What to expect at your Pelvic Floor PT evaluation
So you’ve decided to begin pelvic floor physical therapy? Congratulations! Either your doctor suggested you give it a try, or you had to do your own research to get here. However you have reached this point, you are likely nervous and unsure of what to expect. You have heard some things about “internal” pelvic floor treatment, but what does that really mean? Well look no further, let me prepare you for your first visit!
When you arrive to your initial evaluation you will meet your physical therapist. At Pelvic Core PT, your therapist is a doctor of physical therapy, who has had advanced training to specialize in the pelvic floor. They are extremely passionate about all things pelvic floor and are excited to hear your story. Side note* if you are wondering what the heck we are talking about when we say pelvic floor - the pelvic floor consists of bones, connective tissue, and muscles that support your bowel, bladder, and sexual function. It is also an important transition area between your low back and hips, which is why it can often be a missing piece when addressing orthopedic complaints.
Ok back to your evaluation… your therapist will take you to a private room where you will have time to explain your concerns and discuss the history of your symptoms. The PT will ask you detailed questions to get a better idea of what could be causing your symptoms. You will be allowed as much time as you need to talk and ask questions before moving forward with the examination. This is the time to bring up anything and everything, even if you think it’s unrelated, it truly might be important! At times even accidents and injuries from childhood can be related to pelvic floor symptoms as an adult.
After taking your history, the therapist will explain the next steps with you in detail. This will likely involve an external musculoskeletal exam and an internal pelvic floor muscle assessment. The musculoskeletal exam will look at the range of motion in your back, hips, and ankles. Your PT will check the strength in your legs and core, assess your breathing mechanics, look at postural considerations related to the pelvis, and look at functional movements in standing such as squatting or lifting. We may even look at your neck and jaw because they are closely connected to the pelvic floor!
An internal pelvic floor muscle assessment may be performed at your initial examination. It will only be performed with full consent and comfort of the patient. You are always welcome to bring a chaperone if you would feel more comfortable with your partner or a friend present. This portion of the examination will involve the therapist using one gloved finger with hypoallergenic lubricant, to examine the external and internal muscles of your pelvic floor. It can either be assessed rectally or vaginally, depending on anatomy and complaints. The PT will feel for muscle tightness, scar tissue, and strength, as well as looking for coordination of the muscles with breathing, coughing, and bearing down (like pushing for a bowel movement). There are no speculums involved in your pelvic floor physical therapy, and your comfort is our main concern.
Once the therapist completes the evaluation, they will discuss findings with you to make sure that you understand everything. Based on the findings, you and your therapist will create a plan that involves lifestyle changes (such as drinking more water, dietary considerations, identifying bladder irritants, or changing your bathroom routines), exercises, and manual therapy in order to meet your goals. You will go home with some homework and a better understanding of your body, and this can often feel extremely empowering!
We truly believe pelvic floor physical therapy is for anybody, all genders, and all stages of life.