What should you expect when you see a Pelvic Floor Physiotherapist for the first time?
Keep in mind everything we ask you, we ask with your consent so you don’t have to answer anything you aren’t comfortable answering. You can also decline any of the assessments we will perform.
What are your main concerns?
First of all, we will ask you what your main concerns are and what is bothering you the most. What will ask you what makes your symptom/s worse or better and how your symptom/s might change over a 24hr period.
Obstetric & Gynaecological History.
We will ask about your obstetric and gynaecological history including how many times you have been pregnant, what type of birth you had, if there were instruments used or if you tore etc.
General Medical History/Medications/Surgical History.
We will ask you about your general medical history, if you have had any surgery and if you are taking any medications. This will help us diagnose your condition and rule out any underlying pathology.
Work & Exercise History.
What do you do for work? Are you sitting all day or do you have an active job?
What do you do for exercise? What can’t you do? What would you like to do? What are your exercise goals? This is very important as it helps to formulate a treatment plan that is specific to your needs and goals.
Do you have any incontinence? How much is your daily fluid intake? How often do you void (wee) throughout the day and night? Do you have urgency? Do you leak when you sneeze or cough? Do you leak after you do a wee? Again, all very important questions to help us identify exactly what is going on your with bladder.
Do you have any bowel concerns? How regular are you? Do you have faecal incontinence? What is your stool consistency like? (we will show you the Bristol Stool Chart for this one). Do you suffer from constipation or diarrhoea or both? Do you use a foot stool? Do you have pain when passing a bowel motion? Do you strain? Do you have or have you had haemorrhoids or anal fissures? Do you constantly wipe to get clean? Do you use your fingers to splint the perineum or insert into the vagina to push the poo out? Do you struggle holding in wind? How long does it take to pass a bowel motion? Do you take any fibre supplements? Do you have faecal urgency? The list goes on…
Are you sexually active? Have you had or do you have any pain with sexual intercourse? Is it deep pain or entrance pain? Does the pain linger? How long have you had the pain for?
Once we have asked you all of these questions we will then go onto our physical assessment. This includes an assessment of your pelvic floor. We start with education about your anatomy and physiology and explain the different layers of the pelvic floor. We then explain how we assess you internally so you are fully aware on what to expect. We will have a look at the abdominal wall and check for any separation of the muscles. We will assess your external structures such as your lumbopelvic muscles and joints in terms of strength, length, stiffness, range of motion and function.
Treatment and Action Plan.
Finally, we will prescribe a treatment plan for you with your exercises and explain the outcome of treatment and how many sessions (roughly) you will need.
As you can see, we go through a lot of information in the first session but this is very much an educational session as well so you will walk away learning a great deal about your pelvic floor.
Sarah Anderson BExSc, DPT (Pelvic Floor Physiotherapist)