What Should I Expect for my First Pelvic Floor Physiotherapy Appointment?

    November 7, 2022
    Who is Pelvic Floor Physiotherapy For? 

    Pelvic floor physiotherapy is available to all kinds of folks for a wide range of reasons. For the purposes of today’s blog post we’ll be focusing on women or people with a uterus, vagina, vulva, and vaginal canal. 

    We’re also joined by Keri Martin Vrbanac Registered Physiotherapist, Pelvic Floor Physiotherapist, and Clinic Owner at A Body in Motion Rehabilitation Clinic to help answer some more specific questions about PFPTs and their work. 

    Symptoms that might cause you to seek out the pelvic floor physiotherapy are pain in the (pelvis) pelvic, lower back, or genital region, urinary incontinence or frequency, pelvic organ prolapse (POP), pain with sex (dyspareunia) or when trying to insert a tampon, or difficulty emptying the bladder or bowels.  

    Pelvic floor muscles are like any other in the body, and can become weak or too tight, or a combination of the two. For more in-depth information check out our recent post on the difference between a hypertonic and hypotonic pelvic floor 

    What is a Pelvic Floor Physiotherapist? 

    Pelvic floor physiotherapists (or PFPTs) work to help you rehabilitate your pelvic floor muscles. They are specially trained to conduct internal and external assessments and treatments for your pelvic floor. 

    One thing Keri made sure to point out is that a PFPT’s job is to make sure that you always feel comfortable with your care. 

    “What I always say to my patients, I will be telling you every single thing that I am going to do before I do it. If at any time you are uncomfortable with, you just let me know and we will stop. You are 100% in control of your consent, and if you ever need to withdraw your consent, that’s totally within your right,” says Keri.


    What Should I Expect from My First Appointment?  

    Although pelvic health issues are very common, we know how difficult it might feel to finally make that appointment to see a PFPT, so the first thing is to congratulate yourself for taking the time to care for yourself and taking time out for you! 

    When it comes to your first appointment, the trained administration staff will book your appointment and answer any admin questions you might have and your PFPT will work to understand a holistic picture of your health in order to create an individual plan of treatment for you.    

    As Keri likes to put it, “What I always say to patients, is I’m going to treat you like an onion, we’re going to start on the outside and we’re going to peel away the layers. As a Pelvic Floor PT I am concerned with your body from head to toe, I don’t just focus on the pelvis.”  

    When you meet your PFPT the first part of the session will be a conversation, they’ll ask you questions about your history with pelvic health to get to know more about what’s brought you there and what your goals are.  

    Many of us with pelvic health issues have been experiencing these problems for a long time, even decades, so don’t be shy about taking the time to share your entire story. Keri likes to start with the question, “tell me your story.”

    What is an Internal and an External Pelvic Floor Assessment?  

    Your pelvic floor is made up of the same elements as the rest of your body including joints ligaments, connective tissue, and tendons. An internal and external exam of these elements are a way to get a full picture of your health. Depending on your condition, your first appointment may or may not have an internal exam, “We are able to see and feel externally but internal assessments provide a clearer picture”, says Kerri.  

    An external exam can include your PFPT examining your flexibility by asking you to touch your toes, checking your reflexes or asking whether you’ve experienced numbness or tingling.  

    An internal exam includes your PFPT leaving the room so you can remove the clothing from the lower half of your body and cover up in a sheet for comfort.  

    The great news: it’s not like a PAP smear at the gynecologist’s office, so no scooting down or cold metal stirrups. You’ll be positioned on your back with your knees bent. 

    When the PFPT returns they will articulate each step they’re taking which can include observation, palpation, and special tests. They may check your vulva and labia for any discoloration or issues.

    Many PFPTs use their fingers inserted in the vagina and rectum and may ask you to “bear down” or squeeze to get a sense of where your organs are positioned. Some PFPTs will use a biofeedback device to assess pelvic floor function. 

    An internal exam should never be painful. If you are experiencing discomfort, tell our PFPT and they will stop right away. 


    What Should I Wear to My Pelvic Floor Physiotherapy Appointment? (And other questions)  

    Short answer: something comfortable! You’ll either be sitting and talking or laying on your side or back, so whatever makes you feel the most like you.  

    What about shaving or waxing, you might ask? 

    “I don’t notice if you’ve shaved, I don’t care. I don’t care if your legs are hairy, I don’t care if you haven’t had time to get a pedicure. I want you to come to me as your best self and be comfortable with what I’m doing and that’s it,” says Keri. 

    Note: it’s always a good idea to check with your local COVID-19 mask requirements ahead of time so you know what’s appropriate for your appointment. 



    Is there a blog topic you’d like us to cover? Reach out today to let us know.  


    Here at Hyivy Health we’re dedicated to helping women down there and everywhere. The purpose of this blog post is intended to offer resources and education about pelvic health and is not intended to serve as medical advice. This information provided above is not a substitute for the treatment, advice, or opinion of a medical professional. Always consult with a certified health professional before starting any treatments.