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What to Expect at Pelvic Floor Physical Therapy

Updated: May 2

Have you recently scheduled your first pelvic physical therapy appointment but are unsure what to expect?

This is a common concern that many females have before going to their first pelvic health appointment. In this post, we’ll talk through the different steps of what to expect when visiting a pelvic floor PT for the first time and help put your mind at ease.

Getting to Know You

Just like any other physical therapy setting, pelvic health physical therapists typically start their first visit focusing on evaluating different aspects of you and your pelvic floor. You can expect your therapist to spend time getting to know you, asking you several questions about your symptoms, your mental/emotional health, and health habits in general. 

The therapist will probably provide education on the anatomy of the body, including your pelvic floor and other contributing areas to what you’re experiencing. This portion of the physical therapy initial evaluation will help you to have a better understanding and feel more empowered to participate in your recovery.

Finally, you will likely discuss your goals for coming to pelvic health PT and what you’re hoping to achieve from your experience. This helps the therapist put those goals front and center when you later discuss next steps. 

External Musculoskeletal Examination

Once the therapist has gathered the information they need from getting to know you and your situation, they will likely move into the physical or musculoskeletal examination piece of the first visit. Often the therapist will assess “externally” how well you’re moving, having you attempt various positions and movement patterns. They will note what movements are aggravating and alleviating as well. Most often, you will find that the therapist not only focuses on your pelvic floor symptoms, but also your low back, hips, pelvis, core and so much more.

To learn how the core plays a role in pelvic floor dysfunction, read the blog post here.

It is also possible that they will assess a foundational piece to pelvic health physical therapy - breathing. While you’re talking about your symptoms and getting to know each other, the therapist will likely be observing your resting breathing pattern. From that point, the therapist will want to see if you can appropriately engage and relax your diaphragm, instructing you on proper breath mechanics. You can learn more about the importance of breath work in our blog post here.

The Internal Exam

After assessing you “externally” there is a possibility that your therapist may recommend an “internal” exam. This is exactly how it sounds - the therapist assessing your pelvic floor muscles and coordination internally, accessing the pelvic floor through your vaginal canal. This type of examination can help your therapist gather more important information on how these structures may be leading to your symptoms.

It is not uncommon for patients to be hesitant to consent to the internal pelvic examination. Afterall, it is quite vulnerable and personal. It’s important to keep in mind that you have the right to decline an internal examination, and if you do consent, you can tell the therapist to stop at any time during the internal examination.

If you decide to move forward with the internal exam, your therapist will provide you with the appropriate garments and items needed for the examination.

Developing a Game Plan

Once you and your pelvic floor physical therapist have completed the examination process, you will reconvene to discuss their findings and how those findings may correlate with your symptoms. The therapist will answer any questions that you may have to the best of their ability. 

Finally, once you and the therapist have come to an understanding, they will likely provide you with their recommendations for moving forward. This is what’s called a “plan of care.” The plan of care is your game plan that the therapist has developed to get you on the path to recovery from the symptoms you are experiencing.


At the end of the day, attending your first pelvic floor physical therapy appointment is not as scary as it may seem. You should have an enjoyable experience and feel that your therapist listens to you and is attentive to your concerns and needs. If this isn’t the experience you’ve had, I would encourage you to seek out a different therapist.

Here at Inspire Physical Therapy, we not only offer pelvic floor physical therapy, but a wide variety of services including Fertility Coaching and Mercier Therapy. If you or someone you know has been struggling with infertility, check out our blog post here to learn how we can help with more than just the pelvic floor.

If you’re interested in learning more about this topic or have questions, feel free to reach out to us at 502-939-8564 or request a consultation here.

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