What to Expect at Your First Pelvic Floor Physical Therapy Appointment

Written by a pelvic floor physical therapist at Empower Your Pelvis, in Kansas City, Missouri (Lee Summit, MO and Overland Park, KS)

Starting pelvic floor physical therapy can feel intimidating, especially if you’re unsure what to expect. Many patients feel nervous on their first day—and we totally get it! Whether you’ve had physical therapy for something else, like a knee injury, or this is your first-ever session, pelvic floor therapy may seem like uncharted territory. Some patients are here to discuss deeply personal issues they’ve never voiced before, like pain during intercourse or urinary leakage. Rest assured, we’re here to make this a comfortable, supportive experience. Here’s what a typical first visit with us looks like, so you can feel prepared and at ease.

1. Getting Started: Paperwork and Your Comfort Zone

To make things easy, we send you paperwork in advance via email. Filling it out before your appointment helps us get to know you better and allows you to share as much as you’re comfortable with. If you’d rather discuss certain details in person, that’s perfectly fine. We want you to feel comfortable from the moment you walk through our doors. If you ever feel uneasy or find that the clinic environment doesn’t feel welcoming, it’s okay to consider finding a space that aligns with your needs.

2. The First Chat: Understanding Your Symptoms

Once it’s time for your session, we’ll greet you and guide you back to our private room. If having someone by your side, like a spouse, friend, or family member, makes you feel more at ease, feel free to bring them along. We’ll start with a friendly conversation, diving into the details of your symptoms and experiences. Here’s a bit of what we might ask:

• Bladder Health: How often do you urinate? Do you wake up at night to use the bathroom? Do you experience leakage or need to wear protection?

• Bowel Health: What’s your bowel movement routine like? Do you experience straining, leakage, or bloating?

• Sexual Health: Is intercourse painful, and if so, when does it hurt most? Do you use lubrication, and if so, what kind? Are you able to use tampons or menstrual cups comfortably?

We’ll also talk through other factors like your diet, hydration, and medical history. This part usually takes about 20 minutes, though we’ll take as much time as needed, especially if your case is more complex.

3. Physical Assessment: Checking How Your Body Moves

After our initial conversation, we’ll shift into the physical exam, starting with an overview of your posture and movement patterns. We’ll also check your abdominal area to assess things like breathing, core engagement, and any potential abdominal separation (diastasis recti). Sometimes, we’ll examine specific organs’ mobility to see how they may be impacting your symptoms.

4. The Internal Assessment: What to Expect

Now, let’s address the part most people are curious (or nervous) about—the internal assessment. Knowing what to expect can make this feel much less daunting! First, we’ll give you privacy to undress from the waist down, and you’ll have a sheet or gown for coverage. The assessment is gentle, and we explain each step, ensuring your comfort and consent every step of the way.

We’ll start by observing the pelvic floor muscles, guiding you to contract, relax, cough, and bear down to see how these muscles function. With a gloved, lubricated finger, we’ll assess the muscle tension at different layers and check for any signs of prolapse. You’ll receive constant updates, and you’re encouraged to share any sensations of discomfort or tension.

Once we finish checking for tension, we’ll assess muscle strength and endurance by teaching you how to contract your pelvic floor correctly. If any prolapse signs are present, we might do a few more checks in different positions, such as standing or squatting.

5. Wrap-Up: Your Personalized Home Program

After the assessment, you’ll have a moment to dress, and then we’ll discuss your personalized home program. At Empower Your Pelvis, we send a follow-up email with all the details of your “homework” exercises and suggestions. We’ll work together to set achievable goals and outline a plan that feels right for you. Before you leave, we’ll help schedule your follow-up sessions and provide any necessary products or resources to support you in reaching optimal pelvic health.

By taking this first step, you’re on the path to a healthier, stronger pelvic floor. We’re here to guide you every step of the way!

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If you're looking for “pelvic floor therapy near me”, consider scheduling a consultation at one of our locations in Kansas City-Overland Park, Kansas, or Lees Summit, Missouri. Click here to book your appointment.

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With wellness in your pelvis-

Amanda Fisher, PT, DPT
Owner, Empower Your Pelvis, a pelvic floor physical therapy clinic in Kansas City (Lee’s Summit, MO and Overland Park, KS)