What to Expect at Your First Pelvic Floor Physical Therapy Appointment

 1 in 3 of ALL women will experience some sort of pelvic floor disorder in their lifetime!

Think back to Pre-Covid times… ahh. Not too long though! If you were in public and looked left and right. At least one of those women you saw (or maybe it was you too)  has a pelvic floor condition!  Yet, there is still stigma and taboo discussing pelvic floor problems.

 Common issues that are often related to pelvic floor dysfunction include:

Loss of urine, gas or feces, incomplete emptying of bladder or bowel, frequent or urgent urination/bowel movements, recurrent UTI’s, painful urination, difficult with or painful orgasms, pain with arousal, painful penetration (sexual, tampon, medical exam), constipation, painful periods,  pelvic pain, SIJ pain, low back pain, tailbone pain ect

If one, or more,  of these things has been bothering you, you may benefit from treatment by a pelvic floor physical therapist.  

Even once people know they may benefit from pelvic floor PT,  it is not uncommon to be worried or confused about what is going to happen at a pelvic floor PT evaluation.

This summary is here to help provide you with as much information as possible to help you feel comfortable and prepared in order to have the best experience with any pelvic floor PT.

 Often not knowing is the worst part!

I always make it abundantly clear that you may stop this assessment at any time or refuse any assessment/movement you would not like to. Your therapist should be constantly checking in with you throughout to gain and re-gain ongoing consent.

You are also  entitled to a “Chaperone” to sit in the room when with a health care provider in a private room if that is what you would like. You may provide your own or one can be provided for you.

Next, I will to go over every aspect of an evaluation (as I would do it)  so you know what to expect at this first visit.

 INTAKE FORMS:

 Our intake forms are very detailed and thorough, they include, questions all about bladder, bowel, sexual function, pregnancy, stress, diet, water intake ect . I know this may seem overwhelming or uncomfortable to fill out. Feel free to put as much or a little information into these forms as you would like. We will always discuss more when you arrive and when/if you feel comfortable. 

HISTORY:

 When you arrive and forms are complete you will come back into a private office and often you will review items from your intake form as well as many others. While we always want you to feel comfortable, and you have every right not to share, often symptoms related to the bladder, bowel or sexual function seem embarrassing.  It is often helpful for patients to know that in this speciality we have heard it all! Often the symptoms you are experiencing are very common and we hear them

ALL. THE. TIME.

 As always, as long as you are comfortable, I encourage you not to hold back. *

*There are circumstances in which I as a healthcare provider am obligated to report items told to me by a patient. In cases of active physical or sexual abuse or imminent suicide I am obligated to reports to the appropriate authorities. I always share this with clients so you can choose if you are ready to disclose this information to me or not.

PHYSICAL EXAM:

 This part of the exam you will be fully clothed.

Global Movement Exam: Since our body is a system we begin by looking at how you move. Sometimes, depending on your history we will also assess various functional tasks like squatting to jumping to running. 

Special Tests: We will then assess some more specific mobility and strength tests of your global muscles and joints as well as some special tests of the body to help us understand your unique patterns/compensations

Palpation: We may feel your abdomen and rib cage to assess thoracic and abdominal mobility as well as your breathing patterns.

We often can gain plenty of valuable information from this much of our exam. If this is all we have time for or all you are comfortable with the first day that is 100% ok!

PELVIC FLOOR MUSCLE ASSESSMENT:

At this section of the exam if you would like to proceed, you will undress from the waist down and will be provided with a sheet for over your waist and will lay on a soft table covered in a sheet also.  We don’t use stirrups or crunch paper gowns, which people are often happy about!

The therapist will then look at the muscles and the outer structures of your pelvis. They may ask you to contract, relax or gently bear down with these muscles to assess their mobility. They will then lightly touch the outside muscles on the surface to see if they are tender or in pain and how certain tissues move.

Next, they can assess these muscles in more detail by inserting a gloved lubricated finger into your vagina and or rectum (with consent) in order to assess for tenderness, pain, as well as the strength, endurance and coordination of these muscles. This internal exam should NOT be painful. We gather a lot of helpful information from this internal assessment but some people are not ready for this and that is OK. The goal is for you to leave this appointment confident and comfortable, not in pain.

 PLAN:

After the assessment your therapist should have a fairly good idea of the areas you need to work on in order to help you reach your goals. We are often providing education to you all along the assessment but we will use this time to discuss any further questions you have. We will also discuss your PT exercises and activities which you will complete on your own which are very important!

We will then discuss how often you will need to see your PT and start to estimate how long it will take to meet these goals. Sometimes our timelines and our expectations change but this provides us a rough guide.  

Starting January 2021 Hayley will be seeing clients in person in her space in Aberdeen, NC as well as virtual clients who reside in North Carolina