Physical therapy pelvic floor assessments are different from gynecological exams. This type of examination is performed by a licensed physical therapist who has taken advanced coursework in pelvic rehabilitation. These type of assessments generally last 45 minutes and focus on assessing the muscles and connective tissue for strength, endurance, motor control, and pain. Pelvic floor physical therapy has been shown to cure or reduce symptoms of urinary incontinence, POP, bowel disorders, post-partum dysfunction, and pelvic pain disorders in a non-invasive manner, sometimes preventing surgery1. You do not need a physician referral to seek care; just give us a call and we can set you up with an appointment today!
So what happens in pelvic floor physical therapy?
- History
- During your initial evaluation, your physical therapist will take a detailed history about all of your symptoms.
- Your PT will want to know where and when you have pain, information about previous pregnancies/deliveries if applicable, prior surgeries, and bladder and bowel symptoms such as leakage, frequency, and urgency, straining, or constipation. Questions about sexual function may also be asked such as painful intercourse, fear of penetration, or difficulty with orgasm. Your PT may discuss diet, exercise, and medication use with you as well.
- Examination
- Functional Movement Assessment
- The pelvic floor is just a part of the examination. Your posture, movement patterns, breathing, and transitional movements are very important to figuring out the root cause of your dysfunction. If you are having difficulty with certain movements in your sport, these will be assessed specifically.
- Pelvic Floor Specific Assessment
- If the PT feels a more specific examination of the pelvic floor is necessary, you will be assessed in a private treatment room and comfortably positioned and draped before your PT visually inspects the perineal area (vaginal area) externally to look for any signs of inflammation or irritation.
- Next your PT will ask your consent to do an internal evaluation. This is only if you feel comfortable with this part! Your PT will insert a gloved finger into the vagina to feel for the pelvic muscles, to determine muscle tightness, symmetry and feel for trigger points/pain. Next your PT will measure how strong your pelvic floor muscles are by asking you to contract your muscles. Your PT may also assess for pelvic organ prolapse as well.
- Treatment and Education
- Finally, your PT will design a specific treatment plan individualized to your needs. This may include:
- Manual therapy externally or internally
- Strengthening exercises
- Relaxation exercises
- Behavioral strategies
- Sport or activity-specific strategies
- Functional Movement Assessment
Reference
- Wallace, S. L., Miller, L. D., & Mishra, K. (2019). Pelvic floor physical therapy in the treatment of pelvic floor dysfunction in women. Current Opinion in Obstetrics and Gynecology, 31(6), 485-493.