First Visit for Pelvic Floor Physical Therapy? Here’s What to Expect

What is going to happen?

Women all around the world suffer from various pelvic disorders. It is far more normal than it may seem, since we tend not to discuss these things openly. However, conditions like vaginismus, dyspareunia, vaginal atrophy, vaginal stenosis and other pelvic problems often need treatment. If you have any kind of pelvic dysfunction, it’s possible that your Doctor may refer you for pelvic floor physical therapy.

Ahead of your first visit, you may have questions whizzing around your head. As you may not be used to (or comfortable with) examinations in this region, it’s also normal to be nervous. We wanted to give you the lowdown on what to expect from your first visit to a pelvic floor therapist so that you can turn up with peace of mind.

It may help to know that pelvic floor physical therapy has been around for more than two decades – at least 25 years! There are plenty of compassionate and well-trained therapists around who have worked with pelvic conditions like yours before. They are used to alleviating discomfort on both a physical and emotional level, and they understand your fears and concerns. Let’s take a look at what you can expect from your first appointment:

What does pelvic floor physical therapy cover?

Your pelvic floor physical therapist will have been trained in pelvic anatomy (and the surrounding areas), including the organs, joints, muscles, nerves, and connective tissues. Through both study and experience, they learn about the different pelvic conditions and how symptoms manifest in the body. They have been taught effective treatment protocols for these conditions, and can also show you how to manage or heal symptoms yourself at home.

How should you prepare for your appointment?

Most therapists will ask you to bring a few things along to your appointment. Do refer to the specifics outlined by your therapist, but generally they will ask for documents such as a prescription, insurance card, evidence of tests or records related to your problem, some ID and payment card or cash.

You might want to arrive early in case you are asked to complete some forms on arrival, although these may be sent ahead of the appointment. This is so that the therapist is clear on exactly what needs to happen, and so that you can make the most of your time with them.

What should I wear to my appointment?

You do not need to wear anything specific. They do look at your hips and SI joints though in most cases, so wearing something you can be flexible in like yoga pants might be easier to assess you in than jeans. 

What is the pelvic physical therapist looking for?

Firstly, your therapist will want to assess your personal history and symptoms. They will then talk to you about your particular conditions, your biology, and how and why it is being affected. The therapist will also need to assess areas of restriction and dysfunction so that they can tailor a suitable program for you.

Pelvic floor physical therapy aims to restore mobility and movement, as well as reduction of pain or referred pain. For example, the therapist will be looking for details such as muscle trigger points that cause pain, tight connective tissues or ineffective muscle contractions. 

What do pelvic floor examinations consist of?

Your therapist will need to do a physical examination, which will certainly include the pelvic area and probably the hips, back, and abdomen too. There will also be an internal exam, which is often the part women are nervous about. It is very important as your therapist can gain a lot of information from this.

Although for some it can be uncomfortable, your therapist generally only uses a gloved finger and will be as careful as possible not to hurt you. You will be able to dictate the pace and your therapist will stop if you are not happy to continue. Your pelvic floor physical therapist will be doing their best to put your mind at ease throughout the process, by answering questions and explaining processes before (and while) they happen.

What happens after your pelvic floor physical therapy appointment?

When your assessment is done, your therapist will let you know what they found and what your treatment plan will look like. For example, you may need some of the following techniques to help you overcome your condition:

• Trigger point release
• Visceral mobilization
• Biofeedback
• Pelvic floor stretches and exercises
• Connective or scar tissue release
• E-stim

Pelvic floor physical therapy often includes activities you must do at home. This is why therapists often recommend their clients come to us for vaginal dilators, which are a commonly used tool at therapy sessions. You can use dilators at home in your own time and at your own pace, which can greatly assist progress.

Your therapist may also recommend stretches and exercises or postural changes, and it is wise to make sure you do those if you want to achieve lasting benefits from your pelvic floor physical therapy. We hope your nerves are somewhat calmer now, and if you need to find a pelvic floor physical therapist, we may be able to help with that too. 

Tara Langdale Schmidt is the owner of VuVa Vaginal Dilators. She has Vulvodynia, a pelvic floor disorder. You can always email her at Tara@vuvatech.com if you need help finding treatment options.