Understanding the Pelvic Floor
The pelvic floor is a group of muscles located within the pelvis that provide support to the lower organs, including the bladder, bowel, and reproductive structures. These muscles play an essential role in bowel and bladder control, sexual function, and overall core stability.

Who Should Consider a Pelvic Floor Assessment?
A pelvic floor physiotherapy assessment may be beneficial for individuals experiencing concerns related to bladder and bowel function, pelvic pain, organ prolapse, or sexual health. Common conditions treated include pregnancy and postpartum recovery, pain during intercourse, urinary or fecal incontinence, tailbone pain, and pelvic organ prolapse.

What to Expect at Your First Pelvic Floor Physiotherapy Appointment
Initial assessments typically last about 60 minutes. During this time, your physiotherapist will discuss your medical history, lifestyle, and any symptoms you are experiencing. This may include questions about bladder and bowel habits, sexual health, pain levels, and functional goals. A physical evaluation of posture, lower back, pelvis, and hip movement may be conducted. The physiotherapist will also explain pelvic floor anatomy and its role in your condition. If appropriate, and with your consent, an internal examination may be suggested to better understand muscle function and coordination. Abdominal function might also be assessed. Following the assessment, your physiotherapist will explain the findings and develop a personalized treatment plan with recommendations for improving your condition.

What is an Internal Assessment?
An internal assessment allows the physiotherapist to directly evaluate the function of the pelvic floor muscles through the vaginal or rectal route, without the use of instruments. With your consent, the therapist will guide you through the process, ensuring comfort and addressing any questions or concerns. This assessment helps to evaluate muscle strength, endurance, relaxation, and areas of tension, allowing for targeted treatment recommendations tailored to your needs.

What if I’m Not Comfortable with an Internal Assessment?
While an internal assessment provides the most detailed information, it is not mandatory. If you prefer, an external evaluation can be performed instead, though it may offer less precise insights. Some individuals opt to use the first visit as an opportunity to discuss concerns and learn about the pelvic floor before undergoing a physical examination.

Pelvic Floor Physiotherapy During and After Pregnancy
It is beneficial to begin pelvic floor physiotherapy early in pregnancy (from 6 weeks onward) to establish a care plan. A session around 35 weeks can help prepare the pelvic floor for labor and delivery. Postpartum assessments are recommended at around six weeks after birth to support recovery, address any symptoms, and discuss safe return to physical activity.

Are There Any Reasons to Avoid an Internal Assessment?
An internal pelvic floor examination is not recommended if you have an active infection, such as a urinary tract infection. Your physiotherapist will discuss any contraindications and adjust the assessment accordingly.

What if I Have Pelvic Pain and Am Unsure About an Exam?
If you experience pelvic pain and are uncertain about an internal examination, you are still encouraged to seek pelvic floor physiotherapy. Your therapist will create a safe and supportive environment, working with you to find a comfortable starting point that respects your boundaries.

Can an Assessment Be Done While Menstruating?
Yes, a pelvic floor assessment, including an internal exam, can still be conducted during menstruation if you are comfortable with it.

We look forward to supporting you on your journey to improved pelvic health!