What does the first appointment look like?
What treatments are offered?
Physical Therapy Evaluation: It’s critical to thoroughly review as many of the factors that may have brought you to seeking care – your medical history, current and past symptoms, diet and exercise habits, etc.. It’s just as important to complete a physical evaluation, including but not limited to – postural assessment, functional movement evaluation, orthopedic/neuro screening and, as appropriate, an internal and external pelvic examination.
In truth, your evaluation is ongoing – each session will include assessment of current symptoms/conditions and how they relate to pre-treatment, initial evaluation, your last visit, and so forth.
Manual Therapeutic Techniques: We use a gentle, hands-on approach to reduce tension and pain, improve coordination and retrain muscle function. A key to manual work is recognizing its limitations – primarily that it’s a passive treatment. True recovery empowers you to address issues as well. That’s why ALL manual techniques must also be supported with instruction in self-care, exercise and functional training – to allow your body to adapt and to ensure your progression toward independence.
Dry Needling: Dry Needling (also labeled as “FDN”, “IDN”, trigger point DN, etc.) may sound intimidating, but when applied appropriately is not so scary. Dry needling is the use of very fine filament needles that interact with the muscles and nerves to reduce pain, tension, and in some cases, help to reduce inflammatory processes. Conditions that respond well to DN include orthopedic pain (for example – neck, back, pelvic), headaches or jaw pain and other restrictions (post-surgical scars, hamstring tightness, frozen shoulder, etc.).
Exercise / Activity Training: Whether directed toward strengthening, tension reduction, or optimizing recruitment patterns, exercises and activities are vital to supporting other clinical treatments provided. Note: We use “activities” in addition to “exercises” because for many people with pain or hypermobility, traditional exercises can be difficult while others may be ready to return to high-level exercise like running or CrossFit. Wherever you land, there are many activities you can do to reduce pain or tension – our job is helping to create the perfect treatment plan for you.
Home Treatment Program: Clinical visits are necessary, but much of the program rests in self-care and independent training. Self-efficacy is a primary goal and your confidence in being able to regain control is essential. Some forms of treatment you would complete at home include educational reading and review, manual techniques, exercises/activities, mindfulness, behavioral training (bladder retraining, dietary and nutritional modification) and sexual health training to progress toward your goals.
Pattern Retraining: Also known as Neurologic Re-education – retraining of pelvic function involves improved coordination with the rest of the body for safe and pain-free movement. All regions and tissues are involved, including muscles, connective tissue, nerves, bones, joints, and organs. There are several methods for retraining movement and appropriate recruitment of muscles for improved function. One powerful tool we use for retraining the appropriate neuromuscular activation (Neurac) patterns is Redcord.
Self Care Options: A big focus of all therapy is to make sure you feel confident in self-care. While we go over a slew of home exercises, sometimes gadgetry is also involved. Here are a few of the options we may include in your plan of care.
Pelvic trainers (dilators), wands, weights – self-treatment for pelvic conditions may involve the use of internal tools. We will instruct you in the correct and most effective methods for applying these tools and educate you on proper use.
TENS and at home units – When appropriate, a personal TENS unit may be added to your home program for use outside of the office. TENS is a small, portable unit that utilizes electrical stimulation to target pain. We find that in combination with in office treatment, TENS units can be quite effective in reducing pain for some clients.
Bladder and/or bowel diary – If you’re having any sort of urinary and/or bowel dysfunction, chances are we will have you fill out a log. A bladder/bowel diary incorporates your intake and output along with other factors to help us take a closer look at your daily life and routines outside of the office so we are better able to tailor care.
Belts and other corrective devices – In certain cases (for example – round ligament pain during pregnancy) an SI joint support belt or another type of support can be used to help reduce pain and pressure throughout your day. Throughout your assessment and treatment, your PT will collaboratively address different modalities such as supports that can be utilized outside of the clinic.
What should I expect?
Your first visit is the initial evaluation. It lasts about 60 minutes and is a four-step process.
- We’ll start by talking a bit about YOU – your medical history and any other background info, but also your goals, your true desires of what you’d like to get back to doing!
- The physical part is a thorough orthopedic / neuro screening and functional movement evaluation. We will look at how you move (or don’t), how you stand/sit and then run a few tests.
- The second part of the physical exam will likely include an abdominal and pelvic-specific examination. This will possibly include an internal assessment (vaginal and/or rectal as appropriate). Know that you always have the opportunity to ask questions, delay or refuse internal assessment / treatment.
- We’ll immediately go over your findings and develop a realistic plan of care based on your physical presentation, goals, schedule and needs. You’ll receive treatment during that very first session! You can expect to leave with homework and/or resources to review.
Follow-up visits are either scheduled ahead of time or set up at the first visit. The frequency of visits depends on your particular situation (severity of symptoms, distance from clinic, need for in-person follow-up, etc). All sessions are 1-on-1 with the original evaluating PT – completed in a warm and private treatment space.
