What does that first appointment really look like? Is it worth stressing over? What should you wear? Do you have to take off your pants?
No, whatever you want, and no.
The pelvic floor is so important and so often misunderstood that we recommended that everyone considers scheduling a visit with a Pelvic Floor Specialist in pregnancy and around the six week mark postpartum (or anytime after that since postpartum is forever!). Since this can be such a new concept for people, we asked our friends at Own Your Pelvic Health, a Colorado Based Pelvic Health practice to walk us through what clients can expect from their first visit:
What Will Your Pelvic Floor Therapist Ask?
A good pelvic floor therapist will make you feel comfortable, like you’re chatting with a friend. We spend a lot of time LISTENING. What you say- and how you say it- gives us clues to know how to help. We ask questions about your daily life, what matters to you, and how your symptoms affect what you need & want to do.
We won’t lie - pelvic floor therapy is an intimate experience. We ask personal questions because we want to know what will help you get better - what will help you reach your goals. Most other healthcare professionals don’t ask about the details of your bowel and bladder habits, or your sexual experiences, or the way you get in and out of bed. We ask the questions that help us get to the root of your concerns. We know it can feel weird to talk about poop and sex with a stranger. But this is what we do for a living! We love it, and we know how to make sure you feel comfortable.
What Will Your Pelvic Floor Therapist DO?
So, logistically, every therapist has a unique approach, but this is what our first session often looks like:
(For context, in the women’s health side of our practice, we see primarily TTC, pregnant and postpartum people).
- We start by reviewing your intake paperwork, asking follow up questions, getting into the details, and understanding your goals.
- We spend a lot of time explaining the pelvis, the role of pelvic floor muscles and surrounding musculature, and we have great models and visuals to help. (My personal favorite is the shock people express when they see a life-size model of a clitoris for the first time). This is the stuff that we should get in health class growing up, or from our doctors… but so many people with female anatomy don’t actually know how big the clitoris is or what the pelvic floor looks like.
- We discuss foundational concepts that relate to pelvic floor function; including breathing, pressure management, posture, and body mechanics.
- We move through various functional movement patterns to assess your mobility, strength and muscle imbalance. We help you tune in to your body and bring awareness to moving in different ways.
Do I Have to Have an Internal Assessment?
- If there’s time, and if it’s warranted, we offer an internal pelvic floor exam. We always discuss the exam on a model and we talk through it at length before anyone takes their pants off! An internal exam can be completed vaginally or rectally, and it gives us more information about how your pelvic floor muscles are working. We learn about their strength and coordination, positioning of pelvic organs, any areas of tightness and tension, and we can provide manual treatment techniques to help those muscles improve their efficiency. We use one gloved, lubed finger to assess the muscles, and we talk through each step before we do anything. We also don’t use stirrups or a speculum - it’s not that kind of exam!
If you have any apprehension or concerns regarding an internal assessment, please share them with your therapist. This is not a mandatory part of pelvic floor therapy, and there are often ways to meet your goals without internal treatment. If a therapist ever tells you that it’s a necessary part of your treatment plan, RUN!
Choosing A Pelvic Floor Therapist
Again, every therapist practices differently, but a good pelvic floor specialist will help you feel comfortable, safe, and- most importantly- will help you meet your goals! The details of your first session may vary depending on the reason you’re seeking services, but the foundational concepts are all the same. We all have pelvic floors, and we could all benefit from at least an evaluation! If you’re wondering more about how to find a pelvic floor therapist, we talk all about it here.
Written By: Courtney Weber, OTD, OTR/L
Pelvic Floor Therapist and Birth Doula
Co-owner of OWN Your Pelvic Health