Pelvic Health for Women
Pelvic floor physical therapy addresses problems many people are told to live with. Here is what the first appointment involves, and the answers to the questions that come up most often.
Common reasons to book
Urinary urgency, frequency or leakage. Pelvic, hip or tailbone pain. Pain with intercourse. Heaviness or pressure. Bowel symptoms or difficulty emptying. Abdominal separation. Pregnancy-related pain, or preparation for birth. Recovery after birth or surgery.
If your symptom is not on this list, it is still worth asking about.
Is there an internal examination?
No. There is no internal examination component in telehealth, and you will not be asked to remove any clothing at any point.
Where an internal examination is clinically indicated, this will be discussed with you and a referral to an in-person provider arranged. Many pelvic floor conditions can be assessed and managed effectively without one.
What happens in the appointment
We talk first. What you are experiencing, how long it has been going on, what makes it better or worse, anything relevant from pregnancy, birth or surgery, and what you want to get back to.
Then a movement screen — hips, trunk, breathing, posture. Pelvic floor symptoms are rarely isolated, and the assessment looks beyond the pelvic floor itself.
Then we talk about what is driving your symptoms, and you leave with a plan.
What treatment involves
Education about what is happening and why. Exercises, which may include strength, coordination, relaxation or breathing work depending on what the assessment shows. Changes to how you move, sit, lift or manage your bladder and bowel through the day.
During pregnancy and after birth
Care during pregnancy is available for pain and symptoms as they come up, for staying active safely, and for preparing your body for birth. Nothing needs to be wrong.
After birth, whenever you are ready. There is no need to wait for a six-week clearance to begin talking, and early guidance on breathing, positioning and load often prevents problems later. What is appropriate to do will depend on where you are in recovery.
Questions
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It depends on what is driving the symptoms and how long they have been present. Many people notice a change within a few weeks. Some conditions take longer. You will get a realistic answer at the end of your first appointment rather than a promise at the start.
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Not in Kentucky for an initial evaluation. If something is found that needs medical assessment, you will be told and pointed in the right direction.
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This is a cash-pay practice and does not bill insurance. You can request documentation to submit to your insurer yourself.
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Most people are, at least at first. These are common problems, they are medical problems, and there is nothing about them that has not been discussed before. You set the pace, you can decline anything, and you can stop at any point.
Before your appointment
Space. About six feet by six feet where you can move freely, with room to lie down. A hard floor is better than carpet.
Clothing. Something you can move in, and that lets me see your hips and knees — fitted shorts or leggings work well.
Camera. Set your device where I can see your whole body, roughly at hip height. A laptop on a chair or a phone propped against something works. Have a wall or countertop nearby for balance.
Have ready. A pillow, a mat or towel, and a chair without arms.
Privacy. Somewhere you will not be interrupted, where you can speak freely.
If anything changes — you are unwell, or the space will not work — message me before we start and we will adjust or reschedule.