If you’re wondering what really happens during pelvic floor physical therapy (PFPT), you’re not alone. Many people are referred by their doctor, hear about it from a friend, or encounter it while searching for answers to symptoms such as leaking, pain, or pressure. It’s completely normal to be nervous or unsure about what an appointment entails.
Pelvic floor therapy is designed to help you feel better in your body, and the process is much less intimidating than most people expect. At Origin, we believe that the more you know, the sooner your first visitthe more comfortable and confident you will feel when you walk through the door.
What is pelvic floor physiotherapy and who benefits from it?
Pelvic floor physical therapy (PFPT) targets the muscles that support your bladder, bowels and reproductive organs. These muscles play a major role in the way you move, train and function every day. Whether these muscles are too tight, weak, or a combination of both, you may experience:
- Leaking when coughing, sneezing or exercising
- Pain in the pelvic area or lower back area
- Pressure or prolapse
- Sexual dysfunction or pain with sex
- Constipation or difficulty voiding
Everyone has a pelvic floor, which means everyone can benefit from learning how to care for it. Pelvic floor physical therapy (PFPT) isn’t just for people who are pregnant or postpartum. Regardless of sex or gender, people at all stages of lift seek PFPT for both symptom relief and prevention.
Additionally, pelvic floor therapists are trained in orthopedics and treat the entire body. As specialists in women’s and pelvic health, they understand how the body’s systems work together, and how hormones, posture and daily habits can all influence PF function and overall well-being.
Does insurance cover pelvic floor therapy?
Often yes! At Origin, we accept most major insurance companies, so care is accessible and costs as little as $0 per session. More information about our insurance policies can be found here and here.
Virtual versus clinical pelvic floor therapy
You may be wondering whether you should book your visit in person or online. The truth is, most of what we cover at Origin can be done virtually.
Virtual care
Virtual pelvic floor therapy is suitable if you:
- Prefer the convenience of a virtual visit
- Would you like advice on how to move or do exercises in your home environment?
- There is no clinic nearby
- Cannot find childcare easily
- Having a busy schedule that makes traveling difficult
- Have a history of trauma and want more control over your environment
During a virtual visit at Origin, you will meet one-on-one with a licensed physical therapist via a secure, HIPAA-compliant Zoom meeting. Your provider will listen, assess your symptoms, and guide you through a comprehensive health history, pelvic floor self-monitoring, and customized exercises. When it comes to pelvic floor self-monitoring, you can do this on your own time and report back to us, or we will ask you to turn off your camera so we can guide you through it. You always have a say in what you participate in during PT and our providers follow your pace.
Still not sure? Read more: Is virtual care originally right for you?
Personal care
Similar to virtual visits, during your in-person appointment you will meet one-on-one with a certified physical therapist who will listen, assess your symptoms, and guide you through a comprehensive health history, pelvic floor self-monitoring, and customized exercises. Unlike virtual visits, in-person appointments involve your physical therapist providing hands-on evaluation and other treatment techniques that help you understand how your muscles and body systems function together. Many patients choose a hybrid approach, starting virtually and moving to an in-person approach, or combining both for ongoing support.
In-clinic physiotherapy can be helpful for anyone who:
- Find it difficult to connect with what is happening in their body
- Prefers hands-on treatment
What happens during your first pelvic floor therapy appointment?
Knowing what to expect before your first appointment can take away a lot of the mystery and hopefully ease the anxiety you’re experiencing. The goal of the first session is to learn more about you, teach you about the pelvic floor, how it works and how PFPT can help, and create a care plan with actionable steps you can take right away.
What to bring
Wondering what to bring to your first appointment? We’ve got you covered.
Make sure you bring your insurance card, a prescription from your doctor (if you have one), and that you wear clothes that you feel comfortable moving in. If you are calling virtually, make sure you have plenty of room to move around. Finally, make sure you have completed your intake forms before your appointment.
Intake and training
At the beginning of your visit, your physical therapist will ask questions about your medical history, current symptoms, lifestyle, and what you would like to achieve during physical therapy. This is your time to share your story and communicate your goals.
You will learn how the pelvic floor works, why you may experience complaints and how PFPT can help you. Nothing is done without a thorough explanation, and your PT will encourage questions throughout.
Research
Of course, your physical therapist will also perform a physical examination to better assess your symptoms and their cause and develop a comprehensive care plan. The physical exam may look different depending on your symptoms and goals, and whether your visit is virtual or in-person:
External exam:
Whether your visit is virtual or in-person, your PT will begin by observing your posture, breathing, and general movement patterns, as these can all affect the function of your pelvic floor muscles. If you attend in person, your doctor may ask you to look at your tissues while you perform actions such as squeezing or relaxing your pelvic floor to understand how your muscles coordinate. If you agree, they can gently press the muscles from the outside to get a feeling of tone and sensitivity. During this part of the exam you will not be in stirrups and will be covered with a sheet. There are additional tests that your provider may recommend you perform based on your history, but like any other part of an exam, this is done with informed consent.
Internal pelvic floor examination (in the clinic):
If you and your physical therapist decide that an internal examination would be helpful, your PT will begin with a detailed explanation of each step so you know exactly what to expect. The examination takes place in a private treatment room and you sit comfortably on the examination table with pillows supporting your legs, hips and head (there are still no stirrups here!). You will be given a sheet to cover yourself for privacy.
Before performing an internal examination, your PT will visually check the vulva and anus (the external tissues between your pubic bone and tailbone) for signs of scarring, irritation, or tension. To internally examine the pelvic floor muscles – of course with your permission! – your PT will gently insert a gloved, lubricated finger into the vagina or rectum to assess your pelvic floor. This allows them to feel how your muscles are working, including any strength or coordination problems. It also helps them evaluate the presence of tenderness or trigger points, which are bands in the muscles that can cause referred pain in places away from where they are identified.
A physical examination is never required and will only be performed with your full, informed consent. Your PT will check in with you throughout and adjust or stop at any time to make sure you are comfortable.
Care plan
Before you leave your first visit, you and your therapist will set joint goals and create a realistic home exercise program based on your individual lifestyle and needs. Your PT will explain what to expect during future sessions and how progress will be measured. Recommendations based on the first visit are available for you to view in the patient dashboard.
What an ongoing pelvic floor therapy treatment can look like
Pelvic floor therapy is not one-size-fits-all. Your plan may include:
- Manual therapy to release tension
- Customized strengthening or relaxation exercises
- Education about daily habits and lifestyle changes
- Support in returning to exercise, sex or other activities without symptoms
- Biofeedback to improve awareness of muscle function
Treatment evolves over time and it is normal for you to continue to adjust your plan with your therapist to ensure it suits your goals and current lifting conditions.
Is pelvic floor therapy worth it?
Many people wonder if pelvic floor physical therapy is embarrassing or uncomfortable. The answer is no. Nothing is TMI here! Origin physicians often hear from our patients that they leave their first appointment feeling hopeful and empowered and wishing they had started sooner. With the right guidance, you can learn to reduce uncomfortable symptoms, gain control of your body, and feel more confident in everyday life.
Sources
“Biofeedback.” Physiopedia, editors Tim Watson, Rachael Lowe, Ellen De Boitselier et al., Physiopedia, last edited version 370330. Web. [October 1, 2025]. https://www.physio-pedia.com/Biofeedback.
“Manual therapy.” Physiopedia, edited by Finn Gerstell, Jess Bell, et al., Physiopedia, last edited version 357394. Web. [October 1, 2025]. https://www.physio-pedia.com/Manual_Therapy.
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