What To Expect With Your Pelvic PT Evaluation

What to expect with your pelvic PT evaluation

Feeling Nervous or Uncertain about What to Expect with Your Pelvic PT Evaluation?  Read on and we’ll give you all the details!

At Purple Mountain Physical Therapy, here in Grand Rapids, we provide excellence in clinical treatment for ALL pelvic problems.  Pelvic health has been our laser focus for years.  As a result, we know exactly how to help you and we do this by first listening to you and figuring out what is going on.  You can expect a thorough pelvic PT evaluation that answers your questions and addresses your concerns.

What Does the Evaluation Involve?

With your pelvic PT evaluation you can expect expertise from our Doctors of Physical Therapy.  We begin treatment the first day and never provide you with cookie-cutter, run-of-the-mill, average care. Your care is customized to your findings and your goals.  Here are the steps you can expect with your pelvic PT:

What to Expect Before Your First Appointment:

  1.  Fill Out Your Intake Paperwork Online!  Watch for an email inviting you to do this! You create a login at our secure portal and complete you intake paperwork in preparation for your pelvic PT evaluation.  We are paperless at the office and completing this before the appointment is important.
  2. Our physical therapist will read all of your intake paperwork before your pelvic PT evaluation appointment.  This is crucial, as it helps us begin to formulate a plan for how to treat you and know how to structure your evaluation time so you get the most out of the appointment.  Our therapists glean many ideas and direction for your care from your intake paperwork.

What to Expect When You Arrive for Your First Pelvic PT Appointment:

  1. A Warm Welcome!  We are glad you are here and want to make you feel comfortable and taken care of each moment of your visit!
  2. Our front desk administrator will be there to welcome you and answer any of your questions and tell you how everything works at our clinic.  Important detail to know:  our front desk administrator is here to help you get scheduled and answer any of your questions, so call anytime during business hours and there’s always someone here to answer your questions.  Parking is easy at our clinic, in fact, there are parking spots literally five feet in front of our clinic door!
  3. Our office is sunny, clean and comfortable.  Please arrive a few minutes prior to your pelvic PT evaluation appointment and upon arrival come straight to our front desk administrator to get started.   She will answer your questions and get you checked in.  Afterwards, please make yourself comfortable in our waiting area for a few moments and help yourself to a warm drink.
  4. Our PTs run on time, so you can expect to be seen promptly.  Each pelvic PT evaluation appointment is in a private, comfortable treatment room and lasts upto 55 minutes.  Follow-up appointments are also upto 55 minutes long.
  5. You will see the same Doctor of Physical Therapy each time so you develop a trusting relationship that progressively advances you at each visit.  You and she develop a trusting relationship that is established upon your physical therapist’s insights and assessment of your condition and how your body responds to treatment and your preferences for what you feel is necessary at each visit.  We never bounce you around amongst staff, our patients have experienced that problem elsewhere and it inhibits your ability to get better and to receive a personalized, therapeutic approach specific to your needs.

What To Expect Once We Begin your Pelvic PT Evaluation:

  1. You can expect your treatment to be in a comfortable, private treatment room. You are welcome to bring a family member or person of support.  We will begin by simply talking.
  2. Your pelvic PT will ask you about your goals, symptoms and lifestyle.  We want your treatment to be meeting your goals.  That’s the whole purpose.
  3. Your Goals:  Why are you coming to PT?  What do you hope to achieve through your physical therapy?
  4. Your Symptoms:  We will inquire about any pain, any bladder problems, bowel issues, intimacy related symptoms.
  5. Your Lifestyle:  We love to learn about your day to day habits and activities and what you are presently unable to do because of your condition.  How are your stress levels (because stress greatly influences the pelvic floor, bladder & bowel)?  What exercises do you complete?  What are the movements and postures of your work or day-to-day activities?
  6. Holistic Care: The pelvic floor works in coordination with the hips, core muscles, low back, mid back, rib cage, feet and diaphragm.  Therefore, we will assess and treat these areas because our experience has taught us and research has proven that treating all of these areas holistically is necessary for you to get results.  It is very common that our patients have received care elsewhere that did not work and often the reasons behind this are related to the care was not comprehensive and holistic.  Also, usually, the care is limited in time (they do not give you a full 55 minutes for your appointment) and the care may  not consistently be with the same provider (let’s be honest:  if you bounce between providers there are things missed, lost in translation and/or not advanced effectively).
  7. Trauma-Informed Care   We recognize that you may have experienced any number of traumatic experiences in your life and we are able to meet you where you are at, so that we provide an effective, therapeutic place for you to receive your care.  For some of us, going to the OBGyne is traumatic, so we understand that a pelvic PT may raise your anxiety levels.  Rest assured, we partner with you and work within your comfort zone.  By this, we mean your mind, body and spirit comfort zone and we are continually checking in with you and watching for signs that you are doing well throughout your appointment.
  8. For Children, Parents are included in the Plan of Care and Evaluation:  Our clinic is here to help alleviate the stress and strain in your household, if your child has any bladder or bowel control problems.  We include parents in our pelvic PT evaluation and plan of care so you can expect to be informed of everything we do.  We want to make certain you are fully understanding what we are finding, how you can support your child and that you can be an advocate for your child.  Our Doctors of Physical Therapy know how to expertly navigate a positive, encouraging evaluation with you and your child so your child’s needs are met and you feel less stress.

What is included in an Evaluation?

  1. Pelvic Floor Dysfunction Evaluation begins with us talking: For all of our patients (women, men and kids), we will inquire about symptoms that would be related to pelvic floor dysfunction.  The pelvic floor is a series of muscles that control bladder, bowel and intimacy related functions.  They also serve to support or hold up your pelvic organs.  By learning about your bladder, bowel or (for adults) intimacy related symptoms, we will be able to advise you straight away on things you can do to improve your condition.
  2. Pelvic Floor Dysfunction Evaluation that includes hands-on assessment: Our patients tell us that our pelvic PT evaluation is the most thorough and helpful exam they’ve ever had, including what they get from their physician.  This is because we educate you the entire time and we also go very slowly, muscle-by-muscle, checking each thing that may be contributing to your problems. With your permission, for our adult patients, we gently check all of your pelvic muscles.  Pediatric patients do not receive an internal examination.  The entire time we are working, we are telling you what to expect and what we are finding.  You always have the option to opt out of this, if you don’t feel comfortable.  We provide trauma-informed care and always respect where you are at in terms of being able to experience treatment.  We have SO much to treat (areas from the shoulders to the feet), that if you aren’t ready for a pelvic examination, we have plenty of other things to treat.  Our patients tell us that our examination is the most thorough they have ever received and very educational.  Our examination includes assessing the superficial muscles of the perineum (these get torn often with labor/delivery and contribute to pain with intimacy.  These are also commonly problems in men with pelvic pain, including tip of penis pain, perineal pain and testicular pain) and the deep muscles of the levator ani (these are the muscles you hear about most often, the ones you get told to do a Kegel to improve.).  We also check the accessory pelvic floor muscles, which includes muscles that in a textbook you will read control your hip, but they also are part of your pelvic floor.  Fair warning:  usually kegels are not recommended and can worsen your condition.  We have lots of information on our website about pelvic floor dysfunction, such as this article we wrote.   Here is another resource, from the Cleveland Clinic that gives you more insight into pelvic floor dysfunction.  https://my.clevelandclinic.org/health/diseases/14459-pelvic-floor-dysfunction
  3. Myofascial Assessment: “Myofascial” refers to muscles & fascia.  For bladder, bowel and pelvic pain conditions there are connections between your problem and the muscles and fascia of your shoulder blades, thoracic spine, low back, hips, inner thighs and abdominal wall.  We assess and treat all of these areas and look for problems that are contributing to your symptoms. We are looking for trigger points, muscle guarding, scar tissue restrictions (cesarean scars, hernia surgery scars, laparoscopic scars, low back or hip surgical scars, kidney stone removal scars, etc), fascia denseness/lack of movement, reductions in blood flow to tissues, changes in tissue color (hint: thick, darkened tissues are not well vascularized and optimally healthy).  We provide advanced therapeutic hands-on treatments to address any and all of the problems we find.
  4. Full & Complete Diastasis Recti Abdominus Asssessment (DRA) and Treatment, if warranted:  We check every patient for a DRA, including men and children and, of course, all women including pregnant and postpartum. DRA assessment and treatment is a key specialty we offer our patients.  We commonly find problematic DRAs in our patients.  If you have this, we will let you know the specifics of your problem, how you can help improve it, what you need to avoid doing and how we will build a therapeutic recovery program so you can progressively get this improved.  DRAs influence and can contribute to low back pain, stress incontinence, urinary frequency/urgency, hesitancy with pee stream, hip pain, appearance of a “mom pooch” and more.  If you have this, rest assured, we will get you a full, comprehensive plan to improve this.
  5. Orthopedic Evaluation:  Depending on your symptoms and goals we may assess and treat your posture, strength of your core, flexibility of your muscles, fascia and nerves.  We also assess hips, SI joints, low back joint range of motion & muscle spasms, intervertebral joint motion, alignment of feet, knees and hips, necks, shoulder blades, rib cage mobility, stiffness in your thoracic spine, diaphragmatic and breathing tendencies.  Our doctors of physical therapy have experience treating all orthopedic conditions, such as plantar fasciitis, knee meniscus tears, hip labral tears, gluteal tendinopathy, sciatica, lumbar disc herniations, low back pain, rotator cuff tears, shoulder bursitis, neck stiffness and more.
  6. Nerve Evaluation:  Pelvic pain can be a mystery and there are so many nerves that can contribute to pain.  We know how to assess and treat your Pudendal nerve (and all of its branches), Sciatic nerve, Posterior femoral cutaneous nerve & cluneal nerves, ilioinguinal nerve, genitofemoral nerve, obturator nerve, femoral nerve, peroneal nerve and others. If you are wondering if nerve pain is part of your condition, we can let you know.  Our detailed and specific assessment of your nerve health and passage way through your tissues will inform our treatment plan for you.  Many of our patients have had nerve blocks, steroid injections or PRP injections to various nerves and, yet, still remain in pain; our treatment helps heal nerves and gets you feeling better.  The treatment is directed to optimize the health and blood flow of your nerve and all of the joints and tissues that surround it.  If you have impairment in your nerve, we will let you know what you can do to help improve this and you can expect at every appointment we will be treating this.

Are You Coming to Us Feeling Frustrated, Hopeless or Uncertain about What the Problem is?  If So, You’ve Found the Right Providers for You!

  1. We bring insight into the Puzzle or Confusion of your Problem:  Don’t worry if you aren’t sure what is wrong with you.  During your pelvic PT evaluation, you can expect that it is our job to figure out how we can help you and to partner with you to get you feeling better.  Our clinical experience and high drive for keeping up with research and best practices, allows us to provide you care that is above and beyond what you will get elsewhere.  You can expect to have many of your questions answered throughout your pelvic PT evaluation.
  2. We love challenging and puzzling cases, because we find them very rewarding to partner with you to get you results.  Many of our patients tell us they have had ongoing problems and no one has been able to help them.  Many of our patients don’t know what is the problem.  Many of our patients have failed to feel better in spite of myriad other treatments.  We pledge to give you our best, clinical expertise and to partner with you to get you results.
  3. Our patients comes to us often with a confusing assortment of chronic problems.  We bring clarity to the confusion.
  4. We treat ALL pelvic conditions.  If you are wondering if we have ever seen or treated your condition, even if it is very unusual or complex, chances are high that we have.  We have patients who travel to us from other states.  We have treated individuals who have flown around the world to receive pelvic surgeries and evaluations with top providers for their condition.  Our doctors of physical therapy have many years experience working with major medical centers and expert providers across the country.  We have seen it all and, if we haven’t seen your specific condition before, we have the tools, experience and ability to partner with you to create a plan of care to best help you.
  5. Examples of Common Confusing Symptoms We Often Treat: Urinary urgency, frequency and incontinence, low back pain, pubic bone clicking, SI joint pain, hip/glute pain, anal fissures, vaginal burning, penile pain, constant lower abdominal pain, awareness of the bladder, urinary retention, very slow urinary stream, urinary urge incontinence, adolescent related athletic incontinence, pediatric constipation, pediatric fecal incontinence, bedwetting, tethered cord syndrome, tarlov cysts, constipation, interstitial cystitis, endometriosis, chronic pelvic pain syndrome, pudendal neuralgia, chronic prostatitis, orchialgia, persistent genital arousal disorder, pelvic pressure and pelvic organ prolapse, chronic urinary tract infections, BV or yeast infections, pregnancy related pelvic girdle pain, pregnancy related pelvic congestion, coccydynia, hip labral tears, hip pain after labral repair surgery, chronic prostatitis, post-prostatectomy incontinence and ED, sciatica, pain with sitting, pelvic organ prolapse.  If you have a puzzle of symptoms, rest assured, we can help bring clarity to your path forward because our pelvic PT evaluation identifies the myriad things that are contributing to your condition.  You can expect excellence from us when you receive your pelvic PT evaluation.

By The End of Your Pelvic PT Evaluation You Will Have Much More Clarity and Will Have:

  • Received Treatment
  • Detailed instructions and List of Things to Implement at Home
  • A Clear Understanding of What We Found
  • A Clear Understanding of our Plan and what to expect at the second appointment.

What Do Follow-Up Appointments Include?

Each appointment builds on the prior appointment and gives your body the treatment it is ready to receive.  Our treatment includes any number of interventions such as

  • Hands-on myofascial release
  • Trigger point release
  • Fascial flow & Fascia specific  mobilization methods
  • Nerve optimization hands-on techniques combined with exercise based methods
  • Pelvic floor dysfunction recovery techniques
  • Biofeedback
  • Exercise based training to resolve strength, tightness, weakness and discoordination.
  • Motor control and motor planning training
  • Diastasis Recti Abdominus-specific recovery exercises
  • Postpartum recovery program for return to sport
  • Post-surgical recovery to include rehabilitation of your core and pelvic floor
  • Balance exercises
  • Neural calming exercises
  • Heartrate variability training
  • Osteopenia and osteoporosis-specific training exercises and intervention
  • Chronic pain education
  • Pregnancy related birth preparation
  • Perineal education to avoid perineal traum during labor/delivery
  • Postural alignment and correction exercises and techniques
  • Joint mobilization
  • Deep core stabilization exercises

Our goal for your pelvic PT evlauation is to help you get answers and relief of your symptoms.  Experiencing any pelvic pain, urinary, bladder or intimacy problems is  not fun.  We are here to provide you trauma-informed, therapeutic and expert care to get you back to feeling like yourself.  We hope the detailed information helps you understand what to expect for your pelvic PT evaluation.  If you are interested in being evaluated by one of our doctors of physical therapy who specialize in pelvic health, call our office at 616.516.4334 and we can answer any further questions you may have.

Peace,

Dr. Maureen O’Keefe, DPT

Specializing in pelvic health since 1999.

Expert in complex pelvic floor dysfunction

Member of numerous professional societies devoted to clinical excellence for pelvic health.

Founder of Purple Mountain Physical Therapy

Leader of our Purple Mountain PT team, including our Doctors of Physical Therapy.  We are on a mission to serve our community to reduce pelvic floor trauma, chronic symptoms and dysfunction.