Sarina Beasley, PT, DPT
Therapy For My What???
Yes, Ladies, there is, indeed therapy for your vagina! There is a group of awesome people, and I say that because our specialty is growing to include male practitioners, that focus on pelvic health.
Our biggest focus is on the muscles, bones, and ligaments of the pelvis but this also includes treating problems related to your pelvic organs as well.
What is in my pelvis?
Pelvic Floor Muscles- The pelvic floor is made up a group of muscles with both a right and left side for most creating a bowl. Unlike your legs that work separately, your pelvic floor muscles work as one big team and when you contract one of the muscles you are actually contracting them all.
Ligaments- Ligaments are bands of taught connective tissue that helps stabilize the joints of your pelvis, that includes your sacroiliac joint and your pubic symphysis
Bones- These include your sacrum, iliacus, ischium, and the pubis which the last 3 are fused together on each side. Your pubic bone is separated by your pubic symphysis, a piece of thickened cartilage that pads the center of your pubic bone.
Joints- The sacroiliac joint is on the backside with both a right and a left, in the pubic symphysis creates a joint as well. Unless you are pregnant, postpartum or breastfeeding, these are relatively stable joints and don’t move much. Traumatic injuries to your pelvis can also create instability, but they are much less common.
Organs - Within your pelvis, the bladder, uterus, and rectum can all be palpated on an internal exam. All of these organs move to different positions throughout your cycle and during your regular bodily functions.
Going into a Women’s Health/Pelvic Floor evaluation for the first time can be daunting. And, you may be wondering, “What the heck am I getting myself into?” when walking into that examination room.
I get it - Our training requires that all of us have the same examination performed on us before we do it on you. We learn from each other! Many of us have even seen our own colleagues’ vaginas.
Here is what a typical pelvic floor PT exam looks like:
✔️You are greeted by a down-to-earth, understanding, and easy-to-talk-to physical therapist.
✔️A thorough interview discussing your urologic, GI, OB and gynecologic history, as well as your pelvic symptom history.
✔️A low back, hip, pelvis screen
✔️External examination of your perineal region:
•To see how your pelvic floor functions.
•Check for muscle spasm or pain on the surface of your pelvic floor
•Check for irritation of your tissues
•Assess for visible prolapse of your pelvic organs
•Check your reflexes
✔️Internal digital examination (vaginal or rectal depending on your complaints):
•Assess the strength, endurance, and coordination of your pelvic floor muscles much like we do with any other muscle in your body
•Make sure you are doing your pelvic floor muscle contraction correctly
•Check for muscle spasm or other pain deeper in your pelvis
•Assess other tissues (ligaments, fasciae, pelvic organs) that may be contributing to your symptoms
We typically do not use a speculum or stirrups, though they may be used in more advanced exams.
Particularly for those with very sensitive vaginas, victims of sexual assault, or if you are just uncomfortable and would prefer not to have an internal examination, know that commonly we can assess for many of these things externally, as well.
Now you are fully prepared for your physical therapy pelvic exam. Now get thee to the nearest pelvic health specialist!