You might be thinking, “Why are they nervous?” Because what I do is very different than a typical physical therapy evaluation. Some reasons why they might be nervous or have apprehension are:
- some patients are not sure what to expect and have never heard of pelvic floor physical therapy;
- some patients are nervous because they had a bad experience from a previous pelvic floor physical therapist;
- some are expecting that they are going be told once again that there is nothing wrong them;
- they are scared that this evaluation will cause more pain and not give them the answers they are looking for.
There could also be a myriad of additional reasons and I understand this so I am aware to be gentle and conscientious of anything else that might be going on.
Then I greet my patient with a smile and a handshake at the reception area, introduce myself and bring them back to the examining room where we just begin with a conversation. During this conversation, I ask them to tell me their story based on how comfortable they are and as much as they are willing to share. I feel that storytelling is such a powerful way to get across the impact of what the patient is feeling. Their story can last minutes or over an hour, it can take time to weave events together to bring the pain and/or dysfunction to be revealed. I will interject as needed, or confirm their suspicions of certain symptoms, or say a few things that they might not be able to express themselves. When I say what I believe they are attempting to get across, I usually hear, “Yes, oh my gosh! You said exactly how I feel!” This is when I become hopeful, because I know they are in the right place and they will be able to get the help they need.
Once the intake process, or information gathering takes place we move on to the evaluation, where I explain what I will I be doing mixed in with a a little humor here and there to ease the uncomfortableness of what I might be checking, feeling and looking for. I may look, feel and exam many different areas of the body, not just the pelvis. At times the most uncomfortable part, initially, for most of my patients is when I have to exam their private parts. Because I talk about them all the time and grew up in a family with doctors and nurses all around me, I am very comfortable talking about the body and it’s many functions. You can only imagine what our dinner talks were! I digress, as I exam the more intimate areas – I thoroughly explain what I am doing and why because their comfort is one of the most important factors to me. I always let them know that this is way easier than a gyno or a prostate exam!
Throughout the exam I am able to treat at the same time as I am giving them helpful takeaway points. I suggest stretches and/or exercises and how to decrease any habits that may be perpetuating the problems. I am very adamant that my patients keep good communication with me as far as what I am doing, my approach with different manual techniques, what they feel comfortable with. After the end of the evaluation and treatment, we discuss treatment plans that we both agree on.
My goal is that my patients leave hopeful that this pain will end.