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What is a Pelvic Evaluation? Your Guide to a Pelvic Therapy Assessment

Updated: Mar 6

 February 2024

As a women's pelvic health specialist, I want to make this journey as smooth and informative as possible. Pelvic health is something we often overlook, but it plays a pivotal role in our overall well-being. And as women, it has an impact on so many facets of our lives! So, let's dive in and address any concerns you might have about what a pelvic therapy assessment looks like.


Setting the Stage: Why Pelvic Assessments Matter


The Importance of Pelvic Health:

Imagine your core as the structure of a house. If it's stable, everything else has a good chance of staying in place. Your pelvic floor is the bottom and foundation of this structure.  Your pelvic floor is responsible for not only supporting your organs and maintaining bowel and bladder control, it also plays a role in sexual function and pressure and fluid management. A healthy pelvic floor is the cornerstone of a healthy you.


Concerns are common:

Let's face it – pelvic problems can be intimidating, and an assessment of your pelvic floor may be scary. Many women throughout their life span experience concerns about pelvic pain, incontinence, or core instability in the aftermath of childbirth. These concerns can impact work, relationships, self esteem and activity levels and are very valid concerns. A pelvic floor assessment is the first step in addressing them. It is important to understand the components of a pelvic floor exam and know why we are assessing each structure.  And you always have the freedom to skip  or postpone any part of the exam – I work only at your comfort level!


Getting Acquainted with Your Pelvic Floor: Basics of Pelvic Function


Anatomy 101:

Your pelvic floor is like a mini trampoline, supporting your organs and ensuring everything stays where it should. It must contract to support your organs and maintain closure, but it must also relax to allow movement, digestion, elimination of stool and urine, and allow for penetration. This intricate system works tirelessly to keep you in balance, often without little thought on our part.  The pelvic floor has a role in breathing, digestion, sexuality, urination, and core stabilization.  Understanding the many functions of the pelvic floor and its role in everyday function is the first step in appreciating the importance of your pelvic floor plays in daily life.



Before the Assessment: What to Expect and How to Prepare


Appointment Preparation:

Before you walk through our doors, here are a few tips. If possible, complete the online questionnaire sent to you by email.  This will help focus your time with me and help me prepare to best work with you. Wear something comfortable – yoga pants and your favorite tee are perfect. Bring a list of concerns, like any pain or discomfort you've noticed, when your symptoms are better or worse, or what activities are you avoiding or wanting to return to. And don't hesitate to discuss any fears or anxieties; it's a judgment-free zone here. Nothing is TMI… I have heard it all! And if it is relevant to you, then it is relevant to your care and I want to know about it!

Ensuring Comfort:

When you arrive, I want you to feel at ease. You will be the only patient in the clinic at the time of your appointment and you will always see me as your therapist.

I often play calming or fun music to create a relaxing environment. We can adjust temperature or lighting to help you relax. Think of it as a mini spa day for your pelvic health. If there is something I can do to make your experience more comfortable, let me know! The more relaxed you are, the smoother the assessment process.

Pelvic Therapy Assessment Room
Pelvic Physical Therapy Assessment Process


The Assessment Process: Step by Step

Initial Discussion:

When you first arrive, we simply sit down and talk. Think of this as a friendly chat. We'll discuss your medical history, pregnancies, surgeries, and any issues you've had. This is also the time for you to share your concerns, like changes in bladder control or pelvic pain. I will ask tons of questions and take notes on what is important to you to address. The more we know, the better we can tailor the assessment to your needs. We will also talk about some of your goals and what you hope to get out of therapy. It could be improving muscle strength, addressing pain, making it through boot camp without leakage, or simply enhancing overall pelvic wellness. Your goals guide our journey forward, and we'll celebrate every milestone together.

Assessment Components:

So, what do we actually look at during a pelvic therapy assessment? It's not just about muscles; we're examining posture, breathing, cores strength, and coordination as well. Think of it as a holistic check-up for your pelvic health – an opportunity to understand and improve the well-being of this often-overlooked area.


External Evaluation:

First, we start with a typical external evaluation. It's non-invasive, so no need to worry. We might look at your posture in standing, lying down or on your hands and knees.  I will palpate certain bones and muscles, check your spinal and hip range of motion, and observe how your body moves. I will watch you breathe and see how stable and strong your core is. No wrong findings here – just determining how your body has learned to adapt to the stresses life has presented. It's like a friendly check-up, minus the white coat syndrome.

Internal Assessment:

I know, the internal part might sound intimidating. But think of it as an essential step to understanding your pelvic floor's inner workings. It is not required and often does not happen at the first visit. But, it is a bit like going to the dentist – necessary for a thorough examination. I use only my eyes and my trained hands to assess the soft tissue and muscles, no speculum and no stirrups! First I simply observe the pelvic area as you breathe and contract and relax the pelvic muscles.  Next, I gently press on structures along the outside of your pelvic bones, feeling for muscles and any areas of pain.  Then, if we deem it appropriate, I use my hands to palpate the pelvic floor muscles internally to determine how well they function. 

What we are evaluating:

We are looking for pain or discomfort, soft tissue restrictions or scars, and muscle function. I will evaluate your core and pelvic muscle strength, but it's not about lifting weights. It's more like a friendly squeeze-and-release test, helping us understand how well your pelvic muscles are doing. I use my hands to feel if the muscle is tightening (closing) as well as lifting.  We check for endurance (how long and how many contractions can you complete?) I also assess how the rest of your body reacts to these contractions, to breathing, coughing or even changing positions.  This test gives us valuable information to tailor exercises that will work best for you.

You are in Control:

I will guide you through the process, addressing any potential discomfort, and emphasizing the importance of relaxation. If you become uncomfortable at any point, just let me know and we will stop.



Addressing Concerns and FAQs

Potential Discomfort:

If you experience any discomfort during any of the assessment process, I’m here to help. We can adjust positions, use pillows for support, or take breaks if needed. This is not a case of “no pain, no gain”.  We need to honor the body and its needs and keep pain to a minimum.  Your comfort is our priority, and your feedback guides the process.

Privacy Concerns:

Rest assured; your privacy is crucial. We maintain the utmost professionalism, ensuring you feel comfortable and secure throughout the assessment. You have the ability to change in a private room. We use drapes and provide a private environment to ensure your comfort and confidentiality. I lock the door to the office while we are doing your assessment to ensure no interruptions.



After the Assessment: Understanding Results and Next Steps

Results Discussion:

As we are completing the assessment, I will talk through and explain what we discover and how we can address our findings. It's like receiving a personalized roadmap for your pelvic health journey. I'll explain everything, answer any questions you might have, and ensure you're crystal clear on the findings and the first steps of our plan. It's not a one-size-fits-all approach; it's about what works best for you. We're in this together, and your input is invaluable in shaping your journey to pelvic health. Your goals guide our journey forward, and we'll celebrate every milestone together.

Empowering Questions:

Got questions? Ask away! Before, during or after your visit!  Whether it's about the process, your results, or anything else, I'm here to provide answers and guidance. Remember, knowledge is power, and the more you understand about your pelvic health, the better equipped you are to care for it.



I hope this has shed light on the pelvic therapy assessment process. Your pelvic health is a priority, and Pelvic Therapy can be a step on the road to empowerment. Remember, you're not alone in this journey, and I’m here to support you every step of the way. Your pelvic health matters, and I'm excited to be part of your seamless assessment experience. Cheers to a healthier, happier you!

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