What to Expect When You Are Expecting Pelvic Floor Physical Therapy

So back when we started this blog, we talked a LOT about pelvic health. So here is my attempt to revisit that. Have you ever heard the saying, “The more you know, the more you realize there is more you do not know.”?! Sounds kind of like a famous FRIENDS quote more than an educational reference. It isn’t mind blowing, but break it down. Really read the quote.

Back in December, I had the wonderful opportunity to do an intensive pelvic floor course. This confirmed everything I thought I knew and fueled the fire to learn more. Leading to a second. I think the largest thing on patients minds as they come in to see me, is what the heck should they expect. They are nervous. They are frustrated. They are exhausted. And they are excited. There is just a mix of emotions that go through their head when they come to physical therapy for pelvic health issues.

So here is the short version... you should expect talking. Lots of talking. Lots of questions (by you and from your therapist). And definitely some answers. The more we know about you and your pelvic health, the more we know how we can help you. Sometimes our first session is talking. Talking about your ghosts of pelvic health past, present and future. Basically, we want to know a lot about your history of pelvic health issues, what is going on now, and what are your goals. We aim to start with what is most impacting your daily life.

We want you to be comfortable and able to communicate with us. Communication is a skill that we will work on together, to professionally reach your goals. We will ask about pee, poop, sex and everything in between. Sorry, not sorry. We hope you disclose anything and everything you can remember. It may not seem important. But it is so helpful to put the pieces together. I can’t tell you how many times people say to me “I have never even told my partner this, but...”

Okay, so I can. It happened twice. This week.

Know that we will perform a physical examination. This can be done in multiple ways. An external musculoskeletal exam is performed to assess spinal and pelvic mobility, muscular function, and overall functional movement. If indicated, your therapist may suggest a vaginal exam. This can seem similar to a gynecological exam, however we typically do not use tools and we are examining different structures. We again are simply evaluating spinal and pelvic mobility, muscular function, and overall functional movement- it just so happens that we are doing it for your pelvic floor. Lastly, if indicated, your therapist may suggest a rectal exam. Due to the intricacies of how your spine, hips, bowel, bladder, and reproductive organs (or lack there of), work with your pelvic floor musculature, this may be warranted to evaluate multiple other contributing factors.

All of this can be done at your initial evaluation, or at follow-ups as indicated. Or, not at all. So please, if you are having excitement, hesitation, anxious thoughts, or loathing (unadulterated loathing), please know that we aim to help you at your pace.

Until next time, Allison.