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Determining a Mechanical Component - Pelvic Pain & Lower Urinary Tract Symptoms

Determining a Mechanical Component - Pelvic Pain & Lower Urinary Tract Symptoms

Determining a Mechanical Component - Pelvic Pain & Lower Urinary Tract Symptoms

Part of a bundle
This course includes
4:49:50 of Course Material (View)
1 Year access after purchase
Certificate of completion
This course was recorded in August 2022


Lumbopelvic pain is the number one cause of disability worldwide.  People with chronic LBP are often tough and complicated patients.  

When you treat their low back, do you think to screen their pelvic floor beyond looking for signs of Acute Cauda Equina Syndrome?  Research has shown that 95% of women who have LBP have a concurrent pelvic floor complaint.  This is so commonplace, and yet most of us don't even follow up the bladder/bowel question with further follow-up questions to help sort out the relevance of the pelvic floor complaint.

We have come to accept that many patients who come to us for help with their low back pain are often not “textbook” cases, but usually, come with multiple issues. Could they be related?

Perhaps you are a pelvic health therapist, and focus on the pelvic floor already but don't look for the driver of lumbopelvic pain outside of the pelvic area? 

Low back pain and pelvic floor problems are like two peas in a pod. You have to understand both to really help your patients get better. This may be one reason that worldwide disability with lumbopelvic pain continues to be on the rise.

Learn how to determine if these comorbid symptoms are relevant, and how to help people get better, faster by registering for this course!


Learning Objectives

Upon completion of this course, participants will:

  • Reach beyond the anatomy to understand the inter-relation between the spine, pelvis, hips and LUTS
  • Effectively screen any patient with lower back pain for LUTS through efficient questioning and applying the course principles
  • Determine if patients whose primary complaint is LUTS would have a relevant spinal component (directional preference), and how to systematically address it
  • Understand appropriate outcome measures and when to use the DASS, TSK-11, PCS, Fremantle Back Awareness, CSI, PANAS and PSEQ-2 with your patients



This online continuing education course is targeted to:

  1. Pelvic health physiotherapists usually treat LUTS by addressing bladder health, pelvic floor health, and central nervous system issues.  However, an equally important component of treating LUTS is to understand the relationship between low back issues and LUTS, and use an effective and concise method to determine if a mechanical component exists in an individual.  

  2. All clinicians who see patients with acute and chronic low back pain.  The correlation between Lower Urinary Tract Symptoms (LUTS) and Mechanical Low Back Pain is poorly understood and can change the trajectory of a patient's recovery from either condition when the inter-relationship is uncovered and addressed.

  3. Orthopaedic physiotherapists: One of the foundations of orthopaedic practice is to treat low back pain and pelvic girdle pain. However, aside from screening for cauda equina syndrome, orthopaedic therapists may have little understanding of lower urinary tract symptoms.  The research has clearly demonstrated a strong correlation between LUTS and low back pain for the past decade. With increasing low back pain disability over the past decade, orthopaedic therapists need to broaden their scope of treating low back pain by considering the role of the pelvic floor and LUTS as comorbid conditions.

The course participant should be familiar with:

  • Patients presenting with LUTS who may have a relevant spine component
  • Patients presenting with lower back or pelvic girdle pain who may have relevant LUTS


Course Bundle

This online course is a part of THE Biopsychosocial Bundle - a very special learning opportunity for all healthcare professionals. 

This course can only be purchased with the whole bundle (not as an individual course).


THE Biopsychosocial Bundle is a carefully designed learning experience that includes 6 different courses by 6 experts in their respective fields. These courses have been carefully selected and constructed for clinicians who wish to excel in a biopsychosocial framework.

Learn more about THE Biopsychosocial Bundle by clicking here!


What other Healthcare Professionals are saying about this Course!

Lynda McClatchie is an excellent presenter and her course, Determining a Mechanical Component, incorporates the McKenzie System of Mechanical Diagnosis and Therapy (MDT) method to enhance the assessment and treatment strategies utilized when working with patients who have persistent pelvic pain (PPP) and/or lower urinary tract symptoms (LUTS).

Her course draws on her clinical experience and extensive evidence to emphasize the importance of ALWAYS assessing the lower back when working with patients who have PPP and/or LUTS. She shares a number of her virtual real-life assessments/treatments that help consolidate the education provided.

Any physiotherapist treating low back pain and/or LUTS should definitely consider taking this course as it will likely change your practice and improve patient outcomes.

-Christina Dzieduszycki, PT, MSc(PT)
Registered Physiotherapist

The instructors
Lynda McClatchie
PT, MSc, CertMDT

Lynda has been a clinical physiotherapist for over 27 years, with extensive training in musculoskeletal and pelvic health physiotherapy. She opened Elevation Physiotherapy & Wellness in Mississauga in 2017 after working in downtown Toronto for almost 20 years.

She is credentialed in the McKenzie System of Mechanical Diagnosis and Therapy (MDT) and teaches this system to the senior Physical Therapy students at the University of Toronto.

Lynda has completed several advanced training courses in pelvic health to address issues with pelvic pain, incontinence, pelvic organ prolapse and several other conditions.

When she is not actually working, she can be found on her bike, or hanging out with her husband and two kids.

Reframe Rehab
Online Teaching Company

We are a passionate group of highly trained clinicians who champion virtual, live online education courses to develop a biopsychosocial framework for your clinical practice. Our mission is to break down the silos in clinical practice between musculoskeletal pain, pelvic pain, pain neuroscience education, and psychology by providing timely, cost-effective, live online learning opportunities from the world's leading clinical educators on these topics.

Interested in learning more about Reframe Rehab or taking a course with us? Check us out on Instagram @reframerehab or visit our website to view all our course offerings.

Course Material included in this course
  • Welcome and Introduction
  • Welcome!
  • 2-Month Free Trial on Embodia + Resource Packages
  • Course Manual
  • Slides
  • References
  • Myths That Persist When Evidence Moves On
  • Quiz!
  • Feedback
  • Can LUTS Be Related to the Spine?
  • Lower Back Pain
  • What are Centralization and Directional Preference (and Why They’re Very Important)
  • Does it Matter Which Exercise? (Hint… Yes it Does)
  • Putting It Together
  • Patient Video 1: Jane
  • Case Study 1: Barb
  • Neuroanatomy and why it’s Important
  • LUTS overview
  • The Relationship Between LBP and LUTS
  • Quiz!
  • Feedback
  • Research Relating Pelvic Pain and LUTS with the Spine
  • Clinical Studies that Assess the Spine to Influence LUTS
  • Case Study 2: Adam
  • Chronic Pelvic Pain
  • Lam Study on Chronic Pelvic Pain
  • Quiz!
  • Feedback
  • What Distress Questionnaires Really Look At
  • Distress Questionnaires and What they Mean Practically
  • Quiz!
  • Feedback
  • The Why and How of a Thorough Mechanical Assessment
  • Would you Assess a Shoulder in this Way? You Would Miss Directional Preference!
  • When Sitting Posture Matters and Objective Assessment
  • Lumbar Flexion in Standing Video
  • Lumbar Flexion in Lying Video
  • Lumbar Extension in Standing Video
  • Lumbar Extension in Lying video
  • Progression of Force into Lumbar Extension Video
  • Progression of Force Into Lumbar Flexion Video
  • Lumbar Flexion/Rotation Position
  • Lumbar Side Glides Video
  • Patient Video 2: Lisa
  • Patient Video 3: Velvet
  • Sitting Posture Adjustment and When it is Appropriate
  • Clinical Pearls with Carolyn Vandyken
  • Quiz!
  • Feedback
  • Bonus Assessment + What's Next
  • Bonus: Alexa's Mechanical Assessment
  • Congrats and what's next!

Click on the 'Buy Bundle' button. On the first payment page, there is a spot to put in your coupon code!

Each course purchase is for a single viewer only, and may not be shared. This provides each participant with their own copy of the course bundle to review at their pace and their own certificates of completion.

For clinics/groups of 3 or more clinicians, we offer a Buy 2 get the 3rd bundle free. If you are a clinic with a membership on Embodia, the clinic manager can purchase the bundles on behalf of staff and contact us to receive the coupon code for the free bundle! If you are a clinic that does not have a paid membership on Embodia, you can contact us with the information of the 2 accounts that have purchased the bundle and we will assist you.

If you are a large group/clinic, please contact us at to arrange a coupon code specifically for your group.

This course has been approved for 6 CPD units by the South Africa Society of Physiotherapists (SASP). If you are a physiotherapist in South Africa and would like the number of approved CPDs to appear on your certificate of completion, please follow the steps outlined in this help article. 

Yes, we have added Closed Captions to this course in French and Spanish. You can preview what this is like by going to the Course Materials section and then watch the Free Preview lesson in the course.

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