What to expect for your first pelvic health physiotherapy appointment

When you arrive, we will listen to your story, your history of symptoms and your goals. Using the pelvis model and some educational slides, we’ll talk about some of the things we will be looking for during the assessment such as observing and palpating the perineal region for tension, observing the tissue quality, palpating at the vaginal opening for scar tissue, palpating the vaginal muscles gently for tension and tightness and feeling to what extent the pelvic floor muscles can squeeze and lift. When you cough and bear down, we can palpate for vaginal bulging or tissue descent. We also want to look at how well the pelvic floor muscles coordinate with the way you breathe and the way your abdominals engage as well as specific pelvic floor coordination exercises such as speed, relaxation and graded elevator contractions.

When it is time to start the assessment, we will look at some mobility tests to see how you are moving through your low back, pelvis and hips. We’ll note your posture and breathing pattern and how you walk and squat. We’ll look at the mobility in your rib cage, diaphragm, hips and pelvis and assess your abdomen for scar tissue, fascial tightness or midline weakness. We’ll look at a few core tests to see how your core muscles are engaging. The pelvic floor muscles are just the bottom of the abdominal canister or box, so we need to understand how all these muscles work together!

Once we are ready for the pelvic floor assessment, you can change into a slip (skirt) or use a drape. Our treatment rooms rooms are private and calm and we want you to feel as comfortable as possible. You can keep your wooly socks on to stay cozy!
We’ll explain step-by-step what we are assessing and we can do as little or as much as you feel comfortable. At any point, you can let us know if you are uncomfortable or prefer to assess the pelvic floor in other ways, eg external palpation around the tail bone and sitting bones. There are many ways to assess the pelvic floor! You are also welcome to bring your own lube!

A typical pelvic floor assessment may take 5-15 minutes. The amazing thing is at the end of the assessment, you will have a whole new understanding of these incredible muscles! The findings often really help to validate your symptoms and help us to understand the key contributing factors to your symptoms and to set specific treatment goals. The results of pelvic health physiotherapy are excellent! Most of our clients leave feeling very relieved, reassured, informed and inspired!

We are happy to answer any questions you have and we look forward to seeing you!