November 14, 2019

What to Expect in a Pelvic Floor Physical Therapy Session

What to expect from your first pelvic floor physical therapy session. The first step can be scary to take but so worth.

“I did not know there was physical therapy for THAT!”

This is one of the most common responses I get when I tell people what I do. I am a Pelvic Floor Physical Therapist who treats muscles, tissues and nerves in the body. These play an important role in peeing, pooping, supporting your organs, having sex and birthing a baby. And sometimes those muscles need physical therapy. Here’s what to expect in one of those sessions.

Information gathering

The first session is a lot of information gathering. Our sessions are an hour long and one-on-one in a private treatment room. We first sit and discuss what brings you in, concerns, and ask all the questions about pooping, peeing, sexual health, day-to-day activities, etc.

An assessment ⠀

After getting all the details, the therapist will perform an assessment, which typically includes the following:

  • Looking at your posture⠀

  • Checking pelvic alignment⠀

  • Checking your abdominal wall for tenderness/trigger points ⠀

  • Assessing for diastasis recti/abdominal separation and cesarean scar⠀

  • Pressing on external hip muscles (buttocks, inner thighs)⠀

  • Doing an internal pelvic floor muscle assessment to check strength, tone and tension ⠀

An internal assessment (with your consent)

So yes, we typically go through the vagina for this. You are not in stirrups but rather lying comfortably on your back with lots of pillows for support and it takes just a minute or two. If you have pain we may wait to do an assessment. An internal assessment will ONLY BE performed with your consent. If you would prefer to wait until a future session or not at all, we are totally fine with that. Also, if you are having problems in the rear (pooping issues, tailbone pain, rectal pain or unable to do the assessment vaginally) an internal rectal assessment may occur as well (of course with your consent).⠀


Then afterwards it’s a lot of education on what to start working on immediately, perhaps some stretches if you need lengthening or relaxation or strengthening if you need more support and strength. We’ll then discuss next steps.

We’re here for you

It’s a lot to work into an hour (or less) but should give your therapist an idea if PT is the right thing for you and give you, the patient, a few things to start working on at home until your next session. Most of all, you should feel comfortable. You should feel respected and listened to in your session and not dismissed. The first step can be scary to take but so worth.

Sara Reardon PT, DPT, WCS is the owner of NOLA Pelvic Health and founder of The Vagina Whisperer, a resource for online pelvic health education and therapy to help women worldwide with pelvic health conditions. She is a board certified women’s health physical therapist with a special interest in treating pelvic pain and pregnancy and postpartum conditions. She is a mom, wife, Saints fan and wanna be yogi.

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