Experience Level: Beginner
Contact Hours: 14
The postpartum woman may be one of the most overlooked clients in health care. Knowing the specific rehabilitation needs to help with common problems and to prevent future problems is the goal of this 2-day beginner level course. For the orthopedic-based practitioner, this course will solidify awareness of common orthopedic needs for the postpartum client. For the non-orthopedic practitioner, this course will provide a foundation for working with the client experiencing common postpartum-related musculoskeletal conditions. The course take place live on a remote Zoom meeting, and will open with brief case scenarios that highlight the difference between examination/evaluation in the postpartum vs. non-postpartum population. There will be roughtly three hours of prerecorded content which must be viewed prior to participating in the meeting. Labor and birth, birth complication and injuries, postpartum stages and concerns, and Cesarean birth all set the stage for the postpartum client and will be reviewed. Understanding typical hormonal and systemic recovery and return to “normal” during postpartum will be provided, including early postpartum changes in the endocrine, metabolic, cardiovascular, pulmonary, immune, neurologic/sensory, integumentary, gastrointestinal, urinary/renal, reproductive, and musculoskeletal systems.
This course will cover examination considerations and modifications specific to postpartum, as well as specific questions to ask during history taking and methods for identifying red flags in postpartum. More comfortable positions during the examination/treatment and common posture/gait/balance changes during postpartum are covered. The participant at this course will understand necessary biomechanics training for daily activities, child care, and breastfeeding. As an expansion from the pregnancy rehabilitation course, participants will be taken through progression in diastasis rectus abdominis (DRA) assessment and rehabilitation, including DRA exercises in lecture and lab. Additionally, addressing abdominal wall lengthening and Cesarean scars will be discussed and practiced in lab.
Overview of pelvic floor dysfunction in the postpartum after vaginal birth with external examination techniques will be expanded from the techniques taught during the pregnancy course. Basic bladder and bowel instructions/education for the postpartum client will be provided, along with guidance on when to refer to a pelvic physical therapist. As an advancement from the pregnancy rehabilitation course, progression in assessment and cueing of pelvic floor, transverse abdominis, and multifidus (deep core) muscle activity will be covered in lecture and lab. Lecture and lab will also address assessing and treating abdominal wall trigger points. Providing instruction and treatment in functional use of abdominal muscles with motor control and functional activities and progression of DRA/abdominal wall rehabilitation exercises will be incorporated into lecture and lab activities.
Basic orthopedic focus on common thoracic and cervical/head complaints in the postpartum will be explored during lecture. This course will also briefly review breathing techniques covered during the pregnancy course. Additionally, discussion and lab practice of lumbar and pelvic girdle examination and treatment techniques in the postpartum will expand on topics covered during the pregnancy rehabilitation course. Review and lab practice will be provided for basic examination and treatment of lower and upper extremity birth and labor injuries.
Psychosocial considerations during postpartum will be explored: the “typical” postpartum patient; postpartum depression, anxiety, and psychosis; postpartum recovery after bedrest; collision of reality and expectations; and maternity leave and return to work decisions. Postpartum exercise, fitness, and wellness will ponder the topics of body image and return to fitness and starting exercise in the postpartum. The course concludes with discussion of marketing and billing needs for providing care for the postpartum population.
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.
Are you interested in expanding your practice to treat prenatal patients? Herman & Wallace has put together a Pregnancy and Your Pelvic Floor marketing presentation to help you underscore the importance of prenatal physical therapy.
Gutke, A., Ostgaard, H. C., & Oberg, B. (2006) Pelvic girdle pain and lumbar pain in pregnancy: a cohort study of the consequences in terms of health and functioning. Spine, 31(5), E149-E155.
Ostgaard, H. C., Anderson, G. B. J., & Karlson, K. (1991). Prevalence of back pain in pregnancy: A review. Spine, 16(5), 549-552.
Pre- Recordings: Watch Before the Live Component of the Course
Overview of the Postpartum Client (~1 hour)
Upon completion of this continuing education seminar, participants will be able to:
1. Define common terminology of the labor and delivery and the postpartum period.
2. Describe the physiologic changes in the postpartum period that assist a woman's body in returning to pre-pregnancy state.
3. List the endocrine system changes, including the risk for thyroid dysfunction, that influence the female patient during the postpartum period.
4. Define the stages of labor, common complications of labor and delivery, and the postpartum red flags.
5. Describe common clinical presentations for perineal trauma and pelvic floor dysfunction.
6. List indications and potential complications of c-section deliveries, as well as principles of c-section recovery.
7. List 2 common conditions and recommended treatment for the spine and trunk, abdomen, pelvic floor, pelvic girdle, upper and lower extremities during the postpartum period.
8. Instruct the postpartum patient in safe return to fitness activities.
9. Describe the challenges that new mothers face and instruct in practical strategies for body mechanics, sleep hygiene, and time management for postpartum recovery.
10. Complete medical screening for conditions in postpartum that require referral.
Remote courses require Zoom video conferencing software. You can create an account and download the software to your computer at https://zoom.us/
We use the Pacific Time Zone for all of our start and end times. Please make a note of this and set your calendar accordingly.
A Zoom account is free to create. Before the meeting, we recommend having a practice Zoom session with a friend or colleague so you can test your microphone, video, and internet connection. You can participate in any remote course from the comfort of your home, but will need a stable internet connection in order to participate. We recommend downloading the software and practicing a call with a friend or colleague prior to your course with us. Zoom also offers video tutorials on their website at https://support.zoom.us/hc/en-us/articles/206618765-Zoom-Video-Tutorials.
Still have questions about Remote Courses? Check out our Frequently Asked Questions on Remote Courses
Pamela A. Downey, PT, DPT, WCS, BCB-PMB, is a Board Certified Clinical Specialist in Women’s Health Physical Therapy and Board Certified in Biofeedback for Pelvic Muscle Dysfunction. Owner of Partnership in Therapy, a private practice in Coral Gables, Florida, she treats women and men with pelvic floor dysfunction, related urogynecological and colorectal issues, spine dysfunction, osteoporosis and complaints associated with pregnancy and the postpartum period. Her mission is to educate and integrate healthy lifestyles for patients on the road to wellness.
Dr. Downey has been honored to teach with the Herman and Wallace Institute since 2006. She is an Adjunct Professor in the Physical Therapy Program at the University Of Miami Miller School of Medicine in Coral Gables, Florida, and Nova Southeastern University in Fort Lauderdale, Florida. A certified Polestar Pilates Educator, she utilizes Pilates and therapeutic exercise interventions specifically designed for patients with pre/post-natal, pelvic floor muscle and other lumbo-pelvic pain-related dysfunctions.
Dr. Downey received her Bachelor of Arts from Sarah Lawrence College and her Master of Science and Doctorate in Physical Therapy from the University of Miami School Of Medicine. She is actively involved in professional activities of the Section on Women’s Health of the American Physical Therapy Association, presently sitting as Coordinator of Research Submissions for annual meetings and as a manuscript reviewer for the Journal of Women’s Health. Dr. Downey has lectured nationally and internationally at professional conferences and is the author of multiple published research articles and a book chapter on chronic pelvic pain in the medical text, Women’s Health in Physical Therapy.