What Should You Look For In A Pelvic Therapist?
What should good pelvic floor therapy look like?
If you’ve been wondering - “what should I expect to get out of pelvic floor therapy?”- you are one of many! It is important to go into your first visit with a clear idea of how you are going to be helped.
Before you meet for your first session, you might be asked to fill out an intake form that asks quite a lot of information about what you are coming in for, as well as some other information that you may not think to be as relevant. The first session is really about getting a good baseline of your whole history, as certain questions can help connect the dots from older injuries or surgeries to your current complaints. You might be surprised at how an injury from 10 years ago could be related to today’s symptoms! A complete health history also helps the therapist be as prepared as possible for you when you arrive for your evaluation.
Once you meet your therapist, a thorough evaluation will start with lots of talking. Your therapist will be creating a timeline of how, when, and why your symptoms started, as this will help guide their plan for treating those symptoms. This may include your health history, bladder, bowel, sexual health, daily activities, and most importantly your goals. As you go through these questions, you should feel like you can talk as much as you need as your story is an integral part of your care plan.
In the specialty of pelvic floor PT/OT, there is a lot of detail that should be going into your care, and you should feel like you are being listened to every step of the way.
Once you’ve shared your story, your therapist may guide you into the observation and hands-on assessment, and discuss how and why it will assist in creating your care plan as you go.
This might include:
Posture, breathing, and movement assessment
Assessment of pelvis and spine, hips, and low back for mobility and alignment
Abdominal assessment for any scar tissue restrictions, mobility, or tension-holding patterns, as well as diastasis rectus abdominis (DRA)
Discussing the logistics of an internal pelvic floor assessment which may be completed either vaginally or rectally, and then walking you step-by-step through the assessment itself - if appropriate, and as always with your consent, this piece will include an explanation of how an internal assessment is important to your care.
Toward the end of your evaluation, your therapist will complete their initial treatment plan for you which has been influenced by observations of any restrictions, limitations, pain or discomfort you had throughout the assessment. With this information, they will guide you to some immediate steps to help you reach your goals.
This will typically include a few exercises, bladder/bowel hygiene changes, and lifestyle habits that are sustainable over the lifetime, such as nutrition, sleep, and stress management. You may review the movements while the therapist gives you verbal and/or hands-on feedback about how you can perform this all at home with the best form. These strategies will be your “home exercise program” and you should be able to access some kind of visual reference (video, print-out) of these exercises so you can do them properly at home. For optimal improvement, your therapist should have a plan to have you off the table/floor and doing functional movements- not just on your back with knees bent hooked up to a biofeedback machine or having you do kegels the whole visit. Your list of exercises and how frequently to do them should also be clear to follow.
Oftentimes, your therapist will want to collaborate with the other members of your team including your physicians, OB/Gyn, midwives, urologists, gastroenterologists, orthopedic/performance PTs, personal trainers, massage therapists, acupuncturists, psychologists, counselors, nutritionists, or sex therapists. Ideally, you would finish your appointment with clarity on how your symptoms are going to be treated, as well as confidence that you now have another provider on your team who will help you reach your goals.
Hopefully this provides clarity on the type of care you deserve!
Interested in learning more? Chat with us about your specific needs in a free 30 minute consultation.