Internal Assessments for Pelvic Floor concerns

Internal examinations are the international gold standard for assessing and treating the pelvic floor and our practitioners (Naturopathic Doctor and Physiotherapist), who will be supporting your pelvic health, are trained and sensitive to maintaining your comfort, dignity and ongoing consent at all times. You will always be involved in the decision making around whether to conduct an internal exam or not - and will be explained alternatives if you would rather not proceed. Your comfort and consent are our top priority.

It may seem odd or uncomfortable to imagine having an internal exam to assess your concerns. There are many muscles that impact our sensation and functioning that we can only assess from this method. Assessing the internal muscles of the pelvic floor allows for practitioners to assess how your treatment plan should look as well as give you feedback to support your own body awareness. The exam shouldn’t feel like your typical vaginal exam in your doctor’s office. We aim to make it as comfortable as possible and take the time to explain what we are doing and why. There is no speculum used; however, we anticipate being able to offer pap screening and vaginal exams to test for infection/yeast in the near future.

What to expect in an initial visit

During the assessment, your therapist will take a detailed history of your concerns. If this is with a Naturopathic doctor, you may discuss other health concerns as well. This will be followed by an external exam which commonly includes assessing posture, flexibility and strength around your low back, hips, and pelvis. Afterwards, an external and internal exam may be completed to assess the pelvic floor muscles. This can be done vaginally and/or rectally with women, and rectally with men. While an internal exam will often be recommended and will provide useful information about your pelvic floor muscles, it is not necessary if you are experiencing acute pain or are uncomfortable with the procedure. Based on the assessment findings, an individualized treatment plan will be implemented. Treatment may include advice and education, exercises, and manual therapy. 

What to expect in a follow-up visit

During follow-up sessions, the focus will be on treatment for your symptoms. While treatment will vary between individuals; common treatments include going through exercises, advice and lifestyle modifications, manual therapy, electrotherapy, and relaxation techniques. There may be other assessments that your therapist will complete during follow-up sessions. These tests will allow the therapist to get a full picture of your concerns and to follow the progression of your symptoms. 

Should I expect pain or discomfort

Your therapist’s goal is to improve your symptoms, so while there may be some discomfort with some of the treatment approaches, the aim is to not create a painful response. 

During the assessment, your therapist will be looking for what may be causing the symptoms. For instance, you may get pain in your low back with bending over, and your therapist may ask to see this movement to assess how your back is moving and why you may be getting pain with that movement. While there may be some reproduction of pain symptoms, this should not aggravate your symptoms or give you further pain following the session. 

During treatment sessions, there may be some hands-on techniques utilized to provide relief to your symptoms that may create some mild discomfort, but they should not be painful. The same principles apply for home exercises and techniques provided to you. Some mild discomfort may occur during the exercises, but you should not be feeling pain during or after the home exercises. You can feel open and comfortable to raise any concerns or feelings of discomfort with your practitioner. They can either adapt their technique or adapt your exercises for you.