What to Expect with My First Pelvic Floor Appointment?

By, Gail O’Neill, PFPT

To some, Pelvic Floor Physical Therapy is familiar. Many other people have no idea that this exists. Pelvic Floor Dysfunction may affect Men, Women and Adolescents.

The first appointment is an hour-long Evaluation.  Our goal, as Pelvic Floor Therapists, is to decipher all of the contributing factors that may be involved with causing and/or contributing to our patient’s symptoms.  Some of these symptoms may include urinary and fecal incontinence (urgency, frequency and leaking), pelvic pain and spasm, pain with intercourse, chronic constipation- to name a few.

The first thing we do at the evaluation is to take a detailed history from our patient.  We encourage our patients to describe their symptoms in their own words.  We are interested in how long they have been experiencing these symptoms.  When did they begin? Did anything precipitate them?  Does anything alleviate or make them worse? How do they affect their ability to Urinate, have a Bowel Movement or have Intercourse?  How has this impacted their life?  Have they needed to modify their activities or work duties?

The answers to these questions give us clues as to what area we may want to delve in to more with our evaluation.  Once the interview phase is complete, we leave the room so that our patient can change into a gown.

The examination generally begins with a musculoskeletal exam where we observe the patient’s posture, alignment, and how the patient moves.  This is followed by a general assessment of gross muscle strength.  We then begin to palpate the abdomen, inner thighs, bony pelvis, spine and buttocks.  We are assessing to see if there are any areas of tightness and restriction, joint range of motion deficits and imbalances from one side of the body to the other.

Pelvic Floor

Our focus is then concentrated on the pelvic floor.  As Pelvic Floor Therapists, we receive extensive training to assess these muscles.  We are trained to conduct a Pelvic Floor Internal and External Exam.  Our Pelvic Floor Muscles are located in our bony pelvis behind the vaginal and rectal wall for a female and rectal wall for a male.  The only way to properly evaluate these muscles is to palpate them.  We are ascertaining their quality: muscle tone, presence of trigger points, motor control, and if appropriate their strength.

We are also able to determine the presence of an organ prolapse, diastasis recti, dermatologic issues, nerve entrapment and tissue integrity.

As part of our patient’s first visit, we begin the education phase of their treatment.  We have 3-dimentional models that have the bones, pelvic floor muscles and organs represented.  We systematically educate our patients regarding the proper function of all of these structures and how they relate to one another.  Deficits in one area may create a dysfunction in another.  We highlight the areas we have identified that are not working correctly or are dysfunctional.

The treatment plan is discussed with our patients as well as setting mutual goals for recovery.  These Goals are both Short Term- involving 1-2 visits and Long Term which may be 4-6 weeks depending on the severity of the impairments.

Our evaluations at Pelvic Health Solutions and subsequent treatment sessions are 1 hour in duration with the same therapist.  We pride ourselves in offering comprehensive treatment plans customized to each of our patient’s needs.

We have observed that greater than 50% of our patient population who have been compliant with our treatment strategies have demonstrated some improvement with symptoms and function in the first 2-4 weeks.

If you still have questions, please contact us.

We want to encourage you to get evaluated by one of our outstanding physical therapists, and regain control of your life. Pelvic pain, pelvic floor dysfunction, back pain, tailbone pain—you name it—these conditions do not have to control your life. There is hope. Call us today to book an appointment at (561) 899-7747 for Pelvic Health Solutions.