What Happens in a Pelvic Floor PT Exam?

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A 12-Step Program for surviving your first Pelvic Floor PT Visit

What exactly happens in Pelvic Floor Physical Therapy?  That is a question I receive quite often.  Honestly, next to mental health, coming to your first pelvic floor physical therapy appointment might be one of the more stressful medical appointments to prepare for…as well as likely the single BEST medical appointment you’ve ever attended, and the one that will give you lifetime of functional improvements!

Physical Therapists are specialists in the musculoskeletal system—how the muscles and bones of our body work together to allow us to function in our daily lives with strength and without pain.  Pelvic Floor Physical Therapists are physical therapists who have undergone significant additional training in how to assess and treat the specific muscles of the pelvic region, in order to assist in your recovery from injury, childbirth, or sometimes, just to connect you to these groups for the first time in your life!

The pelvic floor physical therapist will teach you about the positions and functions of the pelvic floor, the anatomy (usually with a 3D model), and most importantly they will evaluate and educate you as to the status of your own pelvic floor muscles.

Just as there are normative values for strength, range of motion and coordination for other parts of your body (knees, shoulders, etc), there are normative expectations for the muscles of the pelvic floor and hips, which pelvic floor physical therapists are trained to assess.  While dysfunction can and does occur prior to functional limitations and pain and/or leaking, when you are actively experiencing pain or dysfunction, there are always telltale muscle signs that the physical therapist can bring your attention to, then help you address!

Pelvic Floor PT in 12 easy steps

  1. Make the Appointment:  It’s literally half the battle to work up the courage to call.  Guess what, it’s a huge deal for you…but this is actually what we do for a living, and we’re good at it.  Don’t be embarrassed. Check out this blog post for instructions in finding a pelvic floor physical therapist.
  2. Show Up: 15 minutes early.
  3. Give insurance cards and or payment information: Most clinics will have payment information available to you–even if they can’t tell you an exact amount, they should have a ballpark estimate for you of what your costs will be.
  4. Fill out intake forms: This is why you came 15 minutes early.  The pelvic floor paperwork is extensive, because the therapists are AMAZING and thorough.  Expect questions about pee, poop, sex, and other things.  The more we know, the more we can  help.  And trust me, we have literally heard and seen it all, so again, don’t be embarrassed.  
  5. Meet your therapist and discuss your intake forms, as well as additional questions the PT might have for you.
  6. Your physical therapist will educate you on your anatomy and ‘normal’ function
  7. Your physical therapist will assess range of motion of spine and hips [or they might do this after your pelvic floor muscle (PFM) assessment]
  8. Your physical therapist will assess your pelvic floor muscles (PFM), usually by internal muscle examination that is totally different than an OB exam.  The PFM are very superficial, and we assess one at a time, with the diameter of a pointer finger–no speculums here!  This lets us figure out WHICH pelvic floor muscle or muscles are to blame for your functional complaints.  
  9. Your pelvic floor therapist will educate you to YOUR BODY, and where YOUR tightness or stiffness patterns lay, where YOUR weakness patterns are, and how these combined are contributing to YOUR SPECIFIC condition and limitations. 
  10. Your pelvic floor therapist will train you in initial pelvic floor physical therapy exercises to perform for YOUR pelvic floor muscles.
  11. You’ll get dressed, therapist may instruct you in additional physical therapy stretches or strengthening, as well as other body awareness activities, like meditation or completion of BLADDER DIARY (link to mine here)
  12. You’ll ask your physical therapist any additional questions, then schedule your follow up appointment and leave with a smile!  

Congratulations!  You survived!!  And hopefully learned a lot about yourself, and pelvic floor muscles, along the way

Still have questions?  Check out my Pelvic Floored Signature Lecture & Exercise Series for a more in depth discussion of what happens in the internal pelvic floor muscle exam, specifically.  It also includes THE most detailed explanation of a self pelvic floor muscle assessment and treatment that you will find on the entire internet!

Thanks for being a part of the Pelvic Floored Family!

High five to you! (I’m a high-fiver…totally true)

Remember to join my mailing list to be kept up to date on all our fabulous progress with the Pelvic Floored Project, as well as new evidence updates on pelvic health in general.

As always, tell your friends, tell your kids and tell your parents! We can, and should, talk about pelvic health!

xoxo, Dr. Kelly

Tell your friends kids and parent graphic

What Happens in a Pelvic Floor PT Exam?
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