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Pelvic PT Part 2: What to Expect At Your Appointment

If you haven't read part 1 of this series, Pelvic PT: What it is and why you need it, please check it out HERE

So you have been told that you need pelvic PT. 
Maybe you have been experiencing bladder or bowel issues.
Maybe you have been having pelvic pain.
Maybe you have been having issues with sex and intimacy.
Maybe you are pregnant or have just had a baby and are either looking to optimize your birth or you might be dealing with some aches, pains or other pelvic issues. 
And now, you are getting ready to schedule an appointment, but you don't know what to expect. 

Your first appointment with a pelvic PT will entail: 

1. An in-depth interview and discussion about your symptoms, history and what you are experiencing. This will include your medical history and also lifestyle. Please don't be afraid to be open and honest with your physical therapist as we are accustomed to dealing with sensitive details and the more we know the better we can serve you.

2. Following that, your therapist will evaluate your posture, movement, strength and look at function as well especially for those who may be having issues with certain functional or even sports/ fitness related activities. 

3. Your pelvic therapist will perform an external assessment which will involve examination of the genitals and an internal assessment to fully and appropriately assess muscle tone, strength, flexibility, ligaments, fascia, assess for pain. For men and in the case of bowel dysfunction, a rectal examination may be done. 

Now I know that for some of you reading this, that might all sound quite intimidating; however in many cases an internal examination may be deferred or it may not be possible such as in cases of pelvic pain or for those clients who are dealing with sexual dysfunction or have been victims of sexual of physical trauma. While it may be the "gold standard" to assess the pelvic floor muscles, there is still much that can be done externally and we respect that with each of our clients. 

Additionally, know that you are the boss and you as a client and your pelvic floor physical therapist are a team, working together to achieve success and work towards your specific goals.

4. Speaking of goals, that is one of the most important things that will be discussed throughout your session. What are your goals? What is it that you would like to get back to? Maybe you are a mom who would like to ensure that you have a great delivery and minimize  birth trauma.  Maybe you are an athlete who would like to achieve your next PR and do so without leaking with every run or with every lift. Maybe you would just like to enjoy sex and intimacy with your spouse without pain. Maybe you just want to enjoy a night out on the town without any leaks with your friends. Or a round of golf without having to know where the closest bathroom is. Whatever your underlying issue or complaint, goals will be created to help guide your treatment and get you to where you want to be. 

A few of the other questions that I am typically asked include: 
"What about if I am on my period?"
For this most women are comfortable with using a menstrual cup however if someone is uncomfortable then internal work can be deferred. This is definitely not an issue. 

"What about kids with pelvic floor issues"
This is a great question! Internal assessments are not done on kids. Sometimes, a biofeedback unit might be used (externally of course). This could be handheld or in some cases might include a monitor whereby pelvic floor muscle engagement or relaxation is coordinated with lights, movement on the screen or a game to help kids to better pair the movement with an action and increase awareness. It's actually pretty fun!

In addition to the assessment and goals, your therapist will come up with a plan of care or a total treatment plan for you which culminates in you achieving your goals and gives you a timeline in which you will do so. Recommendations will be made along the way as needed including:  exercises, stretching and yoga, appropriate or modified activities from functional tasks to sports specific training, nutrition and lifestyle changes and even things like lubricants, or specific tools as appropriate such as wands, dilators and so on. 

So just know that your pelvic session does not have to be scary. You and your pelvic PT are a TEAM, working together for your success. 

If you have any questions or would like to schedule a call to learn more HOP ON A CALL WITH ME

Until next time...

Dr. J

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