Most women I see have been to a gynecologist before, so they kind of know what to expect as far as undressing from the waist down, draping, and the area about to be examined. However, there are also huge differences between an ob/gyn exam and a pelvic floor PT exam. The field of gynecology is looking at the health of the pelvis; I’m looking at it’s function.
Where do we start?
I start with an interview process where we talk about the concerns that brought you to see me. Next, I typically screen for hip and back problems that may be related to your diagnosis. Then the patient lies on a table, appropriately draped, and I examine the abdomen and front of the pelvis. Then I move to the pelvic floor. I do a quick visual assessment of the outside and test for sensitivity. Finally, I exam the pelvic floor muscles internally using one little gloved lubricated finger. I move very slowly with patients that have pain. I will assess your muscle tone, bulk, strength, endurance, coordination, sensation, trigger points, scar tissue and any painful areas. I’ll also assess reflexes and check for prolapse.
Depending on your diagnosis, I may suggest a rectal exam (especially for fecal incontinence and anal prolapse). Depending on your condition, I may spend more time assessing the abdomen (especially for postpartum and endometriosis). If you also have back pain or scoliosis or another possibly related condition, I’ll check that too.
Every exam is a little different because every person is different.
What’s the plan?
At the end, we discuss the findings. I go over the parts of the exam that were really positive and the parts that need some improvement. We talk about how the findings relate to your symptoms, how they might show up in your life in other ways, and how to start making changes to improve your symptoms.We come up with a treatment plan that includes your short term and long term goals. You will leave knowing that you have what you need to start seeing changes very soon.
Will you be comfortable?
I try to make the experience as comfortable as possible. For your physical comfort, I don’t use stirrups or a speculum and you’ll be covered in super soft sheets. For your emotional comfort, you are welcome to bring someone to be in the room with you. This is especially helpful sometimes with people who have a history of trauma.
I am very outspoken about body autonomy. I always make it clear that this is your evaluation and you are in charge. I will tell you what I’d suggest during evaluation and treatment based on my professional experience, but it’s you who approves or declines. I want to be on your healthcare team and I will always respect your boundaries and comfort level.
I’m a wife and a mother of two. I understand the pain, frustration, and embarrassment that can accompany pelvic floor problems. I have been providing compassionate care for 15 years and I’m happy to do whatever I can to help you feel comfortable and cared for.
I hope you get the care you need
Whether you see me or another pelvic floor physical therapist, I hope you get the care you need. Soon! I see so many women after years of living with their problems because they didn’t know that pelvic floor physical therapy existed. Other women just thought their problems were “normal.” We women need to stop telling ourselves and each other that pain, incontinence, constipation, or anything else that bothers us is “normal.” It might be common, but it’s not normal. And we can fix it!
If you’re ready to dive in an work with me, schedule an appointment to see me in real life!
Curious but not ready to plunge in just yet? You can buy my book for women looking to boost intimacy with their partner while taking charge of their lives (in and out of the bedroom)!