Course Description:

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 naso-pharynx and ending at the anal aperture.

• The abdominopelvic canister is “A functional and anatomical construct based on the components of the abdominal and pelvic cavities that work together synergistically”.

• 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.

• 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.

• 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.

Material will be presented that includes the science of and evidence behind the use of fascial based manual therapy with 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. Pregnant attendees may participate in a limited capacity as deep abdominal palpation is ill-advised in pregnant women.  Content is not intended for use outside the scope of the learner's license or regulation.

Goals and Objectives:

Upon completion of this course, participants should be able to:

• Describe the theory and application of manual therapy for the mobilization of visceral fascial
• Understand the biological plausibility of how alteration of the normal mobility of visceral fascial structures can contribute to pelvic dysfunction
• Understand the contribution of neurologic mechanisms in altering the tone and tension of fascia with respect to manual therapy
• Cite potential causes for development of restrictions in the visceral fascia of the urologic system, pelvis, abdomen and thorax
• Understand the influence of somatic and autonomic function, to include respiration, on the normal mobility of the visceral structures within the urinary system
• Differentiate between direct and indirect manual therapy techniques and understand the proper application of each
• Identify visceral structures with relation to the urinary system via external and internal vaginal landmarks
• Recognize abnormal tissue mobility of visceral fascial structures.
• Apply the technique of three-dimensional fascial mobilization to
• visceral fascia utilizing external body and internal vaginal approaches
• Recognize and treat fascial restrictions throughout the pelvis, abdomen and thorax as they may relate to diagnoses of dysfunction within the urinary system
• Develop treatment sequencing with respect to global, local and focal fascial restrictions
• Implement visceral fascia mobilization techniques into a comprehensive treatment program for the patient with urologic dysfunctions to include incontinence, urgency/frequency, retention, and bladder pain as they relate to physical therapy

​​​​​​​​Prerequisites: Level 1 (or equivalent to be approved)

Registration Form

Visceral Urinary November 2024

Schedule

Instructor

Ramona C. Horton MPT completed her graduate training in the US Army–Baylor University Program in Physical Therapy in San Antonio, TX. She then applied her experience with the military orthopedic population in the civilian sector as she developed a growing interest in the field of pelvic dysfunction. Ramona serves as the lead therapist for her clinics pelvic dysfunction program in Medford, OR. Her practice focuses on the treatment of men, women, and children with urological, gynecological, and colorectal issues. Ramona has completed advanced studies in manual therapy with an emphasis on spinal manipulation, and visceral and fascial mobilization.

References

Willard, F. H. (2012) Visceral fascia. In: Schleip R, Findley TW, Chaitow L, Huijing P (Eds.) Fascia-The Tensional Network of The Human Body. (pp. 53-56). Elsevier, Edinburgh.

Lee, D., Lee, L., McLaughlin, L. (2008). Stability, continence and breathing: The role of fascia following pregnancy and delivery. Journal of Bodywork and Movement Therapies, 12(4), 333-348.

Bordoni, B. & Zanier, E. (2013). Anatomic connections of the diaphragm: influence of respiration on the body system. Journal of Multidisciplinary Healthcare, 6, 281–291.

Uberoi, R., D'Costa, H., Brown, C., & Dubbins, P. (1995). Visceral slide for intraperitoneal adhesions? A prospective study in 48 patients with surgical correlation. Journal of clinical ultrasound, 23(6), 363-366.

Cheynel, N., Serre, T., Arnoux, P-J, Ortega-Deballon P., Benoit L. ,Brunet, C. (2009). Comparison of the biomechanical behavior of the liver during frontal and lateral deceleration.

Cox, E. (1984). Blunt abdominal trauma. A 5-year analysis of 870 patients requiring celiotomy. Annals of Surgery. 199(4), 467-474The Journal of Trauma, 67(1), 40-44

Location

PHS Vaughan 

What people are saying

This is a fantastic course for pelvic health physiotherapists. Ramona is a dynamic and passionate teacher who provides a very practical and informative course. I found it very helpful to review the anatomical relationships of the viscera to their neighbouring structures and to learn about how increased tension in the visceral fascia might present in the body. I’ve taken a visceral course with another organization in the past which left me feeling concerned that I couldn’t always “listen” to the tissue with enough sensitivity. I was so excited that on this course I was provided with assessment and treatment techniques that I felt confident to start using the next day with my patients. I love having more tools in my toolkit to help my patients with IBS, persistent abdominal pain, pelvic congestion, pelvic organ prolapse and more…

– Shannon L