PT: What to expect?

[ssha25]

Hi everyone! I’m new here. I am fairly sure I have vaginismus (my gyn couldn’t even get in me enough to make a diagnosis because I freaked out at the appointment. She referred me to physical therapy for pelvic floor. My first appointment is Monday. I have no idea what will happen. Has anyone gone to pelvic floor therapy? What should I be aware of?

[Heather34]

Hi ssha25. I’m so, so sorry for what you are going through right now. I had vaginismus all during my 20s and early 30s. I tried going to ob/gyn appts and could never go through with it as I freaked out at all of these appts (felt extremely anxious and felt burning pain/wall of resistance with any attempted exam). It was so, so hard and stressful to go through. Please know that I’m here for you. I ended up having the Botox treatment program and did not do pelvic floor PT as I could not do any insertion at all (i.e. tampons, dilators, husband’s finger/penis, etc.). However, I have read so many really excellent success stories on this Forum about Pelvic Floor PT and how much it helped. There is one thread I wanted to share:

Physical Therapy Post-Procedure
http://mazewomenshealth.com/forums/topic/physical-therapy-post-procedure/

I also found a great article:
Pelvic Floor Therapy: What it is and What to expect
http://femaniwellness.com/pelvic-floor-therapy-what-it-is-and-what-to-expect/

“What to expect during appointments

The first appointment should include a careful interview and discussion about your experience, including an account of symptoms as well as medical history and lifestyle. Pelvic floor therapists are trained to be sensitive to how personal and intimate these topics and this part of your body can be. The therapist will then evaluate your posture, back, and hips, and they should also explain along the way what they are noticing and how physical therapy can help.

To complete the assessment, your PT/OT may need to conduct an internal exam. Internal examination helps a PT/OT get a full sense of the strength and flexibility of your pelvic floor muscles, ligaments and fascia. For women, this will be through the vagina (though not with a speculum like a standard pelvic exam). For men and some women, the exam is done rectally. In some cases an internal exam is not necessary or possible, such as when your condition involves pain during penetration.

Often a biofeedback examination will be part of the complete evaluation. The therapist will use an internal sensor in your vagina or rectum or external sensors over your skin. These sensors do not do anything to you; they read the electrical activity in your muscles so that you and your therapist can see your pelvic floor muscles at work on a monitor.

If you are on your period or not comfortable doing this part during your first visit, the internal exam can wait until the second appointment. The PT/OT should be sensitive to any pain or discomfort that arises. Be sure to speak up and know that you are in control–nothing should happen without your full consent.

The Take-away: Treatment plan, goals, and timeline

During the first appointment, you may receive some initial advice and education. After the second appointment, you should have a more complete treatment plan. This plan may change based on how your body responds, and may include internal soft tissue work and exercises to do at home. Below are some things that your PT/OT might recommend. Some may require the purchase of a tool and/or lubricant for use.

• Pelvic floor exercises to do at home with or without a biofeedback tool (egg or wand)
• Trigger point massage to release muscle tension
• Insertion and use of a silicone dilator or vibrating wand
• Massage of other parts of the body
• Stretching and yoga
• Other gentle strength-building exercises
• Nutrition and lifestyle
• Mindfulness, breathing techniques and other pain management methods”

I hope this helps. Please know we are all here for you and send our support!!!!