What does a pelvic floor exam by a pelvic floor physical therapist look like?
What can I expect from a pelvic floor exam? Is one of the most common questions we get! People want to know: what are you going to do to me?!
I always smile, pause, and breathe. Here is my answer: Well first you will fill out the online paper work, prior to your appointment, then your therapist will go over it with you in person and ask any remaining questions. Discuss any concerns. Then she will get out the pelvic model and explain the anatomy of the pelvic floor and how it should work. She will likely go into some hypothesis as to what is going on. From there, with your PERMISSION she will step out and have you undress from the waist down with a gown to cover yourself and she will come back in to do a pelvic floor MUSCLE exam. Again, with your PERMISSION, she will perform an exam where she may insert one gloved finger in the vagina or anus. After the exam, your findings and a treatment plan will be explained to you along with a home program for you to begin with at home on day 1!
Well! That is A LOT of words, and since I have been saying this a lot, I say it fast- probably too fast. People essentially “nod” through the phone but let's actually go into this:
1. Paperwork, we all hate it, but it is a necessary evil! First we do need consent and CYA’s signed off on, but also the questionnaire is really thorough. It gives us an opportunity to thoroughly screen you for other issues. Perhaps you are coming in for incontinence but coincidently have constipation? Or Pelvic pain, but also experience prolapse? Or if you are pregnant with a heart condition? All those things are things for us to consider when devising a unique treatment plan. And frankly there isn’t enough time in our 60 minute appointments to screen for everything. This really allows us to work smarter and faster- for you!
2. Once you come in, we will bring you back to a treatment room and we chat! With your clothes on! Yay, ha! We will ask for clarification on anything- perhaps you wrote that you go to the bathroom ‘all the time,’ what does that mean? If you are a chronic pain patient we want to hear your story- what happened 17 years ago? There is no such thing as too much information!
3. We will step out and let you change into a gown, and knock before coming back in. And again, look you in the eyes and ask for consent to perform a pelvic floor exam. Are you comfortable? It is important to know that even though you signed the consent form, and said yes, your body language needs to say yes. If you disassociate or start shaking we will stop. It's like tea. Just because you said you wanted the tea, you can still choose not to drink it- NO ONE is forcing you, and no one will make you feel bad for not drinking it!
4. A pelvic floor exam included one gloved finger in the vagina (or anus). Yes we use lubricant. NO stirrups and NO speculums! We will palpate the muscles inside to see are they weak? Strong? Tight? Normal? Can they contract on command (aka kegel), can they relax? Do they reflexively contract when you cough? All of this is information we need to properly treat you!
5. Once the exam is finished, we will let you get dressed. Explain your results and come up with a program of 3-5 exercises for you to do at home between appointments. Remember it is a dialogue, so it can change!
So I hope this answers any questions you might have! If you have more please reach out to us at info@empoweryourselfpt.com or call us at 832-463-1152.