What you can expect from your Pelvic Floor Physical Therapy Appointment

It isn’t unusual to have some concerns or to be slightly nervous before seeing a pelvic floor physical therapist (PT).  We understand that it can be uncomfortable to talk about bowel and bladder symptoms, pain with sex or the many other symptoms that come along with pelvic floor dysfunction.  But, we want to put your mind at ease and explain what you can expect on your first visit with a pelvic floor PT and discuss what follow up appointments might entail. 

Pelvic floor physical therapy is a niche within the physical therapy world.  We specialize in the assessment and treatment of your pelvic floor muscles.  These muscles control bowel and bladder function, aid in sexual appreciation, stabilization of your spine and sacroiliac joint, organ support as well assisting in circulation.  As pelvic floor specialists we will educate you on these muscles and help determine if your pelvic floor is functioning properly.  

On a first visit, you can expect to spend much of the time discussing your symptoms, expressing your concerns, asking questions and sharing your goals with your physical therapist.  We have time to listen!  Your therapist will also perform a thorough review of your medical history, gather more information about your symptoms and work to formulate a plan that will best help you achieve your goals.  Another portion of the first visit usually includes a physical exam.  Whether it be your first appointment or a follow up appointment, at some point a pelvic floor muscle assessment is performed.  Your physical therapist will conduct this exam internally and externally depending on the situation and the symptoms.  An internal exam can be performed rectally or vaginally.  It is important to determine your muscle strength, assess for tightness or trigger points and to determine if your muscles can move through the full range of motion.  Internal exams are not performed on our pediatric clients.  As pelvic floor PTs, we are very experienced and this exam should be educational for you as a patient and we strive to make you comfortable through the exam.  Most of our patients will say at the end of their exam, “ I learned so much about my muscles and my body and why I am experiencing some of my problems!” Our goal is to educate and empower you as a patient to regain control of your body and to improve your quality of life!

Depending on the findings of the exam, we will then utilize a variety of skills, exercises, and treatment techniques to reduce your symptoms and to improve your muscle function.  We might find it important to work directly on your pelvic floor muscles with internal or external manual techniques(hands on techniques).  We will likely initiate a home exercise program for you to utilize outside of the clinic to further your progress.  This will include stretches, breathing exercises, dietary or behavioral modifications, and self treatment techniques.  We will also address impairments above and below your pelvis by assessing/treating your pelvic alignment, posture, lower body strength, “core” strength, etc.  It is also possible that we will utilize other pelvic PT specific tools such as biofeedback or vaginal dilators.  Biofeedback utilizes external sensors, similar to those used for an EKG heart monitor. These sensors are placed externally over your muscles on the skin, and they “read” pelvic muscle activity and display the information on a computer screen.  This gives you visual feedback as to whether or not your pelvic muscles are resting or are contracting.  We use biofeedback to create a pelvic floor muscle exercise program (aka kegels) specifically for you.  Vaginal dilators are a tube-shaped device that can be used to gently stretch the vaginal walls.  They come in many sizes and can be very effective in restoring pain-free vaginal penetration after a surgery, radiation, or in situations where the pelvic floor muscles are very tight or there is a vulvar skin condition causing pain.  These dilators can be used for trigger point release as well.  

As physical therapists we are trained to assess the musculoskeletal system from head to toe and over the course of your time in PT, we will be doing the same for you.  At Pelvic Wellness Center we have more time to spend with you and we will work to find the root cause of your symptoms and then work with you to determine a plan of care that will be the best fit for you.  Any concerns that you might have about the pelvic muscle assessment will be addressed before the exam is performed.  Our desire is to make your pelvic therapy experience exceptional and we strive to build trust right from the beginning.