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Internal Pelvic Floor Examination Timeline after Delivery

Cynthia Neville, PT, DPT, WCS, BCB-PMD

October 5, 2016

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Question

How long should a physical therapist who practices women's health PT, wait until performing an internal pelvic floor examination after delivery?  

Answer

Typically, wait at least 3 weeks after delivery to perform an internal vaginal pelvic floor exam. By the 10th postpartum day, bleeding has mostly stopped, although lochia, or yellow vaginal discharge, will continue for up to 8 weeks. The neuro-musculoskeletal examination of the pelvic floor begins with inspection of the healing of the perineum, sensation and reflex testing.  


cynthia neville

Cynthia Neville, PT, DPT, WCS, BCB-PMD

Dr. Cynthia (Cindy) Neville, PT, DPT, WCS is Assistant Professor of Physical Therapy, Mayo Clinic Alix College of Medicine, in Jacksonville, Florida. She is a Women’s Health Certified Specialist (WCS), board certified by the American Board of Physical Therapy Specialties. She serves on the faculty of the Mayo Clinic Florida Orthopedic Physical Therapy Residency Program, and advises multiple medical specialty programs at Mayo Clinic Florida. Her outpatient clinical practice at Mayo Clinic Florida serves women and men with pelvic floor disorders. Dr. Neville has authored and co-authored several research articles and book chapters on the topics of pelvic health rehabilitation, pelvic pain, and urinary incontinence. She has presented her research and provided rehabilitation and medical education nationally and internationally. She has developed successful Pelvic and Women’s Health Rehabilitation Programs at premier healthcare organizations including the Rehabilitation Institute of Chicago (now the Shirley Ryan Ability Lab) and Mayo Clinic Florida. At Brooks Rehabilitation in Jacksonville, Dr. Neville developed the first institutional pelvic health rehabilitation program across all levels of care, and the first credentialed physical therapy women’s health residency program in the state of Florida. She has trained more than a thousand physical therapists, occupational therapists, physical therapist assistants, and physicians in pelvic floor examination and pelvic health rehabilitation. 


Related Courses

Physical Therapist Management of Pelvic Floor Tension Myalgia: When Your Patient Has Pain Down There
Presented by Cynthia Neville, PT, DPT, WCS, BCB-PMD
Recorded Webinar

Presenter

Cynthia Neville, PT, DPT, WCS, BCB-PMD
Course: #4358Level: Intermediate2 Hours
  'Detailed explanations and illustrations of how to perform pelvic exam properly as this was not emphasized much in PT school'   Read Reviews
Pelvic floor tension myalgia can cause a range of symptoms including pain in the vagina and rectum, feeling of sitting on a ball or stick, and pain during intercourse. This course will explore why and how pelvic physical therapy is first line treatment for pelvic floor tension myalgia. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.

Ehlers-Danlos Syndrome and Hypermobility Spectrum Disorders in Women's Health Physical Therapy: Look For the Zebra
Presented by Cynthia Neville, PT, DPT, WCS, BCB-PMD
Recorded Webinar

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Cynthia Neville, PT, DPT, WCS, BCB-PMD
Course: #4151Level: Intermediate2 Hours
  'Very Informative'   Read Reviews
Women with Ehlers-Danlos Syndrome (EDS) and Hypermobility Spectrum Disorders (HSD) have a high rate of pelvic floor disorders, and EDS and HSD are highly prevalent in women with pelvic health impairments. This course provides physical therapists with an evidence-based update on EDS, HSDs, and pelvic health and will explore clinical reasoning in pelvic physical therapy treatment for this diverse patient population. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Wag Your Tail! Pelvic Floor Disorders and the Importance of the Coccyx
Presented by Cynthia Neville, PT, DPT, WCS, BCB-PMD
Recorded Webinar

Presenter

Cynthia Neville, PT, DPT, WCS, BCB-PMD
Course: #4164Level: Intermediate2 Hours
  'Great information but very in depth and unless further training probably not something I would incorporate but good to have the basic screening knolwledge'   Read Reviews
MRI studies show that with the performance of correct pelvic floor muscle contraction, the coccyx should move cranially, and with adequate pelvic floor muscle relaxation, the coccyx should move causally. This course examines the importance of the coccyx to the function of the pelvic floor muscles, discusses how coccyx impairments may contribute to pelvic floor muscle disorders, and explore physical therapy treatment options for coccyx impairments. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Physical and Occupational Therapy Treatment Of Abdominal Scars, Adhesions, And Abdominal Cutaneous Nerve Entrapments. Quit Your Belly Aching!
Presented by Cynthia Neville, PT, DPT, WCS, BCB-PMD
Recorded Webinar

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Cynthia Neville, PT, DPT, WCS, BCB-PMD
Course: #4757Level: Intermediate2 Hours
  'Speaker provided review of anatomy, a case study with videos showing the assessment and treatment and shared the benefits and “how to” to work with pain specialists'   Read Reviews
Abdominal scars, adhesions, and nerve entrapments are a source of abdominal and pelvic musculoskeletal pain symptoms. This course will examine and discuss physical and occupational therapist examination and treatment of musculoskeletal symptoms that may be caused by or associated with abdominal scars, adhesions, and abdominal cutaneous nerve entrapments.

Basic Physical Therapy Treatment of Constipation
Presented by Cynthia Neville, PT, DPT, WCS, BCB-PMD
Recorded Webinar

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Course: #3737Level: Introductory2 Hours
  'well organised, and instructor very knowledgable'   Read Reviews
This basic course will introduce clinicians to the physical therapy treatment of constipation. Participants will gain skill and knowledge in simple interventions to improve bowel evacuation that they will be able to apply immediately in the clinic. This course is directly related to the practice of physical therapy and is therefore appropriate for the PT/PTA.

Editor's Note: Regarding Pennsylvania credits, this course is approved by the PA State Board of Physical Therapy for 1 hour of general and 1 hour of Direct Access CE credit.

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