It is common to have some anxiety, mixed with excitement about your first pelvic health appointment. Anxiety about the unknown but excitement about seeking help and starting the journey of recovery. Regardless of the feelings you are experiencing we are here to create a sensitive and supportive environment.
When people enquire about a pelvic health appointment there are many questions ranging from;
What can I expect from my appointment?
Is the internal exam required?
What will the treatment involve?
What kind of questions will i be asked?
What should I wear/bring with me?
First of all, each of these questions are normal and we believe you should be asking these questions, it’s your body and it’s important you are informed and comfortable with all of your health appointments.
What can I expect from my pelvic health appointment?
The first part of your appointment will involve a series of questions. We will discuss why you’ve seeked help with a pelvic health osteopath and the health goals you wish to achieve. Your osteopath will ask you a series of questions about your medical history, toilet habits, sexual intimacy, diet and exercise routine. It's essential that you be as honest as possible as the answers you provide along with how you have answered these questions allows your osteopath to begin building a picture regarding your health concerns.
Secondly a musculoskeletal exam will be performed. This involves a postural assessment from head to toe, a functional movement screen along with an external musculoskeletal and breathing examination.
It is at this point your pelvic health osteopath will determine and discuss with you whether an internal assessment or real time ultrasound is required.
If it’s decided you require the use of real time ultrasound, you will need a full bladder and comfortable clothing.
If an internal assessment of your pelvic floor is recommended, your pelvic health osteopath will thoroughly explain what to expect. If you choose to participate you will be required to sign a consent form. It’s important to know you have the right to change your mind at anytime and If you have any questions please ask.
Your pelvic health osteopath is highly trained and sensitive. They are here to answer all of your questions and provide education regarding what's normal and dysfunctional as we progress through the appointment. At Eastern Osteopathy we believe understanding your body, your anatomy, how things are connected, along with why you’re experiencing your symptoms is an important first step towards recovery.
To begin the internal assessment you will be asked to undress waist down, lie on the table in a comfortable position and drape yourself with towels provided.
No instrument will be used. Just lubricant, a glove and 1 or 2 fingers.
Your pelvic health osteopath will insert one finger (or 2 - this will be decided on a case to case basis) into either the vagina or anal canal. You will be instructed to contract and relax your pelvic floor muscles, cough and or bare down to assess how your pelvic floor functions with an increase in intra abdominal pressure (IAP)
The internal assessment will give your osteopath essential information regarding your pelvic floor and it’s tone, strength, endurance and coordination. This information helps to build a picture about your pelvic floor and whether it is weak, hypertonic and moving appropriately. During this part of the treatment, if a muscle or fascia is tight or dysfunctional gentle inhibition or myofascial release techniques will be used to help restore normal function.
Is the internal examination required?
The answer is no. Is it the best way to assess and treat the PF? Yes. But you 100% get to choose if you are comfortable with this type of assessment or technique. The RTU is a great back up if you choose to opt out of an internal assessment.
The real time ultrasound (RTU) is non invasive and is a quick tool allowing us to assess the pelvic floor and it’s relationship with the bladder. It is also a great way to check to see if the deep abdominals and the pelvic floor muscles are co-contracting. The RTU gives us important information about the pelvic floor and its ability to contract but there lies its main limitation. Although we can tell if you are able to engage your pelvic floor, we are unable to assess the quality and strength of the contraction .
What will the treatment involve?
When assessing your pelvic floor, we don’t just assess its function (ie how strong it is and how many kegals you can you do), we also look at your body as a whole to see if there are any biomechanical issues that could be impacting on how well your pelvic floor and deep core functions.
We will create a personalised treatment plan, where any restrictions identified will be treated using a variety of techniques. We will also advise on a specific pelvic floor rehabilitation program (which may involve a strengthening program or you may need to learn to relax your pelvic floor before beginning a strengthening program) movement practice, breathwork and recommendations for lifestyle changes to help you achieve your health goals.
What should I wear/bring with me?
You should wear comfortable clothes and if the situation permits have a full bladder (if the RTU is not required, you will have opportunity to void.) If you have completed a bladder/ bowel diary have x-rays or blood test or any other relevant information please bring this to your initial consultation.
For more information on women's health consultations, or to make an appointment, contact Kathryn or Elizabeth at Eastern Osteopathy on (03) 9042 0407
