|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.
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.
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.
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.
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:
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.)
7:45 Questions from Day 1, Post-test Day 1
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||1906 Blake Avenue
Glenwood Springs, CO 81601
The Hotel Denver
|402 7TH STREET
Glenwood Springs, CO 81601
Eagle County Regional Airport
|217 Eldon Wilson Rd
Gypsum, CO 81637
Directions from Recommended Lodging to Course Location: (click here if no map appears below)
Kristina Koch, PT, MSPT, WCS, CLT
Kristina received her Masters of Science in Physical Therapy in 1996 from Springfield College in Massachusetts. In 2001, while living in the Los Angeles area, Kristina started specializing in the treatment of pelvic floor dysfunction including bowel/bladder issues and pelvic pain. During her time in Los Angeles, she was fortunate to work with and, be mentored by fellow Herman and Wallace faculty member, Jenni Gabelsburg, DPT, WCS, MSc, MTC. In 2013 Kristina became board certified in women’s health (WCS) by the American Board of Physical Therapy Specialties. She then received her lymphatic therapist certification (CLT) in 2015.
Kristina has successfully helped establish women’s health and pelvic floor physical therapy programs in San Diego, California and Colorado Springs, CO where she currently works in private practice. Kristina treats men, women, children, trans and gender non-binary individuals in her practice. In addition, Kristina serves as a guest lecturer for graduate physical therapy students at Regis University in Denver, CO and, provides educational lectures to medical providers and local community groups. Outside of work, Kristina enjoys spending time with her husband and two children, skiing, running and hiking.
Allison Ariail, PT, DPT, CLT-LANA, BCB-PMD has been a physical therapist since 1999. She graduated with a BS in physical therapy from the University of Florida and earned a Doctor of Physical Therapy from Boston University in 2007. Also in 2007, Dr. Ariail qualified as a Certified Lymphatic Therapist. She became board certified by the Lymphology Association of North America in 2011, and board certified in Biofeedback Pelvic Muscle Dysfunction by the Biofeedback Certification International Alliance in 2012. In 2014, Allison earned her board certification as a Pelvic Rehabilitation Practitioner.
Allison specializes in treatment of the pelvic ring and back using manual therapy and ultrasound imaging for instruction in a stabilization program. She also specializes in women’s and men’s health including conditions of chronic pelvic pain, bowel and bladder disorders, and coccyx pain. Lastly, Allison has a passion to help oncology patients, particularly gynecological, urological, and head and neck cancer patients.
In 2009, Allison collaborated with the Primal Pictures team for the release of the Pelvic Floor DVD program. Allison publications include: “The Use of Transabdominal Ultrasound Imaging in Retraining the Pelvic-Floor Muscles of a Woman Postpartum.” Physical Therapy. Vol. 88, No. 10, October 2008, pp 1208-1217. (PMID: 18772276), “Beyond the Abstract” for Urotoday.com in October 2008, “Posters to Go” from APTA combined section meeting poster presentation in February 2009and 2013. She co-authored a chapter Healing in Urology: Clinical Guidebook to Herbal and Alternative Therapies.
Allison works in the Denver metro area in her practice, Inspire Physical Therapy and Wellness, where she works in a more holistic setting than traditional therapy clinics. In addition to instructing for Herman and Wallace on pelvic floor related topics, Allison lectures nationally on lymphedema, cancer related changes to the pelvic floor, and the sacroiliac joint. Allison serves as a consultant to medical companies, and physicians.
Outside of work, Allison enjoys cooking, reading, exercising and most importantly of all, being a mom! She lives in the Denver metro area with her family.
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.
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.
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.
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).