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Pelvic floor therapy: What to expect at your appointments

Updated: Jun 23

When speaking to prospective clients who are seeking pelvic floor physical therapy, they often wonder what to expect for the initial evaluation and treatment visits. Here is what to expect for your pelvic floor therapy appointments.

Your first pelvic floor therapy visit:

Your first pelvic floor therapy visit will consist of quite a bit of talking. Your therapist will want to hear your general health history as well as any sort of menstrual irregularities, sexual dysfunction, bowel/bladder problems, any pregnancy or birth experiences and so on. There is nothing that is TMI for your therapist. 

After this detailed health history, your therapist will likely perform a physical examination. Generally on the first visit, an internal pelvic floor assessment will be done to see what is going on with the pelvic floor muscles. This is very different from an OBGyn visit. Most of the time, your OBGyn is not examining your pelvic floor function. If you are unsure or uncomfortable with having the internal exam done on the first visit, this is totally fine. The exam can be put off until you feel ready and comfortable. 

The internal pelvic floor exam will give your pelvic floor therapist important information on the strength, tone, and functionality of your pelvic floor muscles. The assessment is very gentle and done by your therapist with a gloved and lubricated finger and can be done either vaginally or rectally, depending on your condition. Your therapist will explain the findings of the pelvic floor exam to you and then give you exercises based on the findings. For example, if your pelvic floor therapist found that your pelvic floor muscles are too tight and unable to relax, she will likely teach you a breathing technique to encourage relaxation through the pelvic floor. 

Other physical exams that will need to be done, but might not be able to be done until follow up visits, include: movement screens (squatting, walking, bending), low back and hip range of motion, as well as an abdominal assessment and any other look at other parts of the body that could be relevant to your symptoms. The pelvic floor does not work in isolation and these areas greatly impact what is happening at the pelvis.

Pelvic floor therapy treatment sessions:

The follow up visits will include some more assessment as needed and will start focusing more on treatments. Here are some treatments you could expect to receive:

  • Skilled manual therapy: Tightness and restrictions can occur in muscles, joints, scar tissue, fascia, and even around our organs. Specific techniques are used to reduce tension and restrictions to allow for better mobility and movement. We will use the road map we discovered in our assessments to guide us where and how to treat. Manual therapy can be done to any part of your body including the hips, spine, rib cage, neck, pelvic floor, or wherever your therapist believes to be affecting your pelvic floor symptoms.

    • Some types of manual therapy include:

      • Myofascial release

      • Visceral or neural manipulation

      • Dry needling

      • Cupping

      • Joint mobilization

      • Scar tissue mobilization

  • Exercise program: Movement is medicine for the body. Our pelvic floor muscles need movement just as much as our legs do. We prescribe specific exercises that address the specific problem you are having. These exercises can include strengthening, stretching, breath work, and functional movement. These exercises are designed to get muscles working together in coordination. And No –, pelvic floor therapy is not just kegals. You may get kegals as an exercise but it will be a small piece of your home program.

  • Posture assessment: How you are holding your body all day affects your organs, joints, muscles, and nervous system in a way that can worsen your pelvic floor symptoms. We will assess the way you stand and sit and practice getting into a posture that is better for your pelvic floor.

  • Lifestyle coaching: We will take a look at your diet, fluid intake, sleep patterns, stress management, bladder/bowel habits, and so on depending on your specific issue. Your daily behaviors may be contributing to your pelvic floor dysfunction. Together, we can track these patterns and discuss some reasonable changes. 

The thought of going to pelvic floor therapy can make a lot of people anxious if they aren’t sure what to expect. However, if you are ever feeling unsure or uncomfortable with any step of the process, don’t hesitate about speaking up. Your therapist should be listening and checking in with you throughout every session with you.

If you are in the Albuquerque area and would like to schedule an appointment at Sacred Roots, give us a call at 505-506-6943!

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