What to Expect at Your First Pelvic Floor Physical Therapy Appointment

Taking the step to see a pelvic floor physical therapist is a proactive choice for your well-being, whether you're navigating postpartum recovery, dealing with discomfort, or simply seeking to understand your body better. My goal is to provide a supportive and empowering experience as you take this step toward improving your body's function and overall health.

Here's a glimpse into what you can expect:

1. The Conversation: Your Story is Key

Your first visit will involve a significant amount of listening from your physical therapist. I'll want to hear about:

• Your current symptoms – any pain, pressure, leakage, or discomfort you're experiencing.

• Details about your bowel and bladder habits, and any issues with urgency, frequency, or constipation.

• Questions about your sexual health.

• Your birth history, if applicable, including details about vaginal or cesarean deliveries.

This comprehensive history helps me understand the full picture of your body's journey and how it might be contributing to your symptoms. Communication is paramount as we all have different backgrounds and comfort levels. My job is to meet you where you are at and respect any and all boundaries you may have. 

2. The Physical Examination: Understanding Your Body

Following the conversation, I will perform a thorough physical examination. This is often a comprehensive yet focused assessment.

• I frequently begin with a posture assessment, both standing still and during activities such as squatting, walking, or going up and down stairs. This will precede range of motion and strength assessments of your hip and core musculature.

• If appropriate, I will likely observe your abdominal muscles for common conditions like diastasis recti abdominis (DRA), a separation of the abdominal muscles.

• For a pelvic floor assessment, I may suggest an external and/or internal palpation, always with your explicit consent. This helps me understand how your pelvic floor muscles are functioning – whether they can contract, relax, and lengthen effectively. During our first visit (or even subsequent visits), we may not even get here, and that's ok! We can discuss alternative assessment and treatment strategies to still get at the root cause of your symptoms.  

 3. Your Personalized Path Forward: Treatment & Education

Based on my findings, I will explain my assessment and collaborate with you to develop a personalized treatment plan. This plan is unique to you and may include:

• Targeted exercises to improve muscle strength, coordination, and flexibility, including specific pelvic floor muscle training and core strengthening.

• Gentle manual therapy to address tight tissues, muscle spasms, or scars (such as a cesarean scar, if applicable).

• Significant education on good body mechanics, constipation prevention, pain management, and strategies for managing intra-abdominal pressure during daily activities.

Your first pelvic floor physical therapy appointment is an opportunity to gain clarity, tools, and confidence. It's about empowering you with the knowledge and strategies to feel better and move forward with greater ease. If you have questions, feel free to reach out or schedule an appointment with me to learn more!