What to Expect at your Physical Therapy Appointment

A physical therapy evaluation begins by taking a detailed medical history, asking you various questions pertinent to your condition, function, activities, and lifestyle, while also carefully listening to your story.

A physical therapy examination may include:

• Performing a postural assessment

• Performing a gait and functional movement analysis

• Assessing your range of motion

• Performing specialized tests

• Assessing your breathing and body mechanics

• Assessing your craniosacral rhythm

• Assessing your muscles, joints, connective tissue (fascial), and nerve pathways for restrictions in mobility and/or reproduction of symptoms

• Testing for weak links along the myofascial chains of your body, and testing the length, strength, and endurance of specific muscles and how they coordinate together.

• Performing a vulvar exam looking for pain and/or symptom generators

• Performing an external and/or internal pelvic floor muscle exam (vaginal or rectal).

The findings on your exam combined with the assessment and your specific history, will determine together where to focus treatment, as well as which treatment techniques may be best for you. Even if your symptoms are greatest in one area of your body, looking at your body as a whole is important during the evaluation and treatment process.

Your whole body is connected and working together as a system during movement, in static positions, but also at rest (when there is still movement-respiration, digestion, etc). Often the areas above or below the painful or symptomatic areas in our bodies can be the driver or contributors to our symptoms. These could be related to biomechanics, related to our movement patterns and musculoskeletal impairments, and/or neurological (neuropathic pain from peripheral nerves, or even nerve roots in the spine.) Hormones can also be at play and contributing to our symptoms, or conditions related to our genital organs and genital tissues. Often in chronic pain conditions, pain and symptoms can begin in one area of our body and eventually spread out to other areas. This can be related to where our brain processes sensations (“smudging” at the sensory homunculous of our cerebral cortex), cross central sensitization of our central nervous system, referred pain from our muscles or organs (somato-visceral and viscero-somatic reflexes), and referred pain patterns from myofascial pain sources. A physical therapist can be thought of as a detective, looking for what impairments could be driving and/or contributing to your symptoms and condition, and how all these pieces fit together.

Treatments may include: