“What is a pelvic physical therapist?”
“Can all physical therapists complete pelvic exams?”
“Did you have special training to be able to perform a pelvic examination?”
“Is the pelvic exam just like my yearly exam with my doctor?”
“Why is it necessary to have a pelvic exam?”
These are just a few of the common questions patients ask when they are referred to physical therapy for pelvic floor dysfunction. Patients often feel apprehension leading up to and during their first appointment as the topic of pelvic health is private. Pelvic issues can be difficult to discuss. There is uncertainty about what will occur during the first visit. Patients do not fully understand how a physical therapist can help them with their particular issue and the majority of people in society do not openly discuss pelvic floor dysfunction so patients often feel they are suffering on an island all alone with no end in sight.
Physical therapists (PTs) are not adequately trained to perform pelvic assessments while in physical therapy school; therefore, not all PTs are equipped to complete a pelvic muscle examination. Pelvic physical therapists attend educational sessions offered through the American Physical Therapy Association Women’s Health Section and Herman and Wallace Pelvic Rehabilitation Institute. Internal pelvic muscle assessment is within the legal scope of practice for properly trained (PTs). The pelvis is just like any other area of the body as it contains muscles, ligaments, bones, nerves, organs, and fascia; however, the only way to adequately assess this area is by undergoing a vaginal or rectal examination.
Physical therapy pelvic exams are different than the pelvic exams performed by doctors. PTs do not use a speculum and spend a large majority of time assessing your muscles, ligaments, and fascia. PTs are assessing for any areas of tenderness, muscle spasms, the ability to contract & release the pelvic muscles, mobility of pelvic organs, fascial mobility, nerve dysfunction, and pelvic muscle strength. The pelvic muscles are no different than any other muscle in your body.
It is very important to state that each and every patient has the right to forgo the pelvic muscle examination. There are other things that physical therapists can do to help you along your healing journey until you feel comfortable having a pelvic exam. Typically once the patient meets the pelvic physical therapist, reviews their unique history, goes through the external examination, and has been properly educated on pelvic anatomy and the reasoning behind the pelvic exam, a large majority of patients chose to undergo the pelvic exam. Your pelvic physical therapist will be open, honest, gentle, and will do everything possible to reduce pain and make you feel as comfortable as possible during your examination and during follow up treatment sessions.
Your pelvic floor muscles are just like any other muscle in your body. The main difference is we cannot see the pelvic muscles, we do not talk openly about these muscles, and a good majority of people do not know that there is anything that can help with pelvic muscle dysfunction. For example, when people experience neck pain they typically report muscle soreness, a loss of movement, and difficulty completing daily tasks such as turning the head while driving to check for oncoming traffic or an inability to participate in certain sports related events. PTs will often complete stretching, strengthening, myofascial release, trigger point release, and muscle energy techniques to eliminate the neck pain and improve motion. PTs complete similar treatment techniques for pelvic muscle dysfunction. Just as neck pain limits function, pelvic muscle tightness can contribute to pain, make it difficult to urinate or have a bowel movement, and make it uncomfortable or impossible to participate in intercourse. Pelvic muscle weakness can interfere with or cause people to completely stop participating in exercise routines that involve running, jumping, and lifting as patients often report urinary leaking during these activities.
At Restore Your Core Physical Therapy, we feel education is of the utmost importance and Amy Robinson, PT received her pelvic certification through the Herman & Wallace Pelvic Rehabilitation Institute. This certification distinguishes her as an expert in the diagnosis and treatment of pelvic dysfunction. She is more than happy to discuss any questions or concerns that you may have regarding the pelvic muscle examination.
www.oprah.com – Physical therapy for your lady parts
www.elle.com – Let Who Put What Where? Finding a cure for pelvic pain
Endometriosis.org – Five Things that pelvic health PTs can do to improve your endometriosis-related pain