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|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.
We always want to hear from those interested in hosting our courses. We work with healthcare organizations of all types, sizes, and locations. Please, Contact us about Hosting Pelvic Floor Level 2A or any other course!
I've really enjoyed my training through H&W and I would highly recommend it! Instructors are extremely knowledgeable, have lots of experience and they truly help establish a solid foundation in pelvic health. I always leave a H&W course feeling like I've learned a lot and feeling rejuvenated in my career and excited to utilize new techniques. Thank you!
-Tricia Almeida - Baltimore, MD
Herman Wallace course are consistently fabulous in their expertise, content, respect for the topic each other and the patient/client. This course, in combination with priors, has just exponentially loaded my skill set. I am excited for future course.
-Tracy Bolster, PT - Park Rapids, MN
I have found every Herman and Wallace course I have taken to be excellent and this was no different. Content can be easily applied clinically and truly changes how I practice!
- Stephanie Ryan, PT, DPT - Ixonia, WI
I very much appreciated the gender inclusive language! Thank you! I appreciate the consistent high quality of the instructors through Herman and Wallace.
- Karen Weaver, OTR/L - Duluth, MN
This was a fantastic course from start to finish. Instructors were amazing, down to earth, serious yet comical all in one. I took away more tips and knowledge to now treat bowel, Male Pt’s and pelvis as well as coccyx pain! I really liked the technique of gently bearing down in order to progress further into a rectum.
-Sarah Elia, MPT - SCARBOROUGH, ME
Outstanding course in content and form instructors are excellent clinicians, teachers, role models. Great attributes of best evidence balanced with passion and fun! Thank You!
-Danielle Moreau, DPT - Providence, RI
We were so lucky to have a kind, generous man in our class who allowed Susannah to perform a male pelvic exam. It was so helpful to observe her techniques as well as a living breathing body! I loved how many resources were given to us. This is just the starting point.
-Veronica Asence, DPT - Burlington, MA
Excellent course. Loved the use of reference to the literature, books, and resources to utilize for practice and personal experience with literature references as well.
-Alyssa Itzkowitz, DPT - Vernon, CT
These classes are packed with great information, giving an overall view of pelvic rehabilitation and great nuggets to take back to your practice.
-Shannon Wade, LPTA - Hatfield, MA
-Ellen Yost, DPT, CLT - North Derwick, ME
Presentations were amazing. Jessica and Heather are extremely knowledgeable and relatable. They made a very difficult topic interesting and approachable. They eased our anxieties regarding rectal pelvic floor treatments and gave us the tools and confidence to begin treating this scope of the pelvic floor.
-Hannah Overfelt - Independence, MO
Bigger diagrams. But amazing teachers!
-Morgan Clark, DPT -Lees Summit, MO
Excellent presentation. The faculty presented the material in an engaging and interesting manner. I like it when the faculty presents their clinical cases because it gives me realistic scenarios. I truly appreciate the open and safe atmosphere to ask any question and the patience in responding. The faculty gave the impression of being personal and truly cared about participant learning the material.
-Michelle Uy Jernsletten,PT,MPT - Seabrook, TX
I really enjoyed everything about this course!
-Tarryn Andrews, PT, DPT - Garden City, KS
Wonderful Course! Completely squashed my apprehension/fear of treating fecal dysfunction, rectal pain, and male patients. So excited to help this population!
-Bethany Wallin, DPT - Manhattan, KS
Awesome course! I feel like a new therapist after this course! So much amazing information that I can’t wait to apply in the clinic.
-Kate Wolf, PT, DPT - Centerville, OH
Herman and Wallace always provide great courses with up to date information.
-Courtney Mattis, DPT - Martinsville, IL
Thank you for all of your expertise, education, and guidance.
- Jillian Hadfield, DPT - Bradley Beach, NJ
Super informative with animated and knowledgeable teachers.
- Rebecca Blau, DPT - Los Angeles, CA
Herman and Wallace Pelvic Floor 2A is my third Herman and Wallace course and this class are 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 taking, comfortable.
- Alexa T Bancel, PT, MPT - Chicago, IL
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