Physical Therapy

A pelvic floor muscle exam can feel intimidating—especially if you’ve had past trauma. A good provider understands that and approaches the exam with care, consent, and flexibility. The most important thing to know is this: you are always in control of what does and does not happen.

Here’s what that exam typically involves, with a trauma-informed approach:

It Starts With a Conversation

Before anything physical, Dr. Johnson will talk with you about your symptoms, goals, medical history, and any concerns. You can share as much or as little as you want—including whether certain exams or touch feel unsafe for you.

Consent Is Ongoing, Not One-Time

Nothing happens without your clear permission. You can expect Dr. Johnson, a trauma-informed therapist to:

• Explain each step before it happens

• Ask for consent along the way

• Check in with you during the exam

• Stop immediately if you ask

You can pause, modify, or skip any part of the exam at any time—no explanation required.

External Assessment Comes First

The exam often begins with looking at posture, breathing, hips, abdomen, and how your body moves. Dr. Johnson may gently assess muscles on the outside of your body—this can give a lot of useful information without any internal exam.

Internal Exam (Optional)

Sometimes, an internal exam (vaginal or rectal) helps assess how the pelvic floor muscles are working—like strength, coordination, or tension.

But for people with trauma:

• This is always optional

• You can choose to delay it or not do it at all

• Alternatives (like external assessment or biofeedback) can still guide treatment

If you do choose an internal exam, it’s typically gentle, uses a single gloved finger, and is focused on muscle function—not anything invasive or rushed.

You Set the Pace

You might decide:

• “Not today”

• “Let’s try part of it”

• “I want to stop now”

All of those are valid. Dr. Johnson will adapt the plan to you.

The Goal Is Safety and Understanding

The purpose of the exam isn’t just to assess muscles—it’s to help you feel safe in your body while identifying what’s contributing to your symptoms. Treatment can still be effective even if the exam is modified.

Bottom Line

A pelvic floor exam should never feel forced or overwhelming. Done well, it’s collaborative, respectful, and paced around your comfort. You deserve care that supports both your physical health and your sense of safety.

Short answer: only if and when you feel ready—and it’s completely okay if that’s not now, or not ever. A pelvic floor exam can be helpful, but it’s not the only way to get care.

What matters most: your choice and control

Having a history of trauma doesn’t mean you shouldn’t get care—it means the care should adapt to you. A respectful provider will never require an internal exam as a condition of treatment. You can:

• Say yes, no, or “not yet”
• Change your mind at any point
• Ask to stop immediately, no questions asked

You can still get treatment without an internal exam

Many people make meaningful progress using:

• External assessments (posture, breathing, core and hip function)
• Movement and strength training
• Education about bladder, bowel, and pelvic health habits
• Techniques for relaxation and nervous system regulation

These approaches can address back pain, incontinence, pregnancy-related concerns, and more—without internal work.

A grounded perspective

Avoiding care altogether can sometimes prolong symptoms—but pushing yourself into an exam before you’re ready can be just as unhelpful. The middle ground is care that meets you where you are.

Bottom line

You don’t have to choose between “no care” and “doing something that feels unsafe.” You deserve care that works with your nervous system, your pace, and your boundaries.

If you feel like you may need to do some mental preparation for the examination, our sex therapist, Mirissa Beavers, is able to help you with the mental barriers and trauma processing that may be necessary before or in conjunction with pelvic floor therapy.

Out-of-Network Doesn’t Mean “Not Covered”

We hear this concern a lot: “If you’re out-of-network, does that mean my insurance won’t cover it?”Not necessarily.

What “Out-of-Network” Actually Means

Being out-of-network simply means we are not contracted with your insurance company. It does not automatically mean your insurance won’t help pay for your care.

Many insurance plans include out-of-network benefits, which can reimburse you for a portion of your visits—even when you see a provider who isn’t in their network.

Why We’re Out-of-Network

Each of our providers has intentionally limited the number of insurance contracts they participate in. This allows us to:

• Provide truly individualized, one-on-one care

• Spend the time you need—not what insurance dictates

• Use the treatments that are best for you, not just what’s covered

• Focus on long-term results, not visit limits or pre-set protocols

So Do We Bill Insurance Directly?

Because we are out-of-network with many plans, we only file claims with companies that we have contracted with. This does vary between providers, and if you have questions about if a specific provider is in-network with your insurance, please reach out to our front desk.  This helps us keep your care centered on outcomes—not administrative restrictions or delays.

How It Works for You with an Out-of-Network Provider

1. You pay for your session at the time of service

2. We provide you with a detailed superbill (receipt with all required codes)

3. You submit it to your insurance company

4. Your insurance may reimburse you directly, depending on your plan

What You Can Do

We recommend calling your insurance provider and asking:

• Do I have out-of-network physical therapy benefits?

• What percentage is reimbursed?

• Is there a deductible I need to meet first?

• Do I need a referral?

The Bottom Line

Out-of-network = we don’t bill your insuranceIt does not mean = your insurance won’t help pay

We’re happy to walk you through how to check your benefits or provide everything you need to submit for reimbursement. Our goal is to make this process as clear—and stress-free—as possible so you can focus on getting better.

SHORT ANSWER: YES!

We offer 2 different Group Pregnancy Classes: Strength for the Journey & Labor/Delivery Positions

Pregnancy Strength Class

Build strength. Reduce discomfort. Prepare your body for birth and beyond.

This class is designed to help you stay strong, supported, and comfortable throughout pregnancy. We focus on safe, evidence-based exercises that target your core, hips, and pelvic floor—key areas that support your growing body and play an important role in labor and recovery.

You’ll learn how to:

• Strengthen your body in ways that support your changing posture
• Reduce common pregnancy aches like back, hip, and pelvic pain
• Coordinate your core and pelvic floor for better function
• Move with confidence in daily life and exercise

All exercises are adaptable for different trimesters, fitness levels, and symptoms. Whether you’re newly pregnant or nearing delivery, this class meets you where you are.

Goal: Help you feel stronger, more supported, and better prepared for both labor and postpartum recovery.

Labor Positions & Birth Prep Class

Move with your body. Work with labor—not against it.

This class focuses on practical, hands-on strategies to help you navigate labor with more confidence and less fear. You’ll learn how positioning, movement, and breath can support comfort, progress, and efficiency during labor.

You’ll learn how to:

• Use different labor positions to reduce pain and improve baby’s positioning
• Incorporate breathing techniques that support your pelvic floor
• Partner with a support person for hands-on assistance and positioning
• Adapt positions whether you’re at home, in a hospital, or using an epidural

We break down what actually happens during labor and give you tools you can use in real time—not just theory.

Goal: Help you feel prepared, supported, and capable—so you can approach labor with more confidence and control.

Both classes are led by Dr. Johnson, once a month at noon on Wednesday, and designed to give you practical tools that improve not just your birth experience, but your overall quality of life during and after pregnancy.

Complementary Services For a Mind-Body Approach

Experiences that lead a child to Play Therapy—such as stress, fear, medical trauma, or abuse—don’t just affect emotions and behavior. They can also show up in the body, including the pelvic floor.

How stress and trauma affect the body

When a child goes through something overwhelming, their nervous system can shift into a protective state (often described in fight-or-flight response or “freeze”). This isn’t just emotional—it’s physical.

Muscles may:

• Tighten and stay guarded

• Lose coordination

• Become either overactive (too tight) or underactive (not engaging well)

The pelvic floor is part of this system, so it can be directly affected.

What that can look like in children

A child who might benefit from both play therapy and pelvic floor physical therapy may show:

• Daytime urinary accidents or urgency

• Bedwetting beyond expected age

• Constipation or difficulty with bowel movements

• Withholding behaviors (avoiding using the bathroom)

• Pain with urination or bowel movements

These symptoms are often confusing because they don’t always have a clear medical cause—but they can be linked to how the body is holding stress.

The pelvic floor’s role

The pelvic floor muscles help control bladder and bowel function, but they also respond to safety and stress signals from the brain.

For example:

• A child who feels unsafe may unconsciously tighten these muscles

• Chronic tightening can make it harder to fully relax to go to the bathroom

• Over time, this can lead to accidents, constipation, or discomfort

Why play therapy and pelvic floor PT work well together

Play therapy helps the child:

• Express and process experiences they may not have words for

• Feel safer in their body and environment

• Regulate emotions and stress responses

Pelvic floor physical therapy helps the child:

• Learn how to relax and coordinate their muscles

• Improve bladder and bowel habits

• Reduce physical symptoms like pain or accidents

Together, they address both sides of the same issue:

• The emotional/nervous system response

• The physical/muscle response

A whole-child perspective

It’s not that the symptoms are “all in their head” or purely physical—they’re connected. Treating both aspects can lead to more complete and lasting improvement.

The bottom line

If a child has experienced stress or trauma significant enough to benefit from therapy, and they’re also having bladder, bowel, or pelvic symptoms, it’s reasonable to consider both approaches.

Supporting the child’s emotional safety and their physical function gives them the best chance to feel better, more comfortable, and more in control of their body.