Feeling Comfortable with Your Pelvic Floor Physiotherapist

By Miral Patel

Are you considering having your pelvic floor assessed, but feel a bit nervous about the internal exam?  I can surely say I felt the same.

Pelvic floor physiotherapists are specially trained and sensitive to intimate issues patients may experience. In fact, when we are trained in pelvic floor physiotherapy we practice ON EACH OTHER!!

I’ll tell you about my first experience.

My first day in a pelvic floor physiotherapy course consisted of a morning of theory and an afternoon of lab. In the morning our instructor humorously asked us who was worried about dropping their pants in the afternoon.  I timidly put my hand up.  Maybe they’d let me off the hook if I was nervous or uncomfortable about it?  Maybe I should say I was on my period to avoid the whole thing.   The instructor chuckled.   “You’ll be perfect” she said.   My eyes widened.  What the hell does that mean I wondered?

When lunchtime came around I didn’t want to eat lunch with any of the other women on the course.  One of them was going to be looking at my vagina right after.  I certainly didn’t want to become friends with them first.  I had a quarter of my lunch and then worried I’d have to have a bowel movement when someone was doing the internal exam on me.  I chose not to finish my lunch and headed to the lab instead. I thought of every possible excuse to not participate in the lab, but at the same time I’ve always believed that I should experience myself anything I do with my patients.

I managed to make it through the lab.  It began with undressing and hiding under sheets. The whole process was quite uncomfortable and awkward.  I cringed the entire time and tried to keep my legs locked and closed for as long as possible.  The internal assessment revealed that I did my kegels wrong and was probably doing more damage then good.  When assessing other individuals on the course I learned that almost every one of us had some sort of pelvic floor issue.   It was eye-opening to see how valuable what I could do as a pelvic floor physiotherapist would be!

At the end of the lab the instructor approached me and asked how things went.  She reminded me that every one of our patients feels exactly the way I did on their first visit.  She emphasized that feeling alone would be one of my biggest learning experiences as a pelvic floor physiotherapist and I have to admit it was.  Almost every one of my patients comes in on their first visit with their legs tightly crossed and dread on their face for the internal part of the assessment.  I always start by telling them about my experience to make them feel better and usually sharing the story alone helps people calm down.

It’s important for patients to know that we as therapists have been through what they are experiencing.  We’ve had the same reservations and fears about letting someone get into our private areas. I’ve never had a patient who experiences that awkward discomfort for any longer than their first visit.  Usually by the end of the visit they all understand the importance of an internal exam and appreciate what we do them.  I’ll finish with saying it’s okay to feel nervous about your first visit.  Feel free to ask your therapist any questions you have before hand or even during the assessment.  I can promise that after that first day it won’t be so awkward anymore and you’ll truly understand the benefits of an internal exam!