Experience Level: Intermediate
Contact Hours: 21 hours
This is a satellite offering of our course, Pelvic Floor Level 2A. 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.
This continuing education course is comprised of 7 hours and 45 minutes of prerecorded lectures followed by 14 hours of live, interactive remote learning and is an 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 the quality of life so dramatically. In the US, the estimate of adult 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 assessment (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 in 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. The course also 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. Satellite lab courses are often limited to very small groups of around ten, meaning seats are scarce. It is highly recommended you sign up as soon as you are able so you do not miss out on a seat. 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.
As this continuing education course includes extensive lab work, all course attendees should come prepared to participate as both clinician and patient. Vaginal pelvic floor muscle examinations will be taught in labs. Labs will be conducted under the supervision of instructors and teaching assistants. There will be a ratio of at least one instructor/assistant for every ten participants. 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.
The Herman & Wallace Institute welcomes all professionals who are appropriately licensed at our courses. Being born with a vagina and other female anatomy is not a prerequisite for attending or participating fully in our courses. No one participant will be required to partner with any other one participant during labs.
Vaginal examination and internal myofascial manual therapy prior to 32 weeks gestation is not the common standard of medical practice. Participants who are pregnant who wish to participate fully in the entire course including in lab must bring a clearance letter from their physician allowing them to participate in the labs is required. Participants who are pregnant also have the option of bringing their own lab model for examination, or they have the option of working in a group of three during lab times.
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. Read more about What to Expect During Courses with Internal Lab Work.
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
Gray's Anatomy for Students - Available at a 25% Discount for Herman & Wallace registrants with promo code 70484. Registrants who already own a copy of this or a corresponding textbook are not required to purchase an additional one.
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.
Recorded Lecture: Watch Before the Live Component of the Course
1. Colorectal Anatomy & Physiology (75 Min)
2. Medical Testing & Rehab Examination (45 Min.)
3. Fecal Incontinence (60 Min.)
4. Constipation (60 Min.)
5. Anatomy: Pelvic Floor, Penis, Scrotum & Contents (60 Min.)
6. Pudendal Nerve Dysfunction (45 Min.)
7. Topics in Inclusive Care (60 Min.)
8. Colorectal Conditions (45 Min.)
15 min. prior to start-time: Log in to Zoom Meeting, Zoom basic and etiquette, roll call
0:00 Questions from Day 1, Post-test Day 1
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.
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 Satellite Lab Course or any other course!
Instructors were very knowledgeable on the topic with added personal experiences. I also enjoyed the books, courses and product recommendations.
- Candice E. Amat, DPT - New York, NY
Instructors are very knowledgeable, helpful, friendly.
- Andrea Yarbrough, PT, DPT - Tampa, FL
Excellent course with great clinical pearls. I definitely feel more confident treating males and performing a rectal exam.
- Rebecca Woodring PT, DPT - Gastonia, NC
This course was great, I learned a lot, and I’m excited to learn more!
- Deidra C. Morrison PT, DPT - Windermere, FL
Amazing course with tremendous information both research and experience-based, that can be applied next day in clinic.
- Sarah Wankowski, DPT - Milton, WI
Course was very well organized; power point was great.
- Susan Walthaus, PT - Jackson, AL
Excellent presentation. Both presenters were very knowledgeable storytelling, humorist, friendly and to the point.
- Claudia Varela MPH, MHSA BSN, RN - Miami, FL
Great Class, learned a lot. Great instructors. Beautiful facility.
- Rona Bennett PTA - Gainesville, FL
Falguni was extra helpful during lab.
- Blair Evanosky PT, DPT - Westford, MA
Please have more courses here! Faculty and location were great! Have capstone is north/east coast.
- Kim Ackernecht, PT - Londonderry, NH
Excellent presenters, knowledgeable, interesting and funny! Hope to see then present again. I appreciate not being told to switch lab partners. It’s hard enough to get emotionally through the first lab, and I learned more by working w/ a lab partner I was already comfortable with.
- Brooke Calhoun, DC - Montpelier, VT
This is the 3rd class I have taken through how as they are all excellent. Instructors are fantastic. Evidence and resources are great. Thank you!!!
- Sarah Sidar, MS, OTR/L - Springfield, VA
Thank you for a wonderful weekend full of learning! I am amazed every time I take a course by how much I can take away and immediately put into practice. Each time I leave a course I feel revitalized and hungry for more knowledge!
- Karen Burnett, PT, DPT - Chicago, IL
Excellent instructors – made a difficult topic interesting, engaging and comfortable to discuss. Thank you Christine and Kim!
- Elizabeth Crommett PT DPT - Danvers, MA
Both instructors were entertaining, engaging and so knowledgeable. The lab instructors were great. Although didn’t get to spend much 1:1 time with them in lab.
- Ashley Drake, PT, DPT - Charlemont, MA
Down to earth and practical. Really appreciated their humour! Dana & Jake really know their stuff.
- Kelly Martin-Smith PT - Loma Linda, CA
As a new grad going into a pelvic floor hospital setting, I feel more prepared and ready to treat men and women with pelvic and colorectal pain. Thank you for helping me feel more prepared.
- Anietie Ukpe-Wallace, PT, DPT - Oakland, CA
H + W does an excellent job translating the literature into clinical guidelines and sets the standards for clinical practices. Instructors are the very best.
- Madeline Star PT, DPT, OCS - Los Angeles, CA
The course was well organized and provided a great knowledge base for me to use right away. I am confident in my ability to tackle a male pelvic floor eval and an FI eval now. I have a huge toolbox of options now.
- Dawn M Jenson, MSPT - Castle Rock, CO
Fantastic class. Lecture’s lab was educational/practical to patient population.
- Holly Bray - Rocklin, CA
Great course overall! Thank you!
- Lauren Hartnett MPT, ATC - Newbury Park, CA
Wonderful class with amazing information. Instructors were knowledgeable, friendly, well informed, and very respectful. I can’t wait to take more course!
- Victoria Hofius Pepper, PT, MPT - Newbury Park, CA
This class helped me feel more confident in my current skills and I learned new assessment treatment techniques in an area that was fairly intimidating.
- Miranda Moncada-Sullivan, PT, DPT - Lansing, MI
I found the course extremely helpful! I found the labs insightful and TAs were always available and willing to help. The instructors provided all the components of evidence-based practice in their presentation. Instructors were very approachable and passionate about patient care.
- Alicia Baker, PT, DPT, CLT - Dayton, OH
I could listen to you two talk and do podcast all day long! This was a fantastic course.
- Kirsten Ferrigan, DPT - Fort Wayne, IN
The class was so informative and I learn so much.
- Ashley Sass OTRL - Fremont, NE
This is my third H & W course and I’m consistently impressed with the course content, instructors & lab assistants. This location & hosts were amazing!
- Geena Kerr, SPT - Clarkston, MI
Valuable course; definitely worth the cost. A perfect primer of bowel function / dysfunction and the male pelvic floor. These taught applications of the content that I will use immediately.
- Anne Benetti, PT, DPT - Escanaba, MI
These instructors made talking about poop for 3 days quite delightful! Well Done!
- Christa Milena Carlomusto, PT, MPT, CLT - Novi, MI
What a great course to help me treat those patients with frustrating bowel. Thank you so much!
- Alisa Herman, PT - Lima, OH
Material is Evidence based, well present, and functionally applicable to so many patients. Susannah and Heather brought helpful clinical example and knowledge. As was the case with PF1, these courses leave you wanting more. Looking forward to PF1B, Well Done!
- Megan Sievers PT, DPT - Holland, MI
Content is incredibly well organized and well presented.
- Holly Tipp, PT, DPT, CSCS - Portland, OR
For a challenging course topic the teachers and TAs were so wonderful, open, and easy to work with. This made me even more in love with Pelvic Floor PT.
- Molly Gray PT, DPT, CertMDT - Boise, ID
This is my second course and I’ve found them both enjoyable and helpful. As soon as I started treating PF I started getting a lot of referrals for bowel/rectal patients (including self-referrals) So I am thrilled to have better tools to help and educate the rural population I work with.
- Bridget Rose, PTA - Carbondale, IL
Pamela is an excellent instructor; I am very interested in taking any other courses she teaches.
- Anna Squires MSPT, OCS - Norfolk, MA
Level 2A was so informational and instructors are amazing. Love how they want to make sure you feel and understand all Labs and content. Feel confident moving forward!!
- Leticia Jacquet, MSPT, DPT - West Hartford, CT
More one on one practice on biofeedback would help.
- Priyal Doshi, DPT, MBA - Alpharetta, GA
This is my 3rd H & W course – they have all been fabulous – I will continue on this course of education for PMD.
- Catherine Brock, OTR/L, BCB-PMD - Fairhope, AL
The instruction was sometimes learned (1st day). All instructors were knowledgeable and very kind with their comments for questions. All were extremely plugged in and helpful during lab time. Also the facilities (Inova) provided lunch/breakfast each day which helped to destress and relax us during the lunch breaks. It made such a difference with our breaks!
- Melinda Ferrell, PT - Springfield, VA
The instructors are passionate, well-informed and the leaders in the field.
- Ariane Casper, PT - Vienna, VA
This was such a wonderful course. I feel so excited to take those skills back to my clinic.
- Emily H. Priestas, DPT - Hagerstown, MD
This class helped bring everything “full-article” for me. I have taken PF1 & PF2B and this class really helped me understand the “other half” of treating PF issues.
- Addie Long, DPT - Lawrence, KS
I got so much out of this course and continue to be so impresses with the knowledge, professionalism and presentation capabilities of the instructors! I can’t wait to get back to the clinic and apply all I have learned.
- Ashley Hoath DPT, OCS - Longmont, CO
Love all H & W courses! The instructors are amazing & make the course so fun! And all the participants have been so helpful w/teaching techniques to new grands!
- Mary Brian Yoffe, DPT - Durham, NC
This course was excellent with learning information about Bowel health and the GI system. I am so happy that I took this course!
-Brianna Mullins, PT, DPT - Kingsport, TN
The instructor and lab assistants were great. They were not intimidating and patient with helping everyone. Course material is very thorough.
-Sharon Lee Lynch, PT - North LIttle Rock, AR
I absolutely love coming of these classes and wish I could come to move. They are so empowering and make me so excited about pelvic health!
-Eva Laughter, DPT - Jackson, MS
Advanced Physical Therapy is such an amazing course host. I am from Ohio and could have attended other 2A courses. But I came to my level I course here at Advanced and knew I had to come back. Sandy and her staff are so knowledgeable and kind. The clinic is beautiful and so clean and comfortable!
-Kandis B Castelli, PT, DPT - springfield, OH
Herman and Wallace course always leave me invigorated and ready to return to the clinic with new idea and confidence. This course was no exception. I feel much better prepared to treat my male patients and perform intrarectal. Thanks Darla, Jessica and TA’s
-Megan Fosko PT, DPT - Hartsdale, NY
I appreciate the instructor’s interaction and education to further spark the drive to learn about pelvic health Thank You for making the course entertaining!
-Kayla Cobbs, PT, DPT - Vinemont, AL
I really enjoyed this course it was way more informative and less uncomfortable than I thought it would be. Both Jessica and Darla were amazing. I appreciated the concern and advice on beginning to treat male patients and ensuring that we feel comfortable treating anyone and how to handle when he don’t.
-Tristan Faile, PT, DPT, OCS - Columbia, SC
Thoroughly enjoyed the class and the instructors! Feel confident about treating males!
-KeriAnne Schmidt, DPT - Manchester, IA
This has been one of the most informative pelvic floor courses. I was initially intimidated by the course material but the instructors made it very educational and relatable to patient care. These were also the best TA's I've had at a course. Also this facility was an amazing learning environment.
-Anne Copeman, PT, DPT - Sioux Falls, SD
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