What is an internal pelvic floor assessment and why is it necessary?
I’ve been treating pelvic floor dysfunction for over 17 years. During my career, I’ve learned the importance of making sure patients know what to expect when they start pelvic floor physical therapy. That’s why I teach my receptionists to explain to pelvic floor patients that they’ll have an internal exam of their pelvic floor muscles at their first visit. I started this because I found that when patients didn’t know what to expect, they were surprised. Once, a patient even brought a gym bag, thinking she’d need to change into workout clothes. I tried to keep it lighthearted and explained she’d actually be changing out of her clothes for the exam.
Sometimes, even after the receptionist has explained the process, patients ask to speak with me or email me to ask WHY they need to have an internal assessment. So, I’m here to explain why a pelvic floor therapist needs to go internally.
Crucial information
An internal assessment of the pelvic floor muscles is crucial for understanding and addressing pelvic floor dysfunction effectively. The muscles are located inside of the vagina and the rectum, so an internal examination allows us to directly assess their strength, flexibility, and coordination. It provides valuable insights into any potential issues such as tension or weakness in the pelvic floor, which might not be apparent through external examination alone. By conducting this assessment, we can tailor our treatment plans specifically to each individual’s needs, ensuring the most effective and personalized care possible. Additionally, it allows us to explain what could be causing the problem and helps us identify possible contributing factors. All of this information provides patients with a deeper understanding of their condition and the things they can do to help resolve it.
It’s not always a strength issue
Pelvic floor issues are not always due to weakness in the muscles. Urinary frequency and urgency, urinary incontinence, constipation, pelvic pain, tailbone pain, and pain with intercourse can all result from a pelvic floor with too much tension (hypertonic pelvic floor). Without an internal assessment, a pelvic floor therapist would not have all of the necessary information to formulate a treatment plan. If you have a urinary urgency and urge incontinence (can’t make it to the bathroom on time), you probably have a hypertonic pelvic floor. If a pelvic floor therapist were to advise you to start doing Kegels without first conducting an internal evaluation, it’s possible that the problem could get WORSE.
You need to check WHERE?
If you have tailbone pain, constipation, or you’re a male with pelvic floor issues, your therapist will need to assess rectally. This was mentioned earlier, but it’s worth repeating. Tension in the muscles found inside of the anus and rectally, can cause all kinds of problems like constipation, fecal incontinence, hemorrhoids, anal fissures, and tailbone pain.
It’s not just a one-and-done
I’m a manual pelvic floor therapist. That means I am hands-on during patient treatments. The information I gather from your initial internal assessment will point me in the direction of a treatment plan. If you have tension in your pelvic floor, I will perform trigger point release on the muscles at each treatment, which means that the internal assessment turns into internal treatment – so you’re not one and done after the assessment.
It’s totally worth the end result
Whether you’re considering seeing me or another pelvic floor therapist, going through the initial evaluation, which includes the internal assessment, and the subsequent treatments is incredibly beneficial. If you’re dealing with urinary or fecal incontinence, pelvic pain, discomfort during intercourse, constipation, tailbone pain, or urinary frequency and urgency, pelvic floor physical therapy truly has the potential to change your life
