Your First Pelvic Physical Therapy Appointment: What to Expect
I spend most of my day educating both men and women about their pelvic floor- what it is, where it is and how it functions. Did you know the pelvic floor plays a role in peeing, pooping and having sex. This group of muscles also support your internal organs (think: bladder, rectum and uterus in females). Overall, it’s a pretty important part of your body, but oftentimes gets overlooked! If you are seeking help with urinary, bowel or sexual symptoms or pain OR your doctor has referred you to a pelvic floor specialist, here is what you can expect. I promise it is not what you might immediately think & it does not have to be scary at all!
Getting To Know You
I typically spend a large majority of the first visit getting to know my patients. It is super important to have a good understanding of your history. It does not have to be intimidating and all of my sessions are done in a private treatment room. This allows you to share what brings you in, what some of your concerns are and what your goals are for your treatment. Other questions might include:
How often do you pee?
How often do you poop?
Do you have any straining when you pee or poop?
Are you noticing any leakage of urine- with activity (laughing, coughing, sneezing) or when you walk to the bathroom, or really any other time of day
Are you sexually active? Do you have pain?
Looking at the Big Picture
After getting to know you and some of your concerns, the next part of our session includes seeing how your body moves, assessing your strength and how your pelvic floor muscles function. Here are a few things I look at:
Watching you walk
Observing your standing posture
Looking at how you breathe
Checking your pelvic alignment
Assessing for tender spots in your abdominal wall
Looking at hip mobility and strength
Checking for tender spots in your hip muscles
If you are postpartum, checking for diastasis recti (DRA) or separation of abdominal wall
Performing external and/or internal assessment of pelvic floor muscles for tenderness, strength and endurance
The pelvic floor is just one part of your body and it is important to see how this group of muscles function with the rest of your body.
So, what is an internal assessment of your pelvic floor?
Some people come into my office dreading an internal assessment. They’ve either read something online or fear they will be in stirrups. Many times, they assume the experience will be similar to ones at their doctor’s office.
First, this part of the assessment is only performed with patient’s consent and you should feel 100% comfortable. It is by no means required and a lot can be done without this part of the exam. It does give me (as the PT) a lot of good information. I will use my index finger, lots of lubricant and insert 1 finger into your vagina. It does not last long, but does give me an idea about how well your pelvic floor muscles are functioning.
What’s next?
After gathering all of this information, it’s time to put the pieces of the puzzle together! I spend a lot of time educating my patients. Often, the topics we cover are things most people don’t talk about. No one tells you how to breathe properly while pooping or what types of food/drinks may be irritating your bladder. After the education, we will then discuss next steps. Some people need some breathing, relaxation and stretches while others may need strengthening. Each plan is specific to you and your needs!
I hope after reading this you feel more comfortable with seeing a pelvic floor physical therapist! Please reach out if you are interested in learning more or need help finding a pelvic PT in your area. You can find me over at ATL Pelvic Health if you are in the greater Atlanta area.
