You have decided that you need help from a women’s or men’s health pelvic floor physical therapist and we have no doubt that you will have questions about what to expect during the initial evaluation and follow up sessions. Our pelvic floor physical therapists are specialized in treating various pelvic floor dysfunctions including urinary/fecal incontinence, pelvic organ prolapse, pelvic pain and painful sex. Here’s what you can expect during your initial evaluation and follow-up sessions.
During the initial evaluation and any follow-up treatment sessions, you are allowed to bring in a friend or partner. For your comfort, all sessions are held with the physical therapist in a private treatment room unless specific exercises are required in our gym area. The initial evaluation and all subsequent treatment sessions are 40 minutes long and are conducted entirely at your personal comfort level. The progression of your treatment is generally as follows:
- Obtaining information on how your pelvic floor dysfunction has an impact on your life.
- Obtaining a thorough history including a general medical history, surgeries/procedure you have undergone and medication you are currently taking
- Bowel and bladder habits including how many time you use the toilet each day and whether you have pain with urination or bowel movement
- Sexual history, breastfeeding and menstruation (for women)
- Obtaining information on the treatment you have tried before
We understand that it may be very difficult for you to discuss some of these topics above. However, your honest responses are very important for your pelvic floor physical therapist to have a good understanding of your limitation as well as establishing best treatment plan to help you return to the lifestyle you deserve.
Next steps of Initial Evaluation are as follows:
- Conducting a thorough musculoskeletal and neuromuscular screening
- Providing a postural assessment
- Education on pelvic floor function and how dysfunction can occur
- Establishing plan of care based on the shared information and musculoskeletal findings
- Developing an individualized home exercise program
- Discussing keeping a two-day bladder diary
First Follow-up Appointment
- Reviewing the bladder diary
- Conducting an internal pelvic assessment (if needed) – all conducted with one gloved and lubricated finger (no speculum needed!)
- Checking for external skin and fascial integrity
- Observing and assessing pelvic floor muscle activation, deactivation, length, and strength
- Educating on proper pelvic floor activation
- Assessing for painful myofascial trigger points
- Assessing for evidence of prolapse
- Developing an individualized home exercise program for the pelvic floor
Subsequent follow-up appointments include the following when appropriate:
- Progressive exercises for treatment
- Myofascial trigger point release
- Biofeedback for proper pelvic floor activation and deactivation education
- Perineal ultrasound
- Heating pads
- Electrical stimulation
If you have any questions throughout the treatments, we encourage you to ask or express your concerns. Our physical therapists are here to help you achieve your recovery goals and create a healing environment for you. If you have any further question prior to the initial evaluation, please give us a call at 408-736-7600. It will be our pleasure to assist you.