After a year of being told that pelvic physio could help me, I finally made the move and made my first appointment. Despite knowing what to expect, I still spent a solid amount of time on google searching things up.
What is included in the physical examination?
Is a rectal exam necessary?
What does treatment look like?
What is dilator therapy?
I realized after my first visit, that the physiotherapist is a great resource to get all my questions answered. But, before your first appointment, these are the top 3 things you should know.
1. Internal and external examinations may be recommended.
Our pelvic floor muscles are complex. There are 3 layers of muscles: superficial, middle, and deep. They are also supported by other muscles in our hip, pelvic, and abdominal region. To access this network of muscles, there are usually both internal and external examinations and treatments recommended. While these examinations are useful for the physiotherapist, it is important to always remember that you as the patient are in control and if preferred, the physiotherapist can modify treatment based on what you are comfortable with.
So, what’s included in the external and internal exams?
External examination + treatment
– General assessment: posture, flexibility and strength of the lower back, hips, and pelvis
– Pelvic exam: external assessment of the pelvic floor muscles. This will usually require assessment in and around the genital region to assess and treat any tight or weak muscles.
– For treatment, massage, stretching, exercises, and a TENS machine can all be used to help your pelvic floor muscles function more optimally.
Internal examination + treatment
– Can be done vaginally and/or rectally
– These internal examinations allow the practitioner to assess the skin condition, reflexes, muscle tone/strength, and pelvic floor function.
– For treatment, internal massage and trigger point release may be recommended.
2. Informed consent is HUGE.
A big part of pelvic physiotherapy is informed consent. Your physiotherapist should be going through the purpose, risk, benefits, and side effects of all treatments and examinations that are done in each visit. Some of these assessments and treatments can be sensitive, triggering, and vulnerable in ways that will differ from person to person. Ensuring you have a practitioner who explains the process step-by-step both verbally and in writing (i.e. on the intake form), and leaves space for any questions, can help to ease any nerves or concerns you may have. Remember, as I said before, you can communicate your concerns with your physiotherapist so that they can tailor your treatment accordingly. You are in control.
3. Pelvic physiotherapy is not just for incontinence
Okay maybe it’s just me, but I always thought that pelvic physiotherapy was for incontinence issues or weakened pelvic floor muscles later in life. While this is an area that can be significantly improved through pelvic physio, there is a load of other health concerns and conditions that can benefit from this therapy, regardless of age. Pelvic floor dysfunction is way more common that you would think.
I made an Instagram post which goes through different reasons you might benefit from pelvic physiotherapy.
If you’re experiencing any of these health concerns, reach out to a qualified pelvic physiotherapist to see if this type of treatment might be right for you.