During the initial assessment, there will be a detailed history taking, an external exam, and if indicated, an internal examination. The external will consist of assessment of postural alignment, strength, and how much movement you have in your low back, hips, and pelvis. An internal examination is completed vaginally and/or rectally. The internal exam provides information on the strength of your pelvic floor muscles, can identify trigger points, and determines how the pelvic floor is functioning. The goal of the session is to evaluate symptoms based on personal boundaries and to NOT create a painful response. To complete the internal exam, the physiotherapist will leave the room for you to undressed from the waist down and have you lie on the treatment table. A cover sheet will be provided. Using non-latex gloves and a sterile surface for lubricant, the physiotherapist will insert one or two gloved fingers into the vaginal canal and/or rectum. The physiotherapist will explain and ask for consent prior to each step of the assessment. **This exam is completed IF you are not experiencing acute pelvic pain, feel comfortable, and consent to the examination.** Based on assessment findings, each client will be given a personalized treatment plan. This may include education with visual aids, exercises, manual therapy, activity modification, and relaxation practices. Follow up sessions will focus on treating the root cause of the symptoms through hands on manual therapy, exercises, breathing techniques, and more!

This completely depends on your preference and your comfort level! Although the muscles of the pelvic floor can be best assessed internally due to their anatomical location, your therapist can offer you other options if you are not comfortable with having an internal exam. **You will always be asked to provide consent before any assessment or treatment is provided and you are welcome to remove your consent at any time.*

Pelvic Health physiotherapists often treat unresolved low back/SIJ/pubis symphysis pain, diastasis recti (abdominal separation), painful sex (Dyspareunia), pre and post natal patients, pelvic organ prolapse (POP), incontinence (urinary or fecal leakage), pelvic pain (vaginismus, interstitial cystitis, endometriosis), and anyone who has undergone pelvic or abdominal surgery.

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