Written By: Naomi Dillon PT, DPT
- A Thorough History
Before determining if you are a candidate for an internal examination of your pelvic floor, you and your therapist will thoroughly discuss your previous history, including if you’ve had any children, if you have pain with sex, if and when you leak, and the history of your cycle. To assist your therapist determine the root cause of your pelvic symptoms, it is critical to be as open as you are comfortable being with them.
- A Pelvic Assessment
If you are a candidate for pelvic floor therapy, based on what your therapist hears during your history, your therapist will ask your consent for an external exam and/or an internal exam.
- External
During the external portion of your exam, your therapist will assess for muscle tension and tender points by palpating your pelvic floor musculature. This can be done over clothing, or with unclothed palpation.
External examination also includes assessment of the skin surrounding the vaginal opening, assessing different reflexes, and your pelvic floor’s ability to contract or relax during different activities.
- Internal
With patient consent, the therapist will then assess internal structures. With an internal exam, your therapist will be able to assess muscular strength, endurance, power, and your ability to properly complete a pelvic floor muscle contraction. They will also assess different portions of your pelvic floor musculature, in order to determine any tender points or tension within the muscle that could be contributing to your pain. If you have symptoms of pelvic organ prolapse, your therapist will also be able to determine the severity of your prolapse via internal examination. You as the patient are able to stop the internal exam at any time and for any reason.
- Education On Your Condition
Following your examination, your therapist will educate you on their findings, the contributing factors to your condition, and may help guide you through a proper muscle contraction or relaxation.
- Setting Goals and Creating a Plan
Following education on your condition, you and your therapist will discuss what your primary limitations are that you wish to get back to.
- Prescription of a Home Exercise Program
At the end of your session, your therapist will discuss your home program with you. They will follow up with an email containing your home program, to assist you in achieving your goals.
