Not Ready for an Internal Assessment? Pelvic Floor Therapy Still Has So Much to Offer
Beyond the Internal Exam — What Happens at Pelvic Floor PT
At Foundations Pelvic Health in Boston’s South End, our pelvic floor physical therapists help so many with pelvic floor issues. For many of our patients, it may be their first time to a pelvic floor PT appointment!
You might be wondering: Can I come to pelvic floor physical therapy without doing an internal assessment? The answer is yes - absolutely! Whether you’re not comfortable with an internal exam, or you’re waiting for OB or surgeon clearance, there is still so much meaningful work our pelvic floor PTs can help you with.
At Foundations Pelvic Health, the pelvic floor is our specialty, but we’re physical therapists first. That means we’re trained to assess and treat the whole body: muscles, joints, fascia, nerves, and even visceral structures. Many people see us for non-pelvic floor concerns such as back pain, neck pain, hip pain, core weakness, and more.
Why Some People May Not Want an Internal Assessment
There are many valid reasons someone may not feel ready (or may not want) to participate in an internal pelvic floor assessment. For some, there may be pain, discomfort, or a history of trauma that makes this type of exam feel overwhelming. Because this area of the body is so often stigmatized or overlooked, simply talking about symptoms can feel vulnerable or even shameful. Others may not yet understand this part of their body and prefer education and trust-building before moving forward with any internal work.
An internal assessment can also feel too invasive or like a boundary someone isn’t ready to cross — and that is completely okay. For some people, religious or personal beliefs may guide this choice as well.
There are also medical reasons someone may need or choose to wait. This includes individuals who are not yet cleared postpartum, those recovering from gynecological procedures, or anyone healing after laparoscopic surgery such as endometriosis excision.
Every one of these reasons is valid. You can still benefit immensely from pelvic floor physical therapy without an internal assessment, and we will always honor your comfort, your consent, and your boundaries every step of the way.
What We Assess (With or Without an Internal Exam)
Our pelvic floor PT assesses a postpartum woman’s core activation as part of her evaluation.
During your initial evaluation appointment with our pelvic floor therapists in our Boston office, we look at a wide range of whole-body movement and function, including:
Spine range of motion
Hip range of motion
Hip strength
Breathing mechanics
Posture
Gait mechanics
Core strength
Functional movement patterns
Visceral mobility
Abdominal fascia and tissue mobility
C-section scar assessment and desensitization
Laparoscopic scar assessment and desensitization
From there, we build a personalized plan of care tailored to your goals and your symptoms. And, if or when you feel comfortable (and once you’re cleared) we can add an internal pelvic floor assessment to gather even more helpful information to guide your treatment.
Education, Support, and Whole-Body Guidance
A large part of pelvic floor physical therapy is education, and we touch upon all the below topics:
Sleep hygiene
Hydration and nutrition guidance
Belly band or support belt fitting
Daily activity modifications
Labor and delivery positioning
Workout modifications
Running and movement mechanics
Many of these apply to pregnant and non-pregnant patients too, alongside pain management strategies and referrals to other providers when needed.
Your Next Step Toward Feeling Better
You don’t need to be ready for an internal pelvic floor exam to start pelvic floor physical therapy! We can begin with whole-body assessment, movement guidance, and personalized support tailored to your needs. If you’re curious about what your first session might look like, reach out to us! We’ll answer your questions, walk you through the process, and help you feel confident taking the next step in your care.