Pelvic floor issues are more common than you might think. Approximately one in three women experience some kind of pelvic floor dysfunction during their lifetime. These issues can range from mild discomfort to severe pain and can significantly impact your quality of life. If you are experiencing pelvic floor issues, you may wonder if a pelvic floor evaluation is necessary, but it can be a valuable tool for identifying and treating pelvic floor issues.
If you are experiencing pelvic floor issues, don't suffer in silence. A pelvic floor evaluation with a physical therapist can provide valuable insight into your condition and help you take control of your health. Our women’s health team at EW Motion Therapy are experts in pelvic floor dysfunction and can create a treatment plan customized to your needs and goals. Even if you decide our services do not fit your needs, keep reading to learn more about what to expect during a pelvic floor evaluation and whether or not it may be right for you.
Incontinence is more common than you might think. Learn more about how physical therapy can help with incontinence here.
What is the pelvic floor?
The pelvic floor refers to the group of muscles, ligaments, and connective tissues that support the organs located in the pelvis, including the bladder, uterus, and rectum. These muscles form a "hammock" shape that spans the bottom of the pelvis, stretching from the pubic bone at the front to the tailbone at the back. Both men and women have a pelvic floor, which is vital to overall health and well-being.
The pelvic floor is responsible for several essential functions, including controlling the bladder and bowel movements, providing support to the organs in the pelvis, and contributing to sexual function. The pelvic floor muscles are essential for maintaining continence, which is controlling the release of urine and feces. These muscles work together to help prevent leakage or incontinence, as well as provide support for the organs in the pelvis. The pelvic floor also plays a role in sexual function, as the muscles can help increase sensation during intercourse and contribute to achieving orgasm. Overall, the pelvic floor is a vital component of the body's muscular and skeletal system, supporting the body's essential functions and overall health.
What happens during a pelvic floor evaluation?
Before we discuss the evaluation itself, let’s go through the process that gets you to a pelvic floor evaluation with a physical therapist. Most people don’t think about their pelvic floor until they start having problems with it, like issues with urinating or pain during intercourse. In reality, however, pelvic floor health is essential for anyone of any age because everyone has a pelvic floor. A pelvic floor physical therapy evaluation may be most beneficial for you if you experience bowel or bladder dysfunction (including leakage or difficulty emptying your bladder, constipation, etc.), pelvic pain, sexual dysfunction, or weakness secondary to pregnancy/postpartum.
If you are experiencing these kinds of issues or have complaints about your pelvic floor, your OB/GYN, urologist, or primary care physician may refer you to a physical therapist. If the referral comes from your primary physician, your physical therapist can discuss follow-up procedures with you after your evaluation. Even if your doctor does not recommend physical therapy, it can still be beneficial if you have pelvic floor issues.
When you come in for your evaluation, your therapist will review your medical history and ask about your symptoms and how long you have had these symptoms. As the pelvic floor is associated with bladder/bowel dysfunction and sexual health, your therapist will ask questions about these topics. Your therapist will also assess your posture, mobility, and strength and provide suggestions accordingly.
Do I have to have an internal exam?
With your consent, your therapist may recommend an internal vaginal or rectal exam to assess muscular tension or weakness, if appropriate. You may have gotten a pap smear with your gynecologist, and if you had a negative experience with that procedure, any anxiety is understandable. However, gynecologists’ and physical therapists’ exams are different. Typically, a gynecologist’s examination uses a speculum and may include cervical swabbing for a pap screen. A physical therapist’s internal examination is performed using one finger and will consist of strength and endurance testing of pelvic floor muscles.
It is entirely up to you whether or not you want to have an internal exam. While it can provide your therapist with helpful treatment information, we want you always to feel safe and comfortable. Your therapist can do plenty of mobility and strengthening activities to address surrounding muscles, such as the hips and core, without performing internal work.
What happens after the evaluation?
Your therapist will discuss examination findings with you, and together you’ll create a treatment plan to reach your goals. This will likely include a bladder log/diary to give your therapist insight into your daily habits, a home exercise program, and continuing treatment with your PT (usually 1-2x/week for 4-8 weeks, depending on symptoms). Some exercises may include kegel activities to strengthen the pelvic floor or pelvic mobility and stretching if there are muscular restrictions in your pelvic floor.
While it can be uncomfortable to talk about, it’s important to advocate for yourself if you’re experiencing symptoms. Let your provider know if you’re struggling with pelvic pain, bladder/bowel dysfunction, or other symptoms, they may refer you to an OB/GYN or urologist, but they can also refer you to pelvic floor physical therapy. Our women’s health team at EW Motion Therapy can meet you where you are in your journey and serve as an encouraging ally and expert member of your care team. If you are curious about what our pelvic floor physical therapy can do for you, click the button below to download our self-assessment and see if our program fits your needs best.
