What to Expect When you Visit a Pelvic Floor PT
Most of the people I treat at our Pelvic Health clinic have one thing in common—they put off seeking treatment for a long time! People don’t think twice about visiting an Orthopedic PT if they have a sore shoulder or ongoing issues with a sprained ankle. But when it comes to addressing pain and problems that specifically impact bowel, bladder, or sexual health, patients are likely to put off getting medical attention for months or even years—even when it’s causing a lot of pain or anxiety.
And it’s completely understandable! These things can be difficult to deal with – but they don’t have to be! A Pelvic Floor PT can help you when you are experiencing pain or problems affecting your pelvic, sexual, bowel and/or urinary health. Conditions such as chronic constipation, urinary or fecal incontinence, painful intercourse, pelvic pain, and the physical impact of pregnancy, childbirth, or aging can all be addressed with a Pelvic Floor PT.
These are intimate issues, and it’s normal to feel nervous. So it is the job of a Pelvic Floor PT to not only get to the root of the problem and help you to understand, but to make sure you are comfortable during the treatment process and help to support you on your journey to overall health.
Which is why I put together this blog post to help you better understand what seeing a Pelvic Floor PT looks like!
What a Pelvic Floor PT Appointment Looks like
If you have ever visited an Orthopedic PT before, the first appointment with a Pelvic Floor PT is pretty much the same as a “regular” PT appointment!
Your Pelvic Floor PT will discuss what has brought you into the clinic – taking a general health history and asking you relevant questions to understand the exact symptoms you are experiencing.
There will be a traditional PT examination and evaluation, assessing muscle function, posture, breathing, and range of movement. There will also be a focus on the soft tissues of the lower back, pelvis, hips and abdomen, as this can impact the pelvis.
Your PT may also recommend assessing the function of your pelvic floor muscles with a physical examination of your vulva, vagina, or rectum. However, it is up to you whether or when you are comfortable to progress with this stage. It may be recommended in the initial treatment or further down the line, and you can decide if you want to go ahead with the exam at that appointment, next appointment, or ever.
Your PT will then provide you with extensive education regarding the anatomy, function, and role of the pelvic floor. You will then be given exercises that focus on strengthening and stretching the key muscles that support the unique pelvic anatomy, targeting the respiratory diaphragm, hips, lower back and pelvic floor. You may also be given instructions on pain management, toileting, and/or stress management strategies.
Important things to know
- External or internal pelvic floor examinations are not mandatory
- Your consent will be asked and repeatedly checked in on during the examination
- You are in control of the process. If you want to stop, we stop. If you need a break, we take a break!
What Is a Pelvic Floor Examination?
If you do consent to a pelvic floor examination, here is a little more about the benefits and process.
What Are The Benefits of a Pelvic Floor Examination?
The pelvic floor muscles, or the Levator Ani and Coccygeus muscle groups, can become overly tight or underactive leading to pain, discomfort or multiple issues that can affect your wellbeing.
A pelvic floor examination is the best way to assess the function of these muscles, and identify specifically which individual muscles are functioning incorrectly. From here, the PT treatment and take-home exercises can be further tailored for your unique body.
What Happens in a Pelvic Floor Examination?
The engagement and release of the pelvic floor muscles affects the external and internal muscles of the vulva and vagina, the penis, the perineum, and the rectum. A pelvic floor examination involves physically assessing the function of these muscles either externally, internally, or both.
First, an external examination involves looking at, assessing and palpating the outer muscles of the vulva or rectum to check for pain, prolapse or other conditions.
Secondly, an internal examination involves inserting one or two gloved fingers into either the vaginal or rectal canal to assess strength and check for painful, tender, or numb areas.
With both external and internal examination, you will be asked to contract and release your pelvic floor muscles (like a Kegel exercise) to determine if the muscles are functioning as they should or if they are under or overactive.
And that’s it!
Your PT will explain exactly what they have found and how PT can be helpful, so you can understand and connect to what it is you are feeling and experiencing. During the examination, your PT will be sure to talk you through the process from start to finish, explaining each step as they are going. Your PT will also repeatedly check in that you are okay to proceed, and you can also request to stop at any time.
Do I Have to Have a Pelvic Floor Examination?
Although the exact diagnosis of many conditions benefit from a pelvic floor examination, what is most important is considering your entire wellbeing. If a pelvic floor examination is going to cause excessive emotional or physical discomfort, or traumatizing in any way, then this isn’t going to be helpful for you and therefore it won’t be recommended.
So no! It is essential to know that if you do not want to have an external or internal examination of your pelvic floor function, then you do not have to have one.
There are many other ways of treating pelvic floor dysfunction, and the musculoskeletal conditions that impact it, such as targeting the lower back and hips through massage and exercises, as well as emotional regulation and stress management techniques.
A Holistic Approach
Stress levels, lifestyle, and emotional wellbeing hugely impact our physical health, affecting everything from posture to pelvic floor engagement.
At SOPTRI both myself (Sylvie Le) and Ellyn Wertella serve as specialized Pelvic Health PTs. We both work to integrate education, behavior modification, yoga, diet, and exercise into our treatment plans. Many of our patient’s have found the relaxation and breathing techniques, such as belly breathing, that is frequently recommended to be invaluable in their wellness journey as these techniques support the nervous system and psychological health.
To find out more about SOPTRI’s Women’s Health clinic, or to make an appointment with Sylvie contact our Warwick clinic. (401) 384-6490 or make an appointment here.
Author: Sylvie Le, DPT, PYTC