How can I expect to benefit from pelvic floor physical therapy?
Think of the issue you are struggling with right now. Maybe it has to do with incontinence, so you have cut down on your water intake and your social life for fear of an accident in public, and are now dehydrated and miss your buddies. Maybe you stopped running or taking an exercise class because you’re worried about leakage, or organ prolapse, or you go to the bathroom 26 times a day and it’s affecting your ability to focus on your work. Maybe sex with your partner is no longer enjoyable because of pain or scar tissue buildup or a lack of function. Maybe you are tired of being in pain, or embarrassed about your body. These problems don’t just go away on their own. Pelvic floor physical therapy is about more than just returning your bowel, bladder or sexual function, and strengthening or lengthening pelvic floor muscles. It’s about giving you the tools you need to reclaim your life.
What will my first appointment be like?
Prior to your first appointment you will fill out a complete history. This is extremely important in order to understand your condition and how it is affecting your life. During the first part of the appointment, I will be asking follow-up questions to your history form you filled out. I’ll listen to what you have to say and jot down some notes.
Yes, these are personal topics and they may be difficult to discuss openly. Please know that our conversations are entirely confidential and the more specific information that you can provide, the more thoroughly I can understand your problem, provide an accurate diagnosis and develop your personalized treatment program for our sessions together.
After getting your history, I do a brief postural and musculoskeletal assessment: to identify how your joints and muscles move, their range of motion, strength and endurance, as well as any imbalances you have that may be contributing to your condition. Then, with your permission, we move on to the external and internal pelvic floor muscle assessment to check your pelvic floor muscles and identify what other factors may be contributing to the issues you’re dealing with. If at any point you feel uncomfortable or are in pain, let me know immediately. These sensitive topics are a part of my daily work, but I do understand they can be very stressful and anxiety-provoking for my patients. We will work together to decrease the stress and anxiety that may accompany your concerns. Pelvic floor physical therapy is only successful if we work together and communicate openly.
Afterwards, we will go over my findings, address any questions or concerns you may have, and discuss our treatment plan going forward to meet your goals.
Do you really have to do an internal exam? How does that work and what happens?
Before we do any external or internal exam, I will show you on a model of the pelvis the muscles and structures I will be assessing. You will be asked to provide consent before any assessment or treatment, and most importantly, you can change your mind at any time. I will leave the room for you to undress from the waist down and lie on the treatment table, covering yourself with the sheet provided. There are no stirrups or speculum involved in pelvic floor physical therapy. I’ll use clean, non-latex gloves and first observe your pelvic floor muscles externally, assessing tissue quality and health, as well as muscle coordination. The internal exam involves inserting one gloved finger into the vaginal canal, or one finger in the rectum, in order to access and assess the front and back portions of your pelvic floor muscles. While I talk you through the entire physical exam, you will provide me feedback about any areas of discomfort, altered sensation, or any other concerns. We can stop at any time, and may not even get to the internal exam on your first visit, depending on your comfort level and symptoms.
Why can’t I just do kegels at home instead of coming in to pelvic floor physical therapy?
Many people think that pelvic floor PT is all about kegels. It’s an incorrect comparison, just like lifting up the laundry basket a few times a week to get an upper body workout is not the same as working with a trainer who gives you a personalized exercise program with sets, reps and endurance training specific to your body. Learning the correct form and providing you with a tailored training program will help you recover much faster. But not everyone needs kegels! Sometimes the issue is tightness, not weakness. Pelvic Floor PTs can help you figure all that out.
How long are the appointments?
Initial evaluations are 60 minutes. Follow-up sessions are 45-55 minutes. Each session will be customized to your specific needs and we understand that your needs can change over time as we work together to decrease the effects of your problems.