What to Expect from a Pelvic Health Assessment
Pelvic Health is a very important part of Physical, Mental, and Social Wellbeing for women, yet it often does not get a lot of attention until there is an urgent problem. Pelvic Health Physiotherapy requires specialised training to provide treatment for health conditions that attain to the pelvis, which are often treatable and can significantly improve symptoms. The keystones of Pelvic Health Assessments are a thorough interview, an evaluation of how the pelvic floor muscles are working, pelvic floor education, and a treatment plan going forward. At Physio Pilates NP, we value quality care, accessibility and connection and provide different Pelvic Health education through individualised Assessments, group education sessions, in our Group Reformer Pilates classes and through Flourish Taranaki, a charitable community collaboration.
What is Pelvic Health Physiotherapy?
Pelvic Health Physiotherapy is a specialised area of Physiotherapy which focuses on the pelvis. While women might sometimes believe that pelvic discomfort is an inevitable side effect of various life stages, such as during the postpartum period and menopause, the truth is that skilled Physiotherapy intervention can often alleviate these discomforts. Pelvic floor dysfunction can impact not only physical health but also mental well-being, participation in social activities, and sports. Women’s Health, or Pelvic Physiotherapists in New Zealand must undergo continuing and specialized education in this area. Our own Pelvic Health Physio Natalia has undergone training with the Herman & Wallace Institute in the United States and Dr. Melissa Davidson in New Zealand.
Why Might Someone Need a Pelvic Health Exam?
“Forget sneezing and staying dry.”
“After having children, I can’t even think about jumping on the trampoline.”
“I have to run to the bathroom every time I get home and cannot hold it anymore.”
“It’s just something we have to live with and will get better on its own.”
“I haven’t felt the same since my hysterectomy.”
“I was told I have prolapse and never of heard of this before and had no idea what to do next. There wasn’t a single hour during the day that I wasn’t aware of the symptoms, and I stopped my activities because it felt like they were making my symptoms worse.”
I’ve been collecting these quotes (thank you friends & family!). Have you said similar things to a friend? I hear these so often at get togethers that there is no shortage of quotes. There are a number of reasons to see a Pelvic Health Physio and so many of them are thought of as a regular part of life, or a side effect of pregnancy and giving birth. These include postpartum recovery, birthing injuries, urinary incontinence, bowel issues and constipation, pelvic pain, pain with sexual activities, and pre- and post-surgical care for urological, gynae, cancer, colorectal and prostate surgeries, to name a few. We can’t forget those pesky falls on the tailbone that nag for months; they are another reason to have your pelvic floor and tailbone checked out.
ACC has come on board and started covering certain birthing injuries, including prolapse, coccyx injuries, muscle tears and tailbone dislocations, for those who have given birth after October 1, 2022 (find a link to the full list of injuries in our Reference list below). There are many different types of incontinence or lack of voluntary control over urination or defecation, many of which can be identified and treated with Pelvic Health Physiotherapy. Continence NZ is wonderful and user friendly resource for educational videos and information about the different types of incontinence and how they can present.
Preparing for the Pelvic Health Appointment
You may have related to one of the quotes or symptoms above and decided to go ahead and book in for a Pelvic Health Assessment. You can do so directly through our website https://www.physiopilatesnp.co.nz/physio-services choosing the option for Pelvic Health Consult or by contacting the clinic by mobile at 0211992119 or via email at admin@physiopilatesnp.co.nz. You will then be emailed a Client Consent Form that asks some General Health questions, and depending on your symptoms, you may be asked to keep a diary of your symptoms for several days. This is to help paint a clear picture of the symptoms and to help plan and set measurable goals that are specific to your experience.
You may also jot down important dates, such as dates of previous surgeries, births and approximate weights of the children if you’ve given birth, any important medical history and current list of medications. Have a good think about what you would like to achieve and what you might want the outcome of Physio to be, whether it is returning to running or activities, or being able to sleep through the night with less trips to the toilet.
We value cultural competence and cultural safety, and if there are any modifications that need to be made, cultural considerations, or anything we should be aware of before the session, you can contact us to let us know. We may ask a family member to accompany minors.
On the day, let us know as early as possible if you are unable to make it or if you feel unwell. A common concern is scheduling the evaluation around the menstrual cycle, and you can absolutely still attend a Pelvic Health Assessment if you are on your period. For your comfort and ease of movement, wear comfortable clothing, and you are welcome to use the toilet if needed before your Evaluation.
What to Expect During the Evaluation:
Client comfort is our number one priority, and you will be asked multiple times during the Evaluation for your consent to proceed. We value good communication, patient safety, confidentiality and collaboration, so as a client you are in control of what happens during the session. We will talk about and jot down various symptoms, and try to make a timeline of the symptoms from the time they began to be noticeable to now. We will talk about related body parts, including the pelvis, hips, and low back. We will discuss once again what Physical exams (external or internal pelvic exam) we will do during the session and what the plan will be. We will go through a list of conditions, such as latex allergy and pregnancy that is <12 weeks, for example, to make sure that doing an internal pelvic exam is safe if we choose to proceed.
The external portion of the exam will include looking at how the muscles around the pelvis work together and in isolation and looking for any patterns or connections to the symptoms. The external portion also involves observing how your muscles work together under different conditions. If you agree to proceed, the internal pelvic health exam then involves checking how the pelvic floor muscles work which is best determined by feeling the pelvic floor muscles internally. The Physiotherapist uses gloves and lubricant during an internal pelvic health exam and observes the client for comfort throughout the exam. There are multiple muscle layers that make up the pelvic floor and multiple muscle actions that we will test. The Pelvic Health Physiotherapist will provide different directions to activate the pelvic floor muscles during the exam and help the client understand what the pelvic floor muscles are doing with different cues.
Benefits of Pelvic Health Exams
An internal Pelvic Health exam is the best way we have to assess how the pelvic floor muscles are working. Physiotherapy treatment for many of the conditions listed above is relatively simple and easy to work into your daily routine, and many times – it works! Doing Pelvic Health Physiotherapy can greatly improve the sense of connection with your body, wellbeing, and mental and physical health.
After the Evaluation
During the Evaluation, we will discuss what the findings of the evaluation mean and make a plan. We may decide that a referral to another specialist may be a good idea. These specialists can include your GP, Gynaecologist, Urologist, Accupuncturist or one of the other Specialists that we work with. Our aim is to treat the person as a whole, and collaboration with other care providers often is the key to holistic care.
Pelvic health should not be an ignored or dismissed topic. It is an integral part of our overall health and wellbeing, and we are lucky in Taranaki to have multiple Specialists including Pelvic Health Physiotherapists that we can access to use these services! Don’t wait to see if your symptoms improve on their own or put off seeking professional care. Your symptoms may be very treatable indeed!
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