Tone Talks

This is an exciting time in pelvic PT and we must keep up with the new research and the world as our understanding progresses and advances.

  • Terminology in medical literature to describe tone is confusing and unclear – we must do better to ensure accuracy and the advancement of science and ultimately the quality of patient outcomes in this field.  In many cases it isn’t what you think it is.
  • “Tone” is the correct term to use when describing what you feel when you palpate a muscle – not tension.
  • But palpation is quite subjective – more research is needed to determine the role of palpation of tone in the clinic – join is to learn more.
  • Instruments are more objective and reproducible and the future looks good for well-done instrument tone assessment research (the past however has not been so good).
  • We should be striving to use instrument assessment of the PFM in our clinic – to get accurate information leading to more successful treatments.
  • EMG is the only way to measure the isolated active component of tone.
  • And it must be quality EMG assessment which requires adequate training to set up and interpret.

Rachel Worman’s landmark research on PFM assessment of tone published in ACOG journal is now available free for 50 days.  This 109 page systematic review is packed with well-done analysis and deep with clinical implications.  It is a MUST READ for instructors, authors and researchers.  Please spread the link widely and fast (looks like it will be free till around Feb 8th).  

Worman R, Stafford R, Cowley D, Prudencio CB, Hodges P.  Evidence for increased tone or overactivity of pelvic floor muscles in pelvic health conditions: a systematic review.  Am J of Ob and Gynecol. Early access Dec 2022. https://doi.org/10.1016/j.ajog.2022.10.027.  

LINK FOR FREE TEXT (through Feb 8th)

The journal club will host “Tone Talks”  a series of discussions to unpack this new information, discuss controversies, learn more, and do better for our patients.  

Recording of January 4th Journal Club (Current evidence for greater tone of the pelvic floor muscles in pelvic health conditions)

Recording of January 23th Journal Club (Which words should I use to describe PFM tone? Words inform thought process and thought process informs treatment. )

Recording of February 8th Journal Club (Measurement of PFM tone by digital palpation)

Additional Courses

Evidence for increased tone/overactivity of pelvic floor muscles in pelvic health conditions: a one hr discussion with Rachel Worman that provides an overview and discusses some practical uses of the framework to interpret literature. At the current exchange rate (.67) it comes to USD$33.50 

EMG Biofeedback Assessment and Treatment of Pelvic Floor Muscle Dysfunction – Dr Beth Shelly PT, DPT, WCS, BCB PMD This course will provide pelvic therapists with comprehensive knowledge on EMG biofeedback assessment and treatment for a variety of pelvic floor muscle conditions.

Foundations of Pelvic Floor Muscle Assessment Using Surface Electromyography newly revised self-paced home study module – authors Dr. Beth Shelly, PT, DPT, BCB-PMD, Board-Certified Women’s Health Clinical Specialist, and Jane Kaufman, PT, M.Ed, BCB-PMD. Register for this on-demand self-paced course.