What To Expect From Your First Pelvic Health Appointment

At Tensegrity Physical Therapy, there is one area of physical therapy that we provide treatment for that most people might not be familiar with. This treatment is pelvic wellness and is provided for both males and females. If this is something that you are interested in learning more about, check our introduction blog post on what pelvic wellness is here

Here is our comprehensive guide for what you can expect from your first appointment with one of our physical therapists.

We start out by asking if our pelvic floor exam has been previously explained by the referring provider. This is because oftentimes people do not know what to expect when they have been referred for pelvic PT.  Either way, we explain each step of the examination and any potential treatment.  

Next, we go through your medical history including bowel bladder function, habits, pregnancies/deliveries (if applicable), sexual health, the impact of quality of life, etc. We ask questions like, “What makes the symptoms worse?”,  “What makes the symptoms better?”, and “What have you tried so far?”. 

We then explain that we would like to do a “normal” PT examination first to make sure that everything in the legs, hips, and back are in good working order. After this examination and informed consent for the next part of treatment, we then leave the room and ask you to either get into a pair of shorts that we provide or get covered by a sheet and remove your underwear. 

Once we return to the room, we again ask permission if we can do an intravaginal or intrarectal examination to more accurately and effectively evaluate the pelvic floor muscles and anatomy. As the patient, you always have the right to say yes or no to this or to even change your mind at any point. There are ways to test the tone and overall function of the pelvic floor without going internally, but we can get a further understanding if we can go internally. 

If an internal evaluation is warranted and carried out, this is what it typically looks like. First, we will put gloves on and proceed with the external examination of the vagina or rectal region with your permission. Once we begin the internal assessment, we work to feel whether or not the pelvic floor has increased tone, low tone, whether it needs to be strengthened, or if muscular tension needs to be released. Internal trigger points can often refer momentary pain to the groin, rectum or the lower back during the release techniques. 

After our initial evaluation, we can then determine whether you need to learn relaxation techniques, strengthening or continued manual release of the pelvic floor with the continued help from our pelvic wellness physical therapists. 

Sometimes no further direct focus on the pelvic floor is needed. Sometimes what you need is to strengthen the gluteal muscles, hip flexors, and/or thigh muscles. The biggest thing we try to pass along to our patients is that this process involves a lot of education and working on biofeedback. 

Often, we have people come in who get pelvic health work done for preventative reasons. Women can help prepare for pregnancies with pelvic floor treatment. Both men and women can work to prevent hip, groin or back pain with pelvic floor treatment. 

If you are noticing some subtle things that you think could even be related to the pelvic floor, we recommend you schedule an appointment with one of us.