The Tummy Team Initial Self-Assessment Today s Date:

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Constance Parker
5 years ago
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The Tummy Team Initial Self-Assessment Today s Date: 1. Describe how you feel when you think about the core/pelvic floor area of your body. You can choose from these or add your own words.

Can you identify any triggers? In the morning When bending Sitting in the car After holding baby During Intimacy At the end of the day 5. How intense is the pain? (low) 1 2 3 4 5 6 7 8 9 10 (high) 6.

1 The Tummy Team Initial Self-Assessment Today s Date: 1. Describe how you feel when you think about the core/pelvic floor area of your body. You can choose from these or add your own words. Weak/Disconnected Frustrated Angry Broken Hopeless Hopeful Sad Consider any pain you have experienced or are currently experiencing. 2. Where do you have pain? 3. When do you have pain? 4. Can you identify any triggers? In the morning When bending Sitting in the car After holding baby During Intimacy At the end of the day 5. How intense is the pain? (low) (high) 6. Is the pain you experience: Sharp Dull Achey Radiating Nagging 7. How often do you have pain? Constant Daily Random Intermittent Consider your posture. 8. Do you feel you can stand up well without pain or fatigue? 9. Do you sit on your tailbone, collapsed; or on your sit bones and elongated most of the day? Tailbone, collapsed Sit bones, elongated 10. Do you notice yourself doing any of the following while standing for any length of time? Leaning on counter Resting on one hip Locking my knees

2 11. Can you sit on a bleacher or bench without back support for more than 10min without fatigue/pain? 12. Are there any other observations you have about your posture? Consider any incontinence symptoms (leaking of urine) you may be experiencing. (You may skip questions if you are not experiencing any pelvic floor dysfunction.) 13. Do you leak with sudden increases in pressure such as coughing, sneezing, jumping, or laughing? 14. Do you leak with lesser increases in pressure such as walking, getting up from a chair? 15. Do you leak with no relation to any movement or position, such as lying in bed? 16. Do you wet yourself before reaching the toilet? 16a. If yes, do you feel: A strong, uncomfortable urge warning before you wet yourself 17. How many days per week would you say you experience a leaking episode? What percent of the time are you not able to control the leaking? 25% 50 % 75% All of the time 19. How often do you wear a pad to deal with leaking? Almost never Sometimes Most of the time All of the time 20. How much leaking are you experiencing? a few drops a small amount Need to completely change undergarments or pad Consider your intestinal tract function. 21. Do you have daily bowel movements? 22. Do you struggle with constipation?

3 22a. If yes, how often do you regularly have a bowel movement? 0-2 times a week 3-5 times a week 6+ times a week 22b. What percent of the time do you feel the need to bear down to eliminate? 10% 25 % 50% 75% 100% 22c. Do you struggle with any of these symptoms? hemorrhoids bloating gas cramping IBS 22d. Do you feel a heaviness or like you cannot fully empty your bowels when you go? (Skip questions section if you are a male) 23. Do you have other heaviness or prolapse symptoms? I m not sure 24. When do you feel these symptoms? 25. What does it feel like? Heaviness As if something is falling out Bulging Pressure inside the vaginal canal 25a. Can you identify triggers for these feelings? Is it worse with any of these? Fatigue Standing Baby-wearing Running On your menstrual cycle 26. Do you have pain during intimacy? If your answer is yes: 26a. Do you have pain? During insertion After insertion 26b. Does the pain increase in different positions? 26c. Describe the pain: Raw Burning Prickly Dry Rubbing Sharp Dull Numb Uncomfortable 27. Do you feel disconnected internally during intimacy? 28. Do you have difficulty reaching orgasm?

4 Diastasis Measurements 29. After watching our diastasis self-assessment video, please indicate what you felt (do your best, this can be hard). List the number of fingers in the separation, if any, and circle the depth that your fingers can press in. Be gentle. At the Navel: fingers Shallow / Medium / Deep 3in. Above Navel: fingers Shallow / Medium / Deep 3in. Below Navel: fingers Shallow / Medium / Deep 30. Did you feel any pulsing? 31. Are the borders of the muscles very distinct and easy to feel, or thin and difficult to feel? Distinct, easy Thin, difficult 32. Do you see a trench when you lie on your back? 33. Do you sometimes see a bulge, tenting or alien-like thing sticking out when you get out of bed, when on your hands and knees, or are coughing/straining? 34. What does your belly button look like? (ex: sticks out, shallow, deep, looks normal, looks weird) 35. How is your skin? (ex: excessive skin, fairly firm, some stretch marks, sensitive to touch, etc.) 36. How did it make you feel to assess your tummy? Check any and all that apply. Emotional Sad Broken Curious Angry Frustrated Hopeful Numb Disgusted Interested Vulnerable Confused Sensitive Other Measurements Before you do anything else, take a picture of yourself from the front and side (showing your skin is good but you can also do it with a fitted tank top if you prefer). You want to get more than just your belly in the picture if you can. Try to get to the top of your head and at least to your thighs. Have someone help you if needed. Your tummy should not be pushed out and not sucked in, but rather where you typically live right now. The same applies to your posture. DO NOT OBSESS OVER THESE PICTURES. They are simply for reference to remember your alignment and level of activation. Store these pictures away for later, you do not have to show them to anyone.

5 Next, take two measurements: one around the widest part of your belly, and another around your navel. Sometimes the navel is the biggest part of your belly. If that s the case, you ll need just one measurement. Around your navel: Around the biggest part of belly: Journaling This can be very emotional so be kind to yourself and recognize the first step to healing is being fully aware of the extent of the weakness or dysfunction you are experiencing. Unfortunately, the first thing we become aware of is how difficult things really are. But there is hope. We will slowly start helping your body to regain the strength it was intended to function in. One step at a time. Take some time to journal about how this symptom inventory has made you feel. Do you feel more aware of the extent of how you are truly feeling and functioning? Do you feel overwhelmed or validated? TheTummyTeam.com

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