There Are Five Ways We Can Assess Your Pelvic Floor
One of the most common questions we get as pelvic health specialists is about how we gain an understanding of what someone’s pelvic floor is up to. Many of our patients have had experiences with internal exams with other providers, but a pelvic floor assessment in pelvic physical therapy looks a little different!
Do I Have to Have an Internal Exam?
The most important thing to know is that a pelvic floor assessment is never required. This is your body and your care, and we always want to meet you where you are. For those that feel comfortable doing an internal assessment, it looks a little like this:
- – You stay covered up for the majority of the assessment, and your provider will always tell you what they are going to do before they do it; no surprises! And, we can stop at any time, you just say the word!
- – Your provider will use a finger that is gloved and lubricated to palpate the pelvic floor muscles, checking their tone and whether any discomfort or tension is noted.
- – Your provider will ask you to do some squeezes of the pelvic floor muscles, some relaxing, and some bearing down. This helps us have a starting point for strength, coordination, and endurance.
- – If you have trouble coordinating the pelvic floor muscles, your provider may try a few different cues to try and help them coordinate better.
For those who aren’t quite comfortable with an internal assessment, that’s okay! We can also:
- – Perform an external assessment with hands on palpation
- – Perform an external assessment over clothes
- – Perform an external visual assessment with no touching at all, eyes only
- – Have you do the assessment yourself and report back what you feel
- – Wait to perform an assessment at a later session once more trust has been established
While an internal assessment gives us the most precise and in-depth understanding of someone’s pelvic floor function, it is more important to us that you get the care you need in the ways you need it! We encourage patients to advocate for their needs and voice their concerns about any proposed part of their care.
Don’t Let It Stop You Booking
Do not let the fear of an internal pelvic exam stop you from seeking pelvic floor PT. We are here to make you as comfortable and as confident as possible about moving forward with treatment.
You are the leader of your own care.
Dr. Kristen Long, PT, DPT, PWCS
What Happens at a First Visit?
An assessment is one part of a first appointment, and not the first part. A good bit of that appointment is spent talking: hearing your story, what your concerns are, and what you actually want to get back to.
The assessment itself is highly customizable, like every visit. Sometimes it is internal, sometimes external. What we are doing is gathering enough objective information to make a clinically informed decision about what will help.
The goal by the end of the session is that you leave with more control and a plan of action, rather than another appointment where nothing was explained.
Questions People Ask Us
What to bring, how a course of care progresses, referrals and payment are all answered on our New Patients page. These are the ones about the assessment itself.
- Can I say no to an internal exam?
- Yes, and it will not end the appointment or leave us unable to help. There are four other ways to assess the same muscles, listed above. You are in charge of which one we use.
- Can I change my mind partway through?
- Yes. Consent is not a single decision made at the start. If you agree to something and then would rather not, say so and we stop. That applies at the first visit and at every visit after it.
- Do I have to decide before I come in?
- No. We offer a free 15-minute phone consultation before your first appointment, which is a good place to ask about this specifically. And a first visit involves a lot of talking before any assessment happens, so there is time.
- Is an internal exam better?
- It reaches the deep pelvic floor muscles, which nothing else does, so it gives us the most direct information. But the most informative assessment is the one you actually feel able to have. An assessment you dread, or avoid entirely by not booking, tells us nothing.
Still Not Sure?
Ask us before you book. The 15-minute call is free and there is no commitment attached to it.
Book a Free 15-Minute Call