Since it is a mystery to most women what a pelvic floor physical therapist does, it helps to know what to expect when signing up.
In the first part of the physical exam, the physical therapist will evaluate things like your posture, abdominal strength and general physical fitness. The pelvic exam is kind of like a gynecologic exam without the speculum; however, it’s likely to include several elements that are unfamiliar to you.
It starts with a thorough visual evaluation of the vulvar skin and vestibule. The therapist uses a cotton swab to touch each zone to see which areas are painful. She then puts a gloved, lubricated finger gently into the vagina and moves it around the pelvic floor to touch the different muscle groups that make it up.
The pelvic floor exam is kind of like a gynecologic exam without the speculum
By putting gentle pressure on different groups of pelvic floor muscles, the therapist can tell if the problem is caused by tight muscles, which is called a hypertonic pelvic floor. She’s feeling for knots, contractions, and inflammation of not only the muscles but the connective tissue as well. She may identify a specific, isolated tender spot, known as a trigger point, that, when touched, reproduces the pain felt during intercourse.
The physical therapist also evaluates your overall muscle strength and coordination by asking you to squeeze her finger using your pelvic muscles. This is like the maneuver you do when performing a Kegel exercise.
The experienced pelvic floor physical therapist not only treats the problem but also plays an important role in helping us determine the source of the problem. In performing a thorough musculoskeletal evaluation of the pelvis, spine and hips, she often finds pelvic asymmetry and muscle imbalances in women with pelvic and sexual pain.
Often the location of the pain is not where the pelvic pain originates. For example, tight hip flexor muscles tilt the pelvis and cause tension in the pelvic floor muscles, which contributes, in turn, to pelvic pain and dysfunction.
Once the source of the pain is identified, the therapist uses several modalities for treatment, including techniques such as myofascial (tissue) release and joint mobilization. Muscle spasms are eliminated using manual soft tissue work and trigger point release directly on the pelvic floor muscles through the vagina and occasionally the rectum.
A pelvic floor exam is a routine procedure that plays a crucial role in assessing and maintaining your pelvic health. By understanding what to expect during the exam, you can feel more at ease and empowered to take charge of your well-being. Remember that open communication with your healthcare provider is key, so don’t hesitate to ask questions or express any concerns you may have. Prioritizing your pelvic health can lead to a happier and healthier life.
