Time for a Check-Up! Establishing Your Pelvic Floor Baseline

Do you remember when you last went to the dentist for a cleaning? How about your last GYN exam? For many of us, these check-ups are a regular part of life every year or so. But when it comes to pelvic floor health, we often wait until something feels really off before we book an appointment. Let us say it: your pelvic floor deserves the same proactive care as the rest of you!   

Whether you’re feeling completely fine, noticing a few small changes, or heading into a new life stage, understanding your pelvic floor baseline can help you stay ahead of issues and take charge of your long-term pelvic health. Read on as we discuss baseline basics, who should get a baseline assessment and why, and what to expect at pelvic floor therapy. 

What is a pelvic floor baseline?

A pelvic floor baseline is a snapshot of your pelvic floor health as it stands right now. Just like all aspects of your body and overall health (your blood pressure, cholesterol, muscle mass, etc.), these tissues can change over time. Familiarizing yourself with your pelvic floor health today (whether you have any symptoms or not!) can help you understand any changes in the future. 

As physical therapist and clinical leader Dr. Sarah Clampett, PT, DPT explains: 

“Being proactive about your pelvic floor health puts you in the driver’s seat, and it’s just as important as getting help when you have symptoms. We want to help you catch changes early, take care of small issues before they become bigger ones, and feel more confident in how your body is working.”    

What happens during the pelvic floor therapy evaluation?

For your first visit at Origin, you’ll meet one-on-one with a credentialed physical therapist who will ask questions about your pelvic floor health, assess your symptoms (if you have them), and guide you through personalized exercises and self-care strategies. While an in-person visit allows your clinician to provide hands-on care, most of our treatments can be done virtually, and cost as little as $0 per session with insurance. 

Our visits begin with a lot of listening: about your medical history, pelvic health and symptoms, and goals for therapy. From there, your clinician will go through an external evaluation to look at your posture and breathing (in-person or virtual), and external pelvic floor tissues (in-person). While it can be helpful, an internal pelvic floor assessment isn’t required, either right away or ever! Your clinician can learn a lot about your pelvic floor muscles from your self-reported symptoms alone. 

 If you decide you’re comfortable with it, an internal assessment can happen:

• In-clinic: No speculums here! With your consent, your clinician will insert one gloved, lubricated finger into your vagina or rectum to check on your pelvic floor muscles. They may ask you to perform some contraction and relaxation movements with your pelvic floor muscles. This checks your pelvic floor strength, coordination, tension, and function. 
• Virtually: You can perform a self-assessment with your camera off in a secure, HIPAA- compliant Zoom meeting, or on your own time, and report back to your clinician. 

After your check-up, your clinician will create a personalized care plan, talk about next sessions, and answer any questions you may have. And that’s it, you did it! Your pelvic floor couldn’t be more grateful for the love and care.  

Who should get a pelvic floor baseline, and when?

Everyone has a pelvic floor, which means everyone can benefit from a baseline pelvic floor assessment and physical therapy! 

Your pelvic floor is an unseen powerhouse that plays a major role in your overall health and well-being, as it helps: 

• Support your organs
• Stabilize your core
• Control your bladder and bowels
• Facilitate reproductive and sexual functioning 
• Circulate blood and lymph fluid

Even with these important functions, it’s easy to overlook your pelvic floor health or ignore it altogether. However, taking care of these muscles can help you prevent future problems or manage and resolve current ones. Pelvic floor physical therapy isn’t only for people with severe symptoms; it can be helpful long before you have any symptoms at all. With this in mind, let’s discuss when to see a pelvic floor therapist.

When you’re feeling fine

Not currently dealing with any leaks, pressure, discomfort, or other symptoms? Amazing! Checking in with your symptom-free pelvic floor can help you learn how to keep it that way. A simple pelvic floor check-up, either in-person or virtual, allows you to understand what your “normal” looks like. That way, you’ll be quick to recognize if something starts to feel off and can address issues before they can become more serious. Preventive pelvic floor care is the name of the game, and we’re here to help. 

When you have minor symptoms

Taking care of your health means paying attention to all your pelvic floor symptoms, no matter how small or infrequent! If you’re experiencing symptoms, you aren’t alone: pelvic floor dysfunction is common in the trans population, and almost one-third of women in the US have at least one pelvic floor disorder. It may be time to check in with a pelvic floor PT if you:    

• Leak a little when you sneeze, cough, laugh, or work out
• Feel either pain or less sensation with sex 
• Feel pressure or heaviness in your pelvis 
• Have trouble peeing or pooping without straining
• Have sudden urges to pee or poop that are hard to control
• Have trouble holding back gas

Some of these are signs of weak pelvic floor muscles, some are signs that they’re overactive or tight, and sometimes it’s both! For example, pelvic floor muscle tightness can cause painful sex, but those same muscles can also benefit from strength exercises. A pelvic floor PT can assess where your muscles' starting point is and give you the personalized support you need.    

When you’re approaching (or already in) a life transition

Life is full of different stages, and certain transition periods can have a significant impact on your pelvic floor health. Your pelvic floor muscles can stretch during pregnancy and delivery, weaken as you age, and even become overactive when you’re stressed. Establishing your pelvic floor baseline before these transitions can help you 1) understand your current “normal,” and 2) keep an eye on any changes if/when they happen. Times to consider a pelvic floor check-up include (but aren’t necessarily limited to):

• Before you get pregnant 
• Before you give birth
• During perimenopause
• Before and after surgery, such as surgery to address pelvic organ prolapse or urinary incontinence  

The importance of knowing your pelvic floor baseline

We know that no one loves making appointments (or if you do, tell us your secret!). That said, adding a quick pelvic floor exam to your calendar helps support your overall health and well-being in so many ways. Benefits of knowing your baseline include:

• Detect problems early: Common life things, such as menopause, childbirth, obesity, smoking, and genetics, can all increase your risk of developing a pelvic floor disorder. Checking in with your pelvic floor can help you notice early symptoms and prevent small bothers from becoming big ones. 
• Get a personalized prevention plan: Whether you’re experiencing symptoms or not, a pelvic floor PT provides you with a personalized care plan that can help keep your pelvic floor healthy and functional. 
• Have a benchmark for future comparison: Our bodies are always changing and adapting; understanding your pelvic floor today gives you a reference point for any changes that happen tomorrow. 
• Restore some peace of mind: Your pelvic floor health doesn’t need to be a mystery! Pelvic floor physical therapy lets you check in with your body, appreciate everything it’s doing, and receive support where it’s needed. 

Checking in with your pelvic floor health 

Supporting your pelvic floor doesn’t need to be scary or difficult, and we’re here to make sure it’s not! Getting a baseline check-up is a quick way to take care of yourself and your pelvic floor, and help you prevent issues before they start. Book an appointment with us today if you’re ready to get started, at as low as $0 per session with insurance.  

Sources

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Kenne, Kimberly A., et al. “Prevalence of Pelvic Floor Disorders in Adult Women Being Seen in a Primary Care Setting and Associated Risk Factors.” Scientific Reports, vol. 12, no. 1, 14 June 2022, https://doi.org/10.1038/s41598-022-13501-w.

van Reijn-Baggen, Daniëlle A., et al. “Pelvic Floor Physical Therapy for Pelvic Floor Hypertonicity: A Systematic Review of Treatment Efficacy.” Sexual Medicine Reviews, vol. 10, no. 2, June 2021, https://doi.org/10.1016/j.sxmr.2021.03.002.

DeLANCEY, JOHN O. L. “Anatomy and Biomechanics of Genital Prolapse.” Clinical Obstetrics and Gynecology, vol. 36, no. 4, Dec. 1993, pp. 897–909, https://doi.org/10.1097/00003081-199312000-00015. Accessed 16 May 2020.

NORTON, PEGGY A. “Pelvic Floor Disorders: The Role of Fascia and Ligaments.” Clinical Obstetrics and Gynecology, vol. 36, no. 4, Dec. 1993, pp. 926–938, https://doi.org/10.1097/00003081-199312000-00017. Accessed 8 Mar. 2021.

Wallace, Shannon L., et al. “Pelvic Floor Physical Therapy in the Treatment of Pelvic Floor Dysfunction in Women.” Current Opinion in Obstetrics and Gynecology, vol. 31, no. 6, Dec. 2019, pp. 485–493, urology.stanford.edu/content/dam/sm/urology/JJimages/publications/Pelvic-floor-physical-therapy-in-the-treatment-of-pelvic-floor-dysfunction-in-women.pdf, https://doi.org/10.1097/gco.0000000000000584.