134 chapter 6: Health exams
If you have stiff or tight muscles
Muscles can suddenly get tight and stiff during
an exam. This happens mainly to women with
a spinal cord injury or cerebral palsy. Sudden
muscle spasms can happen when:
• you move onto an exam table.
• you are in an uncomfortable position.
A friend or family member can
• an instrument such as a speculum is put into the vagina. support your legs during the
• a health worker puts her fingers in the vagina or anus,
as with a ‘bimanual’ or rectal exam.
exam. Then you can relax your
muscles, which makes the
If you have tight muscles, ask the health worker to go
slowly so you have more time to relax. If a spasm happens
during the exam, ask the health worker to stop and wait
until your muscles are relaxed or soft again. Do not pull
or push directly against the tight muscles. This will make
the spasm worse. A friend can gently hold or support the
affected place until the muscle is soft again.
The exam will be easier if you can find a comfortable
position where you can relax and do not have to make
your muscles tight to hold yourself in place. Or ask a friend
or family member to help hold your body during the exam.
If this is not possible, you can roll up blankets and put them
underneath your knees.
You can also roll up a
blanket or use pillows to
support your legs.
IMPORTANT Do not massage or rub spastic muscles. Massage will make the
The pushing exercise
Women with cerebral palsy or spastic muscles often have a hard time
relaxing their muscles. To help relax the pelvic muscles, you can practice a
pushing exercise. First, practice pushing down as if you were trying to pass
stool. Some women imagine they are laying an egg that comes out through
the vagina. After a while, try taking a deep breath just when you start to push.
Practice this exercise before you have the exam. You can also do it again
during the exam, especially before the health worker puts a finger or an
instrument in your vagina. Once the health worker starts to examine you,
it will help if you stop pushing and relax the muscles in your belly. If your
muscles are tight, the health worker will not be able to feel inside you.
A Health Handbook for Women with Disabilities 2007