Courses

This is a Manual Therapy Course for physiotherapists who already have experience in treating the pelvic floor.

Prerequisite

Physiotherapists should have basic knowledge of the pelvic floor anatomy and already be working with pelvic floor dysfunction.

This two-day course is for physiotherapists already working in the field of obstetrics and gynaecology and with experience of internal vaginal examinations. Experience of internal rectal examinations is not essential to attend the course.

The course will provide insight into the complex anatomy of the female pelvic floor and to a lesser extent the male pelvic floor. It has a large practical component, where participants will acquire skills and techniques to treat a wide variety of pelvic floor dysfunctions.

Where specific muscle and fascia of the pelvic floor is difficult to map out, this course will give the therapist the confidence to palpate structures, muscle and fascia, origins and insertions, restrictions and behaviour. The therapist will learn how to determine whether the pelvic floor is reactive secondary to pain mechanisms or whether the pelvic floor is a driver. The presentation of the pelvic floor with complex pain disorders will be explored. Therapists will be able to identify where restrictions are the primary driver and how to restore normal flexibility and muscle function.

Participants are encouraged to practice techniques on each other in order to learn the techniques but also to experience the sensation of being palpated and the changes in their own pelvic floors under the hands of the participating therapists.

The aim of the course:

• To provide participants with the evidence to enhance clinical reasoning in the management of all pelvic floor dysfunction
• To provide participants with news manual skills to enhance current practice
• To challenge participants to re-examine their clinical practice in the light of the presented techniques and evidence

On completion of this course participants will have an understanding of:

• Detailed pelvic floor anatomy with ability to differentiate between superficial and deep pelvic floor muscles
• Theories of pelvic floor muscle dysfunction in bladder and bowel control, pelvic organ prolapse and chronic pelvic pain
• Vaginal muscle / fascial / organ examination and ability to differentiate between overactive and underactive pelvic floor
• Rectal muscle / fascial / organ examination and ability to differentiate between overactive and underactive pelvic floor
• Vaginal manual therapy techniques to treat pelvic floor muscle imbalance
• Rectal manual therapy techniques to treat pelvic floor muscle imbalance
• Self help techniques for pelvic floor release including “Sniff, Flop & Drop”
• Long term rehabilitation and home programmes
• The use of realtime ultrasound to evaluate the changes over a session of pelvic floor manual therapy (where available)

• Theory of pelvic floor anatomy and differentiation of superficial and deep structures
• Guided practical sessions of internal vaginal examination and mapping out of structures
• Theory of vaginal defects and pelvic floor dysfunction where manual therapy techniques may be applied
• Guided practical session of vaginal manual therapy techniques
• Theory of rectal defects and dysfunction where manual therapy techniques may be applied
• Guided practical session of rectal manual therapy techniques
• Introduction to connective tissue manipulation and other manual therapy techniques
• Practical session of connective tissue manipulation techniques
• Documentation of findings, techniques and changes
• Theory and practice of breathing release techniques (“Sniff, Flop and Drop”)
• Exercise progression
• Case studies
• Realtime Ultrasound to demonstrate changes before and after pelvic floor manual therapy (where available)