This 3-day course provides practical, evidence-based knowledge and skill in physical therapy evaluation and intervention with the pregnant and postpartum patient. Didactic instruction includes: anatomical and physiologic changes in pregnancy; differential diagnosis in peri-partum; pregnancy-specific changes in posture and gait; postpartum recovery and scar tissue assessment and intervention; modalities during pregnancy, biomechanical strategies; exercise and wellness in pregnancy and postpartum; vaginal labor and delivery; and Cesarean Section and delivery complications. Additionally, advanced clinical decision making with these populations is discussed. Labs contain a maximum ratio of 8:1 participants to lab instructors to ensure valuable attention to each participant. Labs offer skills that are immediately applicable in your clinic and include: modifications of the pregnant examination; lumbopelvic examination and special tests (particularly for pelvic girdle dysfunctions); diastasis rectus abdominis assessment and intervention; external pelvic floor assessment and exercise (NO internal pelvic floor taught at this course); stabilization exercise in pregnancy and postpartum; Cesarean Section rehabilitation techniques; scar assessment and mobilization techniques; labor and delivery positioning strategies for labor augmentation and pain relief. At the end of this course, all participants will participate in comprehensive situational lab scenarios to pull together all skills learned. Skills integration testing is performed at the end of the third day.
Day 1: 8:00 am – 6:00 pm
Day 2: 8:00 am - 6:00 pm
Day 3: 8:00 am – 3:30 pm
Total: 24 Contact Hours
Upon completion of this course, participants will be able to perform the following:
1) Describe the anatomic and physiologic changes related to pregnancy and postpartum and how they affect evaluation and intervention.
2) Perform an appropriate evaluation of a pregnant or postpartum patient with musculoskeletal dysfunction or pain.
3) Assess for diastasis rectus abdominis with objective measurement skills.
4) Differentiate between musculoskeletal and medical diagnoses based on the subjective and objective evaluation of a pregnant or postpartum patient.
5) Differentiate between low back, pelvic girdle and hip pain/dysfunction.
6) Develop functional goals for musculoskeletal impairments in pregnancy and postpartum based on a systematic interview and examination of the patient.
7) Develop an evidence-based plan of care for physical therapy intervention of pregnant or postpartum patients with musculoskeletal impairments or dysfunction.
8) Perform selected manual therapy interventions for the treatment of pregnant and postpartum patient.
9) Prescribe an appropriate wellness exercise program for a variety of skill levels for a pregnant or postpartum client.
10) Provide consultation on labor and delivery positioning strategies to improve labor outcomes.
- Required pre-reading is to be completed prior to the course. Links to reading material are available on the left hand panel.
OPEN TO: Licensed Physical Therapists, Physical Therapist Assistants, and Student Physical Therapists in their final year of school.
PREPARE FOR COURSE: Required pre-reading is to be completed prior to the course. All pre-reading links are available in the course confirmation e-mail after registration.
ATTENDANCE: You will need to initial and submit this electronic Attendance Agreement form prior to your arrival at the course. Participants are expected to stay through the entire course; please make your travel plans accordingly. Deduction of CEU certificate hours and ineligibility to participate in the CAPP process will occur for participants who leave the course early.
LAB PARTICIPATION: Participants will be working in groups of 2-3 during labs. All participants will participate in labs as both "clinician" and "patient." These labs are appropriate for all participants to fully participate, including pregnant, post-partum and male participants.
The Pelvic Health Physical Therapy Level 1 course is a 3-day live event focusing on the basic skills necessary to treat patients with pelvic health dysfunction with primary emphasis on under active pelvic floor muscle conditions. The focus of the labs will be on external and internal vaginal examination. The student-to-teacher ratio will be 8:1 to ensure adequate supervision during the labs. Lectures will cover anatomy of the pelvic girdle, physiology of micturition, dysfunctions of the lower urinary tract and pelvic muscles as well as patient history examination, and testing and treatment interventions for the patient with under active pelvic floor muscle conditions. Urogynecologic surgeries,medication, prevention of pelvic floor dysfunction and documentation will also be discussed.
Open to: Licensed Physical Therapists, Physical Therapist Assistants, 2nd Year and 3rd Year Student Physical Therapists*. We recommend students have some orthopedic/musculoskeletal coursework in their curriculum prior to attending the course.
Day 1: 7:30 am–5:45 pm
Day 2: 7:30 am–5:30 am
Day 3: 7:30 am–3:00 pm
Contact Hours: 23.0 hours
Upon completion of this course, participants will be able to perform the following:
- Identify and examine the anatomy of the pelvic girdle
- Describe the function of the lower urinary tract and female pelvic organs.
- Demonstrate proper infection control techniques involved in pelvic floor muscle examination.
- Perform an external evaluation of the female genitalia verbally identifying bones, ligaments,muscles and other structures.
- Perform an internal pelvic examination identifying muscles, ligaments, bony prominences with identification of pelvic floor muscle origins and insertions.
- Demonstrate proper technique in testing muscle strength of the levator ani muscles.
- Demonstrate proper technique in testing for pelvic organ prolapse.
- Demonstrate proper use of handheld EMG biofeedback to assess pelvic floor musculature.
- Differentiate between under active pelvic floor muscles and overactive pelvic floor muscles.
- Demonstrate an understanding of bladder tests and measurements (bladder diary, urodynamic testing, pad testing, etc.) that are used in the process of differential diagnosis.
- Demonstrate the ability to compose a plan of care including functional goals, prognosis and length of care for the patient with under active pelvic floor conditions.
- Explain red flags related to treatment of the pelvic floor and understand when to refer to another healthcare provider.
- Understand urogynecologic surgeries and their effect on prognosis and pelvic floor muscle dysfunction.
- Demonstrate understanding of various medications and their effects on the bowel and bladder and identify how that may affect prognosis for a patient with pelvic floor muscle dysfunction.
- Explain the effects of pelvic floor under activity and proper technique of pelvic muscle exercises for rehabilitative purposes.
- Explain the relationship between the abdominal muscles and the pelvic floor muscles as they relate to activities of daily living.
- Describe the various interventions available to strengthen the muscles of the patient with an under active pelvic floor and clinically reason when and why the various interventions might be used.
- Demonstrate proper use of a handheld pelvic floor muscle electrical stimulation unit and explain its appropriate uses for a patient with pelvic floor muscle dysfunction.
- Describe techniques that can be used to train (retrain) the bladder and when each intervention might be used.
Attendance: Participants are expected to stay through the entire course; please make your travel plans accordingly. Deduction of contact hours hours and ineligibility to participate in the CAPP process (for those attending CAPP courses) will occur for participants who leave the course early.
Lab Participation & Consent: Participants will be working in groups of 2 during labs. This course includes extensive labs with intra-vaginal & intra-rectal assessment & examination. The Internal Consent & Release Form.pdf must be filled out and turned in to the instructor on Day 1 of the course (this form is provided on-site). If the course participant does not turn in the completed form on Day 1, he/she will not be permitted to take the course. All participants must participate in labs as both “therapist” & “patient.” Participants who cannot participate as lab subjects are required to provide their own lab partners. Failure to participate as a lab subject, or to provide required lab partner if needed, will result in forfeiture of course completion and registration costs. If you are not sure whether you need a medical model or if you are unfamiliar with the process of obtaining a medical model, please read: Medical Models for Internal Pelvic Assessment.pdf. Participants that MUST provide their own lab partners include (but are not limited to):
- ALL Male participants
- Pregnant women (except with written physician permission for FULL participation)
- Active vaginal infections
- Active STD or herpes lesions
- Active bladder or rectal infections
- Severe pelvic/vaginal/rectal pain that inhibits examination
- Lack of prior vaginal exam by a physician
- Active OB/GYN cancer
Pre-Reading Assignments: Pre-readings are articles and cases that must be read and reviewed prior to Day 1 of the course. Pre-readings will be provided electronically to course participants prior to the course.
English Language Proficiency: If you are a foreign-educated physical therapist/assistant, you will need to pass the TOEFL(Test of English as a Foreign Language) and meet the score requirements. There are some exemptions to the TOEFL requirement for individuals who are exempt under the USCIS regulations. TOEFL scores must be reported directly to SoWH for the purposes of determining eligibility for course attendance. The minimum TOEFL scores we require are the following: Reading: 21; Listening: 18; Writing: 24; Speaking: 26.