What to Expect for Your First Pelvic Floor Appointment at The Cheerful Pelvis!

October 17, 2019

We know that a first appointment for a pelvic issue can be a bit anxiety provoking, and that often times clients have seen many prior professionals, not always with good experiences.

Here’s what to expect on your first appointment with us:

  • We listen to your whole story, and understand the full history and current struggle, as well as your concerns and goals, before we do any physical assessment (sometimes this takes the whole session)
  • If you have chronic pain, we may start by educating you on how pain and the nervous system works, as this often dictates how we start assessing and treating, which means we can start on the same playing field in terms of decision making
  • We assess top to toe first to get a sense of your whole body, as often the driving force of the issue is actually outside of the pelvis, so doing pelvic floor work alone can miss the root cause
  • We use a specific problem task to assess the specific cause e.g. sitting for sitting pain, coughing or jumping for stress incontinence, pelvic floor relaxation for painful sex
  • If there is an obvious root cause driving the issue from outside the pelvis, it can be more effective to treat this first before we go local
  • However if and when we do an internal pelvic exam,
    • You lie on your back with knees bent, they don’t have to be spread wide, nor bum to the edge like a pap
    • We use 1 gloved finger with lube and only go in as much as is pain free
    • If painful, we are only looking to get a basic sense of how tense or reactive the muscles are and how sensitive the nerves
    • If pain free, we ask you to contract the pelvic floor muscles and cough to check your strength and reflexes
    • For more advanced athletic continence issues, we may also crouch underneath you and assess you in standing (not graceful but very helpful!)
    • For people without a vagina or with bowel issues we do a rectal exam, with all the same principles applied
  • we are mandated to use a particular type of medical lube in single use sachets, but if you have sensitive skin and want something particular used thats either organic or more natural please bring some with you

We don’t believe in starting treatment before we have a strong sense of the root cause, so if this is complicated it may take a couple of sessions of testing to figure it out. Once it is clear to both you and us what the cause is, we will discuss treatment options that consider your specific goals, and what is feasible for you in terms of attending Physio and a home program.

If you have any questions or concerns regarding what to expect, don’t hesitate to contact us!