Issues related to the pelvic floor are, by nature, very private and sensitive. If you are scheduled for a physical therapy evaluation for issues related to the pelvic floor, you may be wondering what that entails. Ease any potential anxieties about the unknown by educating yourself on what to expect at your pelvic floor evaluation:  

Discussion of Medical History

Your therapist will begin by asking you several questions to get a better idea of your pelvic floor experience. After a thorough review of your medical history, you’ll give information about your pelvic floor condition and the reason for seeking treatment. You will also go over details about your pelvic health and may be asked to fill out a questionnaire with specific questions related to bowel, bladder, and sexual function.  

To make the most of this time, be prepared to answer questions about:

  • Any medications, surgeries and other medical conditions
  • How your current symptoms began
  • The location, nature, frequency, and intensity of your symptoms
  • Activities, positions or movements that affect symptoms
  • Your goals and what you would like to achieve through physical therapy

Physical Examination

Once you’ve gone over all pertinent information with your physical therapist, they will begin a detailed physical evaluation. A PT will likely observe your posture, alignment, and how you move. Tests and measurements of balance, strength, flexibility, range of motion, sensation, and coordination may also take place.

After an overall body assessment, your therapist will examine the structures of the pelvis. Thorough pelvic floor muscle exams require patients to undress from the waist down to enable visual inspection of the area. An external and internal exam will give information about pelvic floor muscles and soft tissues related to:

  • Strength, endurance, and coordination
  • Symmetry and bulk
  • Awareness
  • Presence of pain or tension

Because the pelvic floor is a private area, your therapist will only perform the internal examination with explicit consent from the patient. You may also bring along a chaperone if it makes the process more comfortable for you. Other situations that may limit or inhibit an internal exam taking place include:

  • Immediately postpartum patients (it is typically best to wait six weeks after giving birth to undergo a pelvic floor exam)
  • Post-operative patients (wait less than six weeks for pelvic floor exam unless an MD approves otherwise)
  • Current infection
  • Severe pelvic pain
  • Pediatric clients or patients without prior pelvic examination

Assessment

After getting the full picture of the cause or causes for your discomfort, your physical therapist will discuss the findings with you. Any imbalances contributing to your symptoms will be reviewed, and you’ll receive recommendations on the best course of treatment. 

Be prepared to ask for clarification if something doesn’t make sense, let your therapist know if they left out something important to you, and follow up with any next steps or questions you may have about moving forward.

Treatment Plan

Once you have a better understanding of the reason for your symptoms and treatment options, your physical therapist will work with you to determine a plan of action. Considering the recommendations together, you will agree on the number of follow-up visits that work best for your budget, schedule, and treatment plan. Your therapist may give you a few exercises to implement at home to focus on any imbalances they found during the examination.

To make the most of this time, be prepared to:

  • Understand your role in recovery and your ultimate functional goals
  • Perform a few exercises or movements
  • Bring your calendar to know when you will be able to return

The plan for pelvic floor rehab depends on how long the problem has occurred and how severe symptoms are. Physical therapists have the privilege of spending the most time with patients compared to the many other clinicians of the medical community. With that time, PTs are better able to understand the problem, give details explanations to patients, and help them organize the rest of the medical team when a multidisciplinary approach is necessary. 

At SET Physical Therapy, we want you to be comfortable and empowered throughout every type of exam and treatment. Our practice features private rooms and knowledgeable therapists are who are ready to listen. Reach out to Set PT today to schedule your pelvic floor exam!