Many patients are fearful about their first session with a pelvic floor physical therapist because most are unsure what pelvic floor physical therapy entails and what to expect. Pelvic floor physical therapists are aware that many patients are fearful at their first session and have much experience helping patients get comfortable with such personal treatment.

So what should you expect at your first session with a pelvic floor physical therapist?

The first thing you should expect is A LOT of talking. The pelvic floor is affected by so many other systems in the body including your thoughts, emotions, how you hold tension and how strong other parts of your body are. Your pelvic floor physical therapist needs to understand your entire history including any recent changes in mental or emotional stress, life changes, current or past orthopedic issues and recent or past traumas to really get to the root cause and understand why you’re having symptoms.

Your pelvic floor physical therapist will also want to discuss what your current symptoms are, how those symptoms are affecting how you live your life and what goals you have for resolving them.

For some patients, the entire first session might not include any physical assessments and instead entirely consist of talking to the physical therapist, and that is okay! Your physical therapist will not know how they can help you, if they don’t know your entire history, so take your time telling your story.

After discussing your history, your examination may consist of some physical assessments. These physical assessments are often broken down into external assessments and internal assessments:

• External assessments typically involve the therapist looking at your posture while you are performing certain movements, examining how specific joints, like your hips, move and assessing how muscles like your diaphragm may be functioning.

• Internal assessments typically involve an intra-vaginal or intra-rectal examination to specifically determine how the pelvic floor muscles are functioning.

After the physical assessments, your therapist will discuss their findings with you and come up with a plan for treatment.

Depending on your symptoms, your first session may or may not include treatment. Remember, it is more important that your therapist do a thorough assessment so that they know what to treat, than rush into treatments that may or may not be effective at resolving your symptoms.

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