What To Expect At Your Appointment:
Whether you have seen a pelvic health physical therapist in the past, or this is your first time, many folks have questions about what will happen during an initial pelvic evaluation. Above all, it is our goal that you feel you are a part of this process rather than feeling poked and prodded. We pride ourselves on offering a very customized experience right down to your first visit. So, while there are some components to an initial evaluation that commonly occur, it is impossible to say exactly what your initial evaluation will look like. However, we also understand that it can help put your mind at ease to have a general idea of what to expect.
Please also know that as physical therapists we frequently use touch to help identify “trouble spots,” but if touch is something that feels triggering or uncomfortable for you, we have other tools and techniques and will discuss what feels best for your experience.
Below are common components of a first visit.
Your History:
During an initial evaluation we spend as much time as you need telling your story of what brought you into our clinic. We will also ask questions related to your bowel, bladder and sexual health. Some of you may feel very comfortable with this type of questioning and for others, this may be new and even uncomfortable. Rest assured we are very comfortable discussing these topics and will meet you where you’re at. These questions allow us to develop a more complete picture of what might be contributing to your area(s) of concern.
Pelvic Floor Physical Therapy
Posture and Functional Movement Screening: How you sit, stand, squat, lift and perform all your daily activities give us information about what muscles are or are not functioning well.
Joint and Muscle Palpation:
Involves applying gentle pressure to different structures in your body to let us know if a joint is optimally positioned and the state of your muscles (ie. tension, trigger points, or decreased activity).
Breathing:
Observing how you breathe, where in your body your breath travels easily and where it may be restricted. We may also place our hands on or around your ribcage to see how it feels as you breathe.
Pelvic Exam:
It is common for pelvic floor muscles to be weak, hold tension or have coordination issues and an internal and/or external assessment may be conducted to assess what is going on with your pelvic floor muscles.. An external assessment involves visually observing your perineal region (think space from pubic bone to tailbone and between your sits bones) as you try to contract, relax and lengthen these muscles. An internal vaginal or rectal assessment involves inserting one gloved examining finger with the use of lubricant to assess muscle strength and tension. An internal assessment is never required for our benefit and something that your provider will discuss with you at your appointment.
Therapeutic Somatic Processing (TSP),™
TSP™ will typically not look like a normal pelvic floor visit. Although we are usually addressing the same concerns as pelvic floor, we do so from a different perspective. That perspective is one that centers upon the fact that many pain presentations stem from a place of protection and need for safety within one’s body. Therefore TSP™ appointments often include no touch from the therapist to the patient, and will often ignore any form of treatment table or exercise. Instead you will work with your practitioner to gain awareness of your own somatic holding patterns and how to slowly undo them. Your therapist will introduce tools that allow you to manage your pain without dependence upon a practitioner. These tools might include areas of breathwork, functional movement (the way you already move on a daily basis), learning consensual touch, learning how to recognize safety and your genuine yes/no, or understanding your own anatomy so that the medical picture becomes clearer.