What to expect in pelvic floor physical therapy
Pelvic floor physical therapy is a specialized form of rehab/physical therapy that focuses on the muscles, ligaments, and connective tissues supporting your bladder, uterus (in women) or prostate (in men), and rectum.
Many people remain unaware of this effective treatment option for conditions like urinary incontinence, pelvic pain, and sexual dysfunction.
Whether you're experiencing symptoms following childbirth, dealing with chronic pelvic pain, or facing other pelvic health challenges, understanding what to expect during pelvic floor therapy can help ease anxiety and prepare you for this potentially life-changing treatment.
Let's talk about what you can expect during pelvic floor physical therapy.
Other names for pelvic floor physical therapy
One of the first things I want to cover is the other names you may hear when folks reference pelvic floor physical therapy.
All of these names refer to the same treatment/specialty, but it's important to be aware of them.
Pelvic floor PT
Pelvic health physical therapy
Pelvic rehab
Women's health PT
Internal pelvic floor physical therapy
Common conditions that benefit pelvic health physical therapy
When it comes to pelvic floor PT, it's important to know that there may be many different pieces to a pelvic floor diagnosis or pelvic floor symptoms.
Low back pain, foot injuries, glute injuries or muscle strains, trauma, connective tissue disorders, heavy lifting, running... while you may not immediately think "pelvic health" or think about the pelvic region when mentioning these different injuries, the pelvic region is heavily involved in all of them and pelvic floor issues can be either a contributing factor or the root cause!
Something you may be aware of is "core strength" or "the core" and your pelvic floor is the bottom part of that "core" that we all talk about. Without the pelvic floor, the core is incomplete. You can read more about the anatomy of the core and core strengthening here as it relates to diastasis recti.
Now, let's talk about the common conditions that can benefit from pelvic floor PT. I'm going to split them up into different categories to make it easier too.
General women's health symptoms and diagnoses and pelvic floor disorders
Pelvic organ prolapse
Pelvic pain
Vaginismus
Vulvodynia
Dyspareunia (painful intercourse)
Endometriosis-related pain
Interstitial cystitis/painful bladder syndrome
Menopause-related pelvic floor changes
Post-gynecological surgery recovery
Diastasis recti
Urinary incontinence (stress, urge, mixed, or functional)
Urinary urgency and frequency
Overactive bladder
Fecal incontinence
Constipation related to pelvic floor dysfunction
Irritable bowel syndrome (IBS) with pelvic floor component
Chronic pelvic pain
Coccydynia (tailbone pain)
Pudendal neuralgia
Levator ani syndrome
Pelvic floor muscle tension/hypertonic pelvic floor
Pelvic floor weakness
Anismus (paradoxical contraction of pelvic floor during defecation)
Bladder and bowel concerns
Sexual function concerns
Pregnancy/postpartum-related symptoms and diagnoses
Pregnancy-related pelvic pain
Postpartum recovery
Diastasis recti
SI joint pain
Birth preparation
Core weakness
Return to activity after birth
Staying active and strong during pregnancy
Other related conditions
Lower back pain
Hip pain
Sacroiliac joint dysfunction
Core weakness
Pelvic instability
Bowel and bladder issues during activities such as lifting, running, etc.
Post-abdominal surgery recovery
Post-colorectal surgery recovery
Sports-related pelvic floor dysfunction in athletes
Pelvic pain following trauma or injury
Leaking while running or lifting
Who can benefit from pelvic floor physical therapy
When we dive deep into who can benefit from pelvic floor physical therapy...you can take a look above at that list of diagnoses and likely come to the conclusion that everyone can benefit from pelvic floor therapy at one point or another.
At my private pay pelvic health practice in Durham, NC, as a Pelvic Floor Physical Therapist, I support women so that they can finally get relief from the pelvic concerns mentioned above.
I also want to make sure that I mention you don't have to have had a baby to see a Pelvic Floor PT. It's a common question I get, so I want you to know that even if you haven't been pregnant, you can be affected by pelvic symptoms and could have some involvement of the pelvic region as it relates to something orthopedic/joint related you're going through.
I see athletes, first-time moms, moms who are many years postpartum, active women, and women who are looking to stay active and not be beholden to pelvic pain, heaviness, leaking, and pressure while they live their lives.
What to expect on the pelvic health consult call
I offer a free consult call for all new patients should you want to learn more about me, my practice, and whether or not we're a good fit for each other. By starting with a consult call, you're able to ask any and all questions you have, we can go through your goals and expectations, and then we'll decide what the next step is, together.
Pelvic consult calls are all done over the phone, so you don't need to worry about coming to the clinic for a quick appointment.
The first appointment: What to expect
During our first official appointment together, we'll start with an extensive medical history and interview. I'll ask lots of questions that will help me put together each piece of your story so that we have a very clear idea about what's going on to cause your symptoms.
Every piece of your story matters.
We'll also get into different types of assessments and evaluations. I'll start with a general health screening, strength testing, range of motion testing, and some movement screening. Don't worry, it's nothing to be afraid of or intimidated by. You will lead the way and you're always in the driver's seat. If you aren't able to perform a movement or you feel pain with a movement, it will simply be data for us to use during your treatment. This is all a part of the problem solving that is your pelvic health therapy!
If I think you may benefit from one, I'll explain exactly what an internal pelvic examination involves and you'll be able to decide whether or not you'd like to proceed. This internal pelvic exam is what sets apart a traditional physical therapist from a pelvic health specialist.
An internal pelvic floor examination allows me to properly assess pelvic muscle function, tension, and coordination of the pelvic muscles. The exam is always in my private treatment room which is much more comfortable than a typical doctor's office setup. My goal is to ensure you feel safe and comfortable during the exam (and honestly, at all times during treatment).
During the internal exam, I wear gloves and use a lightly lubricated finger to gently examine the pelvic floor muscles through the vagina and/or sometimes the rectum if necessary (and agreed upon) depending on your specific condition and anatomy.
I'll evaluate your muscle strength, areas of tenderness or trigger points, muscle tone at rest, your ability to contract and relax the muscles voluntarily, and determine the overall coordination of the muscles.
It's important to me that you know that the entirety of the internal examination is personalized and I am very communicative throughout. This is not a "dissociate/disconnect" experience. I'll communicate clearly about what I'm doing and why and continuously ask for your consent to continue. I also am very familiar working with people who have pelvic pain so I work to minimize pain wherever I can.
I want to ensure your comfort and consent at every step.
It's not uncommon for some patients to feel initial apprehension but most find that the examination is less uncomfortable than anticipated. As a helpful bonus, the internal exam provides essential information for developing an effective treatment plan for your pelvic treatment.
After the examination is concluded, I'll
present all my findings to you,
help connect dots as to why what we’re finding is causing your symptoms,
and outline a treatment plan that is specific to you, your symptoms, presentation during the exam, and goals.
From there, we'll break down what a typical frequency of sessions will be (usually this is 1x/week initially but it is dependent on each individual) and an approximate estimation for length of time that we will work together.
Common treatment techniques and approaches for follow-up sessions
When you return for follow-up sessions, we will use a mix of pelvic floor and general techniques. This will help treat your pelvic floor concerns and also get to the root cause of whatever is going on.
Manual therapy, exercise, and lots of education is what I like to lean on in my sessions.
This isn't a "come once a week forever" type of pelvic health.
And it's not a "lie on the table for the whole session" type of pelvic health.
I'll have you moving, standing, and, if something specific causes you symptoms, like jumping, we'll be doing that, too.
How to get started with pelvic floor therapy in Durham, NC
If you are local to the Durham, NC area, I'd love to work with you inside my pelvic health physical therapy clinic. My clinic specializes in pelvic health and pelvic health treatment. Not just a part of what I do, but what I specifically do.
Pelvic floor PT can be intimidating and pelvic floor conditions can feel embarrassing, hard, lonely, and frustrating. I'd love to help you overcome the pelvic concerns you have and get you back to feeling 100%.
Feel free to get started today by booking a discovery call.
