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IPF2: Intermediate Pelvic Floor Rehab


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This three day, intermediate course will review gender-inclusive pelvic floor anatomy related to overactivity dysfunctions. The participants will gain an understanding of internal assessment and treatment of lumbopelvic/hip musculature. Specific diagnoses including vaginismus, pudendal neuralgia, dyspareunia, prostatitis, coccyx pain, and constipation will be detailed, with interventions encompassing internal and external approaches for treatment, as well as clinical decision- making skills to guide approach. Internal and external assessment and treatment of the obturator internus muscle as it relates to piriformis syndrome and pelvic girdle pain will also be reviewed. This course will serve as an intermediate course, building upon foundational concepts presented in IPF to facilitate the participants’ ability to accurately identify overactive pelvic floor muscles in all genders, develop intervention strategies to address moderate to high complexity pelvic conditions, while reviewing and incorporating skills and concepts presented in IPF to facilitate a whole-body approach to assessment and treatment.

Target Audience: PTs, PTAs, OTs, OTAs, ATs

Instructional Level: Intermediate

Instructional Methods: Hands-on lab, lecture with Q&A, group discussion, patient cases, evidence review

Course Completion Requirements: must attend entire 3-day course, complete the post-course survey and post-course learner assessment

Cancellation policy

CEU Approval Information: 

For individual state approval, please contact us

24 Hour Course

22.5 CEUs approved through the AR PT Board

24 CEUs will be offered for Certified Athletic Trainers

For assistance with applying for OT CEUs, please contact us


**REQUIRED PREREQUISITE** The URI course Intro to Pelvic Floor Rehab or a faculty approved equivalent


Additional information


October 1-3, 2021 Hummelstown, PA

Course Agenda

Day 1:

8-8:30: Welcome, introductions, objectives, goals, course intro

8:30 – 9:30 Anatomy review w/specific mm, with connections to LE mm, spinal stabilizers

9:30 – 10:15 Review of urinary system/Review of GI system

10:15 – 10:30 break

10:30 – 11:00 PFM function, effect of overactive pfm

11:00-11:45 LAB: breathing lab (360 degree excursion, external palpation of LA feeling for descent, nostril breathing, cues for improved awareness)

11:45-12:45 LUNCH

12:45-2:00 Diagnoses common to overactive PFM

2:00-2:30 LAB: Constipation MFR, abdominal techniques

2:30-2:40 lab feedback

2:40-2:50 break

2:50-3:50 OASIS/perineal lacerations/fistula/fissures/Levator avulsion/POP

3:50-4:30 Medical tests for urinary/defecatory systems

4:30-5:00 review q & a, preview day


Day 2:

8:00-8:30 Review Day 1, q&a

8:30-9:00 Intrarectal assessment/treatment

9:00-9:45 LAB Intrarectal walk through w/coccyx mob

9:45-10:00 lab feedback

10:00-10:15 break

10:15-11:15 trauma informed care (include building therapeutic alliance)

11:15-12:00 lecture: Biofeedback w/ sEMG

12:00-1:00 Lunch

1:00-1:45 LAB Biofeedback – sEMG

1:45- 2:45 Review of surgeries in the pelvis

2:45-3:15 external coccyx treatment

3:15-3:45 LAB Coccyx mobs/coccyx pain – external

3:45-4:00 lab feedback

4:00-4:30 Pudendal nerve interventions lecture/LAB

4:30-5:00 review q & a, preview day 3


Day 3:

8:00-8:30 Review Day 2, q&a

8:30-9:30 Muscle mapping of pfm via intravaginal assessment, STM techniques

9:30-10:30 LAB: intravaginal assessment walkthrough

10:30-10:45 break

10:45-11:15 MMT of PFM, assessment of POP

11:15-12:15 LAB: levator ani avulsion, MMT, POP

12:15-1:15 Lunch

1:15-2:15 Evaluation of pelvic pain conditions

2:15-3:15 interventions – ther ex, modalities (estim!), patient/family education, trainers, wand

3:15-3:30 break

3:30-4:00 diagnosis codes, marketing, speaking w/referral sources, goal writing

4:00-4:30 patient case/typical exam of overactive condition

4:30-5:00 wrap up, q&a, feedback

Course Objectives

  1. The participant will be able to identify anatomy/pathophysiology of the reproductive and urologic systems with reference to vaginismus, vulvodynia, dyspareunia, interstitial cystitis/painful bladder syndrome, outlet constipation, prostatitis, pudendal neuralgia and other diagnoses frequently associated with overactive pelvic floor muscles.
  2. 2. The participant will be able to list indications, precautions, contraindications, and universal precautions for internal pelvic floor assessment and treatment.
  3. The participant will be able to accurately identify specific pelvic floor muscle locations with external, intrarectal, and intravaginal palpation.
  4. The participant will demonstrate ability to perform intrarectal and intravaginal myofascial and soft tissue treatment techniques to the pelvic muscles.
  5. The participant will be able to develop appropriate treatment plans for pelvic pain syndromes and other conditions typically associated with overactive pelvic floor muscles.
  6. The participant will be able to describe and demonstrate coccyx evaluation and treatment using internal and external coccyx mobilizations
  7. The participant will be able to describe the anatomic, physiologic and neurological components of defecation and dysfunctional defecation.
  8. The participant will be able to differentiate between neuromusculoskeletal impairments related to pelvic dysfunction and signs and symptoms associated with non-musculoskeletal pathology requiring further medical examination.
  9. The participant will be able to identify and differentiate between diagnoses associated with over activity of the pelvic floor (including IC, vulvodynia, vaginismus, CPPS, constipation, fissures, fistulas).
  10. The participant will be able to discuss appropriate treatment interventions, including manual therapy, therapeutic exercises, modalities, and home exercises program prescription for patients presenting with over active pelvic floor muscles.


Dysfunction of the pelvic floor muscles is extremely common, across all patient populations. Rehabilitation professionals are uniquely qualified to assess the function of the pelvic floor muscles and surrounding neuromusculoskeletal anatomy in order to address the implications of this dysfunction. Therefore, it is critical that the rehabilitation professional be skilled in both internal and external assessment and treatment techniques of the pelvic musculature.

Course Instructors

Ashlie Crewe


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