I know that it can feel really scary to make that first phone call to a pelvic floor therapist, but I want to tell you that it will be worth it! I get on phone calls with new patients at least once a week to help them better understand the landscape of that first visit.
What should you expect from your first visit to a pelvic floor physical therapist?
A conversation
This will be about about your concerns, symptoms, goals, and past medical history.
I will talk about what might be contributing to your symptoms either from the musculoskeletal stand point or from a more medical standpoint.
This can be a quick conversation lasting maybe 10-15 minutes or it can be the bulk of our evaluation time depending on your history and symptoms.
An orthopedic movement assessment
If I’ve done a good job of learning about your symptoms and medical history, I will have a good understanding of what structures are contributing to your symptoms. That conversation will drive the assessment part of your evaluation
The evaluation might look like a movement assessment of your spine or hip. It might look like an in depth assessment of your core muscles and how they are working through a variety of movements. It might be a combination of all of these areas. This is the type of assessment most people expect from a traditional physical therapy assessment.
The pelvic floor is part of a larger system and if I miss a problem elsewhere (back, hip, core, etc) in this system, the pelvic floor piece will be meaningless.
Maybe a pelvic floor evaluation--this totally depends on your comfort level!
The pelvic floor muscle assessment is different from your traditional medical exam because I don’t use stirrups or a speculum to do my assessment. I just use a gloved hand.
Your medical provider has an end goal with their pelvic exams because they need to assess your organs.
A pelvic floor muscle assessment can be done externally around the genitals and rectum. This can give me a ton of information about how these muscles are working.
A pelvic floor muscle assessment can also be done internally. I can assess those muscles through the vagina and/or the rectum. The decision to do an internal evaluation of these muscles will depend on your symptoms and comfort level. Palpating the pelvic floor muscles is very similar to palpating the quadriceps in a patient with knee pain. I am looking for tightness in the muscle that would contribute to pain or limit the muscle from getting stronger.
I will check to see if you can contract those muscles, relax the muscles, and gently lengthen the muscles. Again, this tells me a lot about the function of your pelvic floor muscles.
If you consent to a pelvic floor muscle assessment and at any point you start to feel uncomfortable and want to stop, then tell your therapist. They will stop the exam.
And lastly, another conversation about the findings from the evaluation and how your therapist is going to help you meet your goals.
The first and last conversations are the most important part of the evaluation. If you need help finding a pelvic floor therapist in your area, check out my blog here for links to the most commonly used directories for pelvic floor physical therapists. If you have any other questions, please feel free to reach out! I’m always happy to help!