That said, a pelvic floor exam is very different from an annual gynecologic exam. For example, a pelvic floor physical therapist will watch you walk to determine your range of motion, strength, and flexibility, examine externally and internally, and pay attention to how the muscles and the pelvic floor behave. Are they contracted? Are they relaxed? Are they overreactive to touch? And then, the practitioner will prescribe a treatment plan.
“We’re seeing over a 300% increase in searches for pelvic floor in the last couple of years,” says Carmy. “These issues are more common than seasonal allergies, more common than diabetes, and more common than hypertension. This is a pervasive healthcare issue that’s impacting half the population. Now because of social media, in part because of COVID, there’s a surge of empowerment that we’re seeing among women and taking control of their own health care.”
A session at Origin happens in a private treatment room. A practitioner will visually look at the tissues to see if there’s any scarring or irritation. Then they will assess the perineal body to get a general sense of the movement activity of the muscles to understand the level of sensitivity and minimize discomfort during the exam. So a pelvic floor exam can happen both through the vaginal walls or the rectal walls. “The PT will start with one finger, kind of pushing throughout to feel the muscles,” says Carmy. “That approach usually minimizes the pain and also allows the PT to be super specific to understand the quality of the muscles, understand strength, and if there is any pain, discomfort or muscle weakness. And that’s how they can understand other trigger points over activity or maybe under activity causing those symptoms.”
Although specific to the patient, Origin recommends they come in for somewhere between six to 12 visits on average. And according to Carmy, it takes about six weeks to see muscle change. “Even after the first or second session, there can be a deep sense of relief and knowing that what you’re experiencing has a name,” she adds.
Men, too, can experience pelvic floor issues since its vulnerable to stress, surgery, constipation, and more. “The incidence and prevalence is not documented to be as high in men as in women,” says Uchenna Ossai, PT, DPT, WCS, CSC, and founder of YouSeeLogic. “Most of our research has been done on cisgender men and women, so when I’m speaking, I’m speaking in that context, but hopefully applying it to everyone in between. For a big part of my career. I was seeing 80 percent men with post-prostatectomy, incontinence, erectile dysfunction, testicular pain, rectal pain, penile pain, abdominal pain, ejaculatory pain, and premature ejaculation.”
To that end, pelvic floor physical therapy can be helpful universally—it’s more about education and identifying the issue. “We are just now at the cusp of general awareness,” Harper says.