Complex Pelvic Pain Disorders in Women and Men
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This course includes the video recordings of Sandra Hilton’s “Assessment and Treatment of Complex Pelvic Pain Disorders in Women and Men” and the Pelvic Floor Discussion Panel, plus a reading of Dr. Hilton’s article, “The Puzzle of Chronic Pelvic Pain.”
Each component of the course is described below:
DR. HILTON’S PLENARY PRESENTATION: ASSESSMENT AND TREATMENT OF COMPLEX PELVIC PAIN DISORDERS IN WOMEN AND MEN
Pelvic pain is a problem in men and women, globally affecting individuals as a result of sports injuries, pregnancy, post-surgery, injuries and spontaneous origins. Health care professionals need to be able to screen for pelvic health problems, have effective treatment options and know when to refer for further evaluation.
Complex pelvic pain conditions often require a team approach of the person in pain and a host of health professionals. This presentation highlights the need, screening options, treatment possibilities and referral strategies.
DR. HILTON’S VIDEO SUMMARY
Dr. Hilton provides an evidence and science-based presentation. She tackles a topic that is often avoided by manual and massage therapists; pelvic health and pelvic pain. She sensitively and humorously addresses common blocks practitioners and clients may both have in talking about this region and the types of problems that people may have. We need to learn to talk about this region in ways that both clinicians and our clients are comfortable with.
Dr. Hilton specifically describes what normal bowel, bladder and sexual functions are so that practitioners can help clients identify problems. She then explores modern pain science that underlies the experience of chronic pain and discusses how this is even more complex in the situation of pelvic pain.
She then discusses manual therapy approaches, client self-care and inter-professional referral.
This is an hour and 8 minute video recording.
THE PLENARY DISCUSSION PANEL: PELVIC FLOOR HEALTH: AN INTERDISCIPLINARY APPROACH TO ASSESSMENT, DIAGNOSIS, AND TREATMENT
Holly Henry, RMT moderated the Pelvic Floor Panel discussion with participants Sarah Bjorgan B.SHc, RMT, Sandra Hilton, PT, DPT, MS and Paula Jaspar M.Ed., RMT.
Participants spent about 10 minutes each discussing pelvic floor health from their particular practice perspective. There was a thorough presentation of stress incontinence after birth by Sarah Bjorgan. This was followed up by discussions of stress versus urge incontinence. 1/3 of women will have some type of incontinence in their lifetimes and 59% of women will have pain in the pelvis at some point. Men were not left out of the wide-ranging discussion either.
Panelists discussed the type of language they use with clients as well as numerous clinical stories. They also discussed scope of practice for massage therapists as well as entertaining many questions from the audience.
This is a one hour video recording.
DR HILTON’S PAPER: THE PUZZLE OF PELVIC PAIN: A REHABILITATION FRAMEWORK FOR BALANCING TISSUE DYSFUNCTION AND CENTRAL SENSITIZATION II: A REVIEW OF TREATMENT CONSIDERATIONS
In this paper, Dr. Hilton with co-author Carolyn Vandyken discuss a biopsychosocial framework for treatment of persistent pelvic pain. They go beyond the limits of current physical therapy practice, which they contend is organized around a pathoanatomical focus on tissues and a kinesiopathological focus on movement dysfunction.
If this traditional approach fails to achieve resolution, the authors suggest that a biopsychosocial approach that is evidence-based and biologically/physiologically plausible may help the clinician and patient move forward.
In this landmark paper Hilton and Vandyken discuss how to educate clients about the neurophysiology of their pain experience (lessening emphasis on “broken” structures that can’t be repaired), retraining body maps so that clients with neural “smudging” begin to feel more accurately and less anxiously. They also discuss how to downregulate a client’s sensitized nervous system through hands on approaches, movement, affirmations, laughter and normalizing sleep patterns. They also discuss neural mobilizing movement and the use of goal setting and graded motor imagery.
While manual techniques in certain areas of the pelvis are outside of most massage therapists scope of practice, this paper may open your eyes to other effective and ethical approaches!
The paper is available at: http://www.bethshelly.com/docs/Puzzle_of_Pelvic_Pain_A_Rehabilitation-5.pdf
- Screening for pelvic health conditions of incontinence and pelvic pain
- Discussing pelvic pain complaints with clients
- Utilizing pain education for pelvic pain conditions
- Interdisciplinary collaboration and referral
- Video recording of Dr. Hilton’s 1 hour and 8 minute presentation at the 2016 RMTBC Manual Therapy Conference: An Interdisciplinary Approach to the Science and Practice. Dr. Hilton’s Power Point is also available within the course for downloading and studying.
- Video recording of the 1 hour Pelvic Floor Discussion Panel with Sarah Bjorgan, B.SHc, RMT, Sandra Hilton, PT, DPT, MS and Paula Jaspar, M.Ed., RMT.
- Reading of Dr. Hilton’s 6,100-word journal article, “The puzzle of pelvic pain —a rehabilitation framework for balancing tissue dysfunction and central sensitization, I: pain physiology and evaluation for the physical therapist.” Phys Ther. 2011;35(3):103-111. Available at: bethshelly.com: Puzzle of Pelvic Pain
- It takes 3 hours to watch the videos and perform a preliminary reading of Dr. Hilton’s paper.
Dr. Sandra Hilton, PT, DPT, MS
Dr. Sandra Hilton, PT, DPT, MS graduated from Pacific University in 1988 with a Master of Science in Physical Therapy and a Doctor of Physical Therapy degree from Des Moines University in 2013. She has worked in multiple settings across the US with neurologic and orthopaedic emphasis combining these with a focus in pelvic rehabilitation for pain and dysfunction since 1995.
Sandy is the Co-owner of Entropy Physiotherapy and Wellness, Chicago. She teaches Health Professionals and Community Education classes on returning to function following back and pelvic pain, and co-teaches Advanced Level Male Pelvic Floor Evaluation and Treatment. Her clinical interest is chronic pain and complex pelvic pain disorders for men and women. Sandy brings science and common sense together to help people learn to help themselves.
Sarah Bjorgan, B.SHc., RMT
Sarah Bjorgan, B.SHc., RMT graduated from WCCMT, Victoria in 2004, and has worked in a variety of multidisciplinary settings as an RMT. She received her BSHc from Thompson River University in 2008.
In 2011, Sarah founded the RMTBC Professional Practice Group Women's Health and was the first Chair. Sarah was accepted into the Bachelors of Midwifery program at UBC in 2012 and is currently a full-time student. In 2015, she completed her first original research paper (unpublished) on Midwives' attitudes towards screening for hyper-bilirubinemia.
Sarah has a placement in Victoria, BC, where she lives with her two lovely kids, ages 7 and 4.
Paula Jaspar, M.Ed., RMT
Paula Jaspar, M.Ed., RMT is a Massage Therapist with her Masters of Education from Simon Fraser University. In 1998, she completed her doula training. She continues to offer postgraduate courses. Paula’s work has been published in International Journal of Massage and Bodywork, the DONA International Journal, the BC Massage Practitioner Journal, and Today’s Parent.
Paula is focused on education about massage therapy, women’s health, chronic pain and paediatric massage. She is the co-investigator of Massage Therapy and Labour Outcomes, a randomized control trial that completed at BC Women’s Hospital which showed that massage therapy was able to delay epidural use and that babies breastfeed sooner. Paula’s philosophy to treatment is that massage therapy is a commitment from the patient and the therapist.
Dr. Sandra Hilton, PT, DPT, MS
Biography same as above.
The recording in this course was a plenary presentation at the 2016 Manual Therapy Conference sponsored by the Registered Massage Therapists Association of British Columbia
If this course does not help you to significantly improve your knowledge or clinical skills, notify us within 30 days of your purchase and we will refund your purchase price.