Pelvic Health – What to Expect From Your Assessment

What is pelvic health physiotherapy?

As physiotherapists, we are interested in how your body is working and how that is affecting your ability to live your life the way you would like to. So as pelvic health physiotherapists, we are interested in how structures in your pelvic area function (vagina and uterus in women, and the bladder and bowel in men and women).

We want to know about these functions and how they affect day to day life, including your ability to exercise and participate in hobbies, work, sleep and enjoy relationships. This means finding out about the pelvic floor, breathing muscles, abdominals, leg muscles, back muscles and arm muscles.

Once we understand your functioning, we can find ways to treat this and work towards your goal, whether that is empowering you to say yes to going on the trampoline without worrying about leaking (an example of stress incontinence).

What will my assessment be like?

You will have a 1 hour consultation in a private room. I will be asking lots of questions, some will be personal so I can understand your symptoms and how to help you. I will assess how you move, and if appropriate, do an internal vaginal examination.

What do I check during an internal examination?

Sometimes people avoid seeing a pelvic health physiotherapist because they do not want to have an internal examination.

Don’t worry, you do not have to have one!

An internal examination only part of the whole assessment. I will ask you lots of questions to understand your symptoms and see how you move. You can also change your mind before or during the appointment once we have spoken everything through. If you do decide to have an internal examination, you can change your mind and stop the examination at any point.

Before and during the examination I will explain everything and what happens next, there should be no surprises. To help everything feel comfortable and avoid skin irritation, I will use lots of lubricant.

The first thing I will check are the nerves around the pelvis, by touching the skin on both sides, to ensure it feels the same. I will have a look at the skin around the entrance of the vagina and vulva, looking for any signs of dryness, redness, irritation, scar tissue, dermatological conditions. I will then check the pelvic floor muscles by starting on the outside, and if you feel comfortable, having a feel on the inside with my finger. I will check for: power, coordination, endurance, areas of tension or pain, ability to relax, any asymmetry between left and right sides. We can do this in different positions (lying or standing) depending on your symptoms. I will check the position of the bladder, bowel and uterus in women to check for signs of prolapse, which might need a big cough from you.