In Person & Virtual Pelvic Health
Pelvic Health Assessment
Find answers to common questions about the assessment of pelvic health concerns from the menopause transition, to support in pregnancy and post-partum recovery, pelvic pain, prolapse, and incontinence.
In Person and virtual Pelvic Health
What to Expect During a Pelvic Health Assessment
Here is what you can expect at your first visit:
Upon your arrival at the clinic, you’ll need to fill out some paperwork, including a detailed questionnaire about your bladder, bowel, and sexual function include pain and pleasure. This section will also ask about menstruation, pregnancy, pregnancy loss, and birth experiences. While personal, this information is crucial for tailoring your care. Feel free to share as much or as little as you’re comfortable with; we’ll discuss it more in person.
We will then go to a private room, and we’ll talk about your story, challenges, journey, and goals. I’ll be asking questions, including addressing the details from the questionnaire, and discussing any concerns you have. Remember, your comfort and safety are my priorities, and if there’s something you prefer not to discuss, just let me know.
I will then talk with you a little bit about what I think may be going on from a musculoskeletal, movement, and/or behavioral (habits) standpoint. At this point, I usually pullout some images, a model of a pelvis, etc. and will talk with you about what normal anatomy and physiology looks like in the pelvis and about what I think may be happening with the problems you are experiencing.
We will then do a physical exam. You remain clothed (soft clothing that allows you to move is best but not crucial) and we start with:
A “Big Picture” movement exam
I will watch you walk, stand, sit, and move in many different directions. I will look at how your spine moves (from your neck down), your shoulders, hips, knees, and ankles. While we do this, you’ll also let me know if any movements are challenging for you or lead to any pain, and this helps me understand how your body as a whole is moving.
Specific tests/movements
After the global movement screen, we may go through some specific tests. This can include tests to see how you transfer forces or control pressure through your pelvis by lifting a leg or moving in a certain way, tests to see how the nerves in your spine glide and move, or tests to see what structures are contributors to pain you may be experiencing.
Myofascial palpation
Next, we’ll see what tissues are tender or not moving well around your abdomen, pelvis, or elsewhere if we need to. This includes me gently touching the muscles around the belly, hips, and legs to see if anything feels uncomfortable.
Pelvic floor examination
After that, we will look more closely at the muscles of your pelvic floor. Because the muscles of the pelvic floor are inside the pelvis, the best way to examine them is by doing an internal vaginal or rectal examination. For this exam, you would undress from the waist down and lie down on a mat table, and you are covered with a sheet. I don’t use stirrups or a speculum for these exams (which most people are grateful for!).
We start by working with the outside tissues. Keeping the sheet over you, I’ll ask you to contract and relax your pelvic floor muscles, and gently bear down to see how your muscles move (Don’t worry if you’re not sure what to do, I can teach you!). I may ask you to cough to see how the muscles move reflexively. Then, I often will lightly press on the outside of the muscles to see if anything feels uncomfortable or sensitive to you. I may check how certain tissues move if that applies to the problems you are experiencing. After that, I can examine the muscles in more detail by inserting one gloved and lubricated finger into the vaginal or rectal canal. We can then feel the muscles to see if they are tender or uncomfortable, assess the muscle strength and endurance, and assess muscle coordination.
*PLEASE NOTE: While an internal exam is a very valuable examination technique, some people do not feel quite ready for this, or would prefer not to have an internal exam. Please let me know and I can offer some other options. Also, remember that our exam should not be a painful experience for you. My approach is to tailor the examination to your needs, so that you leave feeling confident and comfortable, not flared-up and in pain.
Post-exam, we’ll discuss a tailored plan to address your areas of concern and work towards your goals. Our conversation will include actionable steps you can take immediately and the frequency and duration of our sessions.
Virtual visits are available for your pelvic health exam and subsequent sessions. We can discuss how I can exam your inner core function and hip and spine mobility virtually and what you can expect with each session.
In Person and Virtual Pelvic Health
Fee Schedule
| TIME (minutes) | PELVIC HEALTH |
| 60 | Initial visit $130 |
| 50 | Longer follow up $110 |
| 40 | Regular follow up $100 |
Walser & Associates can direct bill most Extended Health Care Plans. The copay is the responsibility of the participant.
*Some Extended Health Care Plans do not allow us to direct bill. The participant would be required to make the payment and submit for reimbursement. Any portion of payment that is not covered by an Extended Health Care Plan does qualify for an income tax receipt under Medical Expenses.
Let’s Get Started
Pelvic Floor and Inner Core Screening
More Questions?
Schedule a 15-minute free discovery call with Denise to answer any questions.
Next Steps:
Book a pelvic health assessment with Denise.