What Can I Expect During My First Pelvic Floor Exam?

It happens all the time. A client is referred to me because someone told them they could benefit from pelvic floor treatment but have no idea what to expect. Let me lay it down for you. We will start by getting to know each other and having you share your story of what brings you in. I will ask some follow up questions and establish your goals. 

Once assessment starts, I usually treat my initial pelvic floor evaluation like an orthopedic exam. First, I will observe your gait and posture, breathing patterns, and have you perform some general movements to get an idea of how you move.

Next, I will assess your spine, hips, pelvis, etc. basically anything that may be relevant. If you are postpartum I will get a little more technical checking for core bracing strategies, diastasis recti, c-section scar, and assess tissues that may have been impacted during pregnancy and labor. 

Next, I ask if the patient consents to an internal pelvic floor muscle examination. Sometimes we do this on the first visit but more often than not we perform this on the second visit if given consent. A pelvic floor muscle examination includes examining the vaginal muscles that are located both externally and internally. I will ask you to perform several functions such as a contraction, lengthening, coughing, etc. to look for how those muscles function and will also check for sensitivity/pain of those muscles. Lastly, we assess the strength, endurance, motor coordination of the pelvic floor muscles and possibly look for symptoms of prolapse.

We will finish the examination tying everything together, educate you on what we found and how therapy can help, and get started on your rehab journey! I like to give an overview of what to expect to save you time on guessing if this could be a valuable service and to have clear expectations when you walk into my clinic. 

Just a forewarning, not every pelvic floor therapist treats the same way. A lot of my education comes from taking courses through Herman and Wallace and the Institute for Birth Healing mixed in with various other styles of treatment. If you have more questions feel free to reach out or set up a 15 minute consultation to check if we would be a good fit.