What Exactly Happens in a Pelvic Floor Physical Therapy Visit?

This is a question I receive quite often. And it’s 100% understandable.

Hey there! 👋  It's me,  Dr. Kelly Sadauckas, one of the few double board-certified Doctors of Physical Therapy in Pelvic Health and Orthopedics in the world, and YOUR go-to expert for ALL of the pelvic questions you have, and a few you didn't know you had 🙂. Today, let's reduce the anxiety around pelvic PT, and dive into what exactly happens during your first visit to a Pelvic Physical Therapist (Pelvic Physio, Pelvic PT, etc). 

It's completely normal to feel nervous, but trust me, this appointment is a game-changer for understanding and addressing any pee, poop, or intimacy concerns, and your mind will literally be blown when you realize how very simple, and specific, lifestyle changes and exercises, can get rid of that pee, poop or seggsy time problem SUPER FAST!!

What Happens Before Your First Pelvic PT Visit

Make the Appointment

Scheduling is the first step, and it's easier than you think. Some PTs even offer online booking, so no need to stress about it!  To work with me, it' s as easy as clicking on a scheduling link, selecting in-person or online visit, and away you go!!!

Fill Out Forms

Expect some detailed paperwork about your pelvic health, but don't worry—Pelvic PTs are pros, and there's nothing they haven't seen or heard before. The more detailed you can be here, the quicker we can get to the key issues in the actual visit.   

Show Up On Time

Arrive a bit early for paperwork if needed. Take a deep breath; you've got this!

What Happens During Your First Pelvic PT Visit

Meet Your Pelvic PT

We start by discussing your medical history, your personal goals for the visit, and what you are willing to do to achieve those goals. We review your paperwork, catch up on anything that might have been forgotten, and clarify your personal history, so we can know how to best help you.

Learn About Pelvic Anatomy

• Get a general overview of pelvic anatomy and how it relates to your specific concerns.

• Learn About Pelvic Function

• For instance, if you are coming to PT for pee problems of urges & leaks, after asking you questions, the Pelvic PT might review "what’s normal" for pee function, before continuing with the assessment. This gives your brain time to process the information (because there’s A LOT of it!!)

• And if you have a poop complaint, we might go over "what's normal" for pooping...same with period pain or seggsy-time/intimacy problems. It's important that you learn "what's actually normal" from a trained pro, to understand how we can get YOU there, as quickly and completely as possible!

• Psst: part of the Pelvic Floored philiosopy is to make Pelvic Health as UN-overwhelming as possible. This includes personalized e-mail summaries of "what we found in our visit" that explains your symptoms, and written explanation and videos of prescribed exercises, with me cueing you in similar language as we taught you in-the-visit!!  This improves carry-over, and confidence, about a million percent!!! 

But I got off on a tangent...what happens next in our Pelvic PT visit??

Assessment of Global Flexibility and Strength:

Your PT checks your overall flexibility, strength, and how your body moves, when you are fully clothed. They've been observing you since you walked in, so no need to feel self-conscious now ;).

Assessment of Pelvic Floor Muscles:

If you're comfortable, your Pelvic PT will check the flexibility, strength, and coordination of your pelvic floor muscles. It's a COMPLETELY different assessment from the exam that your obstetrician/gynecologist does, and the Pelvic PT will explain each step of the way.  

Depending on your complaints, the Pelvic PT may check the muscles around the vagina and/or the rectum...but for many reasons, at the first visit, they might only check one region. In future visits, with your permission, and educating you as to "why" they might need that info, checking the muscles around the vag AND rectum, is generally recommended, as is checking strength, control and pelvic pressure in a variety of positions...but in the Pelvic Floored Method, you mostly stay on your back during the initial assessment and interventions, because you need to master motor control THERE, before you advance to standing/squatting, etc. 

More Personalized Teaching:

After the pelvic floor muscle assessment, your PT will share personalized insights about your body, and immediately begin reeducation exercises to address the root cause of your pelvic problem.  

The Internal Assessment is Over!

Before you know it, the internal muscle assessment is over, your Pelvic PT steps out while you redress, and you review those personalized insights again, this time with various models to make sure you understand the 90,000 foot view of what’s going on ‘down there.

Discuss Prognosis

"Prognosis" is the chances of symptom improvement with Pelvic PT. Your Pelvic PT will discuss your prognosis with you, after the internal assessment.  If prognosis looks positive, which it is in 80% of cases, you'll be given exercises to practice at home, and a follow up visit will be recommended. If prognosis is negative, the Pelvic PT will explain why, and recommend next steps. 

Additional Interventions

Depending on your needs, your PT might recommend additional exercises or interventions, always explaining how they'll benefit you, what time commitment is required, and what evidence says about the chance of them helping.

The Long Goodbye

Your first session wraps up, and you'll likely schedule follow-up appointments. Feel free to ask any final questions.

Congratulations, You Survived!

You not only survived but hopefully gained valuable insights into your body and pelvic floor. Good job!

When is my next visit??

That question is a personal one, but in my professional experience, Pelvic PT is NOTHING like standard Orthopedic PT.  We give you simple and specific exercises to master, and then incorporate into your daily life. It's not "do a million reps of this boring exercise 3x a day, and you'll see results in 12 weeks"...but rather "spend 3-5 minutes a day REALLY leaning into this coordination challenge, then try to use a bit of it in daily life, and you'll start to see results in a few days"!

For that reason, the frequency (how often you come) to Pelvic PT is WAY less than standard orthopedic PT, and here are general frequencies I see in practice (in person or online).  It is EXTREMELY RARE for me to see any client for a specific complaint, for more than 10 total visits. Most have full symptom resolution within 6 visits. 

* Postpartum: it's common for the first visit to beat 4-6 weeks postpartum, then 1 visit every 2 weeks until 3 months postpartum...then usually 1 visit a month until 6-9 months post partum. 

* Pee Leaks/ Prolapse Problems/ Constipation Issues: Visits are usually 2-4 weeks apart, until you feel confident in a home program, then 4-6 weeks apart for progression of functional strength. 

* Pain Problems: These are the only population, where we might recommend weekly appointments.  And then again, we might not.  

Okay--that's the skinny on what happens at your first Pelvic PT visit. Do you still have questions? Check out my online course catalogue! Vag Lab and The Signature Series are two TOP SELLERS!! Courses are streamable on ANY DEVICE (including phones and tablets, just download the free Kajabi app, blue K wherever you get your apps) for seamless education & workouts that meet you wherever you are, literally!  

You can also pop over and follow me on Insta to leave me a question, or make an appointment with me, to finally make the pelvis of your dreams a reality!!

Thanks for reading!

xoxo, Dr. Kelly 😊

Follow me on Instagram!
Schedule an in-person or telehealth visit HERE!