First Pelvic Floor Visit: 9 Powerful Insights to Feel Confident & Prepared
- Marnie Hansen
- Apr 3
- 10 min read
Updated: Apr 4
Blogpost written by Dr. Marnie Hansen, April 2026
Introduction to Your First Pelvic Floor Visit
Many feelings can come up when booking your first pelvic floor visit. Feelings like apprehension or intimidation are totally normal... not to mention, common! Many women put it off for years, as the thought of someone snooping around 'down there' can feel a little unsettling. Others think... perhaps what's a mystery should remain a mystery, and simply might not want to know more about their pelvic floor.
Then there comes the day when you just can't ignore it anymore.
We know, we've been there.
But, not to fear. The process is easier and more comfortable than you think!
A well-trained, trauma-informed pelvic floor specialist's main goal is to facilitate a comfortable and inviting healing process throughout the entire spectrum of care. Here at Salt Lake Spine & Pelvis, our top priority is to create a welcoming, respectful, and empowering experience from the very beginning.
Pelvic floor care focuses on improving how muscles, joints, and nerves work together to support bladder, bowel, reproductive, pelvic floor, and core function. Because the pelvis is directly connected to the spine, hips, and nervous system, a whole-body evaluation is key to uncovering the true source of your symptoms.
The most important element to a successful visit is meeting you where you are at and taking it at your pace. Nothing is rushed, and everything is explained. And clear consent is central to every step.
Many women walk into their first visit feeling unsure, but walk out feeling relieved, hopeful, and confident they’ve taken such an important step toward getting the answers they deserve. And they feel better, too!
Why Pelvic Floor Health Matters for Women
The pelvic floor muscles support vital organs, stabilize posture, and play a major role in daily comfort and confidence. When these muscles aren’t functioning optimally, symptoms can often show up in surprising ways.
Common reasons women seek pelvic floor care include (but are not limited to!):
Pelvic pain or pressure
Pain with intimacy
Pregnancy or postpartum recovery
Low back or hip discomfort
Bladder urgency or leakage
Core weakness or instability
Difficulty returning to exercise
Persistent tightness or tension
Painful or irregular cycles
Because the pelvic floor muscles are part of a larger movement system, addressing them can improve comfort, mobility, and overall quality of life.
Step 1: A Comfortable Conversation Comes First
Creating a Safe, Judgment-Free Environment
At our office (and any pelvic practitioner's office, for that matter!), your first visit begins with a conversation in a safe space. You and your therapist sit down together and discuss what you’ve been experiencing and what you hope to achieve.
This is not a rushed intake experience, nor should it be. First visits can range from 60 to 90 minutes, and all the pertinent details are gathered. The discussion is intended to be meaningful, and the purpose is to help you feel heard and understood as we get to the bottom of what is going on.
Some patients feel nervous about sharing their pelvic concerns, but rest assured, nothing you share is unusual in this setting. Pelvic health providers discuss these uncomfortable topics every day... and your comfort is always top priority!
Discussing Symptoms, Concerns, and Goals
Healing is a team process. It's very helpful to let your therapist know:
When your symptoms began, and what they specifically feel like
Particular activities that make your symptoms better or worse
Pregnancy or birth history
Surgical history (Caserian, IVF, hysterectomy, etc)
Exercise habits
Stress levels
Monthly cycle patterns and/or hormonal issues you might be aware of
Previous injuries
Clear goals for recovery (What do you want to do again that you can't do now?)
Common Examples of Patient Goals
“I want to exercise without discomfort.”
“I want to feel confident again.”
“I want sex to feel normal.”
“I want to stop worrying about leaks.”
“I want to feel strong in my body again.”
"I want to stop taking medications for my period."
"My mom had a hysterectomy, and I want to prevent that."
No goal is too small or too big. In fact, pelvic floor therapy can be surprisingly helpful even when there are no obvious symptoms!
Step 2: Thorough Health History & Whole-Body Perspective
Medical History, Lifestyle, and Movement Patterns
Pelvic floor symptoms rarely exist in isolation, and may only be a piece of the puzzle (albeit an important piece!) where your pelvic pain or dysfunction is concerned. Your provider will look at the bigger picture, including lifestyle habits, injuries, daily activities, nutrition, and stress factors that can influence muscle tension and coordination.
Your pelvic floor is an ecosystem of connected fascia, muscles, nerves, and tissue chemistry. Therefore, a holistic, whole-body perspective helps identify root causes rather than simply treating or chasing symptoms.
Why Pelvic Health Is Related to the Spine and Hips
The pelvis acts as your center of gravity, and is a central hub connecting and affecting:
The spine
Your hips
Core muscles like the abs, glutes, and diaphragm
Nervous system (this is a big one with pelvic health!)
Breathing mechanics (also big)
When one area of the body isn’t functioning optimally, the body compensates and adapts in other areas. Over time, compensation patterns, or adapted movement patterns, can lead to tension or weakness in the pelvic floor.
This is what your practitioner thoroughly assesses for!
Step 3: Posture & Movement Assessment
Understanding Weight-Bearing and Load Distribution in the Pelvis
Next comes the fun part!
Your pelvic floor practitioner is a movement specialist and will likely want to take a look at your posture and how you move (we do in our office, as it's so important!). A knowledgeable therapist or doctor will take you through a comprehensive assessment of your spinal and pelvic posture. This helps evaluate how your body distributes weight when standing, sitting, and moving.
Many women love this part of the exam, as it's a wonderful opportunity to learn more about their body and take a closer look at their movement habits. This is all done through the clothes and is an interactive and engaging part of the exam.
Small imbalances in posture can influence how pressure or pain can build in the pelvis.
Your provider may assess:
Standing posture
Walking mechanics (gait analysis)
Hip mobility
Core engagement
Balance patterns
Movement coordination
How Posture Influences Pelvic Floor Function
When the pelvis is well aligned, muscles can contract and relax more effectively and in more predictable patterns.
When alignment is out of balance, your muscles may:
Work too hard
Become tight or guarded (under tensile load)
Struggle to activate properly
Compensate for instability elsewhere
Common Movement Findings
One hip works harder than the other when walking
Limited spinal mobility (the back compensates for imbalanced pelvic movement patterns)
Core muscles not optimally coordinating
Glute muscles under-activating or firing
Excess tension in the hip rotators and hip joints
These biomechanical findings are crucial to the overall process and can help your provider guide personalized care.
Step 4: External Muscle Assessment (Through Clothing)
Muscles That Affect the Pelvic Floor
An external muscle assessment is performed through clothing. This involves gentle muscle palpation to check for tone and tenderness. All the muscles that influence pelvic floor function are checked!
These muscles will commonly include:
Glutes
Hip rotators (piriformis, obturators)
Groin muscles
Lower abdominal muscles
External vulvar muscles
Muscles of the perineum or around the anal opening, if necessary (oftentimes women are surprised at how tight or tender these muscles can be!)
Low back muscles (directly connect to the pelvis and pelvic floor)
Muscles of the thorax/trunk and core (how you breathe can directly influence pelvic floor function)
Why the Glutes, Hips, and Groin Matter
This core group of muscles works in synchrony to support stability, regulate pressure, and function within the pelvis.
If one muscle group is tightened or even underactive, the pelvic floor musculature, which sits like a hammock at the base of the pelvis, compensates over time.
What This Assessment Feels Like
The assessment is gentle and respectful. Many patients are surprised by how informative and enlightening this step can be. Most of our patients report learning a lot about their bodies during this process alone.
Familiarizing yourself with areas of tension that can appear in unexpected places can be quite educational for women. Self-discovery is a pivotal part of the healing journey!
Step 5: Understanding the Internal Pelvic Floor Exam
Why An Internal Assessment Can Be Helpful
The internal pelvic floor muscles can't always be fully assessed externally.
Though not always necessary, an internal pelvic exam can provide valuable insight into:
Muscle coordination
Areas of tension or pain
Strength and endurance
Trigger points
Potential prolapse
Tissue sensitivity and health
(By the way, in our office, we don't use stirrups or uncomfortable speculums for the examination. Sometimes, a handheld mirror is offered to our patients so they can learn more about this important area of their body, and it can be helpful for education and a starting point towards meaningful embodiment during the healing process. We will talk more on that later!).
The information gathered during the internal exam, when done gently and respectfully, can help your therapist create a more thorough treatment plan, and you will likely learn a lot from it, too! Many women are surprised to learn where the deep aches and pains that mysteriously show up in the pelvis come from. And are pleasantly surprised to find there are explanations for it.
Many find great relief in knowing something can be done about it and gain a better sense of direction for their course of healing.
Research also continues to support the value of pelvic floor evaluation in improving outcomes for pelvic pain and dysfunction, and we see it in our office every day!
Consent-Based Care at Every Step
In our office (and as should be the case in all offices), consent is requested at every stage of care.
You are always in control. Consent is ongoing and can be revoked at any time. We empower our patients to develop a sense of agency in the process and encouragethem to let us know if something doesn't feel right.
An internal exam is never required on the first visit and is most often scheduled for the second visit, as thorough information-gathering and proper diagnoses take time.
Optional on First Visit, Often Recommended Later
Light internal work may be introduced during the first visit (in our office, typically at the patient's request), depending on findings, comfort level, and available time.
At our office, you can always say yes, no, or not today.
Your comfort matters most.
Step 6: Gentle First Treatment Options
Gentle Chiropractic Adjustments
If appropriate, a gentle adjustment may be performed to improve spinal and pelvic mobility and relieve pain. Improving joint motion can reduce strain on surrounding muscles and improve coordination.
Light Internal Pelvic Work
This is optional on the first visit, and is done upon request at our office (as well as many other offices). If chosen, internal work is respectful and focused on improving muscle awareness and relaxation.
Individualized Treatment Decisions
No two visits are identical, and care is always customized.
Step 7: Emotional Responses Are Normal
Why Feelings Can Surface During Pelvic Care
The pelvis is an area where many people store tension and deeply embedded emotions. It is not uncommon for feelings to arise during treatment. This is normal and welcomed.
Healing often involves both physical and emotional components.
Working Alongside Mental Health Professionals
Some patients benefit greatly from working with:
Therapists
Counselors
Trauma-informed practitioners
Collaborative care can enhance progress and comfort, and is often recommended.
Step 8: Creating a Personalized Treatment Plan
Collaborative Care and Patient Empowerment
After the assessment, a personalized care plan is created together.
This plan may include:
Movement therapy
Chiropractic care
Pelvic floor muscle retraining
Breathing exercises
Lifestyle recommendations
Coordination with other providers
Setting Realistic Expectations for Progress
Healing takes time and is a process of teamwork.
Many patients notice gradual and noticeable improvements in:
Comfort
Mobility
Confidence
Body awareness
Strength and flexibility
Reduced leakage
More regulated cycles
Enhanced fertility
More comfortable pregnancy
Post-partum recovery
Consistency is key when it comes to the pelvic floor!
Step 9: Why Pelvic Floor Care Is a Team Effort
Patient-Practitioner Partnership
The best results happen when care is collaborative, compassionate, and consistent.
You are an active participant in your healing journey and a partner in the treatment plan decision-making process at all times.
Building Confidence Over Time
Most patients report feeling more comfortable after the first visit than they expected.
Knowledge reduces fear.
Understanding builds confidence.
Progress builds momentum.
Tips to Prepare for Your First Pelvic Floor Visit
Practical Preparation Checklist
Wear comfortable clothing
Bring questions
Eat normally
Arrive hydrated
Allow time to relax before the appointment
What to Wear
Stretchy, comfortable clothing works best. We even recommend cozy socks to wear for the internal work!
Questions to Consider
What are my main symptoms?
When did they begin?
What are my goals?
What should I expect?
A safe, ongoing dialogue with your practitioner is essential to a trustworthy patient-doctor relationship. Listen to what your body tells you when you ask your practitioner questions. These are clues your body is giving you about whether the therapist is the right fit for you.
Frequently Asked Questions
1. Is the First Pelvic Floor Visit painful?
Most patients find their visits to be gentle and informative. Any hands-on work is always adjusted to your comfort level.
2. Do I have to do an internal exam?
No. Internal assessment is always optional and based on consent.
3. How long is the appointment?
First visits are typically longer to allow time for discussion and thorough evaluation. Typically, 60-90 minutes is needed for the first appointment.
4. How many visits will I need?
Ask us! Each care plan is individualized depending on goals and findings.
5. Can pelvic floor care help postpartum symptoms?
Yes. Many women benefit from support after pregnancy and delivery.
6. Is pelvic floor care only for pain?
No. Care can also improve strength, coordination, stability, and confidence.
Can I receive pelvic floor therapy if I'm on my period?
Yes, and it can be quite helpful to regulate and relax the pelvic floor muscles during your cycle.
Can pelvic floor care help with pregnancy?
Pelvic care during pregnancy can help prepare for a more comfortable delivery in most cases.
Can pelvic floor therapy help with perimenopause or menopause symptoms?
Absolutely! Working with the pelvic floor muscles can help with vaginal dryness or discomfort, pelvic floor discomfort, symptoms of prolapse or incontinence, amongst other issues that arise during this phase of life.
Conclusion: Your First Step Toward Healing
Your First Pelvic Floor Visit is the beginning of a supportive partnership focused on restoring comfort, function, and confidence in your body. It is a courageous and admirable endeavor!
Yes, it may feel unfamiliar and scary at first. Maybe even a little awkward... but most patients quickly realize that pelvic health care is simply another form of specialized musculoskeletal care. Knowing this frequently demystifies many questions women have about the process and their bodies.
Pelvic Floor Therapy is intended to be professional, respectful, and empowering care that encourages women to feel a deeper sense of embodiment and ownership of their unique bodies. This is the heart of our practices at Salt Lake Spine & Pelvis. We strive to provide compassionate, personalized care.
You don’t have to navigate symptoms alone; there is help available. The journey begins with knowledge and empowered understanding. And understanding begins with the first visit!
Looking forward to meeting you soon and being a part of the beautiful discovery and healing process that pelvic floor therapy has to offer you :) If you live outside of the Salt Lake area, we are happy to help you find a qualified practitioner in your area. Please reach out!
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