Assessment of the Pelvic Floor and Associated Musculoskeletal System: Guide for Medical Practitioners

Abstract

Objectives This study aimed to assist practitioners in performing an accurate assessment of the external and internal pelvic musculoskeletal (MSK) systems to improve appropriate diagnosis and referral of patients with pelvic floor disorders or pelvic pain and to improve understanding of physical therapy (PT) treatment principles, thereby improving communication between practitioners and encouraging a multidisciplinary approach. Methods A referenced review of the anatomy of the pelvic floor muscles, pelvis, and surrounding structures, followed by a detailed assessment of anatomy, posture, and gait, is presented. A thorough description of PT assessment and treatment is included with clinical relevance. Results When proper assessments are routinely performed, MSK conditions can be recognized, allowing for prompt and appropriate referrals to PT. Assessment and treatment by qualified physical therapists are integral to pelvic health care. After efficient medical assessment, MSK dysfunction can be addressed expeditiously, thereby avoiding further decline. Left unaddressed, pelvic dysfunction may become chronic. Conclusions We propose a guide for MSK assessment of the pelvis and associated structures that can be used for both clinical and research purposes. This guide is designed for health care providers caring for women with pelvic floor disorders, including physicians, advanced practice providers, and nurses. This guide serves to improve communication among multidisciplinary practitioners to refine MSK assessment and treatment approaches and thereby advance clinical care and research.

The RISE FOR HEALTH study: Methods for in‐person musculoskeletal assessment

“…For the MSK component of the in‐person visit, participants are asked to wear comfortable clothing and shoes. Before starting the MSK examination, the rationale for the testing will be presented to participants including how the MSK system may influence the pelvis 12 and an overview of the procedures (Supporting Information: RISE Form 7). A Research Coordinator (RC) will collect an updated medical history including current pain intensity and location along with a query of pain medication taken on the day of examination.…”

Manual therapy formyofascial pelvic pain: A case report and narrative review

“…The diagnosis of MPPS relies predominantly on the patient's history and physical examination. A comprehensive assessment of the patient's history is crucial for accurately diagnosing and effectively managing MPPS [8]. The standardized assessment includes observing the patient's gait, examining the lower back and abdomen, and performing a systematic external and internal examination of the genital area.…”

“…It is essential to obtain informed consent from patients and provide them with a comprehensive explanation of the examination procedure and its purpose [9]. HarmErnandes et al has outlined a detailed assessment protocol for MFPP [8].…”