Your first appointment will last an hour and 20 minutes and will have 3 components – history, examination, and treatment.

1. History– Before doing any examination or treatment, we want to learn all about your symptoms, what brings you to therapy, your medical history, and any imaging or surgeries you may have had. Since the pelvic floor is involved in bowel, bladder, and sexual function we may also ask questions about these topics. Please do not feel like any detail is too small or personal. It’s all part of understanding the full picture of your symptoms so we can help you to feel better. We also want you to feel safe and comfortable, so if you’re not ready to talk about a topic on day one (or day 17), that’s ok! You get to set the pace. We will also ask about your goals for physical therapy and what feeling better looks like for you!

2. Examination – We will begin the examination by evaluating your posture, how you move and walk, your strength, and your range of motion, with particular focus on your back and hips, since these areas frequently play a role in pelvic floor problems. For this first part of the exam, it can be helpful to bring clothes that you can comfortably move in, like shorts and a t-shirt. We will discuss everything that will happen ahead of time, and will only move at a pace you are comfortable with. If you are comfortable and it is medically appropriate, we may also do a pelvic floor exam to directly assess how your pelvic floor muscles move and function. To prepare for a pelvic floor exam, your therapist will step outside of the room and ask you to undress from the waist down and cover your lower body with a sheet that we provide. Using a gloved hand, your therapist will examine your pelvic floor muscles externally and may also complete an internal vaginal or rectal exam using a gloved hand and lubricant. The way in which we approach your evaluation, including whether we assess your internal and/or external pelvic floor muscles, will strongly depend on your individual symptoms and, above all, your comfort. You may also choose to have a friend or family member in the room for any and all portions of your visit.  It is our top priority for every single patient to feel safe, comfortable, and in control during our appointments.

3. Treatment – After your examination, your therapist will share their findings, how they relate to your symptoms, and how frequently we would recommend you should come to physical therapy. In most cases, you will also begin your treatment on the first day. This may include hands-on manual therapy, exercises to do at home, or tips and tricks to help control your symptoms. Please remember that the evaluation is about you – we want to answer any questions that you have during the appointment!