What to Expect on Your First Visit
I threw on leggings and a loose shirt, slid on loafer-style shoes, grabbed my keys and coffee, and headed to my first ever Physical Therapy appointment. I would’ve never guessed it would occur at age 42 and be for pelvic floor therapy.
The crowded office burgeoned with people of all ages engaging in PT with yoga balls and table exercises. Surely, I thought, I won’t be out in the open.
After filling out pages of intimate and detailed paperwork and realizing I needed to pee already — too much coffee — my Physical Therapist, Becky Wilcox at Physical Therapy of Tulsa, walked into the lobby, introduced herself, and led me back to her private room.
Becky looked hip and happy. She had me sit down, go over my paperwork, ask questions, and listen to my answers, sometimes asking more questions based on my answers. I love it when healthcare professionals listen to me.
When she asked me to hop on the table, and I said, I better go to the bathroom first, she wasn’t annoyed or rushed. She told me where to go and waited for me. I felt calm and supported in her presence. From the beginning to the end of the appointment, Becky didn’t treat me like a broken person.
I was nervous and expecting more of a gynecologist-style appointment. That’s not what happened.
I filled out a lot of informational forms. My therapist came out and introduced herself. She took me back to her private room and took her time explaining things and asking me questions. Do you know how some people exude empathy? She is one of those people. I am grateful for this.
When I talked about the trauma that went with my c-section scar, she nodded in understanding. When I mentioned I’d gotten work done on it by a healer, she nodded her head. Instead of being judgy, I felt more empathy and understanding permeate the room. She asked if it had helped. She said she could feel the energy I was talking about.
This is new to me. I don’t usually confide alternative methods to doctors because I never know how they’ll react, and I assume it’ll usually be negative. But, I think alternative modes are being integrated into traditional medicine now, and I’m willing sometimes to take the risk to say things like, I’ve worked with a healer. In this case, it forged a closer relationship from the beginning of my intake.
She asked about my pelvic floor history and I relayed the following information to her.
Pelvic Floor History
I’ve had two children. In 2007, I birthed my son after long labor progressing to an 8 (out of 10) centimeters dilated, only to get to the hospital, screaming in pain for drugs, any drugs, like you see the crazy women on TV doing. Our son was in the brow position.
It was near Christmas, and my OBGYN was on vacation. The new doctor told us our baby's neck could snap if we continued this course and suggested we have a C-section. The phrase “baby’s neck may snap” was enough to convince us. David got all sheeted up in his Tyvek-looking scrubs, and we went into surgery. The surgery was traumatic, but that’s another story.
My recovery was slow and painful — I was healing from a brutal c-section incision. I felt the scalpel for a good chunk of it. I recovered, lost the baby weight, and got quite healthy within the year.
In 2010, we had our second child by VBAC. I was terrified to go through another traumatic surgery. Our daughter was induced at the 39th week, and labor with her was pretty flawless. I did require an episiotomy and had an epidural, but no mind-altering drugs. I was grateful to be aware and present for this healing birth. I even got to hold her head as she was being born.
After I’d healed from delivering our daughter, which was much quicker than the c-section healing, I began running. I ran for about a year until I realized that I had a prolapsed uterus. My doctor warned against doing any high-impact exercise.
My OBGYN wanted to perform a hysterectomy. I thought this was drastic. I got a second opinion. That doctor agreed that a hysterectomy wasn’t necessary at the time.
I don’t find that Pelvic Floor Therapy is something women in my life discuss. I think the first time I heard about it was from my PCP (Primary Care Physician) at my well-woman check-in 2020. I’d been seeing a slew of doctors, and although I was interested, I decided to hold off.
First, Get a Referral From Your Primary Care Physician
Part of me felt embarrassed and unsure of what to expect. Then, my friend Shanna Loga wrote an article about her experience with Pelvic Floor Therapy. Reading her article was a lightbulb moment and a moment of pure gratitude. She is brave and speaks up about something that every biological birth mom should probably know.
I messaged Shanna to confide that I also peed my pants and was encouraged to pursue Pelvic Floor Therapy after reading her article.
When I worked as a gardener in a very physical job at my local botanic garden, I started leaking urine. I wore pads to work. I was in my early 40s and pretty damn embarrassed. But I also figured this is just something moms deal with. I remembered my mom saying she dealt with it. It was just part of what happens after birthing babies.
I resigned from my job in January of 2020. Throughout 2020, I spent many hours sitting and typing. I’d often hold my pee way too long, and when I got up, I’d dribble. I also had a few moments of soaking through my pants entirely. I’m 42. This felt pretty mortifying. I cut back on coffee and tried to remember that the pee-pee dance is for kids, not moms who have had two kids.
My well-woman check was a few weeks ago. It’s the first time I walked into a well-woman check and felt absolutely no embarrassment about laying bare on the table. It’s self-care. It’s important. Women’s Health shouldn’t be embarrassing.
My doctor is a phenomenal woman who had her first baby in August. She took a look at my prolapse and said, “I can refer you to Pelvic Floor Therapy now, or we can wait until it gets worse.” I said, “I want to go now!” with a big grin on my face. Last year, I would’ve been bashful. This year, I felt empowered and confident. “I’d rather prevent it from getting worse. My friend just told me all about her pelvic floor therapy appointment, and I’m so glad she did. I wish more women talked about this.”
My doctor agreed and informed me that we have wonderful Pelvic Floor Specialists in Tulsa. People even come from out of state to see them. She gave me the referral and mentioned she should probably go herself. She encouraged me to talk about this with other women.
Physical Evaluation and Exercise Recommendations
Then, we got around to the evaluation and exercises. I won't write a lot here except that I had no idea how important my abs are to my pelvic floor. I didn’t know my abs should be engaged when I’m doing Kegels. I didn’t know the different ways in which to do Kegels correctly. I wasn’t thrilled when my strength evaluation came out at a 1 from a 0–5. At least I knew how to do them, and my endurance was perfect.
I messaged Shanna to share my low grade. She told me I’d be “cracking walnuts” by the end of therapy but that when we quit doing the exercises, we lose the tone quickly. I’m trying to remind myself of this and actually do my exercises…I’m pretty good at dropping the ball at things with “exercise” or “abs” in them.
Women need pelvic floor education. We need to know how to name and isolate our internal anatomy. We need to know how important our abs are to our pelvic floor. This isn’t information we should have to seek out by ourselves, and it shouldn’t be a hush-hush or embarrassing thing to discuss. There should be post-partum education about pelvic floor therapy, and doctors and gynecologists should provide this education to women. I’d much rather do physical therapy than undergo a hysterectomy operation.
Everyone has a different situation. The more we discuss our experiences and normalize them, the better we can begin to feel, and the more confident we can be in taking action to improve our health, even when it feels a little — or a lot — embarrassing. I hope my experience encourages you to prioritize your health. You’re worth it!
Physical Therapy of Tulsa: 918) 494-3000 | 6767 S Yale Ave, Tulsa, OK | Hours: Monday-Friday 7:00 am - 6:00 pm | Social Media: Facebook
This is the first article in a multi-article series about Pelvic Floor Therapy.
Original version published on April 4, 2021, in Medika on Medium.
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