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What to expect at your first pelvic floor PT appointment

treatment room

So you’re thinking about trying pelvic floor PT but are a little bit hesitant…

...after all, that doesn’t sound like your stereotypical physical therapy! You might be asking yourself:

-What does an appointment even look like?

-Is an internal exam a necessity?

-What does an internal (and/or external) exam entail?

If you’re asking yourself any of these questions, look no further! This blog will walk you through what to expect with your first pelvic floor PT visit and answer all of these questions and more:

First things first, let’s get to know you!

Just like with any other PT appointment, your pelvic floor physical therapist will spend the first few minutes of your evaluation taking a thorough history and discussing your physical therapy goals. This history will not only include questions regarding your chief complaint (i.e. what brings you to see pelvic floor PT) but also questions regarding your comprehensive medical history (ex. how is your overall health, what medications are you taking, childbirth history, any other musculoskeletal issues we should be aware of, etc.).

Next up, objective measurements:

After obtaining a thorough history, your PT will perform a full musculoskeletal examination. This might include: trunk and leg flexibility, core and hip strength, pelvic floor external and internal assessment, etc. It’s important to note that a good pelvic floor PT will not just assess your pelvic floor but perform a comprehensive screening to help discern if there are other contributors to your pelvic floor symptoms.

Wondering what an external and internal pelvic floor examination looks like? Your pelvic floor physical therapist will want to assess the mobility and strength of your pelvic floor muscles. This can be done both externally and internally. An external assessment can be done with either the patient fully clothed or undressed from the waist down, depending on the comfort level of the patient. An internal assessment involves the physical therapist assessing the pelvic floor muscles using one gloved finger with lubricant. The PT will be looking for areas of tension as well as have you perform a pelvic floor muscle contraction (i.e. Kegel) to assess the strength of the pelvic floor. He/she will also assess your coordination between a pelvic floor contraction, diaphragmatic breathing, and deep core activation.

Do I have to have an internal exam? Although an internal examination can give us a little bit more information, there is still PLENTY of information that can be gleaned from an external examination. The ultimate decision as to whether or not the PT will perform an internal assessment is entirely up to the patient and their comfort level. Regardless of whether or not you elect for an external and/or internal exam, your pelvic floor PT will talk you through every step and check in regularly to make sure you are comfortable.

Synthesize the findings and come up with a plan!

After the PT has completed the examination, he/she will spend some time discussing the findings with you and explain how these findings might be impacting/causing your pelvic floor symptoms. This is also the time of the evaluation in which you and the PT will devise a treatment plan to address these musculoskeletal impairments and help you achieve your physical therapy goals. This treatment plan will be highly individualized and is based on the patient’s symptoms, examination findings, and personal preferences.

Hopefully this article sets you more at ease concerning your first pelvic floor PT appointment. However, if you are still having questions, reach out to your local pelvic floor PT. He/she will be able to answer any specific concerns you have and help you figure out if pelvic floor PT is right for you!

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