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What to Expect At Your First Pelvic Health Therapy Session

Updated: Oct 9, 2023


 

So you’ve heard about pelvic floor therapy…


Maybe your doctor recommended it, or a friend has been nonstop exclaiming about their results. Or maybe your instagram algorithm has been showing you reels of middle aged women dancing around in a vagina or poop emoji costumes (their bravery is inspiring!) or facts about the disparities in the healthcare system and the material health care crisis (sadly, it’s true).


Now you’re left wondering, what the heck am I getting myself into?! What should I expect from my first pelvic health therapy session?


I’m here to be the voice to tell you, don’t be intimidated! That fear of the unknown is holding you back from living a life where you don’t have to worry about your bladder/bowel/or pelvic issues. None of these issues are things you “just have to deal with” for the rest of your life. I may be a bit biased (but I mean how could I not be?!). I want every single person to live without leakage, constipation, and pelvic pain. To me, these basic functions of life are taken for granted…until they start causing problems.


So you have worked up the courage to attend your first PT session.

When you meet with a pelvic floor physical therapist, the visit will start the same as if you were coming in for an assessment of your knee or shoulder. We’ll talk about what symptoms or issues you’ve been dealing with. However, due to the very personal nature of pelvic function, some of those questions may feel awkward to answer at first. For example, I ask all of my clients questions like, “How frequently do you have a bowel movement?”, “Does urination ever burn or cause you discomfort?”, “Are you having any pain during or after sex?”. None of these questions are to make you feel uncomfortable, but they provide important information to help me funnel down what might be causing your symptoms, so don’t be bashful.

I will also ask you for an insider’s perspective on what your goals are…in an ideal world, what could we improve (in regards to your pelvic function) to make your life better?


Next, I want to see how your body moves. I may ask you to show me how you pick up your dog from the floor, or what position you prefer to sleep in. I may test your balance ability, or core strength. I’m just looking to see which movement patterns your body prefers to utilize in your day to day activities.


If you are comfortable proceeding, I’ll take a closer observation at what your hip and back mobility is like, observe any scars you may have from past procedures/surgeries.

At this point in time, we’ll discuss what we’ve discovered so far and decide together if a pelvic floor muscle assessment is warranted at this time (this is where many people gulp). For some people, a pelvic floor assessment is not necessary and others do not feel comfortable having the examination completed until their second session. Other people have no problem getting the full assessment completed the day of. While I am here to facilitate the assessment and treatment, it is your body and you get to make the choice on what your treatment looks like.

In my experience, many people are surprised by how quick and painless the examination is compared to what they’ve experienced in the past at say a gynecologist visit (I won’t use a speculum, wahoo!). The pelvic floor exam can be an external assessment, in which observation is used to assess tissue health, determine your coordination and range of motion. If the client is comfortable proceeding, gentle palpation will be used to assess if there are any trigger points present within the muscles, changes in muscle tone or sensation. We can also test the power and endurance of the muscles and may be able to determine if scar tissue is a limiting factor.


I’ll guide you through all of these steps (so no need to try to remember them!) and make it very clear that I am here to help you. Many clients say that they are surprised to have learned so much about their body just from the assessment.If at any time you start to feel uncomfortable or wish to pause/stop, just let me know.


Now by this point in the session, I have some excellent data about how your body functions, what impairments may be contributing to your symptoms, and your wishes about how you would like it to function better. I’ll summarize all of this for you and then be able to recommend the treatment and exercises that are unique to your individualized needs. Together, we’ll set up a plan and answer any questions that may have come up along the way.


Then it’s full steam ahead into reaching your goals!


If you’ve seen a provider who didn’t take the time to thoroughly discuss your symptoms, lifestyle factors, and assess the full body as it functions as a whole…go find another provider! By the end of your first session you should feel empowered and excited to start the journey to reaching your goals. Find a healthcare provider that is willing to listen and respect your preferences. We’re out here and ready to help!




Example of pelvic health therapy session



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