This is a video of Julia Di Paolo of PhysioExcellence giving a quick overview of what happens during the internal assessment from a Pelvic floor physiotherapist. There are other things they look at but these are the 'highlights'.

All right, The first thing we're going to look at is the outside genitalia. We're looking for infection or signs of something that's amiss. We're going to look between the labia very, very gently and making sure everything is okay. Then we're going to very gently insert our fingers one at a time. If there's enough space, then the second one will go in, very gently and very slowly. If you do have pain, not to worry, we'll take that into consideration. What we are doing at the very beginning is just assessing tone.

We talk about whether you have too much tone or not enough tone and what we want is that resistance to stretch. We'll just make our way all the way around and then we'll go in a little deeper and we'll get to see the muscles at the back as well, all the way down and around. Now if you have too much tone I'm not going to be able to stretch. If your tone is too lax, hypotonic, I'm going to be able to stretch it quite a bit. Then we're going to get all the way around. Now seeing as there's enough tone in our model, what I'm going to do next is I'm actually going to do a stretch downwards and splay the labia so I can see into the pelvic floor.

Now this one is empty because it's a model, but I'd be looking for a uterus or a bladder or rectum that's descended so it would be prolapsed and then assess how far down it is. In a real person, I would ask her to then cough or push down so I could see how much movement there was, or how much support was left in the pelvic floor. The next thing we're going to do is then ask for a Kegel. I'll put my fingers back in and I'll ask you to do a Kegel the way you know how and then I'll teach you how to do it correctly if you're not already doing it correctly. We're looking for that squeeze and lifting up movement there. That's pretty much it. Pretty simple and then we come out.



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