What To Expect At Your First Pelvic Floor Physical Therapy Exam

evaluation pelvic floor physical therapy Apr 08, 2022

What to expect at your first pelvic floor physical therapy evaluation.

Just like every other medical exam, we will talk extensively about your medical history, what symptoms you are dealing with and the personal goals that you want to achieve by coming to physical therapy.

Next, we will go through a full-body movement assessment from head to toe. The whole body is connected and we would do you a disservice if we did not look at you as a whole moving human.

Once we have watched how you move as a whole person, we will deep dive into other areas more closely. We will examine your entire spine, rib cage, breathing patterns, abdomen, hips, pelvis and all the way down to your feet. We will be assessing  movement patterns, range of motion, strength, coordination, flexibility etc. 

After we have completed the above, and only with your consent,  we will perform an external and internal pelvic exam. For this  part of the evaluation,  it will be necessary for you to disrobe from the bottom down and a sheet will be draped over you for privacy. We want you to be comfortable. We will then touch the external structures of the vulva and perineum and then again, with your consent,  we will continue on to perform an internal exam. This is similar to an OB/GYN or Midwife exam, however, it is also very different, as we are looking through the lens of a physical therapist and assessing range of motion, strength, trigger points, tightness, scar tissue, prolapse, pressure management and endurance. 

After we have collected all of this information and data, we will synthesize it all for you and develop what is the best plan of care for treatment Meaning, we will let you know how often we would recommend to  see you and what kinds of things we will work on to  resolve your symptoms and get you back to living your life to the fullest.  We want you doing everything you want to be able to do. We pride ourselves in providing very personalized care. During your evaluation with us, you will also receive individualized treatment and a home exercise program to get you jump started in the right direction.

 

Pelvic Floor Exam FAQ:

Why would I need an internal pelvic exam?

Certain important muscles and structures of the pelvis cannot be seen or assessed from the outside. Your pelvis is quite literally the grand central station of energy exchange in the body. Therefore, while we can see a lot and treat a lot from the outside, sometimes things are missed that could help someone fully resolve symptoms and heal, that’s where the internal exam comes into play. 

Does it hurt?

Short answer, sometimes! 

Long answer, many of us have tight/overactive muscles and as we assess them they may elicit your symptoms, pain or discomfort. Your therapist should be able to tell quickly and adjust pressure as needed for your comfort. The great news is, if you are tight/overactive/guarded, internal techniques are effective and efficient treatments and can be performed during the session with little to no discomfort. 

Best answer, when we find areas that are painful or uncomfortable we change our approach to treatment on the spot. The pelvic area is already sensitive, we do not need to create more pain! Our job is to make you comfortable and get you out of pain and discomfort. How do we do this? We perform what is called indirect manual therapy techniques that help ease trigger points and tender spots. Honestly, it seems like magic, but it’s science! Our patients are astounded at the results! 

What if I change my mind?

The nature of the internal exam can be triggering and might bring up feelings of discomfort or unexpected emotions. Your comfort is our highest priority! For these reasons, we as pelvic therapists say “consent is ongoing.” If at any point in the exam, for any reason at all, you want to stop, we are done! No hesitation, no questions asked! You are 100% in control of your body and treatment at all points in time. 

Most sessions we will spend time both inside and outside the pelvis. Remember everything is connected and you are a whole person. If we just spent time on the pelvic floor we would be missing so much! 

What if I have my period?

No problem! You can still attend your appointment! You are a whole person and we have plenty to work on both inside the pelvis and outside the pelvis. It doesn't make a difference to us as your provider. If it makes you uncomfortable, we can hold off on anything internal until the next session if that is what you feel is best. We would hate to cancel 1/4 of our patients because they are menstruating...and that is not ok! You deserve BETTER! 

Is it like a gynecological exam?

Yes but mostly no, let us explain…  

Similar:

  • We both perform internal exams

Different:

  • Pelvic PT’s do not use a speculum (the tool that holds your vagina open during a pap smear) we use one finger to assess the bones, ligaments, muscles and fascia. 
  • Pelvic PT’s spend 60 minutes with you each session. 
  • OB/GYNs and Midwives are looking at organ function, pregnancy progression, healing postpartum.Pelvic PT’s are looking at range of motion, strength, coordination, endurance, trigger points, prolapse, pressure management, etc.
  • Pelvic PT’s do the true “rehab” for everything down there from a musculoskeletal and neuromuscular standpoint. 

We look forward to serving, educating and empower you to become the expert of your own body!



Do you have pelvic floor dysfunction? Let our expert pelvic health physical therapist start your journey off on the right foot! We are here to help.

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