What Should I Expect With Pelvic Floor PT?
Pelvic floor physical therapists are specially trained in the evaluation, assessment and treatment of the muscles, joints and tissue of the vagina and rectum. It is not truly pelvic floor physical therapy without this specific internal pelvic floor muscle examination, assessment, and treatment. Not all pelvic floor PTs are trained to treat men and yes, this is different. Some pelvic floor PTs are trained to treat children, and yes, this matters too.
1. So, what should you expect during a pelvic floor PT evaluation?
On your first visit we will discuss your full history about your symptoms and questions will include:
When did your symptoms start?
What makes them better and worse?
How do they affect your function with urination, bowel movement and sex?
What have you stopped doing because of your symptoms?
What treatments have you had?
What are your goals for PT treatment, what is your desired outcome?
These questions help us decide what areas of the body to evaluate and sometimes it takes a few sessions to evaluate all the necessary structures.
2. What occurs during the physical pelvic floor exam?
Once we are done talking, your physical therapist will conduct a visual exam of your posture, alignment, and movement patterns of the ribs, hips, low back, pelvis, knees, and ankles.
The exam also consists of an assessment by palpation (touch) of any tissue restrictions, imbalances, or changes of the abdomen, inner thighs, pelvis, buttocks, and low back.
We are also screening for systemic, hormonal, neurological and psychological contributors to your symptoms.
As a pelvic floor physical therapists, we are specially trained in the internal examination, assessment, and treatment of the pelvic floor muscles that make up the vagina and the rectum. This exam is intravaginal for women and intrarectal for men (unless indicated for that female patient). We will be looking for any tissue restrictions, imbalances or changes that might be contributing to your symptoms. During this part of the evaluation, you will undress from the waist down, you are covered at all times with a sheet. This part of the evaluation is crucial, but if you are uncomfortable, let’s talk.
Following the examination (and once you are fully clothed again) we discuss the findings, what they mean, your goals for treatment and together we come up with the best treatment plan for you.
2. What does a typical pelvic floor PT session look like:
Each follow up session is typically not the same as the one before it.
At each follow up session we start out by talking about any changes in your symptoms, are they better, the same, worse, or anything new since our last session. Your treatment may change depending on this information.
Most likely each session will include internal pelvic floor muscle work
Treatment includes lots of education, manual therapy (hands on work), and home exercise program. The home exercise program is key to optimal healing of your symptoms and you are an active participant in your care.
3. What if you are on your period and you are scheduled for treatment that day, should you reschedule?
It is not necessary to reschedule your session and does not affect any treatment.
If you are not comfortable with treatment while on your period, you can always reschedule or request that we not do any internal work that day.
4. Does Pelvic Floor Therapy work for all genders?
We treat everyone, regardless of gender. Pelvic floor issues occur in people with bodies. We treat men, women, transgender men and women, and all genders looking for an open minded place to address all of their body's aches and pains.
What should be expected if you are currently pregnant and have been referred to PT or are experiencing pelvic pain, back pain or other issues?
It is safe to have physical therapy at all stages of your pregnancy. Typically internal pelvic floor assessment or treatment is not carried out during the first trimester and can begin at the second trimester. If you are a current patient being treated for pelvic floor issues and begin trying to conceive or discover you are pregnant, please let us know so we can adjust treatment. If you are trying to conceive via IVF or IUI or working with a fertility specialist, your PT sessions will be scheduled with the timing of these treatments in mind.