What Will Happen When I Go To Pelvic Floor PT?
I've been a pelvic floor physical therapist for six years now, and yet it seems like yesterday when I performed my first official examination of an actual patient in the office. I recall feeling as nervous as the patient herself. I had attended the requisite coursework for this task; This entailed a several day class where over forty women gathered in a hotel conference space. We sat in twos at those narrow white tables, nervously wondering how things were going to go down. After all, we had been told that in order to learn about the pelvic floor muscles of women, we would be required to examine each other's pelvic floors to practice. I purposely attended this conference alone, as I didn't have any friends who were interested in taking the class back then. Furthermore, I didn't want my nearest and dearest taking such a close look at my lady bits. A stranger would be preferable.
Whoa... What is a pelvic floor PT looking at during an exam?
Your pelvic floor PT will be assessing the superficial pelvic floor tissues to look at the labia, entry of the vagina, rectum, and clitoral hood. A lot can be discovered just by looking at how mobile these tissues are and if they can contract versus open and lengthen. Your pelvic floor PT may then insert a finger into your vagina to determine how taut or loose the vaginal walls feel. Sometimes there are spots within the pelvic floor that your therapist may hit upon that have not been released during manual or penetrative sex. You may feel areas of heightened muscular activity or spasm during this exam. Many patients often say to me, "I had no idea I was so tight in that one particular area!"
As someone who has been examined vaginally more times than I can count, I agree that it is bizarre to feel these small areas of overactivity which I had never before experienced. Yet, the relief that both my patients and I feel afterwards is remarkable.
Should I do anything in particular before my first session with a pelvic floor PT?
The temptation to shave or get a bikini wax before your first pelvic floor PT session must be avoided! I fell into this trap when I went to my first class six years ago and was groomed as though I was going to wear a thong on the beaches of Miami. Hair removal can be very irritating to people with pelvic pain and tension and this is why they are seeking help in the first place!
Do not feel pressured into tidying up this area of your body for your pelvic floor PT. It may simply flare your symptoms and it won't improve the quality of the internal exam which the pelvic floor PT needs to perform to give you feedback about yourself. Also, if you are going straight to your pelvic floor PT appointment from a day at the office, resist the urge to purchase scented wipes for "freshening up". If anything, try to find a wipe without any fragrance and one that you have used before so that you don't wind up with more problems than you are starting with.
How can I conquer the anxiety I feel about someone looking at my body in this region?
I have only met a few people who have had zero anxiety about this experience. (One was a 21 year old gay male who injured his testicles from having sex; I still marvel at his ability to whip off his pants and show me everything within 22 minutes into the appointment). That said, most people have a lot of fear, or even dread, surrounding an exam of this region of their bodies. Particularly if they have a history of pelvic pain.
I want to assure you that yes, the initial appointment can feel daunting, but what you will learn about yourself will be tremendously valuable. Remember that your pelvic floor PT has been in your position. Remember also that you have been in a great deal of discomfort and that you are finally doing something to address it. You are giving yourself a wonderful gift by allowing someone else to get into your most personal space and allow you to let go of everything that has hurt you in the past.
People with endometriosis may also have bladder issues. Have you experienced overactive bladder (urinary frequency or urgency)?
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