What to expect from your first pelvic floor physical therapy appointment

Pelvic floor physical therapy (PFPT) is a specialized form of therapy aimed at addressing dysfunctions in the pelvic floor muscles, which play a critical role in supporting the bladder, bowels, and reproductive organs. If you’re considering pelvic floor physical therapy for issues like incontinence, pelvic pain, or postpartum recovery, understanding what to expect during your initial evaluation can help alleviate any anxiety and ensure a positive experience.

Here’s a breakdown of what will typically happen during your first visit:

Thorough Health History Discussion

A healthy and thorough discussion starts with effective paperwork. Here at PeakRx, we have clients spend time filling out paperwork that will dive into their core and pelvic floor history. We love this as it allows you from the comfort of your own home to begin to think through your issues. We understand many of the topics we can discuss in PT can be sensitive, so starting off with paper work is a great way to allow you to answer questions independently before coming in to see us.

Your therapist will spend time going through your paper work prior to your appointment to be fully prepared! 

When you arrive, you will be greeted by your therapist and taken to a private space to first have a conversation. We always preface that nothing is TMI (too much information) for us here. We talk about peeing, pooping and sex all day long! Nothing will take us off guard and generally all of it is relevant! So please feel free and comfortable to share what you are willing to discuss! We are here for it. 

General topics we will dive into include:

• General Medical History: Any past surgeries, injuries, or chronic conditions. Your whole body affects your whole body. 
• Specific Pelvic Floor Symptoms: Whether you experience urinary or fecal incontinence, pelvic pain, pain during intercourse, hernias, hemorrhoids and even things like back and hip pain. All of it matters! 
• Lifestyle and Daily Habits: Things like fluid intake, exercise routines, or stress levels that could affect pelvic floor health.
• Obstetric and Gynecological History: For women, this may include details about pregnancy, childbirth, and menstrual cycles. Understanding these details continue to help paint us a picture of your story and why you are dealing with your issues. 

Your therapist will likely ask about any medications you take, as some can influence bladder function or pelvic health. Being open and honest during this conversation is crucial for tailoring the therapy to your needs.

Discussion of Your Pelvic Floor Health Goals

Arguably, this is the most important part of our time together. If you could hit a home run at PeakRx, what would that look like? What are you hoping to achieve? Our goal of the first appointment is to create a plan to get you to where YOU want to be. We may even have you dream bigger because we know that with time, dedication and intentionality, women can achieve a lot! 

 Physical Assessment

The core of pelvic floor physical therapy involves assessing the strength, flexibility, and function of the pelvic floor muscles. This evaluation typically begins externally, and in some cases, may involve internal exams. Here’s what you can expect:

• External Exam: The PT may assess posture, abdominal muscles, and alignment to understand how these areas interact with the pelvic floor. They may also check the surrounding muscles like the hips, lower back, and buttocks for tension or weakness.

• Internal Exam (if necessary): For a more detailed assessment, the therapist may perform a vaginal or rectal exam to evaluate the pelvic floor muscles more thoroughly. While this may feel uncomfortable for some, it’s generally well-tolerated and essential for assessing muscle tone and function. An internal exam is done with a glove and lubricated finger. There are many layers to the pelvic floor, fascia, ligaments and other structures that all can play a part of your symptoms. An internal exam allows us to see very clearly how things are operating! 

Functional Evaluation

We want to see how your body does during your times of symptoms. If you leak urine when you jump, what does the body do when you jump? Pelvic floor therapy is a whole body issue and we will need to assess your body's functional capacity to do the things you love to do without symptoms! We will check for any misalignments, muscle imbalances, or poor posture that could be contributing to pelvic floor dysfunction. This might include assessing how you lift or perform everyday movements that can impact your pelvic health.

 Personalized Treatment Plan

At the end of your evaluation, you and your therapist will sit down and discuss the evaluation. Your therapist will try to identify what exactly is going on with the pelvic floor and why you are experiencing your symptoms. Using the findings from the day, they will be able to map out a customized plan to get you back to doing the things you love, with the people you love without pain or symptoms. Your plan will provide clarity on not only what the problem is, but how long it will take to get there. Your therapist will map out a plan of how often you will come and the things we want you to commit to at home in order to hit your goals! We want this process to be a team approach and work alongside you to make sure the plan is doable for you! 

Tips to Prepare for Your Initial Evaluation

• Wear Comfortable Clothing: Choose clothing that allows easy access to your abdomen and pelvic area. 
• Be Open and Honest: Share as much detail as possible about your symptoms and medical history. The more information your therapist has, the better they can help you. We want you to feel comfortable and safe in sharing with us. 
• Ask Questions: Don’t hesitate to ask about the assessment process, treatment plan, or any part of the evaluation that feels unclear.

Pelvic floor physical therapy can significantly improve your quality of life by addressing issues like pain, incontinence, and dysfunction that many people struggle with in silence. The initial evaluation serves as a foundation for building a treatment plan that works for you. While it may seem intimidating at first, the focus is on making you feel comfortable and empowered in your pelvic health journey.

With a skilled pelvic floor physical therapist guiding you, you can expect compassionate care, a thorough understanding of your needs, and a clear path toward recovery and improved well-being.