An integrative approach to Pelvic Floor Physical Therapy
What is pelvic floor physical therapy?
I am a physical therapist. Just like any other part of the body, I am still very focused on the ligaments, nerves, muscles, joints and making sure everything in your pelvic floor is doing what it’s supposed to do. Your comfort during our sessions is paramount. The evaluation starts with a lot of talking so I can build a good picture of what is going on with you. I give you options for next steps and then we get right into treatment on the first session. It is my priority that you walk away from every session with an individualized plan of care that works for you.
Brittni has advanced certifications and training to treat:
Painful urination
Incontinence of bladder and or bowel
Urinary frequency
Urinary urgency
Urinary hesitancy (difficulty starting to urinate or emptying the bladder completely)
Waking up frequently to urinate
Constipation
Difficulty controlling gas
Pain in low back, genitals, rectum, tailbone
Pain with intercourse
Inability to achieve orgasm
Feeling of pressure or heaviness in pelvic region or rectum
Muscle spasms in your pelvis
Abdominal wall rehabilitation
Prehab and post operative care following cancer, colorectal, urogynecology and reconstructive pelvic surgeries
Ante/postpartum
Perimenopause and menopause symptoms
Peripheral nerve impairments (ex: Pudendal Neuralgia common with cyclists)
Gender Affirming Care
Bedwetting
What to expect during your Pelvic Floor Evaluation:
Here is a step-by-step breakdown of what typically happens during that first 60-minute session.
1. A Conversation
The most important part of the evaluation isn't physical—it's the story you tell. I will ask detailed questions to understand the "why" behind your visit. We’ll discuss:
Bowel and bladder habits: Frequency, urgency, or any leakage.
Pain patterns: When it happens, what it feels like, and what triggers it.
Lifestyle & Goals: What activities have you stopped doing that you want to get back to? (e.g., running, lifting your kids, or pain-free intimacy).
2. A Total-Body Movement Screen
Because the pelvic floor is linked to so many other aspects of your body, will look at how your whole body moves. This usually includes:
Posture and Breathing: How your ribs and diaphragm move (which directly impacts pelvic pressure).
Hips and Spine: Checking for tightness or weakness in the "neighbors" of the pelvis.
Core Strength and Balance: Assessing how your abdominal muscles coordinate with your breath.
3. The Pelvic Floor Assessment (External & Internal)
This is the part that often makes people nervous, but it is handled with the utmost respect and privacy.
Always Optional: You are in the driver's seat. If you aren't ready for an internal exam on day one, that is 100% okay. If you decide you never want to complete an internal exam, we can still utilize other strategies to address your symptoms or I can teach you how you can perform a self-exam at home.
No Speculums or Stirrups: Unlike a GYN exam, this is a manual assessment using a single gloved finger.
What they are looking for: Assessing for muscle "tone" (are the muscles too tight?), strength (can you perform a proper contraction?), and coordination (can you relax them fully?).
4. Findings & "The Plan"
Before you leave, I will sit down with you to connect the dots. You’ll walk away with:
Education: A clear explanation of what is causing your symptoms.
The Roadmap: A recommendation for how many visits you’ll need (often just once a week or every other week in this model).
Home "Homework": Usually 1–2 simple movements or habit changes you can start immediately.
How to Prepare
Wear comfortable clothes: Think leggings, joggers, or gym shorts.
Hydrate & Eat normally: No need to fast or do anything special.
Write down questions: It’s easy to forget them once the session starts