Pelvic floor therapy is a treatment for pelvic floor dysfunction. Pelvic floor dysfunction refers to challenges related to urinary and/or fecal leakage, pain with intercourse, constipation or pain with bowel movements, pelvic organ prolapse, diastasis recti, low back pain, and more. The pelvic floor is a group of muscles, and the only way to address a musculoskeletal problem is with therapy. Pelvic floor therapists specialize in assessment of the pelvic floor and rehabilitation while OBGYNs are not typically trained to evaluate the musculoskeletal system.

An appointment with a pelvic floor therapist is different than an appointment with an OBGYN. While most OBGYN appointments are brief and focused primarily on screening for pathology or ensuring safety in pregnancy, the pelvic floor therapy appointment will last about an hour and will offer a full physical evaluation process. The appointment will begin in a private room, where you have the therapist one-on-one. This is your time to fully discuss your concerns, share your history, and ask ALL the questions you have! Most people say their appointments with a pelvic floor therapist is the most face-to-face time that they get compared to other medical appointments.

Next, the therapist will begin with an external evaluation. The therapist will observe your posture and alignment and check your overall coordination and mobility. The external exam will include an assessment of your abdomen (checking for tight muscles, scar mobility from previous surgeries/c-sections), your low back muscles and the joints, and the muscles of your hips. Information gained from external evaluations are also important!!

If you are comfortable, the therapist will then perform an evaluation of your internal pelvic floor muscles. You will be asked to remove your underwear, and lay on a covered table, and will be draped with a sheet or towel. We do our best to help you remain comfortable with this process and want to be respectful of modesty! The therapist will wear gloves, and will check your external pelvic floor muscles (vulva area), checking for any tenderness, discoloration, and scars from perineal tearing with childbirth. Then, the therapist will place lubrication on one finger and perform the internal pelvic floor assessment intravaginally. This part of the exam process will check for tenderness or tension internally, then will check for coordination as you will be asked to do a pelvic floor muscle contraction (kegel), relax the muscles, and maybe perform a series of contraction holds or quick flicks. If prolapse is a concern, the therapist will also check for movement of the tissues internally. This is a muscle examination, not checking your cervix. This process really only takes a few minutes!

Finally, you will be asked to put your clothes back on and the therapist will review the findings of the examination. Together you will discuss what your goals are, and the therapist will help devise a plan that is best for you on how you can achieve more balance in your body and feel your best. We put utmost importance on patient involvement and want everyone to feel like they are empowered with knowledge and have a full understanding of the findings and plan!

There is no “one size fits all” recommended follow-up. Some patients may need 1 visit a week for a few weeks, while others are fine with more of a monthly follow-up. Your therapist will let you know the recommended appointment follow-up plan and make sure you feel comfortable with it. Therapy should not be stressful so you should not be recommended a plan that you are not comfortable with!

Empowered Wellness Physical Therapy provides pelvic floor therapy and women’s health services in central and north Alabama. Our goal is to help Moms take care of themselves with more ease, so we bring the therapy to your home, gym, or wherever is more convenient! If you are experiencing pelvic floor dysfunction, know that we are here for you and will give you the tools to improve your symptoms so you can live the life you desire!!

In love and wellness,

Stephanie and Kristi

Get in touch with Dr. Stephanie & Empowered Wellness Physical Therapy HERE