Whether you found your way to pelvic floor therapy from being referred by your doctor, hearing about it from a friend, or through the vast and magical world of social media, we are so glad you have found us! Visiting any medical professional for the first time can seem daunting. This is especially so when you are unsure of what a visit will entail. Today, we want to talk about what to expect in your first pelvic floor physical therapy session, so that you feel confident and excited about beginning this journey.
1. Obtaining Patient History
The first portion of your initial evaluation will be history taking; it is an opportunity for you to share your story and talk with your therapist about what your concerns and goals are. Depending on what brings you in, the therapist may ask additional questions to make sure that there is nothing else that might be beneficial to work on. You and your therapist will likely take some time to discuss pelvic anatomy (with Penelope to assist, of course) and the things the therapist feels will be the most valuable to investigate first. Before doing any hands-on assessment, your therapist will explain what that will look like. For many, this includes an internal assessment of the pelvic floor muscles. What on earth does that entail and why would I ever want to do that, you ask?
2. Internal Exam of The Pelvic Floor
First, if an internal exam is warranted, your therapist will describe it in more detail so that you know exactly what to expect. However, it is important to remember that internal assessments are always optional. It may not need to be performed on the first visit and can be stopped at any point if you decide you do not want to continue. Men are often particularly concerned about this aspect of pelvic rehab. Please don’t be – your therapist will respect your comfort level and find strategies to help you, with or without an internal assessment!
That said, an internal assessment is the most direct way of determining the pelvic floor muscles’ role in your primary concerns. It helps the therapist determine what exercises and strategies are likely to be the most effective for you. The doctor will perform an internal assessment, vaginally or rectally, and they typically don’t take long to complete.
We do not use stirrups or speculums, so it is typically a gentler experience than a gynecological exam. The therapist uses internal assessments to determine the tone of the muscles (how tight or loose they are) and assess their strength and endurance. We also evaluate the patient’s ability to correctly control the pelvic muscles, as well as whether there are any areas of tissue trauma and/or muscle spasming. This information is highly valuable in understanding the complex relationship between the pelvic floor and your symptoms. It helps us so that we can make the best recommendations.
3. Developing Your Pelvic Floor Therapy Plan
At the end of your session, your therapist will explain the findings from the evaluation and best treatment options. Pelvic health treatment always includes ample patient education and recommendations for changes to behaviors and/or movements. Treatment often includes manual, or hands-on, therapy both internal to and external to the pelvis. There will likely be exercises for you to complete at home as well. Sometimes we even use fancy technology, such as biofeedback with sEMG.
Your first visit will conclude with a discussion of the next steps including things you can be working on as part of your home program, duration and frequency of treatment, and any questions or concerns that you have. Often, questions do arise between visits. Please do not hesitate to reach out to your therapist via email and ask them! Knowledge is power, and we want to give you all the knowledge and skills we can!
RELATED: Common Questions About Pelvic Floor Therapy
What should I wear to my first pelvic floor therapy visit?
Whatever makes you feel comfortable and confident! Some patients will bring a change of clothes with them if they are coming from work, but this is solely personal preference. We do not care what you wear, we are simply glad you are here!
How long does pelvic floor therapy take?
Everyone responds to therapy differently, so this question is difficult to answer. Some people visit us once or twice, some people come in for a few weeks, and others for months. Our goal is to get you to your finish line, and we will walk (or run) beside you for as long as that takes.
If my therapist suggests an internal assessment, do I have to do it? What if I am on my period? What if I have not had a bowel movement recently?
Absolutely not! Nothing in pelvic floor therapy is ever required and we want you to always feel comfortable. If you are on your period, having an internal assessment is entirely up to you; while it does not impact the assessment or its value, people often prefer to postpone until their next visit. There is no need to fret if you have not had a bowel movement recently, this will also not impact the internal assessment.
Is pelvic floor therapy covered by insurance?
Yes, pelvic floor therapy is covered by the physical therapy benefits portion of your insurance plan. If you have questions specific to your insurance plan, give us a call so that we can help. Be sure to bring a copy of your insurance card if you come in for an appointment.
With Gratitude,
The Grace PT Team
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