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What is a Pelvic Floor Exam?

Imagine taking your car to the mechanic for a service and the mechanic asks you a few questions, takes a look at the car and passes you the bill without taking a look under the bonnet…

If you are seeing the Physiotherapist for a Pelvic Floor related concern, an internal Pelvic Floor exam may be recommended.

Before the internal examination is considered, your physiotherapist will determine why you have come for an assessment including your goals, and what your symptoms are. They will review your past medical history and ask about the treatments you may have already tried for your symptoms. Discussing your history will provide a good indication of what assessment and treatment techniques may be needed.

Next, your physiotherapist will take a look at your breathing, posture (not just your pelvis), check movements of your joints and assess muscle strength as well as how the connective tissues relate to your pelvis from the outside- a holistic approach.

An internal pelvic exam is not mandatory but is the gold standard to assess how your pelvic floor muscles and connective tissue within the pelvis are working. An internal exam may be highly recommended to further investigate the symptoms you are describing or to prevent conditions from occurring. However, your physiotherapist will first discuss and show you where your pelvic floor muscles are located on a model, how these muscles are assessed as well as inform you of any pros and cons associated with carrying out an internal exam in regards to your goals.

WHAT IS AN INTERNAL VAGINAL EXAM?

The patient will disrobe from the waist down- including removal of underwear and position herself on the plinth draped with a towel. Using lubricant, the therapist will proceed to part the labia to visualise the vulva, perineum and anus. At this point, if you are seeking management for pelvic pain, your Women’s Health Physiotherapist will perform a Q-tip test to assess for tissue sensitivity. For my post-natal mummies and mummies who present with pelvic organ prolapse concerns, a measurement called GH + PB (Genital Hiatus + Perineal Body) is performed to determine level of pelvic floor support or tissue distensibility from the urethra to anus. A measurement is taken at rest and on strain (think like trying to blow up a balloon for 6 seconds).

An internal vaginal exam involves the insertion of 1 or 2 fingers into the vagina to individually assess for

  • position of pelvic organs
  • sources of pain or discomfort
  • integrity of pelvic ligaments
  • muscle strength, endurance, co-ordination and tone

This is the gold-standard and gives us the most detailed information about your pelvic floor structures.

I AM NOT COMFORTABLE WITH AN INTERNAL VAGINAL EXAM, WHAT ARE MY OPTIONS?

Alternatives exist such as Real Time Ultrasound (trans-abdominal or trans-perineal) and external palpation (with and without clothing on), should you not wish to complete an internal pelvic exam. The difficulty with these alternatives is that they don’t give that level of detail (pain, muscle performance etc.).

You will always be asked to provide consent before any assessment or treatment is provided.

You are ALWAYS able to remove consent at any time.

If you wish to learn more about the pelvic floor exam or address your pelvic floor concerns, please do call/WhatsApp on 9780 7274 or get in touch over email.

You can also visit our website to learn about other women’s conditions we treat through physiotherapy and how we can help you.

5 Star Google Reviews
Embrace Physiotherapy is committed to 5 star client satisfaction.

My experience with Embrace Physiotherapy has been very good. A very professional approach from the staff, right from the first call I made to seek appointments till the end of the therapy. A special note about my interaction with Alex, my consulting physiotherapist: Alex is very good at her work. She listens to her patients patiently to understand the issues being faced before exploring the solutions. She made me feel very comfortable and helped me to work with her to find the right solution to my needs. Her interactions have always been nice and with an added human touch, enabled me to feel comfortable working with her. She doesn't rush the treatment procedure and has helped me explore more than one solution keeping my condition and the history of complications in mind. She also keeps track of the progress and provides alternate solutions if the current approach isn't yielding the desired results. She is much more than a physiotherapist as she gave some great suggestions about lifestyle which helped me avoid the recurrence of issues.

thumb Sowmya Krishnan
September 10, 2022

the work the professionals at this clinic do is so important - often women’s issues are overlooked as part and parcel of pregnancy and childbirth and it’s essential to realise these conditions don’t have to be just tolerated. i visited this clinic for rehabilitation regarding my csection birth and for other bodily issues proceeding from childcare and over the months i was seeing brenda i have not only managed those issues but also gained a better understanding of how my body works and how to help prevent future recurrence of such problems. everyone working at embrace is wonderfully considerate and approachable - they put you at your ease from the very first moment. cannot recommend this clinic enough. thank you so much for looking after me so well!

thumb helen vs
June 13, 2022

I had a great experience at Embrace physiotherapy with Dr Preet. I started my journey the last trimester of my pregnancy to assess my pelvic floor strength and relaxation level. Dr Preet helped me go through until the end of my pregnancy with exercise plan for the pelvic floor, my hips and quads. My delivery went very smoothly and I am lucky to not have tear or abs separation. I went back after delivery to strengthen back my pelvic floor and got discharge with the chance to fully get back to my usual sport practice. Dr Preet has been wonderful. She listens to your needs carefully and take the time to evaluate your body range of movement. It was also nice to feel understood and share experience as a new mother.

thumb Meggie CL
April 29, 2022

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