Pelvic Primer: Getting Prepared for Your Very First Pelvic Health PT Appointment

Embarking on your first Pelvic Health Physical Therapy (PT) journey can feel super daunting and intimidating, despite knowing that this may finally give you some answers to your pelvic symptom(s)! Whether you're seeking relief from discomfort, optimizing pelvic health, or addressing specific sexual, bladder, or bowel concerns, proper preparation can pave the way for a successful and empowering experience. Let's get it! What do you need to prep or consider for your initial Pelvic Health PT appointment.

1. Reflect on Your Symptoms: Before your appointment, take some time to reflect on your symptoms, concerns, and any relevant medical history. BE SPECIFIC! The subjective interview is when we put on our detective hats to identify what could be the culprit(s) to your concerns and we need specifics. If you are experiencing leakage with running, for example, be prepared to answer whether or not there’s a temporal relationship to your leaks, how much leakage do you experience & how frequent does this happen, what is your cadence (steps per minute), does it happen when you land on one foot or could be either, does it happen right away or after the 5th kilometre, how many pads do you soak through a day, does it feel like a sneaky dribble, can it happen in other contexts like trampoline jumping or jumping jacks, does it happen more often if you’ve consumed coffeine or other bladder irritants, is there an urgency preceding the leak or is it a surprise, how old are your shoes?

2. Dress Comfortably: Wear comfortable clothing to your appointment, as your PT may need to assess and treat areas around the pelvis. Loose-fitting or stretchy attire allows for ease of movement and ensures you feel at ease during the session. If you have an existing injury at the knee or upper body, we may ask you to expose the area as we’re performing the objective assessment; so bringing a pair of shorts or a spaghetti-strap may be most appropriate. Pelvic health physiotherapists are also rostered to perform internal exams; yes, that means internal vaginal and rectal examinations! This means wearing a onesie or unitard will make it very difficult to keep your top on during the exam. If you consent to an internal exam, remember to opt out of wearing your hipster onesie for that appointment!

3. Bring a Journal: Consider bringing a journal to document your symptoms, daily activities, or any changes you notice. PTs may call this a pain pattern, if your complaint it related to pain. If you have pelvic pain, we’d want to know…

- Where is the pain location? Does the pain travel?

- What is the pain quality? Sharp, dull, throbbing, bruise-y, electric, zap down a leg, a line of pain, sore &/or achey. What is your pain intensity? On a scale of 0-10 (10 being, ‘get me to the ER now!’)

- When is the pain worse? Is there a time relationship?

- What aggravates the pain?

- What relieves the pain?

- How frequent does the pain come on? Is it constant? When was the 1st ever onset of the pain?

- How does this pain impact your quality of life, your daily activities, your sleep, your focus!

This can provide valuable insights for both you and your PT, aiding in a more accurate assessment and tailored treatment plan.

4. Prepare Questions: Don't hesitate to ask questions. Your Pelvic Health PT is there to support and educate you. Whether it's about the treatment process, exercises, or lifestyle adjustments, having a list of questions ready ensures you leave the appointment feeling informed and empowered. However, try to respect your appointment time slot, as your pelvic health PT may have a client after you. Your PT should be happy to answer your questions and may ask for you to email your questions ahead of time so they can answer them during the next session!

5. Be Open and Honest: Your PT is a healthcare professional trained to address pelvic health concerns. Be open and honest about your symptoms, concerns, and any apprehensions you may have. This transparency allows your PT to tailor the treatment plan to your unique needs.

6. Relax and Breathe: It's natural to feel a bit nervous before your first appointment. Take a moment to relax and practice deep breathing. Remember, your Pelvic Health PT is there to help, and your comfort is a priority. If it is the internal exam that you’re most apprehensive about, then communicate this early on with your PT. There’s so much treatment that can be offered (YES, that yield results) with alternative external assessment and treatment options! Or perhaps, after you develop a bond and therapeutic trust with your PT, then revisit the possibility of an internal exam.

7. Understand the Treatment Process: During your first session, your PT will likely conduct a thorough assessment to understand your pelvic health and overall musculoskeletal function. This may involve discussing your medical history, performing physical assessments, and developing an individualized treatment plan. In my personal experience, I usually take 30-45min performing the subjective interview, then 15-30min with an external objective assessment. I rarely perform an internal exam, during that 1st visit because I’ve seen many of my clients mentally and physically aren’t ready for the exam; which can produce confounding results for the internal assessment. Another pelvic health physiotherapist may have a different style altogether, so it really depends from practitioner to practitioner.

8. Follow Through: After your appointment, commit to following through with any recommended exercises or lifestyle modifications. Consistency is key to achieving optimal results, and your PT will guide you every step of the way. If you’re not seeing results or feel as if you are not feeling heard and your goals and concerns are not really being addressed… you are allowed to shop around for a different pelvic health PT!

Embarking on a Pelvic Health PT journey is a proactive step towards holistic well-being. By preparing adequately, you set the stage for a positive and informed experience. Remember, you're not alone on this journey – your Pelvic Health PT is there to support, guide, and empower you towards better pelvic health!

*This Blog has been written by Jane Bai and content generated with assistance from ChatGPT, a language model developed by OpenAI.