What To Expect


Your first pelvic floor physical therapy visit

A physical therapy pelvic floor evaluation is very different from the evaluation you receive from your doctor. Physical therapists are experts in assessing muscular tone, strength, flexibility, and endurance, as well as the general health of the musculo-skeletal-neural-fascial system.

Our evaluation of your pelvic floor is very detailed and comprehensive. While it always involves a thorough pelvic floor assessment, it often includes an assessment of your back, hips, and any other region of your body that may be involved.

We share our results with your doctor because sometimes we are able to find things that were missed because we spend more time with you.

While most evaluations are a "clinical hour" of 50 minutes, longer sessions are available with enough advance notice. 

Prelude 

You will fill out our intake forms in advance of your session. This process helps you get your story together and will hopefully prepare you for our in-person or Telehealth evaluation.


Part 1 ~ Your “Her-story,” “His-story,” or “Their-story”

This part of your assessment is the most vital.  We get to know each other.  This is the time you get to tell your story of why you need pelvic care.  You decide what’s important to tell.  I listen. You may choose to include past experiences that led to your current situation—the good, the bad, or the ugly. You get to tell me how you felt about things in the past, how you feel about things now and your concerns going forward.  Is anxiety or lack of sleep an issue? Is pain and loss of function debilitating emotionally as well as physically? I’ll ask some specific questions and tell you about the pelvic floor or educate you about your condition and together we set some goals for therapy. Treatment may begin right here as you learn about your condition and tips for retraining your bladder or bowel or managing your POP!


Part 2 ~ Whole Body Assessment & Respiration Strategy

We will look at your entire body: head to toe.  I will observe your posture, various movement strategies, and how your breathe.  Everything is connected! The diaphragm and pelvic floor are the top and the bottom of our core and must function synergistically.  So it’s one of the first things to observe. We may immediately impose some more treatment: for example, I might institute a little diaphragmatic breathing instruction, or teach you a simple postural cue or corrective exercise.  If further orthopedic assessment is indicated (it almost always is) then we revisit that on subsequent sessions.


Part 3 ~  The Pelvic Girdle/Floor Assessment & Treatment

We will assess the bony alignment of your hips and pelvic girdle; this is done standing, sitting, and lying on your back and/or stomach, even side-lying. If our pelvic floor consent has been signed then you will be draped with a sheet or towel and while in a comfy position, usually with knees propped (PT’s don’t use stirrups!) you’ll receive an external and internal pelvic floor muscle (PFM) exam. We look at your skin and superficial tissues, assessing for tissue health, scars, skin integrity. We observe you move your PFM, by lifting and even bearing down, gauging if you relax well.  We palpate the muscles from the outside to check for tension or pain. And after all that, we will perform an internal 1-finger PFM examination, trying to make it as comfortable as possible.  In people with vaginas, this is often done vaginally, but in some cases, it may be that examining rectally is more appropriate for the condition being treated. As I’m examining your PF, I often teach you things as I’m working.  For example, if we find tension and pain, you’ll leave our session learning how to drop your PFM. Or, if you have POP, you’ll learn ways to move your body and restful inversions to support or reduce your POP.  


Sonoma Pelvic Physical Therapy provides:

  • Skilled Physical Therapy services in a safe, comfortable and private environment   
  • Excellent communication with your doctors   
  • Sound and knowledgeable advice and education about your condition   
  • A comprehensive assessment and individualized rehabilitation program

"Lizanne treats the whole person looking at body and mind in an all-encompassing way. She is brilliant. She is incredibly kind and compassionate. I love how creative she is finding innovative ways to treat complicated conditions always working with the patient to find the best solution.

Lizanne is a gifted clinician with a wealth of knowledge and expertise. You will not find a better therapist and healer. She truly cares about her patients. What a gem."

~Lisa K., RN

I look forward to helping you on your journey...

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