Mobilization of Visceral Fascia for the Treatment of Pelvic Dysfunction

COURSE II: THE REPRODUCTIVE SYSTEM

Level: Advanced level visceral treatment intended for therapists already experienced with internal pelvic floor examinations as well as utilizing internal as well as external visceral manipulation techniques.
Prerequisite: Successful completion of Mobilization of the Visceral Fascia: Level One, the Urologic System. Anal examination and experience with male patients is helpful but not required.
Suggested Pre-reading: Many participants find it helpful to review the anatomy of the pelvis and perineum (Go to "Muscles by Region," then "Pelvis and Perineum").
*Bring an anatomy atlas (preferably Netter) for reference of the visceral anatomy.
Audience: Seminar content is targeted to physical therapists.  Course is open to male and female participants.

Cost: $625

Contact hours: 16.75

CEUs vary by state

Overview

This two-and-a-half day seminar is designed to expand on the therapists existing knowledge concerning the relationship between the connective tissue surrounding the viscera and dysfunction within the urogenital system.  Instruction will focus on the reproductive system and peripheral pelvic nerves of men and women as it relates to physical therapy treatment. This course is geared toward the therapist that has a working knowledge of fascial release and visceral manipulation and wishes to advance their manual therapy skills in this treatment modality.

Material will be presented that will allow the participant to immediately incorporate evaluation and treatment techniques for patients with diagnoses of dysmenorrhea, prostadynia, mechanical infertility, pudendal neuralgia and pelvic pain. The course will include lectures on anatomical structures as well as visceral theory and technique. Lab sections include both external abdominal, pelvic as well as internal vaginal and anal techniques.

This course is taught by Ramona C. Horton, MPT, whose practice is limited to the treatment of pelvic dysfunction and has over 14 years of experience in the field. She has practiced fascial release since 1986 and visceral manipulation since 1996.  She studied under Dr. Barral in the United States as well as in France. Her complete bio is available in the faculty section of the website.

Objectives

1. Complete review of the osteopathic theories of fascial release and all structures of the urinary system covered in level 1.
2. Cite potential causes for development of restrictions in the connective tissue of visceral structures of the reproductive system and peripheral pelvic nerves.
3. Describe the theory and application of mobilization of visceral structures relating to proper function of the reproductive system and peripheral pelvic nerves.
4. Identify visceral structures with relation to the reproductive system via external as well as internal vaginal and anal landmarks.
5. Identify peripheral neural structures via external, internal vaginal and anal techniques.
6. Recognize abnormal tissue mobility and motility of visceral and neural structures within the male and female reproductive system.
7. Apply the technique of three-dimensional fascial release to visceral and neural structures; utilizing external body and internal vaginal and anal approaches.
8. Recognize and treat fascial restrictions within the pelvis as it relates to symptoms of pain, dysfunctional voiding and defecation for the male and female patient.
9. Implement fascial release techniques into a comprehensive treatment program for the patient with varied urologic and gynecologic diagnoses to include prostadynia, dysmenorrhea, anorgasmia, mechanical infertility, dyspareunia, pudendal neuralgia, and pelvic pain as they relate to physical therapy.

Special Considerations

As this course includes extensive lab work, all course attendees should come prepared to participate as both clinician and patient. Vaginal, anal and abdominal approaches to visceral structures will be taught in lab sessions. Male course attendees may participate fully in the entire course.  Absolute contraindication for manipulation of the uterus is the presence of a foreign body in the pelvis including an IUD as well as pregnancy. Female students with an IUD or who are pregnant may participate in this course after signing a waiver and with limited labs performed on them. This will not limit the participants learning or ability to practice on others during labs.  We strongly recommend that pregnant attendees bring a model as vaginal examination, uterine and internal myofascial manual therapy prior to 32 weeks gestation is not the common standard of medical practice.

Audience

Course content is targeted to physical therapists. Content is not intended for use outside the scope of the learner's license or regulation. Clinical continuing education should not be taken by individuals who are not licensed or otherwise regulated; except as they are involved in a specific plan of care.

Course Schedule

Day 1

5:30-6:00        Registration
6:00-6:30        Introduction
6:30-7:45        Review of Visceral Mobilization Urinary System: Osteopathic Theory, Mobility and Motility, Listening,Level 1 Techniques
7:45-8:15        Uterus Lecture: Anatomical Relationships, Clinical Considerations, Mobility and Motility
8:00-9:00        External Uterus Techniques: Demo and labs (Lab I) Sacral Comp/Decom, Sacral Mobility, Uterosacral, Ligament

Day Two

8:30-9:00        Review & Questions: Layer Palpation and Intention
9:00-10:30      External Uterus Techniques: Demo and labs (Lab II) Broad Ligament: Supine, Side lying, Seated & Quadruped, (Lab III)  Pouch of Douglas, Round Ligament, Uterine Motility
10:30-10:45    Break
10:45-11:15    Cervix Lecture: Anatomical Relationships, Clinical Considerations, Mobility and Motility
11:15-12:15    Internal Uterus/Cervix Techniques: Demo and lab (Lab IV) Cul-de-sac, Lateral Mobility, Uterosacral Ligament, Posterior Mobility
12:15-1:15      Lunch
1:15-2:00        Internal Uterus/Cervix Techniques: Demo and lab (Lab V) Os, Fundus Position, Uterine/Cervix Motility
2:00-2:30        Ovaries/Tubes Lecture: Anatomical Relationships, Clinical Considerations, Mobility and Motility
2:30-3:15        Ovaries/Tubes Technique: Demo and labs (Lab VI) Tubo-uterine opening, Tube, Ovary
3:15-3:30        Break
3:30-4:00        Posterior Pelvic Floor Lecture: Anatomical Relationships, Clinical Considerations, Mobility
4:00-5:00        Posterior Pelvic Floor: Demo and lab (Lab VII) Ischiorectal Fossa: Supine, Seated, Prone

Day 3

8:00-9:00        Review of Day 2 & Questions
9:00-9:30        Peripheral Nerves Lecture: Anatomical Relationships, Clinical Considerations, Mobility
9:30-10:15      Peripheral Nerves: Demo and labs (Lab VIII) Inguinal Canal, Obturator Nerve, Sciatic Nerve
10:15-10:30    Break
10:30- 11:30   (Lab IX) Pudendal Nerve: Pudendal Nerve Provocation Test, External Mobilization, Perineal Branch, Dorsal Branch, Alcock’s Canal
11:30-12:00    Anal Canal/Prostate Lecture: Anatomical Relationships, Clinical Considerations, Mobility & Motility
12:00-1:00      Lunch  (60)
1:00-2:00        Anal Canal: Demo and lab (Lab X) Anal Sphincter, Puborectalis, Perineal Body, Pudendal N
2:00-2:45        Prostate:  Demo and labs (Lab XI) Seated, Supine, Side Lying, Inguinal Canal
2:45-3:30        Ligament Mobilization: Demo and Lab (Lab XII) Pubic Symphysis, Sacrospinus, Sacrotuberus
3:30-4:00        Documentation & Case Study Presentation

 

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Unless otherwise noted, all course dates listed below are open and still have space for more registrants. Once a course becomes full, it will be noted on the course event page. 

 

Scheduled Course Dates & Locations