Mobilization of Visceral Fascia: The Urinary System

This continuing education course is a two-and-a-half-day seminar designed to provide comprehensive knowledge concerning the relationship between the connective tissue surrounding the visceral structures of the urologic system as it relates to the musculoskeletal system. This course is geared toward the experienced pelvic health therapist who wishes to integrate advanced manual therapy skills into their treatment regime.

• The fascial system consists of four concentric layers, with the visceral layer, which is the most complex, beginning at the nasopharynx and ending at the anal aperture  (1)
• The abdominopelvic canister is “A functional and anatomical construct based on the components of the abdominal and pelvic cavities that work together synergistically” (2)
• The walls of the canister, although part of the musculoskeletal system, are intimately connected to the visceral structures found within via fascial and ligamentous connections (3).
• In order to function optimally the viscera must be able to move, not only in relationship to one another but with respect to their surrounding container (4).
• Most importantly, the viscera are subject to the same laws of physics as the remainder of the locomotor system with solid structures such as the kidney are particularly affected by blunt force trauma (5, 6).

Material will be presented that includes the science of and evidence behind the use of fascial-based manual therapy with the presentation of relevant visceral and fascial anatomy and their embryologic origins. Emphasis will be placed on clinical reasoning with the goal of immediate implementation of the techniques learned following this introductory course. Students will be instructed in an extensive number of treatment techniques, both external abdominal as well as internal vaginal approaches. Course participants will be able to immediately incorporate evaluation and treatment of visceral fascia for patients with a variety of urinary dysfunction diagnoses.

This course includes extensive lab work; all attendees should come prepared to participate as both clinician and patient. Abdominal and vaginal pelvic approaches to access visceral structures will be taught in labs. Male course attendees may participate fully in the entire course but should make arrangements in advance for a lab model for the internal approaches. Pregnant attendees may participate in a limited capacity as deep abdominal palpation is ill-advised in pregnant women. Seminar content is targeted to licensed health care professionals working within the field of pelvic health. Content is not intended for use outside the scope of the learner's license or regulation.

Special Considerations:
As this course includes extensive lab work, all course attendees should come prepared to participate as both clinician and patient. Abdominal and Vaginal pelvic approaches to access visceral structures will be taught in labs. Pregnant attendees may participate in a limited capacity, bringing a model for internal labs will facilitate the best learning experience as vaginal examination and internal myofascial manual therapy prior to 32 weeks gestation is not the common standard of medical practice. Read more about What to Expect During Courses with Internal Lab Work.

Audience:
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.

Prerequisites:
Pelvic Floor Level 1 through Herman & Wallace or prior seminar instruction in internal pelvic floor vaginal muscle examinations

Required Readings:
1. Horton (2015) Clinical Review: Visceral mobilization for pelvic dysfunction
2. Review of Anatomy Terms
3. Participants should bring an anatomy textbook for reference of the visceral anatomy. If you need to purchase an anatomy textbook Gray's Anatomy for Students is available at a 25% Discount for Herman & Wallace registrants with promo code 70484.