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

  • 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. 





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.



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.


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.


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

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

Nicole Dugan

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).