Wondering what to expect at pelvic floor physical therapy? You’ve come to the right place – here at The Vagina Whisperer, we’re here to help prepare you for what a pelvic floor therapy session actually looks like.
What to Really Expect at Pelvic Floor Physical Therapy
A pelvic floor physical therapist 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.
Just like any muscle in the body, these muscles need attention and care to work optimally.
Common pelvic floor issues that could be treated with pelvic floor therapy include:
- Frequent urge to pee
- Leakage of urine, stool or gas
- Incomplete emptying of urine
- Straining with bowel movements
- Hemorrhoids or fissures
- Pain with sitting
- Pelvic pain with sex
- Abdominal separation/ diastasis recti
- Pelvic organ prolapse
- C-section scar massage
- Birth preparation
If you experience symptoms of pelvic floor dysfunction, this may feel scary to discuss even with your most doctor. However, a number of these symptoms are common, and seeking pelvic floor therapy can help!
Step 1: Let’s chat!
The first session is a lot of information gathering. We want to get to know you and your medical history, not just your symptoms. This is often a full forty-five minute to hour-long session in a private treatment room. You are welcome to bring someone else in with you if you’d like, too!
We discuss concerns you may have – are you worried about pelvic organ prolapse? Are you experiencing muscle spasms? We’ll also ask questions about peeing, pooping, sexual health, gynecological health, pain, day-to-day activities, and exercise. The goal is to get a full picture of your pelvic health and let you know what to expect at pelvic floor physical therapy.
This will help to inform our assessment and highlight what is most important for you during physical therapy.
Step 2: Let’s assess!
After getting the details, the therapist will perform an assessment, which typically includes the following:
- Looking at your posture and checking pelvic alignment
- Assessing body mechanics – especially if you have little ones or are lifting weights
- Checking your abdominal wall for tenderness/trigger points
- Assessing for diastasis recti/abdominal separation
- Assessing breathing and pressure management
- Assessing external hip muscles (buttocks, inner thighs) and abdominal, low back and hip strength coordination and endurance
- Observing and assessing the pelvic floor muscles externally
Step 3: Let’s treat (with your consent)!
Next, we’ll perform an internal exam with your consent. Consent is incredibly important here.
If you prefer to wait until a future session and/or have a support person in the room with you that’s absolutely okay. We go at a pace that’s comfortable for you.
These assessments differ from a gynecological exam as there are no stirrups or speculum, and we are assessing your pelvic floor muscles, not reproductive organs. While you lie comfortably on your back, a therapist inserts a gloved, lubricated finger into the vagina. They check your pelvic muscles for function, tone, and tenderness.
An internal rectal assessment is for problems in the rear, such as pooping issues, tailbone pain, or rectal pain. This is also for those without a vagina or who are unable to do the assessment vaginally.
The assessment does not take long, just a few minutes and your therapist will talk you through our findings along the way! If any anytime you want to stop or pause, communicate with your therapist.
Step 4: Let’s start creating your personalized treatment plan!
After the assessment, we’ll let you know what we found in your exam and how it relates to any symptoms you are experiencing. You will receive education and exercises to start at home and discuss what your next therapy sessions will address.
For example, you may need some stretches and pelvic floor muscle downtraining to relax and lengthen the pelvic floor muscles. Perhaps you need pelvic floor muscle strengthening if you lack the support or optimal strength. Occasionally patients will need a treatment option that involves a combination of the two.
We will then schedule follow up appointments to ensure you’re progressing well. Therapy is not a quick fix – it takes time and commitment. But the payoff is always worth it!
FAQs about your first pelvic floor PT session
What should I wear to pelvic floor therapy?
Wear whatever you’re comfortable in! Many patients come in athletic wear while others are in business attire between work meetings. You may need to wear athletic clothing/shoes for future sessions, so check in with your therapist.
Is manual therapy required?
Manual therapy includes massage, internal pelvic floor therapy through the vagina or anus, or externally to your abdominals, buttocks and thighs. This can be an important part of therapy. Though not required, it can be a helpful to relieve muscle tension and tight tissues, mobilize scars and improve posture.
How much does pelvic floor therapy cost?
Pelvic floor therapy by a clinic or provider that is “in-network” is covered by your insurance provider. You may still be responsible for a co-pay or the cost of the session depending on your deductible.
Many pelvic floor therapy providers are not in-network with insurance providers, and the cost of your session will be a flat fee that the clinic charges. This can be called cash-based, cash-pay, out-of-network or fee-for-service. These clinics can provide you with a statement of services and payments that you can send to your insurance provider to go toward your “out-of-network” deductible.
Ultimately the cost can vary by geographical region from about $150-$400 per session – check with a pelvic floor therapist in your area.
Pelvic Floor Therapy is for everyone!
The first session may seem a little overwhelming with a lot of new information about this important group of muscles!
However, treatment starts slow and easy, with some at home exercises before your next session. This way you can start progressing quickly and feel empowered to put in the work for your pelvic health!
Most importantly, pelvic floor PT’s goal is for you to feel heard, comfortable, and respected. This is an intimate part of your body and can impact your ability to live comfortably everyday. Seeking PT for pelvic floor disorders from specially trained doctors can greatly improve your quality of life.
If you aren’t sure if you need pelvic floor therapy, take this short quiz to assess your symptoms and find a program that’s right for you. The V-Hive provides short, at home workouts for a full range of pelvic floor issues – and the first week is completely free.
