There is typically a sense of anxiety that comes along with your first visit to a pelvic health therapist. What can I expect from this visit? What exactly are we going to do? How uncomfortable will it be to discuss the ins-and-outs of peeing, pooping and sexual function? Is the internal exam really necessary?
Fear not, the first objective of your initial visit with a pelvic health therapist is to make sure you’re comfortable and at ease! The beginning of the visit will consist of an interview and discussion about why you’re interested in therapy, what you feel is going on with your body and what your personal goals and expectations are. Your therapist will ask you questions about your health history, bathroom habits, sex life, exercise routine, and diet. These questions and how you answer them are integral in understanding the dysfunction and developing your plan of care…so be as honest and candid as you can! Along the way your therapist will be able to answer any questions you have and can provide education and insight as to what is normal versus abnormal. Ultimately, the pelvic health therapists who carry out this work are highly trained, sensitive professionals who will discuss these issues with you thoroughly before continuing on to the next portion of the visit.
Second, a neuromuscular assessment will be performed. This typically includes a head-to-toe postural assessment, a functional movement screen, a neurological screen and an external exam of the musculoskeletal system. After the external assessment your therapist will be able to determine whether or not an internal assessment of your pelvic floor is necessary. Prior to an internal assessment, your therapist should thoroughly explain what to expect and can provide visuals of the anatomy that will be assessed. The provider will ask for your consent prior to beginning the internal assessment and you have the right to change your mind at anytime!
Ask questions if anything is unclear! Most pelvic health therapists have a number of educational tools to match your learning style and help you understand WHY things are happening. Understanding the anatomy of our body, how things are connected, and why you are experiencing what you’re experiencing is the first step in healing.
For the internal assessment, you will be asked to undress from the waist down, get into a comfortable position and should be provided with a drape to cover yourself. There are no instruments used, just gloves and lubrication. Providers will use one finger inserted into the vaginal or rectal canal to assess the structures of the pelvic floor. The therapist may ask you to contract or relax the muscles, and/or may ask you to cough or bear down during the assessment to get an idea of how your muscles are functioning with increases in abdominal pressure. This step is integral in understanding the big picture of where your muscles are in their present state. The internal assessment allows the therapist to understand which pelvic floor muscles are weak, tight or not moving appropriately. Completing the internal assessment will help to guide the overall approach of your treatment.
After the interview, external assessment and internal assessment, the provider will collaborate with you to develop a treatment plan that is best designed to help you reach your goals.
To health + wellness for your pelvis,
Kelly