How Is Pelvic Floor Dysfunction Assessed?
In my last post, I discussed what the pelvic floor is and what dysfunction could look like. Today, I’ll discuss how pelvic floor dysfunction is assessed. As mentioned in my last post, pelvic floor dysfunction could look like urinary leakage, fecal/gas leakage, constipation/diarrhea, vaginal/pelvic heaviness, bladder/urethral pain, pelvic pain, abdominal discomfort or weakness, lower back pain, and more.
When assessing pelvic floor dysfunction, I’ll usually start by asking the patient about symptoms and sometimes I’ll have them keep a symptom log such as a bladder or bowel diary for a few days to track their symptoms. Next, I’ll want to perform a physical exam. I will perform on a patient if they are in the clinic or I’ll talk through how to self-assess step-by-step if I am working with them remotely. I’ll perform a musculoskeletal exam to check out their strength with a specific focus on pelvis/hips and abdominals. If someone has been pregnant, I will check for abdominal muscle separation, known as diastasis rectus. I’ll take a look at their lower body mobility and flexibility to see if there is anything we need to address there. Some other things I take a look at include posture, breathing mechanics and gait.
Photo by Zita Laura Szasz
With the patient’s consent, I can examine their external and/or internal pelvic floor muscles. An internal assessment is done either vaginally or rectally, depending on their symptoms. I use a gloved, lubricated finger to assess the internal muscles and tissues that could be contributing to any dysfunction. I explain the exam every step of the way and the patient always has the right to decline an internal assessment, without question. During a pelvic floor exam, I am looking to test muscle strength, coordination, endurance, as well as assessing for any muscle tissue restrictions or tender points.
After my exam, I explain my findings to the patient and then describe what I believe would be the best course of treatment. Stay tuned to my next post which will describe how pelvic floor dysfunction is treated. If you are interested in learning more about how you may benefit from pelvic floor physical therapy, you are welcome to schedule a free virtual consultation with me or get on the mailing list to learn about upcoming prenatal & postnatal fitness classes. Feel free to email Mariam@TahaPT.com or reach out via Instagram (@TahaTrainingandPT).
By Dr. Mariam Taha, PT, DPT, CSCS
Mariam is a Doctor of Physical Therapy specializing in pelvic health and owner of Taha Training and Physical Therapy. Mariam received a Bachelor’s Degree in Exercise Physiology and Doctorate of Physical Therapy from the University of Massachusetts Lowell. She has done extensive continuing education coursework in pelvic health and has a Certificate of Achievement in Pelvic Health from the American Physical Therapy Association. She is also a strength and conditioning specialist. Mariam always strives to make physical therapy an enjoyable experience and is motivated by working with a variety of patients. She believes in helping everyone achieve a healthier lifestyle.
Taha Training and Physical Therapy offers pelvic floor physical therapy, personal training, and small group training. They specialize in pelvic floor therapy as well as labor and delivery preparation. Sessions are offered virtually and in-person at their Brookline location. Check out their website to schedule your free consultation to learn more! www.TahaPT.com
