Before Your First Visit
Make a list of questions that you have to discuss on your first visit.
List signs and symptoms that can be of importance to the therapist.
Have in writing key past medical history, previous treatments, current medications, and other important information.
Your history:
During an initial evaluation, I spend as much time as you need telling your story of what brought you into the clinic. For those with pelvic issues, I will also ask questions related to your bowel, bladder and sexual health. Some of you may feel very comfortable with this type of questioning and for others, this may be new and even uncomfortable. I am very comfortable discussing these topics and will meet you where you’re at. These questions allow me to develop a more complete picture of what might be contributing to your area(s) of concern.
What To Expect At Your Appointment:
During a musculoskeletal exam, I like to look at everything, from your head to your toes, as everything is connected and a want to get a complete assessment of your body. I will take a look at your posture to examine your alignment and watch to see how you move as it will give me an indication of how you perform functional activities. If you are coming to see me for a pelvic exam, it is my goal that you feel you are a part of this process and you feel in control. Every initial examination is personalized based on your history and presentation, so my assessment will be based on my cumulative findings and your treatment will be designed to fit your needs.
Please also know that as physical therapists we frequently use touch to help identify “trouble spots,” but if touch is something that feels triggering or uncomfortable for you, I have other tools and techniques and will discuss what feels best for your experience.
Pelvic Exam:
An internal assessment is never required for my benefit and is something that I will discuss with you at your appointment. I don’t always have to perform a pelvic exam, but it may be necessary for me to assess why you are having pain or incontinence. It is common for pelvic floor muscles to be weak, hold tension or have coordination issues and the internal and/or external assessment will allow me to assess what is going on with your pelvic floor muscles.. An external assessment involves visually observing your perineal region (think space from pubic bone to tailbone and between your sits bones) as you try to contract, relax and lengthen these muscles. An internal vaginal or rectal assessment involves inserting one gloved examining finger with the use of lubricant to assess muscle strength and tension. These techniques are only performed if you are comfortable and you are always in charge.