What to expect on your first visit with a Pelvic Floor Physical Therapist

An initial evaluation (first visit) with a Pelvic Floor Physical Therapist will last anywhere from 45 minutes to an hour, typically. 

• The evaluation will begin with a thorough medical history talking about symptoms and concerns
• We will go over an anatomy review of the pelvis, hips, and spine in regards to muscles, joints, nerves, organs, and connective tissue.
• We will perform an orthopedic examination, including examination of the spine and lower extremities. 
  • This will likely include assessment of range of motion, flexibility testing, and assessing your strength with manual muscle testing.
  • Depending on your symptoms and your history, we might palpate structures like your abdomen, scars (C-section, abdominal surgeries), spine, hips, and other bone structures. 
• Next, if consent is provided by the patient and if time allows, we would perform an internal examination of pelvic floor musculature. 
  • An internal examination is not a speculum exam, it is one gloved finger assessing muscle tone, your ability to contract and relax the pelvic floor, strength, and endurance. 
  • An internal examination is not required to treat the pelvic floor, but there is great value in being able to palpate the muscles directly, which will provide information about the cause of symptoms and the most effective way to treat them. 
  • Patients or the PT may defer internal examination to the second visit if time, comfort, or other factors are limiting. 
• At the conclusion of the evaluation, you will be provided with a home exercise program (HEP), which typically includes 1-3 exercises to work on the observed limitations during your examination. 
  • HEP are individualized and tailored to each patient's needs. 
• Pelvic floor patients are generally seen once every week in the clinic to allow adequate time to work on prescribed HEP.