Persistent pelvic pain (internal) in athletes is not well understood. This 1-hour discussion will explore the interconnected systems that can contribute to the development of pelvic pain, while taking into consideration the added complexity and intertwined amplification of symptoms created by the athletic mindset, post-injury loss of sport and community, and high-level return to performance demands. Research updates will further participant understanding of the role of pelvic floor overactivity in athletic pelvic health needs. Finally, a case study describing the clinical course of a professional iron distance triathlete with persistent hip and pelvic pain will provide a framework for the discussion of biopsychosocialstrategies to support symptom resolution and return to sport.

Objectives-Upon completion of this session participants will:

• Describe the anatomical, physiologic, and functional inter-relationships between the hip complex, postural control, and pelvic health systems as a therapeutic bridge between musculoskeletal, performance, and pelvic health considerations.

• Articulate the added biopsychosocial complexities of the athletic mindset on persistent pelvic pain, particularly in the context of high-performance demands, post-injury challenges, and the loss of sport and community.

• Discuss the role of pelvic floor overactivity in persistent pelvic pain in athletic individuals.

• Value abdominopelvic health and access to fitness of choice as components of whole person care.

Schedule:

• Understanding Pelvic Pain: Terminology, biopsychosocial contributors (10 min)


• Pelvic floor functional, physiologic, and anatomical inter-relationships (10 min)


• Biopsychosocial Athletic considerations (10 min)


• Case Study: Meet Kate- Professional Iron-Distance Triathlete (20 min)


• Q and A- (10 min)

Contact Us to inquire about hosting a workshop: Contact Us

Treating and Training the Female Runner – Hybrid Online + Live Course**

The female runner presents practitioners with unique challenges. Women are 2x more likely to sustain a running injury than men; experience a higher rate of incontinence than age-matched women in the general population; and need to navigate the changes brought by pregnancy and postpartum to continue to participate in their sport of choice. It is critical that both male and female orthopedic, sports medicine, and pelvic health professionals recognize and have skills to address the inter-relationship of musculoskeletal, performance and pelvic/abdominal health needs of female runners in their care. These issues are intertwined within the brains and bodies of athletic females, we can no longer separate them in our clinical and fitness programming.  

All professionals that treat female runners need to be able to understand at depth, reason through and build programs that answer clinical questions such as: 

• How can we use running to return women to optimal musculoskeletal, pelvic and performance health, instead of eliminate it until they are “better”? 


• How does impact control, or lack thereof, simultaneously contribute to common musculoskeletal and pelvic health presentations in female runners? 


• How do we create dynamic control for a runner versus stiff stability offered by abdominal hollowing, holding or “core” stabilizing ideas? 


• Why are young women who have never had children leaking during running and how does that effect running efficiency and performance? 


• How do we harness optimal intra-abdominal pressure for trunk control without contributing to pelvic and abdominal health issues?


• How do you build a program to prepare a new mom to return to running post-partum? 


• How are painful hips or low back while running and painful sex intertwined? 


• What is the path back to running for women with pelvic organ prolapse? 


• How does diastasis recti impact trunk and pelvic control in running? 


• What running form considerations common to females can be modified to address musculoskeletal, pelvic/abdominal, and performance needs?


• How do we build resilience in our female runners to prevent future injuries?

This hybrid online/live 2-day course** will blend theory and practice to bridge the gap between our understanding of musculoskeletal, and sports performance with pelvic, abdominal and pregnancy/postpartum health considerations for female runners. The course is intended to be an entry level (and all external) opportunity for musculoskeletal and sports medicine practitioners unfamiliar with pelvic health AND pelvic health providers unsure of how to prepare a patient for a return to sport to gain the foundational knowledge, clinical reasoning and relevant skills to integratively assess and address the full clinical picture for their female runners.  

*(Information, reasoning, and strategies can be applied to other types of female athletes).

**Participants are required to complete a 2-hour online module (Module 1 of Piston Science Part One) that provides the evidence and conceptual foundation for the approach Julie Wiebe takes with female athletes. This module must be completed at least 2-months prior to attending the live course. This will provide participants time to apply the concepts clinically, develop questions, generate robust conversation and allow us to pursue more advanced topics in the live component. Module One will not be reviewed, but applied out of the gate in the live portion. You will need to provide a Module One completion certificate to receive course handouts.

The first module of Piston Science Part One is a part of the course (but is a separate purchase from registering for a course through the course host). More modules are recommended to optimize your experience on site. Registrants get discounts on the following:

Module One only

Modules 1-4 

Modules 1-7 (full course)

Learning Objectives:

At the conclusion of this course participants will be able to: 

1. Articulate the challenges facing female runners due to unique anatomical, physiologic, pressure and neuromuscular variables.


2. Distinguish between the demands (speed, endurance, load, impact, intra-abdominal pressure etc.) placed on the stability system of a female runner by different fitness and sport pursuits in order to develop targeted treatment strategies to meet those demands. 


3. Discuss the evidence demonstrating the link between the central stability and pelvic health systems to broaden practitioner theoretical understanding of intervention strategies that simultaneously impact both systems. 


4. Recognize the relevance of pelvic health considerations to musculoskeletal and performance issues in orthopedic and sports medicine clinical settings. 


5. Develop clinical strategies that access the anticipatory postural control system through breath mechanics interventions, muscular recruitment order, pelvic floor integration, alignment support, and intra-abdominal pressure management to promote continence, prolapse and diastasis management within fitness activities.


6. Learn to monitor, cue, and modify function and fitness form and strategies to facilitate impact attenuation, manage intra-abdominal, and promote proximal hip control in order to simultaneously optimize pelvic, musculoskeletal and performance health. 

Pre-Requisite: 

1. Module One of Piston Science Part One (completed at least 2-months prior to the course). 


2. Bring a video of one or two runners (and/or your own running) with written permission to share with others and use for labs. Videos should be from the front, side and behind. 


3. Bring video of squats, single leg squats, a squat jump and hops all from side and front views of at least one of the runners or yourself.  


4. Sign and return the course Terms and Conditions.

Highly Suggested: It is highly suggested to take Modules 1-4 of Piston Science Part One. Module One is a conceptual introduction. Modules 2-4 provides assessment and intervention strategies to optimize the coordinated action of the Diaphragm/TA/Pelvic Floor as a dynamic foundation for movement, function and fitness. These techniques are not specifically instructed in this course.

Schedule: 

Day One (Live):

8:00-8:30-Registration 

8:30-8:45-Introductions and Course Orientation

9:00-10:30 – Module One Applied to Female Runners (this is not a review, but next steps)

10:30-10:45-Break

10:45-12:00-Clinical Reasoning for the Female Runner

12:00-1:00- Lunch

1:00-2:00- Assessing the Female Runner (An ALL EXTERNAL and functional approach)

2:00-2:45-Lab assessment techniques

2:45-3:00- Break

3:00-5:00- Assessment and collective clinical reasoning of a live volunteer from the community

5:00-5:30-Q and A 

Day Two (Live):

8:30-9:30 – Q and A; Review

9:30-10:30- Pelvic and Abdominal health considerations for female runners

10:30-10:45-Break

10:15-11:00- Case Review/Application (Triathlete with Prolapse; Triathlete with Pelvic Pain)

11:00-12:00- Build the Return to Run Program (Make it look like running)

12:00-1:00- Lunch

1:00-2:00 – Lab: Build a Program for a client or volunteer 

2:00-2:30- Running as Intervention: Clinical Decision Making When to Return to Run 

2:30-2:45- Break

2:45-4:45- Treatment Progressions/Regressions/Ongoing Plan for community volunteer

4:45-5:00-Final synthesizing comments

5:00-5:30 Q and A

Contact Us to inquire about hosting a workshop: Contact Us

Despite inclusion in most definitions of the core, few rehabilitation or fitness programs integrate the pelvic floor or diaphragm into strengthening or neuromotor training. An integrated clinical model of the pelvic floor requires a broadened definition of pelvic floor function beyond merely maintaining continence. When linked to the diaphragm, the pelvic floor acts as a powerful proximal stabilizer of lumbosacral, sacroiliac, pubic symphysis, and pelvic-hip joints ensuring efficient LE and UE mechanics. In addition, the dynamic interplay of these deep muscular elements will balance and harness the intra-abdominal pressure system as a component of central stability.

Clinicians will be introduced to an innovative, clinical model that incorporates a neuromuscular-based core recruitment and IAP balancing strategy, driven by external cueing of both the pelvic floor and diaphragm. This provides a sturdy, yet dynamic foundation that is responsive to the demands of function, movement, fitness and sport. Regardless of age or sport of choice, building programs that maximize results without compounding common women’s health issues such as incontinence, and organ prolapse is a critical clinical skill for all clinicians who treat females (regardless of specialty).

Session participants will have the opportunity to experience the material themselves through exercises that integrate the diaphragm/pelvic floor piston into core stabilization, postural muscle patterning, gait, fitness and sport specific activities.

The Diaphragm/Pelvic Floor Piston for Adult Populations: Part One

Day 1:

8:00 – 8:30 – Registration

8:30 – 9:00 – Introduction

9:00 – 10:00 – Neuromuscular Core Strategy

10:00 – 10:15 – Break (provided)

10:15 – 11:00 – Life span core dysfunction

11:00 – 12:30 – Core Strategy enhancing alignment

12:30 – 1:30 – Lunch (on your own)

1:30 – 2:30 – Diaphragm functional eval and activate with lab

2:30 – 3:30 – Pelvic Floor eval and activate with lab (external evaluation)

3:30-3:45 – Break (provided)

3:45-4:30 – Clinical steps: Interaction demo/alignment practice

4:30-5:00 – Q and A

Day 2:

8:30 – 9:30 – Q and A/Day One Review Lab

9:30-11:00 – Training postural relationships (Posterior Oblique Synergist lab)

11:00-11:15 – Break

11:15 – 12:15 – Lateral Synergist lab

12:15 – 1:15 – Lunch (on your own)

1:15-2:15 – Anterior Oblique Synergist lab

2:15-3:15 – Rotational Synergist lab

3:15-4:00 – Core Strategy in gait

4:00-4:30 – Fitness/Plyometrics: Embed the Strategy

4:30-5:00 – Q and A /Case Studies

Contact Us to inquire about hosting a workshop: Contact Us

Instructors: Shelley Mannell, Julie Wiebe

Continence is a challenge for many of the families encountered by paediatric PTs and OTs. However, few rehabilitation professionals feel confident to address these needs, and lack relevant tools to address them in the context of the clinical setting. Standard behavioural and environmental interventions seem to fall short for neurodivergent children (and many neurotypical kids). In this 2-day hybrid course Shelley Mannell, PT and Julie Wiebe, PT will equip the paediatric professional with an updated and accessible framework that integrates the postural control, neuromuscular, and pressure systems that contribute to continence (its more than just a pelvic floor problem). Providers will gain relevant strategies that complement their existing skill set to address continence control issues alongside other treatment needs while honoring the unique circumstances of families and children with developmental, sensory, and motoric challenges. Clinical reasoning will be offered to support application across the continuum of needs for both neurodivergent and neurotypical children from birth to adulthood.

Day 1 Online Participants are introduced to a dynamic systems assessment of continence challenges. New intervention strategies are discussed that simultaneously address the interconnection between postural control, balance, gait, constipation, and continence. Concepts basic to the Dynamic Core for Kids approach will be highlighted and expanded with a specific focus on breath mechanics as a gateway into the interlinked central control and continence systems. There will also be discussion regarding further interconnections between sensory processing and emotional regulation within the context of continence.

Day 2 In-person Participants will have the opportunity to explore both functional, movement- based assessment tools, as well as, hands-on external assessment of diaphragm and pelvic floor function for application in appropriate cases. Assessment of abdominal wall integrity, the significance of congenital Diastasis Recti Abdominis on continence and balance as well as treatment options/progression will be explored. (Attendance on Day One is a prerequisite to attendance on Day Two.)

For more information and to register, click here.

Objectives

On completion of Day One, the participant will be able to:

1. Discuss the prevalence of continence issues 3 different paediatric populations.


2. List 4 modifiable lifestyle factors that can have an impact on continence in both neurotypical and neurodivergent children.


3. Develop 3 constipation intervention strategies for parents to help prevent nighttime accidents.


4. Describe the link between postural control and continence control.


5. Integrate breath mechanics as a gateway for pressure management in 3 therapeutic activities.

On completion of Day Two, the participant will be able to:

1. Demonstrate a basic level of skill in assessment of components of the central control system – Diaphragm, Transversus Abdominis, and Pelvic Floor (including external palpation with consent).


2. Articulate and identify functional and movement pattern deficits that reflect the interrelationship of central control and continence deficits.


3. Discuss and devise intervention strategies that address balance, gait, postural control, and movement inefficiencies that simultaneously offer continence control support.


4. Demonstrate a basic level of skill in assessment of Congenital DRA.


5. Develop intervention strategies to manage Congenital DRA in different age groups/physical capabilities.

Contact Us to inquire about hosting a workshop: Contact Us

There are many issues that underlie a child’s readiness to learn. Teaching staff face many challenges in the classroom (and parents at home) with posture, attention, difficulty sitting still, impulse control, clumsiness and more. Physical Therapists Shelley Mannell and Julie Wiebe present down-to-earth, practical explanations and tools for teachers and staff to help children optimize their physical, emotional and sensory foundation to support their learning.

Topics of discussion for the day include the relationship of breathing and core stability to alignment, toileting, emotional self-regulation, sensory processing and attention. Discussion of the need for the brain and body to move and the role of breathing creates a practical approach to supporting the whole child at school and at home.

A combination of lecture, videos and practical experiences facilitate an engaging day of learning that will equip teachers and parents with the know-how and practical skills to use in their classrooms and families on Monday morning.

Contact Us to inquire about hosting a workshop: Contact Us

Instructors: Shelley Mannell, Julie Wiebe

This two-day course is designed to equip pediatric rehabilitation professionals with the knowledge, clinical reasoning, and tools to apply a systems based, neuromuscular central control framework to the specific needs of a variety of neurodiverse children: Autism Spectrum Disorder (ASD), Cerebral Palsy (CP), Developmental Coordination Disorder (DCD), hypotonia, and more.

Primary course content is divided into 2 days.

Day 1: Clinicians will be introduced to a neuromuscular, systems approach to central control (Core Strategy) that is distinct from traditional concepts of core strength. This integrative model uses the diaphragm and breathing mechanics as an access point for central control (aka core stability). This attainable and relevant starting point for pediatric populations impacts multiple intertwined systems including postural control, balance, sensory processing and emotional regulation as well as functional gross and fine motor skills. The development of and challenges to central control in neurotypical and neurodiverse populations are discussed. A specific assessment model of the elements of the central control system (diaphragm, abdominal wall, pelvic floor, and pressure system) is provided. An intertwined understanding of the influence of alignment and external support to optimize availability of the elements of this system is demonstrated.

Day 2: Participants will learn to integrate Core Strategy into treatment, movement, and functional activities that have immediate application to a variety of clinical settings (direct treatment, school, and home programs). Case presentations and small group learning will promote concept synthesis and clinical reasoning to implement Core Strategy in clients of differing ages (preschoolers age 2+, school age and teens) and diagnoses. Participants will also discuss how to integrate Core Strategy Techniques with Neuro-Developmental Treatment handling skills and sensory processing intervention to support a greater range of clients.

 

Course Objectives:

• Describe the difference between a neuromuscular, systems approach to dynamic central control (‘Core Strategy’) and the traditional musculoskeletal, strength-based concept of ‘core stability’.


• Articulate the differences in the development of Core Strategy between neurotypical and neurodiverse children.


• Identify the contribution of efficient and effective core strategy to the development of emotional regulation.


• Evaluate the behavior and function of the diaphragm, transversus abdominis, pelvic floor, and intra-abdominal pressure system, both as individual components and collectively as an interconnected deep central control system.


• Develop a well reasoned thought process to individualize a treatment strategy that balances and encourages teamwork for elements of the deep central control system.


• Provide alignment cueing and external support options to optimize availability of the elements of the deep central control system.


• Utilize breath mechanics strategies as a pediatric-friendly entry point to access and encourage teamwork in the deep central control system and support movement and function.


• Implement clinical strategies that integrate a deep to superficial framework of neuromuscular system integration as an underpinning for function, balance, gross and fine motor skills.


• Synthesize assessment findings to develop a well-reasoned treatment plan for a variety of neurodiverse populations exhibiting challenges with core strategy in movement, balance, emotional regulation, sensory organization, functional motor skills and activities of daily living.

 

Course Schedule (subject to change):

Day 1

8:00 am Registration

8:30 Introductions and pre-work

8:45 Foundational concepts

10:00 Neurotypical and neurodiverse development

11:15 Alignment concepts

12:30 pm Lunch

1:30 Integrated systems – diaphragm

3:00 break

3:15 Integrated systems – pelvic floor

4:30 End

Day 2

8:30 am Q & A, recap

9:00 Children with neuromotor needs: Posterior Oblique Synergist

10:30 Break

10:45 Children with neuromotor needs: Anterior oblique synergist

Noon Lunch

1:00 pm Children with increased motor capabilities

1:15 Balancing anti-gravity flexion and extension

1:30 Small group learning and discussion

2:00 Creating rotation

2:30 break

2:45 Clinical applications,

3:00 Treatment planning: small group learning

4:00 Additional populations

4:15 Q & A

4:30 End

Contact Us to inquire about hosting a workshop: Contact Us

Instructors: Shelley Mannell, Julie Wiebe

In Dynamic Core for Kids therapists were introduced to the assessment of the Core and intervention strategies for children with motor challenges. Dynamic Core for Kids 2 provides the opportunity to gain an increased level of mastery with assessment and treatment planning for children with a variety of motor challenges. Day 1 will begin with review of the important concepts in treatment of the Core and update therapists on the current research literature. Opportunities for assessment and treatment planning will occur for the rest of Day 1 and Day 2 through video clips and problem solving. Therapists are invited to bring a video clip of one of their clients to share with the group. If you are interested in gaining an advanced level of skill with Dynamic Core for Kids, join us for an exciting 2 day learning experience. Participants for this course need to have completed the Dynamic Core for Kids 1 (previously Core Restoration for Kids with Motor Challenges course).

Contact Us to inquire about hosting a workshop: Contact Us