What to Expect at Your First Pelvic Floor Physical Therapy Session

We will ask you your story

We want to hear what’s bringing you in, what your goals are for physical therapy, and any information that you think we should know. Your pelvic floor is involved in bladder function, bowel function, sexual function, and stabilizing your trunk and pelvis. We’ll ask you questions about each of these things to better understand how your pelvic floor functions. You can share as much information with us as you feel comfortable. We also invite you to ask any questions you have – there are no silly questions here, and we want to address what is most relevant to you.

We will assess you holistically

Your pelvic floor doesn’t work in isolation! We’ll look at your breathing, functional movement patterns, flexibility, strength, and posture. We’ll also ask about your daily habits and other body systems. Treatment is never just about doing kegels. It is not uncommon to focus on education and behavioral changes, or for our treatment interventions to take us up to your upper back or down to your feet as we try to get to the root of the issue.

Our assessment will be an ongoing process

We’re trying to gather a lot of information, so in future sessions we are constantly assessing, re-assessing, and problem-solving with you. We don’t give anyone a one size fits all plan or pass you off to a physical therapy aide. Instead, you’ll be working one-on-one with a physical therapist or physical therapist assistant with advanced training in pelvic floor physical therapy at each session.

Our assessment may involve an internal vaginal or rectal pelvic floor exam

You have options for us to assess your pelvic floor, and you get to decide how and when we do it. An internal vaginal or rectal pelvic floor exam gives us the most information about your pelvic floor to guide your treatment plan. We will look at your pelvic floor muscle coordination, strength, endurance, tension, range of motion, and more. You can also opt for an external exam only or get to know us for a few sessions before deciding to do an internal exam.

What We Treat in Pelvic Floor Physical Therapy

We warmly welcome people of all genders – everybody has a pelvic floor!

Below are just some of the conditions that we either treat or help you to manage.

Pelvic Pain

  • Pain with sexual activity
  • Endometriosis
  • Bladder Pain Syndrome (Interstitial Cystitis)
  • Pudendal Neuralgia
  • Post pelvic surgery pain

Sexual dysfunction

  • Vaginismus
  • Erectile Dysfunction secondary to pelvic floor issues

Urinary symptoms

  • Urinary incontinence
  • Urinary urgency
  • Urinary frequency
  • Difficulty with bladder emptying

Bowel symptoms

  • Constipation
  • Fecal incontinence
  • Fecal urgency

Pregnancy and postpartum care

  • Pelvic organ prolapse
  • Diastasis recti
  • Pain/dysfunction related to scar tissue
  • Birth preparation

Orthopedic conditions

  • Pelvic girdle pain including SIJ pain and pubic symphysis dysfunction
  • Pain at low back, hips, groin, abdomen
  • Coccydynia (tailbone pain)

Pediatrics

  • Enuresis
  • Constipation
  • Voiding dysfunction
Stacey Ellingson, DPT bothell physical therapy