Worried or nervous about your first women's health and pelvic floor physio appointment? Not to worry! This is totally normal and Sami outlines what to expect and her assessment and treatment process at Body and Birth Physiotherapy.

Learn more about women's health, natural movement, pelvic floor health and pregnancy, or book in with us at:
www.bodyandbirthphysio.com

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Most people are nervous or a bit apprehensive before their first Pelvic floor Physio visit. This is totally normal and understandable as it can be a very personal and private appointment, and I had the exact same feelings prior to my first pelvic floor assessment. However, most people leave saying "Well, that wasn't nearly as bad as I expected!" Now I cant say for sure what most people expect, but I'm very happy to exceed expectations!As we are physiotherapists first and foremost, the structure of the visit is similar to an orthopaedic or musculoskeletal visit with the main difference being that it is in a private room.

First off, we get a detailed history of your current symptoms, including your past history of any injury or pregnancies, your pain and/or bladder and bowel habits. This is then followed by a biomechanical assessment of your posture, gait, lower back, pelvic and hip movements.

As the patient, you are in control of the entire session and do not have to give any information or undergo any assessment unless you are comfortable with it. However, both the history taking and the physical assessment components are important as they help to give the therapist clues about the possible underlying causes of your symptoms. It also allows you to become more comfortable with your practitioner.

At this stage, your physio may discuss some of your symptoms in further detail, or hypothesise as to what may be contributing to your problem. I generally explain my thought process, along with the anatomy and function of the pelvic floor muscles and organs using helpful diagrams or models (show Paddy!). 
With your consent, we would then proceed with a specific assessment of the pelvic floor which allows me to assess the function of the muscles - are able to fully contract AND relax your pelvic floor muscles, how is your control and coordination, what is the underlying tone or tension in the tissues, and is there any indication of prolapse, scarring or restrictions in the tissue, or neural sensitivity.

The internal assessment is done via the vagina with just with gloved fingers (no speculum required) and definitely does not necessarily have to happen on the first visit if you do not feel comfortable with it.

I leave the room while my patients get changed - generally you would take off everything from the waist down and take a seat or lie down on the treatment table with a sheet covering your lower half. When I return, I’ll explain again in detail the different parts of the assessment, and only ever proceeding with full consent.This assessment can, of course, vary depending on the patient and therapist. Some pelvic health therapists do use probes, devices and computers to measure the activation of the pelvic floor muscles, but personally I can feel that I can get a much clearer impression of the individual muscles contracting, any restrictions and muscle without.

I always emphasise to my patients that if they feel unsure about the process or if they experience any physical discomfort that they should let me know and we can stop or modify the assessment. Remember, you are always in complete control of your body and the visit.  Education and exercise forms a huge part of my treatment approach as I feel that I am best able to help you by teaching you how to heal yourself. Sometimes, however, it is helpful to do specific retraining of the pelvic floor muscles while I can give you feedback, and sometimes even manual therapy internally to assist in releasing tension or freeing up restrictions in pelvic floor tissues.

Appointments are especially great for prental women looking to become pregnant, currently with child or are a few weeks postpartum, especially if you have pelvic pain, diastasis recti, incontinence, back pain or pelvic floor dysfunction like symptoms. If you have any questions please give us a call or email!

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