What to expect from your first pelvic floor physiotherapy session.

Updated: May 2, 2020

So what exactly happens in a pelvic floor physiotherapy session?

"You put your finger where?! "

This is usually the response I get when I explain what my job as a pelvic floor physio entails.

A pelvic floor physiotherapy session shouldn't be something to be nervous about! Once you have made the commitment to see your Pelvic floor physio, here is what to expect:

1. A lot of talking

The first session is going to be all about gathering a lot of information . Our sessions will be an hour long and one-on-one in a private treatment room. We will first sit and discuss what your concerns are, and ask you all the questions about your pooing, peeing, pain, sex, and your day-to-day activities.

2. An assessment ⠀

After understanding your concerns and getting your history the therapist will perform an assessment, which typically means they will look at the following:

· your posture⠀

· pelvic alignment⠀

· your abdominal wall for tenderness/trigger points, diastasis recti/

abdominal separation and cesarean scar⠀

· hip muscles (buttocks, inner thighs), length and tenderness/ trigger points

· Doing an internal pelvic floor muscle assessment to check strength, tone and tension ⠀

3. An internal assessment

Internal assessment are only done once you have: given consent, signed the consent form, the physio has fully explained what the assessment will look like and then checking consent again.

Typically we do an internal assessment through the vagina, using gloves and one index finger. This is not like a gynae visit, you will not be in stirrups and we will not use a speculum. You will be lying comfortably on your back with lots of pillows for support. The whole assessment typically takes only a minute or two. We will look for strength, tone and tension.

We will never do an assessment if you are unsure and if you would prefer to wait until a future session.

Sometimes if you have pooing problems, tailbone pain, rectal pain or unable to do the assessment vaginally) an internal rectal assessment may occur as well (of course with your consent).⠀

4. Education

You will be receiving loads of education throughout and we might give you some ideas on what to start doing immediately , for instance stretching if you need lengthening or relaxation or strengthening if you need more support and strength. We will discuss your next steps in detail.

5. Ongoing support and next treatment session

We have a lot of work to do in an hour (or less) but it should give your therapist an idea of what the next steps are for you. And also give you a few things to start working on at home until your next session. We strive for you to feel respected and listened to in your session. We know that the first step can be scary to take.

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