PELVIC Floor Level 1 & 2

Herman & Wallace Pelvic Rehabilitation Institute

Pelvic Floor Level 1 and 2B

Level 1 October 14-15, 2023

Level 2B November 18-19, 2023

Course Description

Level 1

This continuing education course consists of pre-recorded lectures followed by live, interactive remote learning that will be completed by groups meeting at a
specific satellite location. The instructor will be presenting to all satellites from a remote location via Zoom. Participants in this event will meet in person to watch the Zoom presentation in the same location. During labs, participants will pair up and be guided by the on-site lab assistants. This course was designed to provide a thorough introduction to pelvic floor function, dysfunction and treatment interventions. This course is geared to the 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 (please note that, for the time being, SEMG is being demonstrated in video lectures; for hands-on learning, consider attending Biofeedback for Pelvic Muscle Dysfunction). The information is immediately applicable to clinical practice. Presentation of evidence-based evaluation and treatment techniques will be emphasized.

Level 2B

This is a satellite offering of our course Pelvic Floor Level 2B. A satellite means that participants will be gathering in a given location and watching the instructor
present remotely on the same screen. During labs, participants at the satellite course locations will pair up and be guided by the local lab assistants. Self Hosted
pairs and groups will not be provided a lab assistant and will instead be guided remotely by the course instructor. This 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 down training 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 a 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 the trunk and pelvic control.

Course Objectives

Level 1

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

Level 2B

1. Identify anatomy and 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 anatomy with external and internal vaginal examinations.
3. Perform internal vaginal myofascial and soft tissue treatment techniques to the pelvic floor and pelvic wall muscles.
4. Describe and teach three neuromuscular relaxation training techniques for the pelvic floor.
5. Perform a neuromuscular relaxation training technique.
6. Perform external perineal examinations appropriate for female pelvic dysfunctions including vaginismus, vulvodynia, dyspareunia, pelvic organ prolapse and interstitial cystitis/bladder pain syndrome.
7. Perform patient-related education and behavioral instructions appropriate for urogynecologic conditions.
8. Demonstrate muscle assessment tests for the pelvic floor to identify anterior and posterior vaginal wall relaxation (pelvic organ prolapse.)
9. Describe and demonstrate abdominal wall evaluation and treatment interventions of manual therapy, and specific therapeutic exercise for transversus abdominis, diastasis recti, nerve dysfunction, and myofascial pain.
10. Develop treatment plans for pelvic pain syndromes andprolapse.
11. Be able to implement aspects of trauma-informed care inpractice.
12. Treat specific conditions including PCOS, endometriosis, yeast infections, post-urinary tract infections, vulvar pain, dyspareunia, pelvic organ prolapse, interstitial cystitis.


October 14 Level 1 Day 1
6:45am Pelvic Floor (PF) Anatomy and Evaluation
7:30am Lab 1: PF Exam Techniques Part 1: Observation, Identification, Muscle layers, ICS Scoring
8:45am Break 
9:00am Pelvic Floor Evaluation (Continued)
9:30am Lab 2: PF Exam Techniques Part 2: PF MMT, Laycock Exam, Pelvic Clock, Obturator Internus
10:30am Lunch
11:30am Urinary Incontinence Examination & Interventions Part II
1:00pm Break
1:15pm Lab 3: Bladder Diary Activity
2:00pm Questions
2:30pm Adjourn
November 18 Level 2B Day 1
7:00am Pelvic rehabilitation concepts, anatomy and specific palpation
7:30am Prolapse anatomy, evaluation and treatment (Part 2) 
8:30am Break 
8:45am Lab 1: Specific layer palpation and prolapse 
9:45am Examination skills pelvic pain 
10:45am Lunch
11:45am Lab 2: Examination techniques for pelvic pain
12:45pm Trauma-Informed Care 
1:45pm Break
2:00pm Lab 3: Thermistor activity & restorative practices 
2:45pm Mini prolapse & pain case discussions
3:15pm Summary & questions, post-test 
3:30pm Adjourn
October 15 Level 1 Day 2
6:45am  Lab 4 Prep, Lab 4: Screening of Breathing & Load Transfer Strategies, Abdominal Wall Dysfunction
7:30am  Break
7:45am Lab 5: Pelvic Floor Examination and Prolapse Exam, External Palpation
9:00am Specific Diagnoses in Female Pelvic Pain
10:30am Lunch
11:00am Managing Movement Part II: Pressures & Load Transfer
12:45pm Final Lab Preparation Presentation
1:00pm  Lab 6: Final Pelvic Rehabilitation Examination, Evaluation, & Treatment
2:00pm Break
2:15pm Case Studies
2:45pm Questions (Resources, Billing, Marketing, Etc.), Wrap-up
3:00pm Adjourn


November 19 Level 2B Day 2
7:00am Pelvic pain manual skills 
8:00am Lab 4: Pelvic pain manual skills 
9:15am Break
9:30am Abdominal neuromyofascial techniques lab prep 
9:45am Lab 5B: Abdominal neuromyofascial techniques 
11:00am Lunch
11:45am  Breathing & pressure management lab prep 
12:00pm  Lab 5A: Breathing and pressure management
12:45pm Case studies, treatment progressions, resources
1:30pm Questions, summary, and wrap-up
2:00pm Adjourn

Course Dates and Registration

Level 1 – October 14-15, 2023

6908 N Santa Monica Blvd, Fox Point, Wisconsin


Level 2B – November18-19, 2023

6908 N Santa Monica Blvd, Fox Point, Wisconsin


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