Courses Instructed by Nicole Dugan

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Description
Schedule
Objectives
Location/Lodging
Instructors
Discounts

Price: $695 ($725 within one month of the course)
Experience Level: Beginner
Contact Hours: 24.0

This continuing education course is comprised of 9 hours of prerecorded lectures followed by two-days of in-person learning, and was designed to provide a thorough introduction to female pelvic floor function, dysfunction and treatment interventions. It is geared to the physical therapist who wants to synthesize the information and apply it to individual treatment programs for urinary incontinence or the musculoskeletal components of urogynecologic pain syndromes such as chronic pelvic pain (CPP), vulvar pain, and interstitial cystitis/painful bladder syndrome (IC/PBS). This continuing education seminar teaches evaluation and treatment interventions by instructional assessment of the pelvic floor muscles with internal vaginal examination and SEMG biofeedback assessment. The information is immediately applicable to clinical practice.
Presentation of evidence-based evaluation and treatment techniques will be emphasized. Outcome measures and quality of life questionnaires will be presented for both urinary incontinence and pain syndromes. Daily lab time allows for supervised instruction of pelvic floor muscle evaluation with external palpation and internal vaginal examination of pelvic floor musculature. For each condition the therapist will learn to: recognize the key signs and symptoms that lead to impairment, functional limitations and disabilities; use an evaluation/outcome tool; and perform a suggested protocol of treatment interventions. Clinical treatment interventions will include therapeutic exercise, SEMG biofeedback, external manual therapy, patient related education/behavioral instructions and electrotherapeutic modalities.
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.
Special Considerations:
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. Partiicipants 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.
This course instructs in the use of biofeedback equipment. Equipment at the course will be supplied by our biofeedback vendor, Current Medical Technologies. If you would like to contact them prior to the course to inquire about equipment purchases, you can do so using this link. A representative will be able to assist you if you tell them which Herman & Wallace course you will be taking.
10-14 days before the course, participants will receive an invite to join Teachable, an online learning platform. Teachable is where you will find pre-recorded videos and other pre-requisite learning, manual files, your liability waiver you must sign in order to participate, and any links to Zoom (if the course is a remote option). After the course is over, Teachable is where you will find your post-test and evaluation form to tell us what you thought, as well as your certificate. It is required in Teachable that you complete all components in order. Pre-recorded videos that are required must be watched before going onto the next session.
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.
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.
Assignments
In order to derive the most benefit from this course, we ask our participants to internalize the required reading materials and complete a diary assignment prior to attending. Please complete this assignment prior to the first day of the seminar. We ask that participants keep a personal bladder diary measuring and recording fluid intake and urine output for two days - one work day and one non-work day. Specific measurements (use a large measuring cup or urine collection “hat”) of urine output are needed for at least one day, and on the following day one can estimate by counting seconds while voiding.
1. Bladder Diary (Print two copies)
2. Bladder Diary Assignment Instructions
3. Patient History Form
4. Biofeedback Video - Please download and listen to the presentation
Required Readings
1. Diagnosis, Treatment, and Prevention of Urinary Incontinence
2. The International Pelvic Pain Society Patient's Booklet on Chronic Pelvic Pain
3. Principles of Biofeedback from Professor Tim Watson's website- an incredible resource!
4. Neuromuscular Electrical Stimulation (a download from Tim Watson's site: electrotherapy.org.)
5. IUGA/ICS report on female pelvic floor terminology
6. Many participants find it helpful to review the anatomy of the pelvis and perineum
7. Gray's Anatomy for Students - Available at a 20% Discount for Herman & Wallace registrants (use discount code ELS25OFF). Registrants who already own a copy are not required to purchase an additional one. For those who are interested in making the shift to digital, there is an ebook version of Gray's Anatomy for Students through the above link.
Please Contact Us with any questions about the use of this text as a required reading in this course.

Recorded video lectures to be viewed in-full prior to the Day One of the course (Total video lecture time 9 hours)

Pelvic Floor Anatomy & Function (45 minutes)
Pelvic Floor Evaluation and Examination (1 hour 30 min)
Managing Movement (1 hour)
Awareness of Trauma in Pelvic Rehab (1 hour)
Urinary Incontinence (1 hour 30 min)
Introduction to Pelvic Pain (1 hour)
General Treatment of Pelvic Pain (1 hour)
Electrical Muscle Stimulation (1 hour 15 min)

Day One:
7:30 Registration
8:00 Introduction, goals, objectives, questions
8:30 Pelvic Floor (PF) Anatomy and Evaluation
9:15 Lab 1: PF Exam Techniques Part 1: Observation, Identification, Muscle layers, ICS Scoring
10:15 Break
10:30 Pelvic Floor Evaluation (Continued)
11:00 Lab 2: PF Exam Techniques Part 2: PF MMT, Laycock Exam, Pelvic Clock, Obturator Internus
12:00 Lunch
1:00 Urinary Incontinence Examination & Interventions Part II
1:45 Lab 3: Bladder Diary Activity
2:30 Break
2:45 Lab 4: Screening of Breathing & Load Transfer Strategies, Abdominal Wall Dysfunction
3:30 Electrical Stimulation (ES), sEMG Biofeedback Lecture
4:00 Lab 5: sEMG Biofeedback & Electrical Stimulation Applications
5:00 Questions
5:15 Adjourn

Day Two:
7:30 Questions, Post-test Day 2
7:45 Pelvic Organ Prolapse
8:45 Lab 6: Pelvic Floor Examination and Prolapse Exam, External Palpation
9:45 Break
10:00 Specific Diagnoses in Female Pelvic Pain
11:15 Managing Movement Part II: Pressures & Load Transfer
12:00 Lunch
1:00 Managing Movement Part II: Pressures & Load Transfer
1:45 Final Lab Preparation
2:00 Lab 7: Final Pelvic Rehabilitation Examination, Evaluation, & Treatment
3:15 Break
3:30 Case Studies
4:00 Questions (Resources, Billing, Marketing, Etc.), Wrap-up
4:15 Adjourn

Upon completion of this continuing education seminar, participants will be able to:
1. Identify the muscle layers and specific muscles of the pelvic floor
2. List the pelvic floor muscle functions
3. Describe and perform pelvic floor muscle evaluation techniques utilizing observation, vaginal palpation, and SEMG biofeedback
4. List appropriate outcome measure tools for urinary incontinence, pelvic organ prolapse and pelvic pain
5. List indications, precautions, contraindications, and universal precautions for pelvic floor examination and treatment
6. Identify specific pelvic pain conditions (vulvodynia, IC and CPP) and common physical therapy interventions
7. Identify the various types of urinary incontinence and behavioral treatment options available to the physical therapist
8. List two diagnoses that would benefit from applications of electrotherapy
9. Describe the applications of SEMG biofeedback for the pelvic floor
10. Develop evidence-based treatment plans and progressive clinical goals for female pelvic floor dysfunctions

Name Street Address (Links to Map)

Course Location

Ability Rehabilitation

4501 Vineland Road Suite #103
Orlando,FL 32811

Recommended Lodging

SpringHill Suites by Marriott Orlando at Millenia
(407)-352-2500

5403 Millenia Lakes Boulevard
Orlando, Florida 32839

Nearest Airport

Orlando International Airport
Airport Code: MCO

1 Jeff Fuqua Blvd,
Orlando, FL 32827

Directions from Recommended Lodging to Course Location: (click here if no map appears below)
Heather S. Rader, PT, DPT, PRPC, BCB-PMD

Dr. Heather Rader the owner of Rader Pelvic Physical Therapy, a practice devoted to the treatment of pregnancy related pain and dysfunction, incontinence, pelvic organ prolapse, and complex pelvic pain in men and women. A physical therapist since 1994, she graduated from the University of Miami with a Master’s degree in Physical Therapy and she completed her Doctorate in Physical Therapy from the University of St. Augustine in 2011. She has been board certified in the use of Biofeedback for Pelvic Muscle Disorders since 2006. She was awarded the Pelvic Rehabilitation Practitioner Certification in 2014 and served as a subject matter expert and question writer for the PRPC examination. She is on faculty with the Herman & Wallace Pelvic Rehabilitation Institute, teaching Pelvic Rehabilitation around the country several times a year, teaching courses in the Pelvic Floor Series and Pregnancy Series and is the author of the Geriatric Pelvic Floor course.
Her mission as an educator is to assist in the national expansion of qualified pelvic floor therapists and promote awareness of pelvic floor dysfunction to medical professionals and the community at large. She runs a social media site on Facebook called “Team Pelvic Floor”, which posts articles and facts about pelvic floor rehab while promoting a team approach to treating pelvic dysfunction. She is a practice consultant and mentors therapists wishing to incorporate pelvic rehabilitation into their practice.
Work Cell: 352-409-7603
Office: 352-585-9135 Fax: 239-275-0277
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
Web: www.RaderPelvicPT.com
Facebook: www.facebook.com/TeamPelvicFloor

Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS

Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS graduated from Temple University’s MPT and DPT program in 1997 and 2003, respectively. At the onset of her career, she obtained clinical specialty and is now a board certified Women’s Health Clinical Specialist through the APTA and Certified Lymphedema Therapist through Lymphedema Association of North America. She spent 18 years working at Penn Medicine / Good Shepherd Penn Partners developing and mentoring in both the Pelvic Floor and Lymphedema rehabilitation program. While there, she oversaw the development and accreditation from the APTA for Women’s Health Residency Program. Nicole’s clinical specialties have allowed her opportunity to participate in multiple NIH funded multi-center research studies and publications. In 2015 Nicole joined Jefferson Health System in Philadelphia to focus on developing the Pelvic Rehabilitation program. With a focus on functional manual therapy, her clinical practice focuses on treating all genders for pelvic dysfunction, pregnancy/ postpartum/ bowel/ bladder and sexual dysfunction.
Nicole is dedicated to the multidisciplinary approach to managing patients with pelvic dysfunction. She is adjunct faculty at many academic programs including multiple Doctor of Physical Therapy programs, Jefferson Medical College, and Nursing school. She has been an invited speaker at international conferences on lymphedema management and pelvic rehabilitation. She provides pelvic rehabilitation services in Jamaica, WI through Medicine In Action medical mission. She is the co-founder of the Philadelphia Regional Pelvic PT Alliance which is a multidisciplinary organization focused on providing education and networking opportunities for Pelvic Therapists. When Niki is not working she enjoys travel, golf, and spending time with her husband and daughter.
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).

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	Name	Street Address (Links to Map)
Course Location	Ability Rehabilitation	4501 Vineland Road Suite #103 Orlando,FL 32811
Recommended Lodging	SpringHill Suites by Marriott Orlando at Millenia (407)-352-2500	5403 Millenia Lakes Boulevard Orlando, Florida 32839
Nearest Airport	Orlando International Airport Airport Code: MCO	1 Jeff Fuqua Blvd, Orlando, FL 32827

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Update 3/25/2020: As a precaution against the spread of COVID-19, this course has been postponed. Once we have a new date confirmed, we will update our website and make the event available for registration. We appreciate your understanding during this difficult time. Please practice good hygiene, and be safe!
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Description
Schedule
Objectives
Location/Lodging
Instructors
Discounts

Price: $695 ($725 within one month of the course)
Experience Level: Beginner
Contact Hours: 24.0

Recorded video lectures to be viewed in-full prior to the Day One of the course (Total video lecture time 9 hours)

Name Street Address (Links to Map)

Course Location

Unity Health System

2655 Ridgeway Ave
Rochester, NY 14626

Recommended Lodging

Hampton Inn Rochester-North
(585) 663-6070

500 Center Pl Dr
Rochester, NY 14615

Nearest Airport

Greater Rochester International Airport
Airport Code: ROC

1200 Brooks Ave
Rochester, NY 14624

Directions from Recommended Lodging to Course Location: (click here if no map appears below)
Dustienne Miller, MSPT, WCS, CYT

Trading the skyscrapers of NYC for the hills of Sonoma County, Dustienne set up her clinical practice in Santa Rosa in 2012. After a wonderful year filled with sunshine and amazing food she moved to Bean Town to be closer to her family. Her clinical practice, Flourish Physical Therapy, is located in lively Copley Square, Downtown Boston. She is a board certified women's health clinical specialist recognized by the American Board of Physical Therapy Specialties. Dustienne weaves yoga postures and breathing into her clinical practice, having received her yoga teacher certification through the Kripalu Center for Yoga and Health.
Dustienne had the honor of speaking at the Combined Sections Meeting of the American Physical Therapy Association in 2013. Her lecture, titled "Yoga for Pelvic Pain", was met with such enthusiasm that another session was added to accommodate her interested colleagues.
Her love of movement is apparent not only in her physical therapy and yoga practice, but also in her career as a professional dancer. Dustienne danced professionally in New York City for several years, most notably with the national tour of Fosse. She bridged her dance background and physical therapy working for Physioarts, who contracted her to work backstage at several Broadway shows and for Radio City Christmas Spectacular.
Dustienne passionately believes in the integration of physical therapy and yoga in a holistic model of care, helping individuals navigate through pelvic pain and incontinence to live a healthy and pain-free life. She is the creator of the yoga video series Your Pace Yoga. Check out her website, www.yourpaceyoga.com, where you will find her blog, guided meditation, and resources.)

Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS

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	Name	Street Address (Links to Map)
Course Location	Unity Health System	2655 Ridgeway Ave Rochester, NY 14626
Recommended Lodging	Hampton Inn Rochester-North (585) 663-6070	500 Center Pl Dr Rochester, NY 14615
Nearest Airport	Greater Rochester International Airport Airport Code: ROC	1200 Brooks Ave Rochester, NY 14624

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Pelvic Floor Level 1 - Washington, DC - June 5-7, 2020 (Rescheduled)

Update 4/17/2020: As a precaution against the spread of COVID-19, this course has been postponed. We appreciate your understanding during this difficult time. Please practice good hygiene, and be safe!

We have a new date for this course: October 23-25 2020.

Description
Schedule
Objectives
Location/Lodging
Instructors
Discounts

Price: $695 ($725 within one month of the course) Experience Level: Beginner Contact Hours: 24.0

Presentation of evidence-based evaluation and treatment techniques will be emphasized. Outcome measures and quality of life questionnaires will be presented for both urinary incontinence and pain syndromes. Daily lab time allows for supervised instruction of pelvic floor muscle evaluation with external palpation and internal vaginal examination of pelvic floor musculature. For each condition the therapist will learn to: recognize the key signs and symptoms that lead to impairment, functional limitations and disabilities; use an evaluation/outcome tool; and perform a suggested protocol of treatment interventions. Clinical treatment interventions will include therapeutic exercise, SEMG biofeedback, external manual therapy, patient related education/behavioral instructions and electrotherapeutic modalities.

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.

Special Considerations:
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. Partiicipants 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.

This course instructs in the use of biofeedback equipment. Equipment at the course will be supplied by our biofeedback vendor, Current Medical Technologies. If you would like to contact them prior to the course to inquire about equipment purchases, you can do so using this link. A representative will be able to assist you if you tell them which Herman & Wallace course you will be taking.

10-14 days before the course, participants will receive an invite to join Teachable, an online learning platform. Teachable is where you will find pre-recorded videos and other pre-requisite learning, manual files, your liability waiver you must sign in order to participate, and any links to Zoom (if the course is a remote option). After the course is over, Teachable is where you will find your post-test and evaluation form to tell us what you thought, as well as your certificate. It is required in Teachable that you complete all components in order. Pre-recorded videos that are required must be watched before going onto the next session.

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.

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.

Assignments

In order to derive the most benefit from this course, we ask our participants to internalize the required reading materials and complete a diary assignment prior to attending. Please complete this assignment prior to the first day of the seminar. We ask that participants keep a personal bladder diary measuring and recording fluid intake and urine output for two days - one work day and one non-work day. Specific measurements (use a large measuring cup or urine collection “hat”) of urine output are needed for at least one day, and on the following day one can estimate by counting seconds while voiding.

1. Bladder Diary (Print two copies)
2. Bladder Diary Assignment Instructions
3. Patient History Form
4. Biofeedback Video - Please download and listen to the presentation

Required Readings

1. Diagnosis, Treatment, and Prevention of Urinary Incontinence
2. The International Pelvic Pain Society Patient's Booklet on Chronic Pelvic Pain
3. Principles of Biofeedback from Professor Tim Watson's website- an incredible resource!
4. Neuromuscular Electrical Stimulation (a download from Tim Watson's site: electrotherapy.org.)
5. IUGA/ICS report on female pelvic floor terminology
6. Many participants find it helpful to review the anatomy of the pelvis and perineum
7. Gray's Anatomy for Students - Available at a 20% Discount for Herman & Wallace registrants (use discount code ELS25OFF). Registrants who already own a copy are not required to purchase an additional one. For those who are interested in making the shift to digital, there is an ebook version of Gray's Anatomy for Students through the above link.

Please Contact Us with any questions about the use of this text as a required reading in this course.

Recorded video lectures to be viewed in-full prior to the Day One of the course (Total video lecture time 9 hours)

Pelvic Floor Anatomy & Function (45 minutes)
Pelvic Floor Evaluation and Examination (1 hour 30 min)
Managing Movement (1 hour)
Awareness of Trauma in Pelvic Rehab (1 hour)
Urinary Incontinence (1 hour 30 min)
Introduction to Pelvic Pain (1 hour)
General Treatment of Pelvic Pain (1 hour)
Electrical Muscle Stimulation (1 hour 15 min)

Day One:

7:30 Registration
8:00 Introduction, goals, objectives, questions
8:30 Pelvic Floor (PF) Anatomy and Evaluation
9:15 Lab 1: PF Exam Techniques Part 1: Observation, Identification, Muscle layers, ICS Scoring
10:15 Break
10:30 Pelvic Floor Evaluation (Continued)
11:00 Lab 2: PF Exam Techniques Part 2: PF MMT, Laycock Exam, Pelvic Clock, Obturator Internus
12:00 Lunch
1:00 Urinary Incontinence Examination & Interventions Part II
1:45 Lab 3: Bladder Diary Activity
2:30 Break
2:45 Lab 4: Screening of Breathing & Load Transfer Strategies, Abdominal Wall Dysfunction
3:30 Electrical Stimulation (ES), sEMG Biofeedback Lecture
4:00 Lab 5: sEMG Biofeedback & Electrical Stimulation Applications
5:00 Questions
5:15 Adjourn

Day Two:

7:30 Questions, Post-test Day 2
7:45 Pelvic Organ Prolapse
8:45 Lab 6: Pelvic Floor Examination and Prolapse Exam, External Palpation
9:45 Break
10:00 Specific Diagnoses in Female Pelvic Pain
11:15 Managing Movement Part II: Pressures & Load Transfer
12:00 Lunch
1:00 Managing Movement Part II: Pressures & Load Transfer
1:45 Final Lab Preparation
2:00 Lab 7: Final Pelvic Rehabilitation Examination, Evaluation, & Treatment
3:15 Break
3:30 Case Studies
4:00 Questions (Resources, Billing, Marketing, Etc.), Wrap-up
4:15 Adjourn

Upon completion of this continuing education seminar, participants will be able to:

1. Identify the muscle layers and specific muscles of the pelvic floor
2. List the pelvic floor muscle functions
3. Describe and perform pelvic floor muscle evaluation techniques utilizing observation, vaginal palpation, and SEMG biofeedback
4. List appropriate outcome measure tools for urinary incontinence, pelvic organ prolapse and pelvic pain
5. List indications, precautions, contraindications, and universal precautions for pelvic floor examination and treatment
6. Identify specific pelvic pain conditions (vulvodynia, IC and CPP) and common physical therapy interventions
7. Identify the various types of urinary incontinence and behavioral treatment options available to the physical therapist
8. List two diagnoses that would benefit from applications of electrotherapy
9. Describe the applications of SEMG biofeedback for the pelvic floor
10. Develop evidence-based treatment plans and progressive clinical goals for female pelvic floor dysfunctions

	Name	Street Address (Links to Map)
Course Location	GWUH Outpatient Rehabilitation Center	2131 K St. NW Washington, DC 20037
Recommended Lodging	Avenue Suites Georgetown (202)333-8060	2500 Pennsylvania Ave NW Washington, DC 20037
Nearest Airport	Washington Dulles International Airport Airport Code: IAD	Dulles International Airport, 1 Saarinen Cir Dulles, VA 20166

Directions from Recommended Lodging to Course Location

Dustienne Miller, MSPT, WCS, CYT

Dustienne had the honor of speaking at the Combined Sections Meeting of the American Physical Therapy Association in 2013. Her lecture, titled "Yoga for Pelvic Pain", was met with such enthusiasm that another session was added to accommodate her interested colleagues.

Her love of movement is apparent not only in her physical therapy and yoga practice, but also in her career as a professional dancer. Dustienne danced professionally in New York City for several years, most notably with the national tour of Fosse. She bridged her dance background and physical therapy working for Physioarts, who contracted her to work backstage at several Broadway shows and for Radio City Christmas Spectacular.

Dustienne passionately believes in the integration of physical therapy and yoga in a holistic model of care, helping individuals navigate through pelvic pain and incontinence to live a healthy and pain-free life. She is the creator of the yoga video series Your Pace Yoga. Check out her website, www.yourpaceyoga.com, where you will find her blog, guided meditation, and resources.)

Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS

Nicole is dedicated to the multidisciplinary approach to managing patients with pelvic dysfunction. She is adjunct faculty at many academic programs including multiple Doctor of Physical Therapy programs, Jefferson Medical College, and Nursing school. She has been an invited speaker at international conferences on lymphedema management and pelvic rehabilitation. She provides pelvic rehabilitation services in Jamaica, WI through Medicine In Action medical mission. She is the co-founder of the Philadelphia Regional Pelvic PT Alliance which is a multidisciplinary organization focused on providing education and networking opportunities for Pelvic Therapists. When Niki is not working she enjoys travel, golf, and spending time with her husband and daughter.

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).

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Description
Schedule
Objectives
Location/Lodging
Instructors



Price: $250
Experience Level: Beginner
Contact Hours: 8.75





This remote continuing education course provides live instruction in foundational content in pelvic floor rehabilitation physical therapy. This course consists of the same content contained in the pre-recorded lectures of Pelvic Floor Level 1. Participants who join us for this remote course will have a chance to experience these lectures live with an HW faculty member, who will answer questions in real time.
Participants may choose to take this course and then sign up for the full-length Pelvic Floor Level 1 course, which includes labs, and is offered in both In-Person and Satellite formats. Participants who sign up for the full Pelvic Floor Level 1 course will receive the pre-recorded lectures of the content contained in this course, which they may use to review. It is therefore NOT required that one take Pelvic Floor Level 1 Part 1 prior to taking the full-length Pelvic Floor Level 1 course. However, this is the perfect option for a therapist who has yet to find a Pelvic Floor Level 1 in their region, and who wants to begin their pelvic rehab training while practicing strict social distancing, or the therapist who is curious to learn more about pelvic rehab but is not yet ready to attend a course inclusive of labs. 
Included in the remote course is a thorough overview of pelvic anatomy, concepts and techniques in trunk and pelvic evaluation and examination including the observation and retraining of movement patterns. Lectures will cover specific conditions including urinary incontinence and pelvic pain. Concepts related to trauma-informed care will also be included in this comprehensive introduction. Participants are encouraged to come with questions about starting their journey becoming pelvic rehab practitioners for the instructor. 
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.
Please Note: Those who were registered for a Pelvic Floor 1 course which was postponed due to Covid-19, and whose course has not been rescheduled yet, are invited to attend this remote Pelvic Floor 1 Part 1 course at no additional fee. Please contact us to verify eligibility and register if you would like to take advantage of this offer.
 
Required Readings
1. Diagnosis, Treatment, and Prevention of Urinary Incontinence
 2. The International Pelvic Pain Society Patient's Booklet on Chronic Pelvic Pain
3. IUGA/ICS report on female pelvic floor terminology
4. Many participants find it helpful to review the anatomy of the pelvis and perineum
5. Gray's Anatomy for Students - Available at a 20% Discount for Herman & Wallace registrants (use discount code ELS25OFF). Registrants who already own a copy are not required to purchase an additional one. For those who are interested in making the shift to digital, there is an ebook version of Gray's Anatomy for Students through the above link.
 
Please Contact Us with any questions about the use of this text as a required reading in this course.

 
Special Considerations:
This course will be offered as a live, interactive remote course on Zoom, taught by an instructor who will teach introductory didactic lectures and answer questions.
 
 
The times listed are for the morning offerings of PF1.1 All times are Pacific Time. 




Day One:
9:00 Log on, Zoom basics, introductions, goals, objectives
9:30 Pelvic Floor Anatomy & Function 
10:15 Pelvic Floor Evaluation and Examination 
11:45 Break
12:00 Managing Movement
1:00 Awareness of Trauma in Pelvic Rehab
2:00 Adjourn


Day Two:
9:00 Questions from Day 1
9:15 Urinary Incontinence
10:45 Break
11:00 Introduction to Pelvic Pain
12:00 General Treatment of Pelvic Pain
1:00 Questionns
 1:15 Adjourn




 
Upon completion of this continuing education seminar, participants will be able to:
1. Identify the muscle layers and specific muscles of the pelvic floor
 2. List the pelvic floor muscle functions
 3. Describe pelvic floor muscle evaluation techniques utilizing observation, vaginal palpation, and SEMG biofeedback
4. List indications, precautions, contraindications, and universal precautions for pelvic floor examination and treatment
5. Identify the various types of urinary incontinence and behavioral treatment options available to the physical therapist
6. Begin to develop evidence-based treatment plans and progressive clinical goals for pelvic floor dysfunctions
7. Recognize key components of trauma-based care
Attending a remote course is easy and safe, and you can do it entirely from the security and comfort of your own home or clinic without having to find a lab partner.
 
Important thing to note: 
- To attend a remote Herman & Wallace course, registrants will need Zoom video conferencing software. This is a requirement. One can create an account and download the software to their computer at https://zoom.us/
- We use the Pacific Time Zone for all of our remote course start and end times (this is not the case for in-person and satellite lab locations). 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
Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS 
Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS graduated from Temple University’s MPT and DPT program in 1997 and 2003, respectively. At the onset of her career, she obtained clinical specialty and is now a board certified Women’s Health Clinical Specialist through the APTA and Certified Lymphedema Therapist through Lymphedema Association of North America. She spent 18 years working at Penn Medicine / Good Shepherd Penn Partners developing and mentoring in both the Pelvic Floor and Lymphedema rehabilitation program. While there, she oversaw the development and accreditation from the APTA for Women’s Health Residency Program. Nicole’s clinical specialties have allowed her opportunity to participate in multiple NIH funded multi-center research studies and publications. In 2015 Nicole joined Jefferson Health System in Philadelphia to focus on developing the Pelvic Rehabilitation program. With a focus on functional manual therapy, her clinical practice focuses on treating all genders for pelvic dysfunction, pregnancy/ postpartum/ bowel/ bladder and sexual dysfunction.
Nicole is dedicated to the multidisciplinary approach to managing patients with pelvic dysfunction. She is adjunct faculty at many academic programs including multiple Doctor of Physical Therapy programs, Jefferson Medical College, and Nursing school. She has been an invited speaker at international conferences on lymphedema management and pelvic rehabilitation. She provides pelvic rehabilitation services in Jamaica, WI through Medicine In Action medical mission. She is the co-founder of the Philadelphia Regional Pelvic PT Alliance which is a multidisciplinary organization focused on providing education and networking opportunities for Pelvic Therapists. When Niki is not working she enjoys travel, golf, and spending time with her husband and daughter.
 
 


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Description
Schedule
Objectives
Location/Lodging
Instructors



Price: $250
Experience Level: Beginner
Contact Hours: 8.75





This remote continuing education course provides live instruction in foundational content in pelvic floor rehabilitation physical therapy. This course consists of the same content contained in the pre-recorded lectures of Pelvic Floor Level 1. Participants who join us for this remote course will have a chance to experience these lectures live with an HW faculty member, who will answer questions in real time.
Participants may choose to take this course and then sign up for the full-length Pelvic Floor Level 1 course, which includes labs, and is offered in both In-Person and Satellite formats. Participants who sign up for the full Pelvic Floor Level 1 course will receive the pre-recorded lectures of the content contained in this course, which they may use to review. It is therefore NOT required that one take Pelvic Floor Level 1 Part 1 prior to taking the full-length Pelvic Floor Level 1 course. However, this is the perfect option for a therapist who has yet to find a Pelvic Floor Level 1 in their region, and who wants to begin their pelvic rehab training while practicing strict social distancing, or the therapist who is curious to learn more about pelvic rehab but is not yet ready to attend a course inclusive of labs. 
Included in the remote course is a thorough overview of pelvic anatomy, concepts and techniques in trunk and pelvic evaluation and examination including the observation and retraining of movement patterns. Lectures will cover specific conditions including urinary incontinence and pelvic pain. Concepts related to trauma-informed care will also be included in this comprehensive introduction. Participants are encouraged to come with questions about starting their journey becoming pelvic rehab practitioners for the instructor. 
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.
Please Note: Those who were registered for a Pelvic Floor 1 course which was postponed due to Covid-19, and whose course has not been rescheduled yet, are invited to attend this remote Pelvic Floor 1 Part 1 course at no additional fee. Please contact us to verify eligibility and register if you would like to take advantage of this offer.
 
Required Readings
1. Diagnosis, Treatment, and Prevention of Urinary Incontinence
 2. The International Pelvic Pain Society Patient's Booklet on Chronic Pelvic Pain
3. IUGA/ICS report on female pelvic floor terminology
4. Many participants find it helpful to review the anatomy of the pelvis and perineum
5. Gray's Anatomy for Students - Available at a 20% Discount for Herman & Wallace registrants (use discount code ELS25OFF). Registrants who already own a copy are not required to purchase an additional one. For those who are interested in making the shift to digital, there is an ebook version of Gray's Anatomy for Students through the above link.
 
Please Contact Us with any questions about the use of this text as a required reading in this course.

 
Special Considerations:
This course will be offered as a live, interactive remote course on Zoom, taught by an instructor who will teach introductory didactic lectures and answer questions.
 
 
The times listed are for the morning offerings of PF1.1 All times are Pacific Time. 




Day One:
9:00 Log on, Zoom basics, introductions, goals, objectives
9:30 Pelvic Floor Anatomy & Function 
10:15 Pelvic Floor Evaluation and Examination 
11:45 Break
12:00 Managing Movement
1:00 Awareness of Trauma in Pelvic Rehab
2:00 Adjourn


Day Two:
9:00 Questions from Day 1
9:15 Urinary Incontinence
10:45 Break
11:00 Introduction to Pelvic Pain
12:00 General Treatment of Pelvic Pain
1:00 Questionns
 1:15 Adjourn




 
Upon completion of this continuing education seminar, participants will be able to:
1. Identify the muscle layers and specific muscles of the pelvic floor
 2. List the pelvic floor muscle functions
 3. Describe pelvic floor muscle evaluation techniques utilizing observation, vaginal palpation, and SEMG biofeedback
4. List indications, precautions, contraindications, and universal precautions for pelvic floor examination and treatment
5. Identify the various types of urinary incontinence and behavioral treatment options available to the physical therapist
6. Begin to develop evidence-based treatment plans and progressive clinical goals for pelvic floor dysfunctions
7. Recognize key components of trauma-based care
Attending a remote course is easy and safe, and you can do it entirely from the security and comfort of your own home or clinic without having to find a lab partner.
 
Important thing to note: 
- To attend a remote Herman & Wallace course, registrants will need Zoom video conferencing software. This is a requirement. One can create an account and download the software to their computer at https://zoom.us/
- We use the Pacific Time Zone for all of our remote course start and end times (this is not the case for in-person and satellite lab locations). 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
Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS 
Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS graduated from Temple University’s MPT and DPT program in 1997 and 2003, respectively. At the onset of her career, she obtained clinical specialty and is now a board certified Women’s Health Clinical Specialist through the APTA and Certified Lymphedema Therapist through Lymphedema Association of North America. She spent 18 years working at Penn Medicine / Good Shepherd Penn Partners developing and mentoring in both the Pelvic Floor and Lymphedema rehabilitation program. While there, she oversaw the development and accreditation from the APTA for Women’s Health Residency Program. Nicole’s clinical specialties have allowed her opportunity to participate in multiple NIH funded multi-center research studies and publications. In 2015 Nicole joined Jefferson Health System in Philadelphia to focus on developing the Pelvic Rehabilitation program. With a focus on functional manual therapy, her clinical practice focuses on treating all genders for pelvic dysfunction, pregnancy/ postpartum/ bowel/ bladder and sexual dysfunction.
Nicole is dedicated to the multidisciplinary approach to managing patients with pelvic dysfunction. She is adjunct faculty at many academic programs including multiple Doctor of Physical Therapy programs, Jefferson Medical College, and Nursing school. She has been an invited speaker at international conferences on lymphedema management and pelvic rehabilitation. She provides pelvic rehabilitation services in Jamaica, WI through Medicine In Action medical mission. She is the co-founder of the Philadelphia Regional Pelvic PT Alliance which is a multidisciplinary organization focused on providing education and networking opportunities for Pelvic Therapists. When Niki is not working she enjoys travel, golf, and spending time with her husband and daughter.
 
 


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Pelvic Floor Level 1 Part 1 - Remote Course - September 12-13, 2020 (SOLD OUT)

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Description
Schedule
Objectives
Location Lodging
Instructor
Discounts

Price: $695 ($725 within one month of the course)
Experience Level: Intermediate
Contact Hours: 22.5

This continuing education course is a three-day (8 hours of online content, followed by a 2-day in-person course) 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 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 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.
Special Considerations:
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. Read more about What to Expect During Courses with Internal Lab Work.
10-14 days before the course, participants will receive an invite to join Teachable, an online learning platform. Teachable is where you will find pre-recorded videos and other pre-requisite learning, manual files, your liability waiver you must sign in order to participate, and any links to Zoom (if the course is a remote option). After the course is over, Teachable is where you will find your post-test and evaluation form to tell us what you thought, as well as your certificate. It is required in Teachable that you complete all components in order. Pre-recorded videos that are required must be watched before going onto the next session.
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 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.
Required Readings:
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:
1. Male Pelvic Pain - go to malepelvicfloor.com
2. Many participants also find it helpful to review the anatomy of the pelvis and perineum

References
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

Recorded Lecture: Watch Before the In-Person 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.)

Day One:
7:30 Registration
8:00 Introduction, Goals, Objectives
8:30 Colorectal Anatomy and Physiology Review, Anorectal Examination
9:15 LAB 1: Anorectal Evaluation: Sidelying Anorectal Examination & Muscle Mapping
10:15 Break
10:30 Fecal Incontinence, Case Study
11:15 Constipation, Case Study
12:00 Lunch
1:00 Pelvic Pain: Prostatitis, Scrotal Pain
2:00 Coccyx Dysfunction
3:00 Break
3:15 LAB 2: External Palpation & Intervention Posterior Pelvis
4:15 Prostatectomy Part I
5:15 Questions
5:30 Adjourn

Day Two:
7:45 Questions from Day 1, Post-test Day 1
8:00 Prostatectomy Part II
8:45 Pudendal
9:45 Break
10:00 LAB 3: Internal Interventions for Coccyx, Pudendal and Pelvic Pain
11:15 LAB 4: Inclusive Language
12:00 Lunch
12:45 Colorectal Conditions
2:00 Break
2:15 LAB 5: Final Pelvic Rehabilitation Examination, Evaluation, & Treatment
3:30 Questions
4:00 Adjourn

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.

Name
Street Address (Links to Map)

Course Location

Marathon Physical Therapy

99 Vanderbilt Ave
Norwood MA 02062

Recommended Lodging

Courtyard Boston Norwood
(781) 762-4700

300 River Ridge Dr
Norwood, MA 02062

Nearest Airport

Logan International Airport
Airport Code: BOS

1 Harborside Dr
Boston, MA 02128

Directions from Recommended Lodging to Course Location: (click here if no map appears below)
Heather S. Rader, PT, DPT, PRPC, BCB-PMD

Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS

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Pelvic Floor Level 2A - Boston, MA - September 19-20, 2020 (Rescheduled)

	Name	Street Address (Links to Map)
Course Location	Marathon Physical Therapy	99 Vanderbilt Ave Norwood MA 02062
Recommended Lodging	Courtyard Boston Norwood (781) 762-4700	300 River Ridge Dr Norwood, MA 02062
Nearest Airport	Logan International Airport Airport Code: BOS	1 Harborside Dr Boston, MA 02128

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Description
Schedule
Objectives
Location/Lodging
Instructors
Discounts

Price: $695 ($725 within one month of the course)
Experience Level: Intermediate
Contact Hours: 22.5

This three day (8 hours of online content, plus 2-days of in-person learning) intermediate-level continuing education course further defines skills and knowledge learned in the foundational Pelvic Floor Level One course. Specific, advanced examination techniques such as pelvic muscle mapping and interventions including downtraining of overactive muscles is instructed. With a specific focus on urogynecologic conditions including prolapse and pelvic organ descent, various pelvic pain diagnoses, and abdominal wall rehabilitation, the participant will be able to learn specific skills to treat these conditions that have a significant negative impact on a woman's health. Evidence-based references and case studies will be presented for thorough understanding of current medical evaluation and management of each condition.
Instruction in female urogynecologic anatomy occurs throughout this continuing education course, along with education in current terminology and clinical models related to trunk and pelvic control. Detailed internal vaginal and external perineal examinations are included in the practical lab activities, during which the participant will have two instructors and several experienced lab assistants as guides. An entire lecture is dedicated to the management of prolapse and pelvic organ descent so that the pelvic rehabilitation provider will be able to develop clinical and home program strategies for the patient who presents with conditions such rectocele, cystocele, or uterine prolapse.
Common conditions associated with female pelvic pain are included throughout the three days of education. Such diagnoses may include vulvar pain, vestibulitis, interstitial cystitis or bladder pain syndrome, episiotomy, dyspareunia, lichen sclerosis, lichen simplex, or lichen planus. Both abdominal and pelvic muscle tenderness is higher in patients who have chronic pelvic pain, and increased pelvic muscle tender points have been noted to correlate with higher rates of depression, dyspareunia (pain with sexual function), and bowel dysfunction. (Montenegro et al., 2009; Montenegro et al., 2010) Assessment and treatment of pelvic and abdominal wall tender points is instructed along with abdominopelvic nerve dysfunction and relaxation training- all are strategies that the clinician can employ immediately following completion of this continuing education course. The important and sensitive topic of sexual abuse and trauma as it relates to pelvic dysfunction and to care of the patient is discussed.
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.
Special Considerations:

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.

Prerequisites:
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.
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.
Assignments:
In order to derive the most benefit from this course, we ask our participants to be sure to internalize the material and to review any areas of knowledge that are recommended as foundational and prerequisite skills:
Prerequisite Skills Review
Required Readings
1. Stress Urinary Incontinence and Pelvic Load Transfer by Diane Lee and Linda-Joy Lee
2. Read the articles from the National Vulvodynia Association website on vulvodynia and its diagnosis
3. Painful Bladder Syndrome/Interstitial Cystitis by Jane M. Meijlink
4. Review the anatomy of the pelvis and perineum
5. The Standardization of Terminology of Pelvic Floor Muscle Function and Dysfunction Report from the Pelvic Floor Clinical Assessment Group of the ICS
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.

References
De Souza Montenegro, M. L. L., Mateus-Vasconcelos, E. C. L., Silva, J. C. R. E, Nogueira, A. A., Dos Reis, F. J. C.,& Poli Neto, O. B. (2010). Importance of pelvic muscle tenderness evaluation in women with chronic pelvic pain. Pain Medicine, 11(2), 224-228.
Montenegro, M. L. L. S., Gomide, L. B., Mateus-Vasconcelos, E. L., Rosa-e-Silva, J. C., Candido-dos-Reis, F. J.,
Nogueira, A. A., & Poli-Neto, O. B. (2009). Abdominal myofascial pain syndrome must be considered in the differential diagnosis of chronic pelvic pain. European Journal of Obstetrics & Gynecology and Reproductive Biology, 147(1), 21-24.

Recorded Lecture: Watch Before the In-Person Component of the Course
Pelvic rehabilitation concepts, anatomy (30 mins)
Prolapse Part 1 (45 mins)
Medical and multidisciplinary management of pelvic pain (1 hour)
Specific conditions: vulvar pain, dyspareunia, vaginismus (1.5 hours)
Neuromuscular relaxation (1 hour)
Specific conditions (IC, endometriosis, PCOS, UTI) (1.5 hours)
Breathing and pressure management (45 minutes)
Abdominal and neuromyofascial techniques (1 hour)

Day One:
7:30 Registration
8:00 Objectives, introductions, overview
8:30 Pelvic rehabilitation concepts, anatomy and specific palpation
9:00 Prolapse anatomy, evaluation and treatment (Part 2)
10:00 Break
10:15 Lab 1: Specific layer palpation and prolapse
11:15 Examination skills pelvic pain
12:15 Lunch
1:15 Lab 2: Examination techniques for pelvic pain
2:15 Trauma-Informed Care
3:15 Break
3:30 Lab 3: Thermistor activity & restorative practices
4:15 Mini prolapse & pain case discussions
4:45 Summary & questions, post-test
5:30 Adjourn

Day Two:
8:00 Questions from Day 1, review post-test
8:30 Pelvic pain manual skills
9:30 Lab 4: Pelvic pain manual skills
10:45 Break
11:00 Abdominal neuromyofascial techniques lab prep
11:15 Lab 5B: Abdominal neuromyofascial techniques
12:30 Lunch
1:15 Breathing & pressure management lab prep
1:30 Lab 5A: Breathing and pressure management
2:15 Case studies, treatment progressions, resources
3:00 Post-test, course evaluations, questions and summary, wrap-up
3:30 Adjourn

Upon completion of this continuing education seminar, participants will be able to:
1. Identify anatomy/pathophysiology of the female reproductive and urologic systems with reference to vaginismus, vulvodynia, dyspareunia, pelvic organ prolapse and interstitial cystitis/painful bladder syndrome.
2. Identify specific pelvic floor muscle locations with external and internal vaginal examinations.
3. Perform internal vaginal myofascial and soft tissue treatment techniques to the pelvic muscles.
4. Describe and teach three neuromuscular relaxation training techniques for the pelvic muscles.
5. Perform an SEMG pelvic floor muscle assessment and interpretation for appropriate treatment intervention.
6. Perform external perineal examinations appropriate for vaginismus, vulvodynia, dyspareunia, pelvic organ prolapse and interstitial cystitis/painful bladder syndrome.
7. Perform patient related education and behavioral instruction pertaining to discussed urogynecologic conditions.
8. Demonstrate muscle assessment tests to identify anterior and posterior vaginal wall relaxation (pelvic organ prolapse).
9. Develop treatment plans for pelvic pain syndromes.
10. Complete appropriate screening and referral as needed for patients who are healing from sexual trauma.

Name
Street Address (Links to Map)

Course Location

Franklin Pierce University

670 North Commercial Street
Center Tower, Third Floor
Manchester, NH 03101

Recommended Lodging

DoubleTree by Hilton Manchester Downtown
(603) 625-1000

700 Elm St
Manchester, NH 03101

Nearest Airport

Manchester–Boston Regional Airport
Airport Code: MHT

Manchester, NH 03103

Directions from Recommended Lodging to Course Location: Click here if map is not shown below.
Susannah Haarmann, PT, CLT, WCS

Susannah Haarmann, PT, CLT, WCS graduated from the University of Georgia with a Bachelor of Science degree in Psychology in 2003. In 2007 she attended North Georgia College and State University obtaining a masters degree in Physical Therapy. Before focusing her attention on the practice of women’s health, Susannah became a well-rounded therapist working in various settings from acute care to outpatient manual therapy. She completed a residency in women’s health at Duke University in 2012 and currently treats the women’s health, lymphedema and orthopedic populations at Mission Hospital in Asheville, North Carolina. Susannah’s passion for improving quality of life in cancer thrivers shows in her dedication to oncology rehabilitation program development at Mission Hospital and sharing her knowledge with other therapists via the course ‘Rehabilitation for the Breast Cancer Patient.’ Outside of being a dedicated therapist, Susannah enjoys traveling, the arts and is an outdoors woman.

Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS

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Pelvic Floor Level 2B - Manchester, NH - August 22-23, 2020

	Name	Street Address (Links to Map)
Course Location	Franklin Pierce University	670 North Commercial Street Center Tower, Third Floor Manchester, NH 03101
Recommended Lodging	DoubleTree by Hilton Manchester Downtown (603) 625-1000	700 Elm St Manchester, NH 03101
Nearest Airport	Manchester–Boston Regional Airport Airport Code: MHT	Manchester, NH 03103

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string(1543) "Rescheduled! - Pelvic Floor Level 2A - Philadelphia, PA - March 13-15, 2020
Update 3/12/2020: As a precaution against the spread of COVID-19, this course has been postponed. We will publish the new dates once we have them finalized with the hosting institution. We appreciate your understanding during this difficult time. Please practice good hygiene, and be safe!
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Description
Schedule
Objectives
Location/Lodging
Instructors
Discounts

Price: $695 ($725 within one month of the course)
Experience Level: Intermediate
Contact Hours: 22.5

Name Street Address (Links to Map)

Course Location

Thomas Jefferson University Edison Building

130 S 9th St.
Philadelphia, PA 19107

Recommended Lodging

Holiday Inn Express Philadelphia-Midtown
1-888-480-0427

1305 Walnut Street
Philadelphia, PA 19107

Nearest Airport

Philadelphia International Airport
Airport Code: PHL

8000 Essington Ave
Philadelphia, PA 19153

Directions from Recommended Lodging to Course Location: (click here if no map appears below)
Pamela Downey, MSPT, DPT, WCS, BCB-PMD

Pamela A. Downey, PT, DPT, WCS, BCB-PMB, is a Board Certified Clinical Specialist in Women’s Health Physical Therapy and Board Certified in Biofeedback for Pelvic Muscle Dysfunction. Owner of Partnership in Therapy, a private practice in Coral Gables, Florida, she treats women and men with pelvic floor dysfunction, related urogynecological and colorectal issues, spine dysfunction, osteoporosis and complaints associated with pregnancy and the postpartum period. Her mission is to educate and integrate healthy lifestyles for patients on the road to wellness.
Dr. Downey has been honored to teach with the Herman and Wallace Institute since 2006. She is an Adjunct Professor in the Physical Therapy Program at the University Of Miami Miller School of Medicine in Coral Gables, Florida, and Nova Southeastern University in Fort Lauderdale, Florida. A certified Polestar Pilates Educator, she utilizes Pilates and therapeutic exercise interventions specifically designed for patients with pre/post-natal, pelvic floor muscle and other lumbo-pelvic pain-related dysfunctions.
Dr. Downey received her Bachelor of Arts from Sarah Lawrence College and her Master of Science and Doctorate in Physical Therapy from the University of Miami School Of Medicine. She is actively involved in professional activities of the Section on Women’s Health of the American Physical Therapy Association, presently sitting as Coordinator of Research Submissions for annual meetings and as a manuscript reviewer for the Journal of Women’s Health. Dr. Downey has lectured nationally and internationally at professional conferences and is the author of multiple published research articles and a book chapter on chronic pelvic pain in the medical text, Women’s Health in Physical Therapy.
She can be reached at 305 666-3232 or This email address is being protected from spambots. You need JavaScript enabled to view it.

Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WCS

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Nicole L. Dugan, PT, DPT, MSOD, CLT-LANA, WC

Courses Instructed by Nicole Dugan

Pelvic Floor Level 1 - Orlando, FL - November 15-17, 2019 (SOLD OUT)

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Pelvic Floor Level 1 - Rochester, NY - April 24-26, 2020 (Rescheduled)

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Pelvic Floor Level 1 - Washington, DC - June 5-7, 2020 (Rescheduled)

Update 4/17/2020: As a precaution against the spread of COVID-19, this course has been postponed. We appreciate your understanding during this difficult time. Please practice good hygiene, and be safe!

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Pelvic Floor Level 1 Part 1 - Remote Course - July 11-12, 2020 9:00am - 2:00pm Pacific Time

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Pelvic Floor Level 1 Part 1 - Remote Course - September 12-13, 2020 (SOLD OUT)

9:00am - 2:00pm Pacific Time

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Pelvic Floor Level 2A - Boston, MA - September 19-20, 2020 (Rescheduled)

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Pelvic Floor Level 2B - Manchester, NH - August 22-23, 2020

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Rescheduled! - Pelvic Floor Level 2A - Philadelphia, PA - March 13-15, 2020

Update 3/12/2020: As a precaution against the spread of COVID-19, this course has been postponed. We will publish the new dates once we have them finalized with the hosting institution. We appreciate your understanding during this difficult time. Please practice good hygiene, and be safe!

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Upcoming Continuing Education Courses