This three-day course for the experienced pelvic rehab therapist will address manual treatments and problem-solving assessments for the major contributory nerves from the sacral plexus to the pelvis in an organized, systematic fashion. Peripheral sacral plexus nerves included in this course are (sciatic, superior and inferior gluteal, coccygeal nerves, inferior dural tube, pudendal nerve, dorsal clitoral/penile branch, perineal branch, and inferior rectal or hemorrohoidal nerves), which run anterior to the sacrum and coccyx. To effectively decompress the pathway of these nerves, one must also precisely address the torsional patterns of the sacrum with the uterus, the sacro-coccygeal transition, torsional patterns or misalignment   within the coccyx, the interplay of the sacrospinus and sacrotuberous ligaments along common sites of neural entrapment, as well as the position of the sacrum. Assessment and treatment of all the above structures will be address and combined into a usable clinical package with problem solving and manual and therapeutic solutions. Clinical assessment and differential diagnosis will include history, symptoms, strength and sensation changes, and differential neural tension testing for each major peripheral nerve of the sacral plexus. Students will practice interactively mapping the pathway of each nerve and neuro-fascial techniques to decompress the nerve along the path, including common sites of entrapment and impingement. Treatments will encompass manually releasing the specific fascial pathway of each nerve, decompressing the peripheral plexus, and direct neural manipulation. Once the nerve path is addressed, neural mobilization with movement (gliding), manual regional integration with the nervous system, and home program to maintain neural strength and mobility will provided in easy to use handouts for your patients (when applicable).

This course will be very lab heavy, around 65% of the course will be interactive, hands-on learning. PF2A or another intra-rectal pelvic mapping course is a pre-requisite for this course, and this course is an excellent course to follow Capstone.

Nerves transmit pain messages. When nerves are compressed they can cause pain or weakness. Pelvic rehab is traditionally centered around muscles, but muscles are at the will of the innervating nerve. Frequently the nerve is overlooked as the source of pain or weakness. Unfortunately, the patients who receive diagnoses such as neuropathic pain or nerve entrapment are presented with few options. Pelvic neural pain can be mimic or be the actual cause of vulvodynia, labial pain, gluteal and low back pain, SI pain, lower abdominal and bladder pain, pubic symphysis pain, as well as many other syndromes and weakness, such as hypertonicity in the pelvic floor or anorgasmia.

Prerequisites:
Participants must have prior experience with internal vaginal assessment. Pelvic Floor Level One and intermediate coursework, Pelvic Floor Level 2A or other intra-rectal mapping course is a required pre-requisite.

What to Bring to Class:

1. 5 colored markers or felt tip pens
2. 4 colored permanent markers (not black)
3. 2 old washcloths that you can cut up (to make a treatment tool)
4. 1 old hand towel (to make a treatment prop you will take home)
5. One pair of scissors (strong enough to cut washcloth)
6. Masking tape or athletic tape
7. A soft tissue treatment tool or cupping set
8. A pen
9. Nailclippers, as you will need very short nails for this class
10. Optional: Yoga Mat and pillow for your lab table (we have a LOT of lab in this class and laying on desks can be quite painful for such long periods of time). The pillow and yoga mat can make you more comfortable.

Please note: on day 3, it will be helpful if you can pack a lunch.

Required Readings:
Sacral Nerve Pre-Course Videos

Highly Suggested Text:
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.