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The Performer’s Pelvis: Managing Pelvic Floor Dysfunction in Dancers and Artistic Athletes

The Performer’s Pelvis: Managing Pelvic Floor Dysfunction in Dancers and Artistic Athletes

The Performer’s Pelvis: Managing Pelvic Floor Dysfunction in Dancers and Artistic Athletes

CA$899.00
This course includes
18:50:57 of Course Material (View)
Lifetime access after purchase
Certificate of completion

 

Course description:

Dancers and artistic athletes have unique movement and training demands involving repetitive impact, extreme ranges of motion, intense artistic expression, and quick adaptation to physical environments/performance spaces. Pelvic floor dysfunction is common in these high-level athletes, and there is a need for more clinicians who can understand their performance demands as well as deliver high-quality care for pelvic floor concerns like incontinence, pain, and prolapse. This course bridges pelvic health with musculoskeletal practice and performing arts medicine, with a focus on external and functional/movement training to address pelvic floor concerns in dancers and artistic athletes. 

Join this course for a 9-week dive into all things pelvic floor and performing artist. You will enhance your knowledge of pelvic floor anatomy and function and how this integrates into breathing, pressure-management, movement demands, health concerns, and orthopedic issues commonly found in this population. You will develop skills to assess and treat the pelvic floor from head to toe, integrating pelvic concerns with orthopedic perspectives and consideration for the overall health and well-being of the dancer/artistic athlete. 

Come learn new skills for management of the artistic athlete’s pelvic floor with Brooke Winder, physical therapist and Expert with Pivot Dancer, a knowledge-sharing platform that provides improved access to evidence-based content to the dance community. 

 

Course Objectives: 

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

  • Understand and explain pelvic floor anatomy, function, and dysfunction as it relates to the unique movement and training demands of dancers and artistic athletes.
  • Screen for and (externally) evaluate pelvic floor dysfunction in performing arts settings.
  • Recognize common breathing and intra-abdominal pressure-control deficits in dancers and artistic athletes, and design exercises and interventions to address these deficits and offload the pelvic floor.
  • Recognize specific movement demands of dancers and artistic athletes, including repetitive impact and extreme ranges of motion, and their relationship to pelvic floor function and dysfunction.
  • Prescribe exercises to address overall movement dysfunction and load attenuation to optimize pelvic health in dancers and artistic athletes.
  • Screen for general health considerations relevant to this specific population, including autonomic nervous system dysregulation, digestive dysfunction, RED-S, menstrual dysfunction, and hypermobility, and explain how these issues impact the pelvic floor.
  • Implement management techniques to optimize digestive and nervous system function within a performing artist’s demanding training and performing schedule.
  • Implement exercise and self-care interventions to specifically address pelvic floor muscle coordination, strength, and mobility deficits in performers.
  • Identify key orthopedic intervention strategies for the neck, low back, hip, and foot/ankle that can address pelvic floor dysfunction from an effective whole-body perspective.
  • Demonstrate patient-centered communication strategies to best address sensitive concerns that often surround the pelvic floor.
    Sessions:

 

Outline of this 9-Week Live Online Course

**Please Note: If you cannot attend a live session, you will have complimentary, lifetime access to the recording. Embodia will be recording each live session, editing the content to make it enjoyable for you to take on your own time, and we will post it as a course on Embodia Academy. You will be provided complimentary access to the course. 

 

WEEK 1: Pelvic Floor Anatomy, Function, and Feel for Dancers and Artistic Athletes 

In this session, you will be introduced to pelvic floor anatomy, pelvic floor function, and the anatomic connections between the pelvic floor, trunk/spine, and hips relevant to the unique movement demands of dancers and artistic athletes. Experiential learning will help you build awareness of pelvic floor activation and relaxation and understand how shifts in alignment, positioning, movement cues, breath, and tension can affect the pelvic floor.

You will learn common signs, symptoms, and risk factors involved in pelvic floor dysfunction, which risk factors are more prevalent in dancers and artistic athletes, and basic screening/evaluation tools for pelvic floor dysfunction that can be used in typical performing arts settings. Current research relating to pelvic floor dysfunction in dancers and artistic athletes will be shared. 


WEEK 2: Breathing and Intra-Abdominal Pressure: Efficiency for Performing Artists

In this session, you will explore the breathing and pressure management system by diving into the anatomic and functional relationship between the glottis, diaphragm, and pelvic floor.

You will gain improved understanding of how vocal and breathing strategies can impact the pelvic floor, as well as how to address common breathing habits in dancers and performing artists that can lead to non-optimal pelvic floor function. Interventions to improve breathing variability and efficiency for artistic athlete demands, including thoracic cage and upper quarter mobility exercises, breathing exercises, and self-mobilization techniques, will be demonstrated. You will also be introduced to the basics of intra-abdominal pressure management and its importance in pelvic floor health for dancers and artistic athletes.

 

WEEK 3: The Pelvic Floor in a Larger System—Pressure Management, Impact, and Extreme Ranges of Motion

This week will begin with a review of intra-abdominal pressure management and current related research. We will explore the commonly-developed habit of “over-tensioning” the pressure system in dance and artistic athletic endeavors—including understanding typical teaching strategies that can perpetuate these habits.

You will learn how to educate dancers that “drawing abs up and in” cannot be their only strategy for stabilization, and be able to show them why through movement and exercise interventions. This session will also dive into repetitive impact loading and extreme ranges of motion required of dancers and artistic athletes, and how to address these demands with a focus on optimal loading and/or offloading of the pelvic floor. 

 

WEEK 4: General Health Considerations and their Impact on the Pelvic Floor: Nervous system and Digestive Health for Performers

This session will focus on the impact of the autonomic nervous system (both parasympathetic and sympathetic) on the pelvic floor.

You will discover why dancers and artistic athletes may experience uniquely high levels of stress that can influence pelvic floor symptoms via nervous system sensitization and disruption of the HPA-axis, as well as how to calm the nervous system through specific techniques. Secondly, this session will address how digestive health impacts the pelvic floor (as well as the nearby low back and hip).

Relevant gastrointestinal system anatomy and function will be introduced. We will discuss strategies to help dancers and artistic athletes optimize digestive function through movement, self-mobilization, daily and bowel/bladder habits, and adapting to unpredictable travel and performance schedules. 

 

WEEK 5: General health considerations and their impact on the pelvic floor: RED-S and Hypermobility

What is RED-S (Relative Energy Deficiency in Sport), why are dancers and artistic athletes at high risk for RED-S, and how does it impact the pelvic floor? In this session, we will discuss fueling considerations and concerns in performing artists, including the relationship to menstrual dysfunction and other hormonal concerns.

Screening methods and appropriate referrals for RED-S and overtraining syndrome will be included. This session will also cover pelvic floor concerns commonly associated with hypermobility, a frequent presentation in dancers and artistic athletes, and what we can do to help. 


WEEK 6: Pelvic Floor-Specific Training for Performers

This week we will return to a specific focus on the pelvic floor muscles and how to train them. Sample cases involving both hypertonic and hypotonic pelvic floor dysfunction will be discussed. Interventions (external) and exercises will be presented to address both hypertonic and hypotonic pelvic floor dysfunction, including examples of integrating this training into higher-level athletic function in dancers and other performers. 

 

WEEK 7: Treating from Head to Toe to Help the Performer’s Pelvis

This week will focus on integrating knowledge from an orthopedic perspective into the management of pelvic floor dysfunction in dancers and artistic athletes. You will learn how approaching problems at the neck, low back, hips, and feet can have a huge impact on dancers and artistic athletes struggling with pelvic floor symptoms.  

Research and clinical perspectives will be shared linking the pelvic floor to common orthopedic presentations. Exercises and strategies to address key joints above and below the pelvic floor will be explored with a focus on optimizing function in performing artists. 

 

WEEK 8: Communication Considerations in Treating the Pelvic Floor

This week will focus on developing basic skills to build a truly patient-centered environment for treating the pelvic floor in dancers and performing athletes.

Topics will include:

  • Age-appropriate education and exercise to optimize pelvic floor function in pediatric or adolescent dancers and artistic athletes,
  • Common considerations for dancers who are pregnant and post-partum (note, this is not a comprehensive pre- and post-natal course)
  • The basics related to trauma awareness and gender inclusivity in pelvic floor care.

 

WEEK 9: Pulling It All Together

This week will involve final case studies and a discussion of how to pull together the information for efficient use in the clinical setting. Discussion and Q&A time will allow participants to explore further questions and ideas related to what they learned in weeks 1-8.

This session will finish with a one-hour movement class where you become the participant and experience a conditioning session that integrates breath, pelvic floor function, and pressure-management strategies into a flow of whole-body exercises.

 

Audience:


This course is perfect for physiotherapists and other rehabilitation professionals who have an interest in the pelvic floor, dancers, and artistic athletes. Previous experience in pelvic floor assessment and treatment is not needed. 

The instructors
Brooke R. Winder
PT, DPT, OCS, Board Certified Orthopedic Specialist in Physical Therapy, Pelvic Health Physical Therapist, BASI-Certified Pilates Instructor

Brooke Winder is a Southern California-based physical therapist with 11+ years of clinical experience, specializing in orthopedic and pelvic floor health for dancers, artistic athletes, weekend warriors, and fitness instructors. She also serves as Assistant Professor in the Department of Dance at California State University, Long Beach, where she Coordinates the Bachelor’s degree program in Dance Science and teaches courses in functional anatomy, injury prevention, wellness, and Pilates. Brooke provides backstage care for touring professional dance companies, physical therapy services for summer dance intensives, and community workshops to dancers and dance educators. She is particularly passionate about educating the dance and healthcare community about pelvic floor issues such as incontinence, prolapse, and pelvic pain, and empowering dancers and practitioners to know how to address these symptoms. Having spent many years as a dancer and a former competitive gymnast, Brooke has a deep understanding of the unique demands and capabilities of artistic athletes. She serves as an expert for Pivot Dancer, a knowledge-sharing platform that provides improved access to evidence-based content to the dance community.

Brooke has been published in The Journal of Orthopedic and Sports Physical Therapy, Journal of Electromyography and Kinesiology, Clinical Biomechanics, and Orthopedic Physical Therapy Practice magazine. She has presented research on pelvic floor health in dancers at venues such as the American Physical Therapy Association Annual Combined Sections Meeting, the International Association of Dance Medicine and Science Annual Conference, and the Performing Arts Medicine Association International Symposium. Brooke earned a Doctorate in Physical Therapy from the University of Southern California and a Bachelor of Fine Arts in Dance from Chapman University. She is a Board-Certified Specialist in Orthopedic Physical Therapy, a Certified Pilates instructor through Body Arts and Science International, and a former professional dancer with Southern California-based Backhausdance. She is also a certified POPUp Pro, having completed focused study in the management of pelvic organ prolapse. Brooke is a member of the International Association of Dance Medicine and Science, Performing Arts Medicine Association, and serves in leadership in the Performing Arts Special Interest Group of the Academy of Orthopedic Physical Therapy in the American Physical Therapy Association.


Pivot Dancer

Pivot Dancer is a knowledge-sharing platform which provides evidence-based content to the dance community. We bring together experts from around the world to give you unprecedented access to knowledge acquired through years of experience in the world of dance and science. Learn more at https://pivotdancer.com/
Course Material included in this course
  • Week 1: Pelvic Floor Anatomy, Function, and Feel for Dancers and Artistic Athletes
  • Week 1: Slides
  • Pelvic Floor Impact Questionnaire - Short Form 7
  • ICIQ - UI Short Form Questionnaire
  • Pelvic Floor Distress Inventory - Short Form 20
  • Introduction
  • Pelvic Floor Anatomy - Muscles
  • Pelvic Floor Anatomy - Connective Tissues
  • Innervation of the Pelvic Floor Region
  • What About Function?
  • Practice Pt1 - Lift
  • Practice Pt2 - Relax and Bulge
  • Clinical Applications
  • Week 1 Wrap Up
  • Feedback - Week 1
  • Week 2: Breathing and Intra-Abdominal Pressure: Efficiency for Performing Artists
  • Week 2: Slides
  • Week 2 Special Guest Slides
  • Supine Assessment Pt1
  • Supine Assessment Pt2
  • Introduction to Breathing
  • Common Habits of Artistic Athletes
  • Enhancing Breathing Efficiency
  • Exercise Options
  • Breathing Training
  • Pressure
  • What's Voice got to do with it?
  • What's Going On?
  • In-Studio Exercises and Practice
  • Concluding Questions Week 2
  • Feedback - Week 2
  • Week 3: The Pelvic Floor in a Larger System—Pressure Management, Impact, and Extreme Ranges of Motion
  • Week 3: Slides
  • Week 3 Introduction and Review
  • Pelvic Organ Prolapse
  • Considerations for Intra-Abdominal Pressure
  • Assessment Options
  • Training Optimal IAP Management
  • Impact
  • Nathaniel's Background
  • Nathaniel's Performance Demonstration
  • Group Discussion
  • Feedback - Week 3
  • Week 4: General Health Considerations and their Impact on the Pelvic Floor: Nervous system and Digestive Health for Performers
  • Week 4: Slides
  • Week 4 Introduction
  • Strength Training Programs
  • Develop Core Strength
  • Questions for Dom
  • Stressors and the Nervous System
  • Nervous System Interventions
  • Vagus Nerve Tone
  • Gastrointestinal Health and the Pelvic Floor
  • What can Artistic Athletes do for GI Health?
  • Week 4 Wrap Up
  • Feedback - Week 4
  • Week 5: General health considerations and their impact on the pelvic floor: RED-S and Hypermobility
  • Week 5: Slides
  • Week 5: Special Guest Slides
  • Relative Energy Deficiency in Sport (RED-S) Clinical Assessment Tool (CAT)
  • 2014 Female Athlete Triad Coalition Consensus Statement on Treatment and Return to Play of the Female Athlete Triad
  • Week 5 Introduction
  • Nutrition and RED-S
  • The Impact of RED-S on Athletes
  • RED-S Screening
  • RED-S Questions Pt1
  • RED-S Questions Pt2
  • Consequences on the Pelvic Floor and Gut Health
  • Hypermobility, Artistic Athletes, and the Pelvic Floor
  • Issues Associated with Syndromic Hypermobility
  • Management Considerations for Hypermobility
  • Week 5 Closing Questions
  • Feedback - Week 5
  • Week 6: Pelvic Floor-Specific Training for Performers
  • Week 6: Slides
  • Week 6 Introduction
  • Impacts of Injury
  • Pregnancy and the Artistic Athlete
  • Recalling the Pelvic Floor Assessment
  • Evidence for Pelvic Floor Muscle Training
  • Teaching Pelvic Floor Activation
  • The Pelvic Floor and Higher Level Activity
  • Management for the Hypertonic Overactive Pelvic Floor
  • Other Pelvic Floor Mobilization Techniques
  • Bladder Tips for Our Artistic Athletes
  • Week 6 Questions
  • Feedback - Week 6
  • Week 7: Treating from Head to Toe to Help the Performer’s Pelvis
  • Week 7: Slides
  • Week 7 - Introduction
  • The Cervical Spine
  • Exercises for the Cervical Spine
  • Other Connections to the Neck and Shoulders
  • The Low Back and the Pelvic Floor
  • Sacroiliac Dysfunction
  • The Hip and the Pelvic Floor
  • Tips to Improve Hip Function
  • The Foot and Ankle and the Pelvic Floor
  • Foot and Ankle Exercises
  • Week 7 - Wrapping Up
  • Feedback - Week 7
  • Week 8: Communication Considerations in Treating the Pelvic Floor
  • Week 8: Slides for Communication Considerations
  • Edinburgh Postnatal Depression Scale (EPDS)
  • Week 8 - Introduction
  • Normalizing the Conversation
  • Questions for Dinah
  • The Basics of Trauma Informed Care
  • Screening for Trauma
  • Recognizing Trauma in the Clinic
  • Basic Transgender and Non-Binary Considerations in Pelvic Floor Treatment
  • Stressors for People Who Are Transgender
  • Pregnancy and Post-Natal Considerations for Artistic Athletes Pt1
  • Pregnancy and Post-Natal Considerations for Artistic Athletes Pt2
  • Chapter 8 - Wrapping Up
  • Feedback - Week 8
  • Week 8: Slides for Addressing the Pelvic Floor in Pediatric Performers
  • Week 9: Pulling It All Together
  • Week 9 - Introduction
  • Postpartum Considerations
  • Subacute Postpartum
  • Bringing It All Together
  • In-Roads for Assessment and Treatment
  • Example Patient Presentations
  • Common Stories
  • Exercise Demonstration
  • Course Wrap Up
  • Feedback - Week 9
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