Before your first visit, you will be sent questionnaires, or you can download them here. It is very important that you fill out the appropriate questionnaires before your first appointment as they will provide valuable information on the factors that can be influencing your condition. You may feel some of the questions are on a more personal level, but this information can help me effectively treat you. Some of the questions perhaps will not apply, if this is the case, you can simply skip them or they can be reviewed on the first appointment. If you are not comfortable answering some questions, that is perfectly ok too. I strive to create a safe and caring environment without judgement or bias. I am here for YOU and to address your concerns and you may feel more comfortable in answering them later on as we build a better rapport.
The first thing that will occur is a review of the questionnaires and I will ask you more questions to gather subjective information to better outline your concerns and your goals for treatment.
After that, a musculo-skeletal assessment of your back, pelvis and hips will be completed to look and mobility, flexibility and postural influences. Then you will be asked to disrobe from the waist down and cover up with the sheet after I have left the room. The assessment will then continue as the connective tissue around your abdomen, hips, groin and inner thighs are felt for any tension or trigger points. Connective tissue is the webbing of tissue that is between the muscle and the skin. Restrictions in this tissue from underlying abdominal or pelvic organ dysfunction, injuries, postural changes or surgical scars can directly influence your pelvic floor. After that, an observation of the perineum will be done to assess the integrity of the skin, the activation of the pelvic floor and other potential problems like scarring from childbirth or surgeries. External palpation of the perineum will be the next step to look for any tension or trigger points of the external pelvic floor muscles. Finally, an internal exam is completed to assess the state of your pelvic floor muscles and determine if they are weak and lengthened or short and tight. This is the most important part of the assessment as it will guide the outlining of your treatment and exercise program. Find out why it is important to have an internal done and why you should accept nothing else when it comes to pelvic issues here. Special tests to determine if a prolapse is present are next. In some cases, a rectal exam is also necessary to determine if a rectocele is present and to assess muscles that are closer to the tailbone and can affect some pain conditions. In men this is always necessary as it is the only way to effectively assess the pelvic floor muscles.
REMEMBER that YOU are in full control of the assessment at ALL times. Your consent is required for me to perform any part of this assessment. I will explain everything as I go along and ask for your consent at every step. If you are uncomfortable at all, you can and should ask me to stop. If there is anything I can do to make the assessment/treatment easier for your, please let me know as well.
At the end of the assessment we will determine goals for treatment together, and I will provide you with ample education and information on my findings and what they mean. You will be given some exercises to do at home and possibly some lifestyle modifications that can help resolve your symptoms. Sometimes small changes can make a significant difference. You will also be given lots of opportunities to ask questions.