Pelvic Floor: What to Expect on Your First Visit

Health History
Prior to seeing your physiotherapist, you will be asked to fill out a health intake form, as well as one or more questionnaires regarding your current condition.  This gives your physiotherapist a better understanding of your health history and how pelvic health dysfunction is affecting your life.

Privacy
Pelvic floor physiotherapy session are held in a private, comfortable room where your privacy is a top priority.
Your certified pelvic floor physiotherapist will begin by asking a series of questions regarding your health history and your current condition.

Examination 
Following this discussion, your physiotherapist may recommend performing an external and/or internal (vaginal and/or rectal) examination.  During the internal exam, the ability to contract and relax the pelvic floor muscles will be assessed, as well as how these muscles work together with the rest of your body. Assessing the joints, mobility and strength of the lower back, hips, and sacro-iliac (SI) joints are also an important part of the pelvic floor assessment.

Treatment
Based on the information given on your health history, your description of symptoms and an examination, your pelvic floor physiotherapist will then recommended the most effective course of treatment for your needs.

Why is an Internal Exam Important?

An internal exam is not mandatory; however, it is the gold standard to assess how your pelvic floor muscles and the connective tissues within your pelvis are working.  The pelvic floor muscles are internal muscles and are difficult to properly assess externally.  Although it is common for people to blame pelvic issues on weak pelvic floor muscles, that is not always the cause of the problem– sometimes, these muscles can be tight which can be the root of the problem.  Without an internal exam, it is impossible to know exactly what is going on.

Research has found that verbal and written instructions of pelvic floor exercises (think: Kegels) are not enough. People are not understanding how to activate their pelvic floor muscles and are often doing exercises incorrectly.  An internal exam allows your physiotherapist to recommend the appropriate exercises for you individually and to help ensure you are performing them correctly.

For men- What can I expect from a pelvic floor physiotherapy appointment?

You will be asked about your issue and how it impacts your life. The physiotherapist will also ask questions about previous and current medical conditions, past or up-coming surgeries, medications that you are taking, bladder and bowel habits, as well as sexual function.

There is an external and internal exam

During the external assessment, the physiotherapist will assess your posture, breathing, flexibility of the spine, pelvis, hips and knees, and the strength of your core, buttocks, and muscles around your pelvic floor and tailbone.

Sometimes is also necessary for an internal assessment for men. This is a rectal exam to examining the muscles, tissues and skin of the thighs, buttocks, abdomen and pelvic floor internally. No instruments are used during the exam. The physiotherapist will assess for muscular strength, endurance and tonus.

Even If an internal exam or internal treatment is recommended, clients still have the right to refuse an internal exam during the assessment or follow-up treatments. The physiotherapist will discuss it with you.

Treatment

After the assessment, a personal tailored treatment plan is developed. The treatment can be with an education component, manual therapy, home exercises programs, therapeutic ultrasound, electrotherapeutic modalities, tape techniques or any other physiotherapy technique.