What should you expect from your first pelvic floor therapy session?
Pelvic floor therapy typically does not look or feel like your traditional physical therapy. If you are seeking this kind of care, you may be pregnant or postpartum, and/or you might be experiencing incontinence, pelvic pain, painful intercourse, constipation, low back pain, hip pain and more. If you are dealing with any of these issues, a pelvic floor evaluation is an excellent idea.
Pelvic floor PTs and OTs are trained in the evaluation and treatment of orthopedic and musculoskeletal conditions with advanced training in the specialty of pelvic health.
Many women believe that they just have to live with painful intercourse or leaking urine when they run after their kids or when they sneeze but that is not the case. These conditions are not usually talked about or are considered normal because they are common. You do not need to manage them alone! Pelvic floor therapy can help to drastically improve or completely eliminate these symptoms as well as provide you with the skills you need to return to the activities you love to do safely.
So now that you have found your way to pelvic floor therapy, what should you expect from your first visit? If you are coming in for an in person evaluation, here are some things you can expect:
When you arrive, I will greet you and take your temperature and have you go through a screening process for COVID-19. After that is complete, the evaluation will begin with an in depth conversation. To me this is the most important part of your first visit.
We want to learn all about YOUR STORY.
Some topics that we will cover include:
Your medical and health history
Your current symptoms and or conditions for which you are seeking treatment
Your bladder and bowel habits
Your lifestyle including; daily and work activities, diet, what you love to do for exercise
Your learning style
Your specific goals for therapy
From this point onward, we are a team.
Next, we will perform a musculoskeletal assessment. This looks very similar to a “traditional” physical therapy evaluation. Here, we will evaluate your posture, breathing patterns, and movement patterns in various positions such as how you sit, stand, bend, squat, lift, etc. We will assess the strength and mobility of your abdomen, spine, and hips. Since the pelvis and the pelvic floor are a deep foundational part of the body, there is much more to treating the pelvic floor than just looking at the pelvis!
From there, your therapist will introduce you to the basic anatomy and function of your pelvic floor, how it relates to your specific symptoms or condition and the process of my external and internal pelvic floor assessment.
An internal assessment of the pelvic floor musculature is important because the pelvic floor muscles live inside the pelvis and the way we can access them best is within the vaginal and rectal region. These tissues which include muscles, tendons, fascia and bone are just like anywhere else in the body. The internal pelvic floor portion of your evaluation does not need to happen on your first day or even at all and we will make this decision together.
Prior to your internal assessment, your therapist will step out of the room and have you undress from your waist down and then we will return when you are comfortable and under a sheet. During the internal exam, your therapist will observe how your pelvic floor muscles move and function. We will perform a manual assessment of your pelvic floor muscles externally and internally to determine their strength, endurance, and coordination as well as identify any muscle tightness or tenderness. We don’t use a speculum or stirrups and it is important to me that you are comfortable as possible.
To Learn more about the internal exam, see our Blog Post What To Expect During An Internal Pelvic Floor Exam and Internal Manual Pelvic Floor Treatment
After the musculoskeletal and pelvic floor assessments, your therapist will explain my findings and my recommendations for your treatment going forward. Then, we make a plan of action TOGETHER.
Since your initial evaluation is 90 minutes, there is most often time for some initial treatment.
Initial treatment may include:
Postural retraining
Breathwork & Yoga
Functional movement training
Corrective exercise
Manual Therapy
Soft tissue massage
Myofascial release
Joint mobilization
Kinesiotape or McConnell Tape application
Dry Needling
You will leave your first visit equipped with a game plan and an initial home program which may include:
Yoga & stretching
Strengthening exercises
Self treatment strategies
Bladder and/or bowel retraining strategies
Accessible communication with your therapist throughout your treatment is imperative for your progress. Your therapist is available to you via messaging in your secure portal and email in between your sessions. We are always here for you. This helps make each session more effective.
Your pelvic floor therapy evaluation is an important step on your way towards feeling well and improving your life. Although it can be intimidating to approach these personal topics with someone new, we can assure you that you will leave feeling glad you did!
Schedule your FREE 30 minute consultation with one of our pelvic health physical therapists:
Photos Credits: Bonney Durham Photography
