces the participant to pelvic rehabilitation of the male patient with an emphasis on topics of male pelvic anatomy, urinary incontinence, prostatectomy, and male pelvic pain. The content in this course prepares the therapist to work with male pelvic conditions by reinforcing what is common to the care of both men and women, as well as teaching that which is unique for the male patient.Current medical evaluation (with tests such as defecography, manometry), medical management (for anorectal pain and for colorectal conditions), and evidence-informed clinical interventions will be instructed.
Please note, the Pelvic Floor series of courses typically fill up about 2-3 months before the scheduled course date. It is highly recommended that participants register well in advance to reserve their seats. If you need your employer to send a check for your registration payment, please click the Request Invoice button on the course event page to reserve your seat.
As this continuing education course includes extensive lab work, all course attendees should come prepared to participate as both clinician and patient. Rectal pelvic floor muscle examinations will be taught in labs. Past participants have found that wearing comfortable clothing that is easy for changing (such as skirts or athletic shorts) is very useful for labs. Due to temperature variations from clinic to clinic we would recommend wearing comfortable layers.
PLEASE NOTE: This course includes internal assessment and exam techniques, which will be practiced in partnered pairs in lab time. H&W strives to foster an environment that is safe and supportive. Survivors of past trauma should be aware that performing or experiencing internal exam may be triggering, and that many, regardless of their histories, feel strong emotions when practicing these techniques. In order to foster an environment that is non-triggering and safe for all participants, we recommend all participants consider the emotional impact they may experience during the course, and consider consulting a trauma counselor or therapist prior to attending.
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.
Pelvic Floor Level 1, through Herman & Wallace or Pelvic PT 1 through the APTA is required. Exceptions to this policy may be granted on a case-by-case basis, to inquire about such exceptions please contact us.
1. The National Digestive Diseases Information Clearinghouse Handout on Fecal Incontinence
2. The National Institute of Diabetes and Digestive and Kidney Diseases Article on Constipation
3. The International Pelvic Pain Society Article on Pudendal Nerve Entrapment (PNE)
4. The European Urology Association'sGuidelines on Chronic Pelvic Pain
5. Principles of Biofeedback from Professor Tim Watson's website electrotherapy.org
6. Gray's Anatomy for Students - Ebook available at a 20% discount at the preceding link (use discount code ELS25OFF). Registrants who already own a copy, are not required to purchase an additional one. Please Contact Us with any questions about the use of this text as a required reading in this course.
Additional Helpful Resources:
Constipation. (2013) National Institutes of Health. Retrieved January 22, 2014 from http://digestive.niddk.nih.gov/ddiseases/pubs/constipation
Whitehead, W. E., Borrud, L., Gode, P. S., Meikle, S., Mueller, E. R., Tuteja, A.,...Ye, W. (2009). Fecal incontinence in US adults: epidemiology and risk factors. Gastroenterology, (137)2, 512-517
Upon completion of this continuing education seminar, participants will be able to:
1. Describe anatomy of the colorectal region.
2. Explain physiology of the gastrointestinal system including pathophysiology pertaining to bowel dysfunction.
3. Perform examination and evaluation of pelvic floor function related to anorectal structures.
4. Recognize types of fecal incontinence and develop plans of care for intervention including behavioral training and education.
5. Recognize and treat constipation, name the signs, symptoms, and interventions for hemorrhoids, fissures, fistulas, and other common colorectal conditions.
6. Identify specific pelvic floor muscles and key bony landmarks within the anorectal canal.
7. Perform external and internal rectal myofascial treatment techniques such as Thiele’s massage and trigger point release.
8. Perform patient education and behavioral training for constipation, fecal incontinence and pelvic pain syndromes.
9. Describe and teach three SEMG downtraining (relaxation) strategies for the overactive pelvic floor.
10. Describe and demonstrate coccyx evaluation and treatment using internal and external coccyx mobilizations.
11. Describe male urogenital and pelvic floor anatomy, identify signs and symptoms of prostatodynia
12. List key medical diagnostic procedures for colorectal conditions.
This course was amazing overall. The instructor provided an open, comfortable environment for learning for practitioners of all experience levels. Thank you!
-Emily Hoffmann PT - Cleveland, OH
Loved Pamela’s guidance during the first lab. She walked all of us through it step by step , so that I felt very confident is what I was feeling.
- Catherine Apicella, MPT, PYT-C - Hatfield, PA
Thank you for all of your expertise, Education and guidance.
- Jillian Hadfield, DPT - Bradley Beach, NJ
Super informative with animated and knowledgeable teaches.
- Rebecca Blau, DPT - Los Angeles, CA
Herman and Wallace Pelvic Floor 2A is my third herman and Wallace course and this class is filled with useful information to help treat the Pelvic Floor population. My only regret is not taking this class sooner after my training in PF Level 1.
- Susan E. Miller PT, DPT - Littleton, CO
Tina and jenni were amazing! They made a class that I was apprehensive of talking comfortable.
- Alexa T Bancel, PT, MPT - Chicago, IL
7. Great course for colorectal Dysfunctions. I was apprehensive for years but finally took the course. Tina and Jenni did an amazing job easing participants into rectal examinations.
- Martina Fogt, MPT - Los Angeles, CA