Just like any profession, not all therapists are created equal. As physical and occupational therapists, we have varying levels of post-graduate education and training. Pelvic health is a very specialized subsetting within rehabilitation therapy. Most of our training occurs after graduating PT or OT school, which means not many therapists actually know how to treat the pelvic floor.
So be sure you are seeing someone who actually specializes in pelvic health and that’s what they see and treat day after day. Ask the question: “Do you treat pelvic health conditions on a daily basis?”
The pelvic floor muscles live deep inside the pelvis. We can only gather so much information on what the pelvic floor is doing externally— therefore we are mostly theorizing what the pelvic floor is doing if we don’t actually assess it internally to feel what it’s doing. Internal assessment can be transvaginally and/or transrectally— of course, always pending patient consent.
In my opinion, if we skip an internal exam, we are missing a large part of the musculoskeletal and functional exam. Ask the question: “Do you examine and treat internally?”
Our pelvic floor muscles work together with the rest of our body, especially our core, glutes, diaphragm, ribs, and spine. It is integral to be assessing and treating the whole body in order to get best results. If you are only having the pelvic floor addressed and you’re not seeing the results you want… seek another opinion. Ask the question: “Do you address the whole body in your pelvic floor treatment?”
Be sure you know who you are working with and know their strengths and limitations. There are a plethora of “pelvic floor specialists” out there on social media that are not actually pelvic floor therapists. Many are personal trainers, coaches, etc. Some of them are very knowledgeable about the pelvic floor and have sought out specialized training in these areas which is GREAT! However, many have not and are not experts in that area. Only physical and occupational therapists can perform internal pelvic floor muscle exams and treatment… not trainers, coaches, nurses, massage therapists, etc. Ask them: “What is your training like when it comes to the pelvic floor?”