First of all, congratulations!

You’ve booked (or want to book) your initial evaluation with us at Pelvic Health and Wellness! We’re here to help you understand what to expect at your pelvic floor physical therapy evaluation. Our goal is to ease your nerves and ensure a positive experience.

First, we listen and chat

The first thing we do is listen to your story. You can expect to talk a lot at your first visit to give us a thorough understanding of your current symptoms and the history of how they developed. We’ll ask different (often very specific) questions about:

• Bladder and bowel health

• Sexual health

• General physical health/activity

• Other aches/pains/injuries/surgeries 

• Childbirth/fertility/menstrual history

• Hydration and food

• Home/work demands 

• Sleep quality

• Stress management

After we’ve gathered this information, we’ll move on to the physical evaluation. The pelvic floor functions as part of the body, so it’s essential for us to get an idea of how your whole body is moving. We’ll do a screen that takes into account your posture, breathing, muscle tightness/flexibility, muscle weakness, and strengths. Often, this includes an assessment of the spine, hips, and abdomen in addition to anything else relevant from head to toe. 

Internal evaluations

This part doesn’t need to be scary! I want to preface this section by saying *We will ONLY do an internal evaluation/treatment with your full, informed consent, and you will NEVER be required to have one.

*DEEP BREATH IN, DEEP BREATH OUT*

What is an internal pelvic floor evaluation, and why do we do it? 

An internal pelvic floor muscle assessment means using one finger (while wearing gloves and using lubricant) to palpate (press on) each muscle within the pelvic floor. It gives us a way to directly assess the pelvic floor muscles. 

The table is typically set up with a pad underneath you and a sheet to pull over the top of yourself. We step out of the room for you to undress from the waist down and lay on your back underneath the sheet. When you’re ready, we come back in and help position your legs so your knees are supported by pillows. No stirrups here!

We will start the assessment at the vulvar/perineal/anal tissues externally (as relevant to your anatomy) to check for skin health and palpate muscles that are near the surface. We communicate with you the entire time about where we are pressing, what the muscles feel like, and ask for your feedback. We progress to palpating internally in the vaginal canal (or rectum as appropriate). We assess muscle restriction, hypo- or hypersensitivity, strength, ability to lengthen the muscles, pelvic organ prolapse, and any tissue tenderness. 

When do we NOT do an internal evaluation?

There are times when an internal assessment is not appropriate. That includes, but is not limited to:

• Being less than 6 weeks postpartum

• If there’s an active infection

• If there is significant pain or fear of pain with an internal evaluation

• You don’t consent to one

One of the best parts of our job is that we individualize our assessment for you! If you’re only comfortable with us visually checking the tissues or palpating the muscles outside of the canal, then that’s what we’ll do. If you want to wait a few visits (or more) before having an internal assessment, we’ll wait. If you never wish to have an internal evaluation, that’s okay, too.

Next steps

At the end of the assessment, we’ll summarize our findings, discuss how often we would like to see you, and give you at least 1-2 things to start working on at home to reach your goals. 

Hopefully, this provides clarity about what a pelvic floor evaluation is like here at Pelvic Health and Wellness, and you feel confident that you’ll get the care you deserve. We’re so excited to work with you and can’t wait to see you soon!

About Pelvic Health & Wellness

Pelvic Health & Wellness was built with you in mind. We practice whole-person, individualized pelvic floor physical therapy in a caring and safe environment. Our therapists specialize in treating pelvic health concerns such as pain, incontinence, prolapse, constipation, and various pregnancy and postpartum-related conditions.

We understand that being ready to talk about and address your pelvic floor wellness concerns comes from a place of strength. Our physical therapists are here to support and encourage you on your journey back to pelvic health so you can get back to doing what you love!

If you are ready to take the first step in reclaiming your pelvic health and wellness, contact us today.