Mobilization of Visceral Fascia for the Treatment of Pelvic Dysfunction

COURSE 1: THE UROLOGIC SYSTEM

Level: Beginning level visceral treatment intended for therapists already experienced with internal pelvic floor examinations.
Prerequisite: Fascial Mechanoreceptors Article
PF 1 or prior seminar instruction in internal pelvic floor vaginal muscle examinations
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 provide comprehensive knowledge concerning the relationship between the connective tissue surrounding the viscera and dysfunction of the urologic system as it relates to physical therapy treatment. This course is geared toward the therapist that wishes to integrate advanced manual therapy skills of fascial mobilization into their treatment regime.

Material will be presented that will allow the participant to immediately incorporate evaluation and treatment techniques for patients with diagnoses of urinary incontinence, urgency, retention and bladder pain. The course will include lectures on anatomical structures as well as visceral theory and technique. Lab sections include both external abdominal as well as internal vaginal techniques.

The concept of Visceral Manipulation was developed by Jean-Pierre Barral, DO.  It is a gentle manual therapy technique that releases connective tissue restrictions between the viscera and related somatic structures such as muscles, fascia, ligaments, nerves and bones.

This course is taught by Ramona C. Horton, MPT, whose practice is limited to the treatment of pelvic dysfunction and has over- 15 years of experience in the field. She has been practicing visceral manipulation since 1996 and has 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

Upon completion of this course, participants will be able to:

1. Describe the theory and application of mobilization of visceral structures relating to proper function of the urinary system and pelvic floor.
2. Cite potential causes for development of restrictions in the connective tissue of visceral structures of the urologic system, pelvis and thorax.
3. Differentiate between direct and indirect release techniques and understand the proper application of each.
4. Identify visceral structures with relation to the urinary system via external and internal vaginal landmarks.
5. Recognize abnormal tissue mobility and motility of visceral structures.
6. Apply the technique of three-dimensional fascial release to visceral structures; utilizing external body and internal vaginal approaches.
7. Recognize and treat fascial restrictions throughout the abdomen and thorax as it relates to symptoms of dysfunctional voiding.
8. Develop treatment sequencing with respect to global, local and focal fascial restrictions.
9. Implement fascial release techniques into a comprehensive treatment program for the patient with varied urologic diagnoses to include incontinence, urgency, retention, and bladder 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 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. 

Audience

Seminar 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:
5:30pm-6:00pm  Registration
6:00-6:30  Introduction
6:30-8:00  Concepts of Visceral Mobilization and Fascial Release
Principles of Osteopathy
Fascial Anatomy
What is Visceral Manipulation
Fascial Stacking Exercise
8:00pm-9:00pm  Direct & Indirect
(Lab I) Fascial Release Techniques for Horizontal Diaphragms

Day 2:
8:30am-9:00am  Review & Questions, Layer Palpation Exercise
9:00-9:45  Visceral Listening, (Lab II) Local Listening Technique
9:45-10:15  Bladder Lecture: Anatomical Relationships, Clinical Considerations, Mobility and Motility
10:15-10:30  Break
10:30-12:00  External Bladder Techniques: Demo and labs
(Lab III) Lateral Mobility Testing & Treatment, Median and Medial Umbilical Ligament (Urachus), Scar Release
(Lab IV) Pubovesical Ligament, Seated & Quadruped
12:00-1:00  Lunch
1:00-1:45  External Bladder Techniques: Demo and lab
(Lab V) Obturator Foramen: Testing & Treatment, Bilateral & Motility
1:45-2:15  Kidney/Ureters Lecture: Anatomical Relationships, Clinical Considerations, Mobility and Motility
2:15-3:15  Kidney/Ureter Techniques: Demo and labs
(Lab VI) Anterior & Posterior Approaches, Ureter Mobilization
3:15-3:30  Break
3:30-4:00  Small & Large Intestine Lecture: Anatomical Relationships, Clinical Considerations, Mobility and Motility
4:00pm-5:00pm  Small Intestine: Demo and lab
(Lab VII) Mesenteric Root, Small Intestine, Posterior Peritoneum

Day 3:
8:00am-8:30am  Review of Day 2 & Questions
8:30-9:15  Large Intestine: Demo and lab
(Lab VIII) Cecum & Sigmoid
9:15-9:45  Internal Techniques Urethra & Bladder Lecture: Anatomical Relationships, Clinical Considerations, Mobility & Motility
9:45-10:00  Break
10:00- 12:00  Internal Bladder Techniques: Demo and labs
(Lab IX) Urethra: Longitudinal, Transverse, Bi-Manual Scar, Tissue Release: Indirect/Direct
(Lab X) Perineal Membrane, Pubovesical Ligament, Trigone & Bladder: Indirect/Direct/Mobility, Bladder Motility
12:00-1:00  Lunch
1:00-1:30  Coccyx and Pelvic Floor Lecture: Anatomical Relationships, Clinical Considerations, Mobility
1:30-2:15  Coccyx/Pelvic Floor Techniques: Demo and labs
(Lab XI) Urogenital Diaphragm, Internal Coccyx/Coccygeus, Pelvic Floor/Obturator Foramen,
2:15-2:45  Thoracic Relationships: Anatomical Relationships, Clinical Considerations, Mobility
2:45-3:30  Thoracic Mobilization: Demo and Lab
(Lab XII) Thoracic Mobility at Diaphragm, Ribs, Sternum and Costo-diaphragmatic Recess
3:30pm-4:00pm  Documentation & Case Study Presentation

* Refreshment will be available during afternoon labs after 3:00.

All participants are expected to stay through the entire course to receive their CEUs.

 

 To Register, please select the link for the specific course date and location below.

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