A LOT of talking. The functions of the pelvic floor affect many other organs and systems, and we want to make sure that we have an understanding of anything else that is affecting these muscle groups. We ask a lot of questions related to your pain - ie Increasing? Decreasing? Timing? Frequency? Sharp/shooting/burning? And many questions related to bowel, bladder and sexual function to get a better understanding of how these systems are working, because of their relationship to the pelvic floor.
Education is extremely important. You need to understand not only the anatomy of the pelvic floor muscles and organs but also about your specific condition, bladder and gut health, respiratory function, movement patterns and many other things that could be a contributing factor. It can seem like an overwhelming amount of information, so make sure you ask as many questions as you need to understand.
A musculoskeletal exam is performed that can be done either external (lumbar spine and hip movements, functional testing, breathing patterns) or internal (assessing the muscles of the pelvic floor through the vaginal or rectal canal) or both. This depends on the person and practitioner, and is determined after a thorough history has been obtained, and at the comfort level of the patient. The internal exam gives us a better understanding of exactly how your pelvic floor muscles are working, and we can pinpoint areas of tightness, pain and weakness. If an internal exam sounds extremely intimidating, there are many other ways to begin the treatment, and can always come back to that if the symptoms are not resolving.
We then create a plan of care to address your goals. This includes frequency of visits, exercises for home or in the therapy office, self-care options and what to expect at the next visit. Each visit we reassess your movement, limitations and gains and continue to modify your program, until we reach your goals.
Always feel free to call to speak to a Physical Therapist prior to your evaluation, for any other additional questions!
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