If you’ve been to physical therapy before, you’ve likely experienced a large open gym space with several PTs and aides hustling about, each attending to 2-3 clients at once. Many women considering pelvic floor PT wonder, how could this be a comfortable setting for MY problem? What would a PT even do for my (bladder, painful sex, vaginal prolapse, etc.)?”

This post will answer many of those basic questions about what pelvic floor PTs do, and what you can expect from your first visit at SHEFit Physical Therapy.

What is pelvic floor therapy?

Pelvic Floor Physical Therapy is a specialized niche of physical therapy. After the standard doctorate degree and licensure required for all PTs, pelvic floor PTs pursue extensive post-doctoral training on the internal muscles, nerves, and organs of the pelvis and abdomen including the bladder, bowel, and reproductive systems. This training enables us to address concerns like bladder incontinence/urgency, pelvic organ prolapse, pain with sexual  activity, and other types of pelvic pain such as endometriosis or interstitial cystitis. Since these systems live inside the pelvis, specialized pelvic floor training includes intravaginal and intrarectal assessment of the pelvic floor muscles, which is not taught in PT school. When choosing a provider, it is wise to ask if they have this type of training. If they do not, they may not have the skills needed to address your pelvic health concerns. 

The pelvic floor PTs at SHEFitPT also have advanced training in pregnancy and postpartum care. This includes pregnancy-related pain, prenatal fitness, birth/labor preparation, postpartum recovery, and postpartum fitness including diastasis recti and pelvic organ prolapse.

Our combined training in orthopedics, pelvic floor and pregnancy makes us the best providers to support you in your pregnancy and postpartum journey! 

What to Expect at your first visit:

After booking, the first step will be completing intake forms. You will find a lot of detailed questions you may not expect! This is because the pelvic floor is connected to many systems in your body, and symptoms you may not realize are related can be important. There is no such thing as “TMI” in our office!

At SHEFitPT you will be seen in a cozy private treatment room – not an open gym. When you first meet with your doctor, she will review your intake with you and ask additional questions she thinks are important. She’ll also ask about any other symptoms, concerns, or even emotional stress that could play a role in your recovery. Equally important are your goals for the future – we can’t help you achieve your wellness goals until we know what they are! We take a holistic approach, which means we want to address you as a WHOLE person, not just a pelvis.

After this thorough conversation, it’s time to take a look at your body! Your PT will observe and assess how you stand, breathe, and move. She may perform functional tests, strength, and mobility testing. Wearing comfortable clothing that allows us to see your abdomen and pelvis, and allows you to move freely is helpful. 

As we seek the root cause of your concerns, your PT may recommend an intravaginal or rectal pelvic floor muscle assessment. This is your choice, so if you do not want or don’t feel ready for such an exam, you are free to decline. There is a wealth of information we can gain from an internal exam that is difficult to gain without one, so if recommended by your PT it is worth considering. 

A pelvic floor exam is quite different from a pelvic exam from your GYN. First, there is typically no speculum, no stirrups, and we aim to keep you as comfortable as possible. We observe first, then use gentle palpation with a gloved finger to assess the sensitivity, mobility, and strength of the muscles and nerves inside the pelvis. We talk you through everything as we perform the assessment, explaining what we find and how it relates to your condition. We will also use this time to start necessary treatment, easing you through techniques to relax, lengthen, and strengthen these muscles as we go. You will leave this exam feeling much more confident in how your pelvic floor and organs function,your connection to them, and what you need to do to reach your goals.

As we go through each part of the evaluation we actively provide education and instruction on action steps to start working on at home. At the end of your session we will recap the key items we want you to focus on at home and create a “home exercise program” (HEP) for you using our online software and app, describing the key education we covered and any movements or activities we have recommended.

Lastly, your PT will make a recommendation on a plan for future visits. If you have scheduling limitations that may impact our recommended plan, don’t hesitate to speak up – we are in this together! After saying goodbye to your PT you can stop in with the front desk to schedule, or you can do so online. 

When you leave our office you will feel educated, empowered, and confident in beginning your path toward recovery and overall wellness! 

To Recap:

1. What is pelvic floor PT?

A specialized niche of physical therapy requiring extensive post-doctoral training in not only musculoskeletal rehab but the urogenital, digestive, and reproductive systems (bladder, bowel, reproductive and sexual function). A qualified Pelvic Floor PT will be confident with intravaginal and intrarectal assessment of the pelvic floor. Pelvic Floor PTs may or may not also specialize in pregnancy.

2. What should I expect at my first visit?

Your care at SHEFit PT will take place in a welcoming, private environment with a compassionate and experienced doctor of physical therapy. You will have a holistic assessment encompassing both your pelvic health and other musculoskeletal/wellness concerns, and you will leave with a new sense of understanding, empowerment, and a plan for restoring and reconnecting to your body!

If you have any further questions about pelvic floor PT, SHEFit Physical Therapy, or whether we are the right provider for you, do not hesitate to reach out to me directly at sheri@shefitpt.com, or call our office at 858-247-2660.