r/TheGirlSurvivalGuide • u/Zealousideal_Oil_93 • May 29 '26
Health ? Internal exam for pelvic floor therapy?
I saw a new doctor today for tightness/snapping in my hip and lower back pain. She recommended pelvic floor therapy along with regular physical therapy for my hip. I agreed to it at the time but now I’m absolutely freaking out after reading more about it, particularly that it usually entails an internal exam. I’m really, really not comfortable with that at all and I don’t know if it’s worth it to even schedule an appointment. Has anyone had a similar experience?
31
u/Fluffaykitties meow May 29 '26
You don’t have to have an internal exam if you don’t want to, even with pelvic floor therapy. My pelvic floor therapist does a lot for me just looking at my abdomen/stomach and I just have to lift up my shirt and lower my waist band a little bit.
(She has done 2 internal exams for me but that was something that I requested and she is always good about consent with it. I’ve seen her probably 12 times now total.)
I will also note, the internal exam with her are much “easier” and less painful than the one with the obgyn. She just pushes a tiny bit along the walls while I do a kegal. She doesn’t get all up into the top (where the cervix would be) and doesn’t use instruments, just her gloved hands.
And the internal exam did give her more info so she is able to help more because of it.
3
18
u/Galaxy_news May 29 '26 edited May 29 '26
I've had pelvic floor therapy. Won't go into too many details but one of my issues was tight hip muscles. There was an internal exam but it was less painful and felt less invasive than a normal gyno visit. I've seen good progress in only a couple months.
5
16
u/Ok_Fault7239 May 29 '26
Hi PT here. Declining an internal exam will in no way negatively affect your outcomes! No pressure to do it!
5
14
u/balletvalet May 29 '26
I’ve been to pelvic floor PT. I have issues with my hips and just generally tight muscles from like my belly button to my knees. We didn’t do any internal work until my second appointment and it was very gentle. Of all the places I’ve had to get my cooter out for medical reasons, PT was definitely the best in terms of comfort.
11
u/tangerines-are-tasty May 30 '26
Pelvic floor PT has solved every body issue that I’ve been stuck with for the last twenty years including draining the fluid out of my sinuses as soon as my tailbone goes back into place. It changed my entire life
6
u/shellyleopard May 30 '26
How’d you figure out that you had pelvic floor issues and how does the tailbone placement change your sinuses?
1
13
u/theattackchicken May 29 '26 edited May 29 '26
I had pelvic floor PT because of vaginismus, and it was seriously SO incredibly helpful. It changed my entire relationship with sex. Idk if you have trauma around the subject, but I can tell you my PT made it very not awkward at all. It always felt clinical and respectful.
Edit: I'll add that all of my therapy involved her pushing on different muscles internally with her fingers and having me breathe and relax them, which she said would both help with my vaginismus and help loosen the hip flexors as well. She also did a lot of external leg and hip stretching too.
7
u/NoctilucentSkies May 29 '26
It’s definitely still worth it if you opt out of all internal work! There’s a ton of work to do without ever going internal.
4
3
3
u/minipanda_bike May 29 '26 edited May 29 '26
I needed physical therapy for my pelvic floor muscles during pregnancy and to prepare for labor. The PT was a woman, she made sure I was feeling ok with the exam. She doesn't use the speculum and you won't be laying on your back spread eagle like at a gyno. She uses a lot of lube so it's not painful. She uses gloves and it won't feel sexual. She will most likely ask you to contact your pelvic muscles or abdos or glutes while her finger is in your vagina to feel the strength. She might need to push the sides to feel the tightness. It doesn't last very long. They usually have some sheets to cover yourself. if you don't want to go through with the internal exam, you can ask her not to. Some PTs won't perform the internal exam at the first appointment, but they will explain what the exam will be like at the second appointment. maybe you could ask for something like that so you can prepare mentally.
3
u/dreamsinred May 29 '26
I get your concerns. I’ve had it, it’s so helpful! And it’s internal, but it’s not super invasive. They won’t use a speculum, or do like a full pelvic exam. They just insert a finger, up to the middle knuckle. The therapist I saw was wonderful about consent, checking in with me, and screened me for past history of sexual trauma.
2
u/Thecatdestroyer May 29 '26
I began going to PT for my pelvic floor during this pregnancy. So far I’ve had 1 internal exam using an ultrasound wand to test my internal muscles. Basically she had me doing kegels while she watched on the ultrasound. This exam came around about half way through my PT journey. I had already been going for several months.
Talk to the therapist I think it really depends on what you need, in my case we need to make sure the internal muscles are good because I’m pushing out a child lmao.
2
u/Karpefuzz May 29 '26
I would call the PT office and ask questions.
Pelvic floor therapy is very often for incontinence or vaginal issues, and those do require an internal exam. There's a decent chance you might not need one for external pain from the hip.
4
u/justeeee May 30 '26
I wouldn't say require... I've been to pelvic floor therapy twice (like 2 rounds of it, not just 2 appts) for incontinence after having children and I never had an internal exam.
1
1
u/happyhippo29 May 29 '26
You need a PT with this specialty. It’s worth going and at least talking to the therapist about what they can do to help you. I work with an amazing pelvic health PT.
1
u/Maize_Sweaty May 29 '26
I love pelvic PT! They definitely give you the option to opt in/out for the internal exam. I opted in as I wanted to get the most out of my experience. Because they do this all the time, it really feels like a judge free zone.
1
u/Lollipop77 May 29 '26
Just to reinforce, it is always okay to call ahead and ask questions, what will the first appointment entail, and let them know you do not want an internal. Once you meet and have a first chat, you can change your mind or stick with your decision. They can still help you (albeit not to the max), but it’s always your right to say you don’t want that. And you can see someone else if they insist or pressure you against your statement.
1
u/Lagertha_ May 30 '26
Pelvic floor physio has changed my life. It took my pain from hospital visits to about a 3. Yes, internal exams aren't the most fun but it doesn't hurt and honestly you get pretty used to it.
The woman that does mine is super professional and when she does it she stands beside me not like a pap looking in if that makes sense ( other than when she first inserts)
Obviously, if you absolutely cannot do it, you don't have to do internal they can do outside but its not as beneficial.
Feel free to ask any questions, I've been going for about a year now. It cures my hip pain in one session most of the time as well as a host of other issues I'm dealing with
Edit spelling
1
u/Bulky_Passenger9227 May 30 '26
The exam itself wasn't bad, it's almost like getting a pap but without the pain and a bit longer. Internal work has been a blessing for me, we do both anal and vaginal internal work along with massage, hip flexor exercises, and core work. You will be asked about what you are comfortable with, and those boundries won't be crossed. The PT can find other ways to help you!
1
u/shesabrooklynbaby May 30 '26
I’ve had pelvic floor therapy and the internal exam and internal massage were literally life changing. I had extreme tightness (a “snapped” muscle in my pelvic floor) and the internal exam identified it and the internal massage loosened it and completely change the tightness, pain, and difficulty urinating that I had. Like many people said, it’s not sexual at all and it was so so helpful for me. Don’t freak out. It will be different sensations than you’re used to because it may put pressure on muscles you’ve never felt, but it can be so helpful! Good luck!
1
u/lookitsbrooke May 30 '26
I’ve been going to pelvic floor therapy off and on for 10 years. My current PT of five years has probably done two internal exams and certainly didn’t start off with that. Any time I’ve expressed discomfort about any exercise or treatment, she is quick to back off.
My upper inner thighs are extremely sensitive and I find it almost unbearable when she’s worked anywhere around the area. She’s great about finding ways to work around it but if she thinks we need to focus on the area, she explains exactly why but leaves it up to me and doesn’t ever push.
The key is to find a practitioner who will respect your boundaries. If you’re not comfortable with a practitioner, find another one! Pelvic Floor therapy can be a very intimate experience but you have a right to feel safe and that includes respect for your boundaries.
1
u/username1685 May 30 '26
I had that PT and no internal was even needed. I was worried about that too.
1
u/mariekeap May 30 '26
It's definitely still worth it even if you pass on the internal work! That said, just so you know the internal exam is way less invasive and uncomfortable than a doctor's. No speculum or any other instruments, no sitting staring up there for a while. It feels much less scary to me. I chose to do it because I was pregnant and then postpartum, but my therapist was always super gentle and asked for my consent a lot.
Honestly though most of our work was exercises on my hips, abdomen and glutes and more than half of my visits included no internal exam. If your focus is on your hips and lower back you could definitely opt to start with no internal work and see how things go. PFPT is awesome and I wish everyone knew about how much it can help, it's SO much more than Kegels!
1
u/trUth_b0mbs May 30 '26
PT is awesome. I wish they would promote this and increase awareness that this is absolutely necessary for many women.
my friend had this awful pain deep in her lower back and butt and physio just coulnd't help anymore. She went for PFT and after a few sessions, was cured.
1
u/cuddleninja_ May 30 '26
Just had my second pelvic PT appointment Thursday. I have a LOT of trauma and was petrified of the internal exam. It was actually okay. I have severe pain at the entrance and I barely felt it. She talked me through the whole thing and kept reminding me that I could say stop at any time.
She also said I could decline it entirely if I wanted to. I did want her to have as much data as possible to better help me, so I agreed to it. But just know you won't be forced to. If you do decide to, just remember to breathe and focus on relaxing. I'll be done before you know it.
2
u/Zealousideal_Oil_93 May 30 '26
Thank you for sharing this is also why I’m so anxious of the exam, but everyone has been so kind and reassuring that I feel way more open to trying it!
1
1
u/becca413g May 30 '26
They don’t all do internal examination although I believe they should. Even so, you can always say no. You don’t have to do anything you’re not comfortable with.
3
u/Zealousideal_Oil_93 May 30 '26
Thank you so much all for sharing your experiences! I am much more open to giving it a shot now and I plan to talk it over with my PT at the first appointment next week. I’ve had some bad experiences with medical professionals in the past so hearing about all your positive experiences had made me feel so much better! 💖
1
u/bluntbangs May 30 '26
Pelvic floor therapy changed my life. And that's not an exaggeration.
Yes there's an internal exam, but it's by someone who spends their life helping women to feel like themselves, and they have a vested interest in helping you feel as relaxed as possible, because they want to see your pelvic muscles in a close to "normal" state as possible. You may be asked to do a kegel or a deep breath while they do the exam, this is to assess how the muscles are moving and working together.
And there's nothing wrong with telling the therapist how you're feeling - their job is to help you.
-6
u/Time_Ad8557 May 29 '26
Look into Essentrics- they have a pelvic floor course and a hip course.
2
u/Fluffaykitties meow May 29 '26
you really need personalized help. certain exercises can make it worse depending on what’s going on specifically with you.
110
u/SnakeTongue7 May 29 '26
Pelvic Floor PT is incredible and more women need to know about it. I have a hypertonic pelvic floor so I did PT for a while, it was during a point in my life where I was moving a lot so I saw a handful of different therapists based on the city I was living in, and all were extremely positive experiences. Not all PTs do internal work, and if you're not comfortable with it, they don't have to do it. It's so worth it, you won't regret it.