We realize that for most of our patients, a referral to see the “Pelvic Physical Therapist” can be terrifying. Usually this is the first time anyone has heard of this type of specialty and people have all sorts of great ideas for what they are getting into. It always makes us laugh a little bit (just inside, don’t worry) when our patients come in the first day wearing gym clothes and tennis shoes. This type of physical therapy is a little bit different from what you might have expected. Let us help you with getting prepared.
You should expect:
1) A comprehensive discussion about your medical history: Because of the nature of most of the problems we treat, your physical therapist will ask you a lot of specific questions about your bladder, bowel and sexual function. She will also want to talk to you about your obstetric history, your dietary habits, as well as any problems with pain that you have been experiencing. Make sure you share your medical history and information about any problems you are dealing with as completely as possible.
2) A full musculoskeletal evaluation: We want to determine what kind of role your muscles, joints, bones, scar tissue, connective tissue, etc. have on the symptoms you are experiencing. We will usually look at your spine and around your pelvis, as well as check your muscle strength in your legs, hips and core.
3) The possibility of a vaginal or rectal exam: Don’t freak out. I know that this is usually surprising to hear for many of my patients. Depending on what you specifically have going on, you may benefit from an internal examination of the pelvic floor muscles in order to understand the involvement they have in the symptoms you are experiencing. The pelvic floor muscles run like a bowl inside your pelvis. They run around the opening of your urethra-going up to your bladder, your vagina-going up to your uterus (clearly, females only), and your anus- going up to your colon. They are located internally. Meaning, we can’t touch them from the outside. So, that is why we have to assess them vaginally or rectally. This exam is crucial in understanding what is happening with your muscles.
4) A detailed plan of care: After your physical therapist examines you, she will sit down and discuss with you the results of the exam and what her plan will be to get you feeling better. Ask any and every question you may have. She should discuss with you how often she will want to work with you, how many appointments you should expect, and what specifically your treatment will include. Many patients get better in as little 6-8 visits. Some patients take longer than that depending on the nature of your condition.
Hopefully this is helpful! Please ask any questions you may have in the comments section!
Written By: Jessica Powley PT, DPT