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Rectal Treatment for Pelvic Health



Get $50 off AND a LIVE Q&A with Nicole when you join Cohort #2 this October!

Sound Familiar?

  • I'm not sure how to integrate rectal evaluation and treatment into my clinical practice
  • I do rectal evaluations for "obvious" issues like GI or coccyx pain but don't know about using it for other patients
  • How do I bring up rectal treatment with my patients?  
  • My patient is hitting a plateau and I don't know where to go next
  • I'm not sure how to integrate rectal evaluation and treatment into my clinical practice

You're not alone!  Rectal evaluation and treatment is a hugely important tool for pelvic PTs, and one that we aren't using as often or as well as we need to be to help our patients!

Rectal: Evaluation & Treatment

Most pelvic practitioners don't feel as comfortable treating rectally as they do vaginally.  We struggle to discuss it with patients, put it off and ultimately miss important clues and often the "why" of their symptoms!

This course is designed to teach you how to incorporate rectal evaluation & treatment into your practice.  It's not just for bowel or "obvious" situations, but can benefit almost all of your patients and be the missing piece.

"Gave me the confidence I needed to immediately start incorporating rectal evaluation and treatment into my practice." - Julie B.

"Before this course I felt like I was just poking around in the rectal canal if/when I did a transrectal assessment.  Now I understand what I'm looking for!" - Kelsey G.

This course is for Pelvic Health Providers:

✔️ Who don't consistently perform a rectal evaluation & treatment for their patients

✔️ Who feel uncomfortable talking to their patients about rectal treatment

✔️ Who want to understand how rectal treatment can be important in almost all diagnoses (not just in 'obvious' situations!)

✔️ Who want to be a well-rounded clinician and capable of a full pelvic floor assessment


Read what people like you are saying about Rectal Evaluation & Treament

Jenna K.

"Nicole does an exceptional job with incorporating evidence and her clinical pearls into an online platform that easily facilitates learning. Already seen my patient outcomes improve and I know I’m a better practitioner now."

Julie B.

"I got the confidence to immediately start incorporating rectal evaluation and treatment into my practice. Nicole provides the framework for clinical reasoning...and also provides practical demonstration of the techniques. Highly recommend!"

Kelsey G.

"This course has changed how I feel as a practitioner for my patients. In all honesty, before this course, I felt like I was just poking around in the rectal canal if/when I did a transrectal assessment. Now I understand what I’m looking for and can explain it well."

Rectal Course Contents

Confidently incorporate rectal evaluation and treatment into your clinical practice to find the "missing piece" for your patients 

Clinical Reasoning with Rectal

Evaluating the importance of rectal treatment for your patient.

Rectal Decision Tree

Determining "reasons to rectal" for patients who can benefit.

The "Obvious" GI Issues

Considerations for treating constipation, fecal incontinence, coccydynia and post-proctectomy surgery

Post-Natal Symptoms

Rectal considerations for prolapse, painful intercourse, urinary incontinence, perineal tears and other post-natal issues.

Pelvic Pain 

Rectal considerations for IC, pudendal neuralgia, painful intercourse, endometriosis, vulvodynia, vaginismus and other pelvic pain.

"How To" Rectal

Bimanual treatment, positioning (not just side-lying!), draping, and other techniques.

Rectal Anatomy Review

Anatomy is Evidence!  Review the connections and anatomy better treated with rectal techniques. 

Discussing Rectal with Patients

Don't be uncomfortable bringing up the topic with patients and educating appropriately about rectal treatment.

Teaching Rectal Self-Care Techniques

Working with patients who can benefit from a home self-care program. 

BONUS - Practice Assessment

Determine how well you're currently using rectal treatments in your practice.

BONUS - Measurement Techniques 

Discussion of the most important outcome measures for rectal issues. 

Strengthen More Functionally with the

Adaptive Strengthening Approach (TM)

Course Objectives

  • More functional strengthening to get your patient up off the table

  • Understand how any exercise can be a pelvic floor exercise

  • Learn how to do a standing assessment (without it being 'weird!)

  • Be able to replace isolationist strengthening with adaptive strengthening for better patient outcomes

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Logistics & Details

  • Online, self-paced and lifetime access

  • Detailed demonstrations on a model and live volunteers

  • 12 full-length modules

  • Anatomy review of the pelvic floor and how it functions in a system




✅  BONUS: Weekly accountability check-ins (if you'd like them!)

Use Your Full Degree Again!

One of the side benefits of a more functional strengthening approach?

It's actually fun!  For both us and our patients.  We get to use the full scope of our degree.  Put the pieces together for our patients.  Figure out the 'why' and address it for true, lasting change.

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In looking at our field, I believe one of our biggest limitations is how many of us aren't comfortable evaluating and treating rectally.  It's literally half of the pelvic floor!

When I work with out-of-town patients or do remote consultations, I often find patients have been seeking treatment for years without a rectal exam!  Or, if they've had one, it was a 'quick check' and never addressed again.  For so many of our patients, this is a huge missing piece!

At best, we've taken something like H&W 2A or APTA 2, which focus almost exclusively on "obvious" uses of rectal in GI and colorectal issues.  While this is important, it doesn't answer many of the most important questions:

Questions this course will answer include:

✔️ Which of our 'non-obvious' patients can benefit from rectal evaluation and treatment?

✔️ What are the unique considerations for pelvic pain diagnoses?  Post-partum issues?  "Orthopedic" complaints?

✔️ How do we actually perform a rectal evaluation and treatment?  How do we use bimanual treatment to maximize effectiveness?  How do we drape?  How do we perform rectal treatment in more than just side-lying position?

✔️ How do we bring this up with patients?  How do we educate properly?

✔️ How do we teach home care programs that incorporate rectal treatment?

Nicole Cozean

  • Founder of PelvicSanity Physical Therapy and Pelvic PT Rising

  • Author of "The IC Solution"

  • Run the Pelvic PT Rising Podcast

  • Creator of the Pelvic PT Huddle 

  • Co-Founder of PelviCon, the first conference by and for pelvic rehab

  • Named ICN Physical Therapist of the Year and first PT to serve on the ICA Board of Directors

  • Chapman University Alumnae of the Year

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