Listen, I have treated patients for pelvic floor concerns for over 11 years now so I have seen and heard A LOT!

With that said I am going to unpack the most common concerns we hear from patients about starting pelvic floor therapy & why they think it may be awkward.

To start, I get it! You have to undress, lay on a treatment table, on a sheet (hopefully not one made of paper), covered with a gown (again, fingers crossed it isn’t paper), and then let someone look at and poke around at your genitals…. And how isn’t this awkward?!

I mean when you put it like that, yeah it does sound awkward. But your pelvic floor therapist has been there, done that. When we are learning to be a pelvic floor therapist we go to a course, listen to a ton of lecture material to understand the in’s and out’s of pelvic floor therapy. Then we partner up with strangers, make quick introductions, and half of the class undresses while the other half makes an educated guess as to how we assess the pelvic floor (we do this on each other so you don’t have to be our guinea pigs).

So yeah, we have experienced the whole letting-a-stranger-assess-our-pelvic-floor-shortly-after-meeting-them thing. We do this so we can truly understand how our patients may be feeling that first day and so we can do everything in our power to make it less awkward.

And, okay so we aren’t just poking around, I swear we have a lot of training to do this. We want to be here! We think the pelvic floor, and all the mysteries it holds, are so fascinating. So what is there to be concerned about?

Being naked?

We have seen more vulvas, vaginas, penises, testicles, butts, and boobs than we can count. This is a normal part of what we do and it is important that we are able to see the areas involved in your symptoms. But don’t worry, we still respect your modesty and will keep as much covered as we possibly can to help put your mind at ease. 

Shaving?

Why? Do you want to shave? Then shave! Do you hate shaving? I get it! We have seen all levels of pubic hair so nothing surprises us. And we have no expectations as to what your vulva or penis or testicles or anus should look like. They all look different and yet they all look the same.

Sometimes the labia minor is longer than the labia majora, sometimes the labia majora houses everything underneath it. Sometimes the penis has a foreskin and sometimes it doesn’t. Sometimes the anus has a hemorrhoid and sometimes it does not. No matter what, you are normal! Oh and that pertains to your legs too - we don’t care if you shave your legs or not.

Smells?

Bodies smell - it is part of being human. When skin touches and bodies sweat they have smells - not necessarily bad smells, just smells. We are used to that. Trust me, once you’ve treated a teenager’s feet after they have been in the same shoes all day at school and sports practice and then come to PT and do those exercises before you do the manual therapy part of the job, no other smells bother you anymore. #iykyk

Blood?

Periods happen. We don’t mind a little blood (or a lot of blood) when we are doing internal work. But we get it, you may not feel the same way. We don’t have to do internal work if you don’t want to during your period (or really any time if you aren’t feeling up to it). There are always plenty of other things we can work on.

Pee or poop?

This one isn’t super common but even so, we are wearing gloves and have these special pads we lay down just in case things happen. And yes, sometimes we can feel stool in your rectum when we do internal work. If we are lucky, you will go home after we have treated your pelvic floor and have a great bowel movement! We hear this a lot after we do ILU massage too. 

But, what if I fart?

So you fart! You won’t be the first, or the last. It happens - not often - but it happens. And we just keep on going as if nothing happened. Or we acknowledge it and laugh together and keep on treating. Again, bodies are bodies, and part of that includes farting. 

TMI?

There truly is no such thing as ‘too much information’ in pelvic floor therapy. We need to hear all about your poop - color, consistency, frequency, positioning, etc; your pee - color, frequency, amount; pain with intimacy - where, when, what position; etc. We want to hear it all because it helps us to understand what you have been dealing with. These details tell us more than you can imagine. 

Negative feelings?

Sometimes pelvic floor therapy brings up old memories or unwanted feelings - unfortunately this is part of the process. We are trained to be ready for this and help you navigate through it. We also work with amazing mental health providers if you need a recommendation to help you unpack the feelings and memories that may come up.

Vanity?

Are you worried that your concerns about your vagina looking different after your delivery will sound vain? Maybe how your c-section scar makes your stomach look now? Or should you get circumcised now, after all these years? Or that you are considering a tummy tuck or mommy makeover to help with your postpartum body?

You are ABSOLUTELY not alone. We hear this all the time and they are valid concerns. While your medical providers will tell you things look fine or your partner(s) will tell you things are great - you are still allowed to feel all of the feels. 

We will help you navigate each one from the pelvic floor expert lens, share how and what we can do to help your pelvic floor and abdominal tissues function and look the way you want. But we will also be honest about the limitations of pelvic floor therapy and when your goals are outside of our scope of practice. 

Trust me, deciding on surgeries such as getting that mommy makeover is not the easy way out! It is major surgery and your body will need help from the experts to recover and regain strength and mobility - so we are here to catch you on the back end. 

All that to say, if you are feeling nervous about coming to pelvic floor therapy that is totally normal! We will do everything we can to make it as comfortable as possible. We explain each step of the process, why we want to perform a certain assessment, and what it will tell us about your symptoms so you can make the most informed decision. We also do this so we can help make it as un-awkward as we possibly can. 

So if you think you need the help of a pelvic floor therapist give us a call!