If you’ve been here for any length of time at all, you know I’ve been passionate about physical therapy for as long as I can remember. After I started working with female athletes in my sports residency program, I learned that pelvic floor issues are so common — and finding qualified PTs to treat them was… not so common. 

Now, I use my doctorate in physical therapy to educate women (especially mamas!) online and treat them in person in my clinic. Pelvic floor issues are treatable and even preventable. And while pelvic floor physical therapy is not often considered standard care in the United States, I’m doing everything I can to change that. 

So, believe me when I say that pelvic floor physical therapy can be life-changing. But I also know it can be intimidating, especially when you aren’t sure what to expect at your first appointment. Not all pelvic floor PTs are equal, and it’s important to find a provider who can truly help you with any pelvic floor dysfunction you’re experiencing and give you a treatment plan that helps rather than harms. Today, I want to ease your mind by helping you determine if you’ve found a good physical therapist — here’s how you’ll know! 

12 signs you’ve found a good pelvic floor PT

1. A good pelvic floor PT can evaluate and treat you internally. 

First things first: I know the idea of internal exams can feel embarrassing or uncomfortable. However, a trained pelvic floor physical therapist will put you at ease by explaining the process and ensuring you feel comfortable with every step. Remember, you are never obligated to undergo an internal exam! However, they can often be helpful, since most pelvic floor issues are not visible externally. 

Even if you don’t need an internal exam at your first appointment, your physical therapist should be trained in vaginal and rectal examinations. Don’t be afraid to ask before you book! If they’re certified to practice pelvic floor PT, they will definitely know how to perform both. 

Question to ask before booking: Are you trained in internal exams?

2. A good pelvic floor PT will not rely exclusively on internal work or tissue massage for pain relief.

Look, I’m a huge fan of tissue massage and internal work — they are valuable tools in any pelvic floor physical therapist’s repertoire! However, these two techniques do not provide a full treatment plan. Internal work and tissue massage can alleviate immediate symptoms, but combining exercise and internal work is often the most effective in maintaining your pain-free status and preventing future issues from arising.

Question to ask before booking: What kind of treatments and techniques do you use in your clinic? 

3. A good pelvic floor PT will incorporate a combination of mobility, stability, and strength work.

As a follow-up to the previous point, tissue massage and internal work are best when they’re coupled with exercises that improve your mobility and stability. Mobility work helps you improve your range of motion, and strength training helps you build and control your muscles. Both are essential in pelvic floor treatments!

Question to ask before booking: Will you give me mobility and strength work to do at home? 

4. A good pelvic floor PT listens to you! 

Unfortunately, most of us have been in an appointment at some point with a provider who just didn’t listen to us. It’s frustrating and demoralizing when someone doesn’t take your pain or symptoms seriously. You may not be able to find out if your PT is a good listener before your appointment, but if you don’t feel heard or you aren’t treated well in your initial session, you absolutely can and should cancel subsequent appointments and try again with another PT. It’s worth it to work with someone who seeks to understand you and your body!

5. A good pelvic floor PT frequently updates your home exercise program based on your progress.

This one’s pretty simple, but you want to find a PT who will create a program that moves and grows with you. The exercises that worked best for you on day 1 may not be helpful on week 6! You want to work with a physical therapist who will customize your plan to give you the best results. 

Question to ask before booking: Will you update my home exercises as I progress through treatment? 

6. A good pelvic floor PT ONLY treats one patient at a time. 

I cannot express to y’all how strongly I feel about this point. By its very nature, pelvic floor physical therapy is up-close and intimate. No one should not be treating these issues in a group setting. You can avoid this by making sure your physical therapist specializes in pelvic floor treatment and offers 1:1 appointment times. While group sessions can be helpful in other types of PT, this is just not the case when it comes to your pelvic floor. 

Under the typical insurance model, your pelvic floor PT might not be able to provide 1:1 care for the full 60 minutes due to the frustrating limitations of insurance. That said, if an insurance-based PT is all that you can find, inquire about how the duration of each session and how much of that session will be 1:1!

Question to ask before booking: Do you treat patients one-on-one, or will there be other patients present?

7. A good pelvic floor PT puts YOUR goals and desires at the forefront of your treatment plan. 

If you’re booking an appointment for pelvic floor physical therapy, you likely have a specific goal. This could be reducing incontinence, treating pain with sex, preparing your body for childbirth, or any number of other things! Find a pelvic floor PT who will help you accomplish your goals — because after all, it’s your body, and you deserve to find someone who will work by your side to help you feel confident and strong! Just like point 4, you might not be able to determine this before your session, but if you don’t like the treatment plan laid out for you and don’t feel heard, don’t be afraid to shop for a new PT clinic. 

8. A good pelvic floor PT treats you personally (and is actually a physical or occupational therapist!)

In many physical therapy settings, students or other employees assist doctors of physical therapy in client treatment. But when it comes to the pelvic floor, you should always have an expert at the helm. Make sure that your treatment program in the clinic of your choice will be chosen by a doctor of physical therapy. To find out if that’s the case, just ask! If the clinic mentions that a PT/OT aide or rehab tech will be the one with you a majority of the time, I would proceed with caution.

Hear me out: there are some great PT/OT assistants out there who are qualified to treat the pelvic floor – but just make sure they are working in tandem with your doctor of physical therapy (or occupational therapy), which means they’ll create your treatment plan together!

Finally, only a physical therapist/occupational therapist or physical therapy assistant can practice physical therapy. If your OBGYN or midwife says they have an “in-house” option that is performed by a nurse or anyone other than a PT/OT – say no! Trust me, you want only the best when it comes to treating your pelvic floor and you don’t want to waste resources on ineffective treatments.

Question to ask before booking: Is a doctor of physical therapy or occupational therapy treating me the entire time?

9. A good pelvic floor PT is not afraid to say “I don’t know” or “let me do some research and get back to you on that”. 

Like I said at the beginning of this post, I’ve been passionate about physical therapy for as long as I can remember and even have my doctorate — and still, I don’t have immediate answers to every single question I get from my clients! A good PT doesn’t necessarily have all the answers — and they definitely shouldn’t give you an answer if they aren’t certain it’s correct! Instead, find a physical therapist who will research as needed and follow up with you. This is less of a “question to ask” and more of a disposition to look for as you spend time with your PT in sessions. 

10. A good pelvic floor PT is not afraid to refer you elsewhere if treatment is not working or they have other concerns. 

Even the best pelvic floor physical therapists sometimes need reinforcements. Trust me: while it might feel discouraging not to see progress or to need an outside referral, it’s actually a sign that your PT is going to bat for you and is committed to getting you the best possible treatment plan! I have had the privilege of meeting and working with lots of great PTs, and we all just want to see our clients feeling strong, healthy, and happy — whatever it takes. 

11. A good pelvic floor PT looks BEYOND the pelvic floor. 

I talk about this often: the pelvic floor is one piece of your bodily puzzle. Your pelvic floor connects to your hip joints, tailbone, and pelvis, and it works in conjunction with many other muscle groups to keep your body aligned and keep your internal organs safe. If you’re experiencing pelvic floor dysfunction of any kind, it’s important to look at the bigger picture! A good pelvic floor PT will help you treat any systemic issues going on so that you can find lasting relief (instead of only providing exercises that help in the short term). 

12. A good pelvic floor PT treats you in a facility with access to strength training equipment. 

Your pelvic floor PT does not have to work in a full gym, but you should have some space to work on guided strength during your sessions. Like I mentioned, pelvic floor wellness is part of a bigger puzzle, and improving your overall strength and mobility will have positive effects on your pelvic floor! 

Question to ask before booking: Does the clinic have access to strength training equipment?

Finding a good pelvic floor PT near you 

And there you have it: a dozen ways to know you’ve found a good pelvic floor physical therapist. Whether you’re pregnant, postpartum, or experiencing pelvic floor concerns, it’s never a bad time to find a pelvic floor physical therapist near you. If you’re not sure where to start, these directories are a great place to look! 

• Pelvic Rehab
• Pelvic Guru
• APTA Pelvic Health
• Baobei Body                   

I hope you walk away from this post feeling empowered and ready to ask questions, advocate for yourself, and find a great pelvic floor PT who will journey with you toward the outcomes you desire!