Everyone has a pelvic floor, and it is found at the base of the pelvis. It consists of muscles, fascia, and neural structures. The pelvic floor is responsible for bladder function, bowel function, and sexual function. Further, the pelvic floor muscles are a key component of your core, helping with stability in the pelvis and trunk of the body. Poor pelvic floor function could result in bowel, bladder, sexual issues and/or pelvic pain.

Pelvic floor physical therapy is a niche within a niche of physical therapy: orthopedic PT. We simply include the pelvic floor into our assessments and treatments. During evaluations and treatments we are considering the strength, endurance, length, and control of the pelvic floor alongside other musculoskeletal, neuromuscular, fascial, and visceral fascia structures in the body that may be contributing to impairments.

As the pelvic floor is in charge of urinary function, bowel function, and sexual function, those who have pelvic floor dysfunction may experience the following, but are not limited to:

– Difficulty with bowel movements and urination, increased/decreased urinary frequency, straining with urination or defecation.

– Painful intercourse (dyspareunia), difficulty inserting tampons, pain during orgasm/ejaculation, pain after orgasm/ejaculation, difficulty obtaining/sustaining an erection

– Pain around the abdomen and/or pelvis, mid to low back pain

– Improving aches and pains in the pregnancy/postpartum population, training in pushing for labor

During the initial evaluation, your pelvic physical therapist will have already gone through your intake form. You pelvic PT will take you back to a private treatment room and ask further details about what you are experiencing. This will guide your pelvic physical therapist on what to look for in your initial evaluation. After we gather information about you, your pelvic physical therapist will look at all external structures (structures outside of the pelvic floor) and internal structures (structures within the pelvic floor). Generally, the first visit we focus in between the rib cage and the knees, unless there is something that is guiding us to check elsewhere. After the examination your pelvic physical therapist will go through everything they have found that pertains to your case and they will draw up a treatment plan to get you to your goals.

Please wear comfortable clothing that you are able to move around with as there could be exercises I provide you that require flexible clothing.

I’m glad you asked. Internal examination is assessment of the pelvic floor muscles transvaginally or transrectally. This means, your physical therapist will use a single, gloved finger and assess the pelvic floor muscles through the vaginal canal or rectum. Here, we are able to gather information needed to help you attain your goals. We can assess pelvic floor muscle strength, tension, range of motion, how you are able to control your muscles, involvement of neural structures, etc. through internal examination.

Your physical therapist will decide if this is necessary for your evaluation and treatment, and in many cases it is crucial that these muscles are evaluated. Your physical therapist can gather a copious amount of information with external work (musculoskeletal structures not assessed transvaginally or transrectally), and they will be able to treat those structures as necessary. However, in most cases the pelvic floor muscles are involved. If you are not comfortable with undergoing this assessment and treatment, your physical therapist will not do this without your consent and will happily discuss your options.

Yes! Your period will not interfere with an evaluation or a follow-up treatment. However, I understand that some menstruating people may not be particularly comfortable having an internal exam/treatment while on their period. Because of this, I always ask for consent from the patient if they would like to proceed with an internal at this time. If you would rather not have an internal examination and/or treatment we can work on external structures only.

All sessions at The Pelvic Model are an hour long.

Absolutely. We start your initial evaluation with an assessment, and if we find impairments, we tend to treat as we go. As we get to know you and how your body works, it is important for us to combine treatment and continual re-assessment.

The Pelvic Model services are provided by licensed physical therapists, and services may be covered by your insurance provider as out-of-network medical care. We provide a superbill after each visit for you to submit to your insurance for reimbursement.

To keep things fair for every patient/client that needs to be seen, we have a cancellation policy. Per our cancellation policy, if you need to reschedule or cancel your session, we require 48 hours advance notice. If you cancel or reschedule your session within 48 hours, you will be charged for the session.