For women this can be either vaginal or rectal, depending on the issue and the patient’s decision. For men this is a rectal exam. The assessment starts with examining the muscles, tissues and skin of the thighs, buttocks, abdomen and pelvic floor externally. Providing that there are no reasons not to proceed with an internal exam, one will be performed. No speculum or other instruments are used during the exam. The physiotherapist checks for muscular strength, endurance, coordination, proper ability to contract and relax the muscles and for tender spots, “knots” or trigger points. The initial internal exam usually takes 5-10 minutes or less. Sometimes a small amount of treatment may be done. This would include teaching someone how to squeeze or relax the muscles, or perhaps internal massage techniques to help with pain.
Clients always have the right to refuse an internal exam at any point during the assessment or during any follow-up treatments. Even without an internal exam, other assessment or treatment options might be available to you. See below for a brief description