A frequent question I get is what to expect at a Pelvic Floor visit? I’m glad this question is coming up because more awareness to pelvic PT is happening and more women are seeking help and getting healed!
1) Your first visit is called an evaluation. This visit typically last from 1-2 hours with the goal to figure out what symptoms are contributing to your main issues. Your Physical therapist will take extensive time reviewing your history and asking many, many, many questions! You may be taken aback by all the question asking but it is highly important for your therapist to get a good background to be able to best help you. Your PT is trying to understand your full history and connect dots that you may not have known were connected.
The history part of the evaluation is very important so don’t shy away from giving answers as you feel comfortable. Some questions may not only be about your medical history. Questions that will definitely come up include, past trauma/abuse (sexual, physical, verbal, emotional), accidents (motor vehicle, falls), sexual history, and mental health (anxiety/depression, suicide).
In addition to the topics above these are some common questions:
When did your symptoms start and what makes them worse and better?
What activities do you have trouble doing/ What activities do your symptoms limit?
Have you stopped doing said activity do to your symptoms?
What type of work/job do you have?
Do you have kids? Have you lost/and or terminated a pregnancy?
Have you had any losses in the family?
Have you seen other PTs or physicians? Other holistic practicioners?
Have you had any surgeries? Any diagnostic tests?
What medications are you using?
Any recreational drugs or illegal drug use?
I know these are sensitive topics. Answer as you feel comfortable. Pelvic Floor PT is an intimate specialty. If you don’t feel comfortable with your provider, healing will be more difficulty. Also, if you don’t feel comfortable to answer these questions on the first day its ok! In the subsequent sessions as you get to know you therapist more, then please share! The more you PT know you, the better she is able to tailor your healing program to suite your needs.
It is also impossible to dive into everything on the first session. Every session your PT will reassess your symptoms and connect more dots as they contribute to your healing journey.
2) The next part of the evaluation is the external examination. This includes observing how you walk, sit, lay down, bend and twist, pick up objects. Your therapist will assess your Range of motion and strength of your back, hips, knees etc. Your therapist may press on your back and hips and abdomen to see if there are any tender points to touch that reproduce the symptoms you came in for. Your PT will also assess your breathing and how that is important for the Pelvic floor muscles.
Just like with the history, the examination can continue over several visits. Instead of rushing through, your PT will most likely want to do a thorough job of assessing your structures. Your PT will focus on what they believe are the most pressing findings related to your chief complaint and build an initial program from that to start you on your way to recovery. They will add to your healing program as you continue in their care in the subsequent sessions.
3) Internal examination. This is rarely done the first visit due to time and wanting you the client to be comfortable and aware of what goes on in the internal exam in terms of purpose and goals for treatment and assessment. So, I will write another blog just on the internal exam of the pelvic floor.
4) Homework and goal setting. This should be a discussion and include you the client on what you hope to be able to do or get out of Pelvic Floor PT. Do you want to get back to running after pregnancy, reduce pain, improve strength, stop leaking, comfortable sex? Definitely share this with your physical therapist. Your opinion and goals matter! It doesn’t make sense for your PT to create a program for your that you won’t follow because it’s not what you want to work on! Lastly, your therapist will give you something to work on before your next visit. This can be exercises, something to purchase, habits for daily living etc.
Improving your symptoms and reducing pain and dysfunction may take several visits with you the client cooperating to do your homework that is prescribed.
Pelvic Floor conditions are rarely isolated and symptoms can converge and expand the issue leading from one problem to another. So, you may have back pain, knee pain, pelvic pain etc. This may require multiple specialists for holistic healing including acupuncturist, yoga, naturopathic physician, OB/GYN and the list goes on.
I hope this was helpful in understanding your first visit! Getting the word out about Pelvic floor Physical therapy is something I love to share about. The more people know then the more people get healed!