Examinations vaginal and rectal are among the specific techniques that we use in physiotherapy for the diagnosis and therapy of pelvic floor muscles.

This is an internal examination, thanks to which the physiotherapist can very accurately assess the condition of the muscles, their tension, sensitivity and ability to engage correctly.

Unlike visual, palpation, or ultrasound examinations, these techniques allow us to have a direct contact with pelvic floor muscles, and thus more targeted therapy.

What is the difference between a vaginal and rectal examination?

Both techniques differ primarily in the area they treat.

Vaginal examination

It is performed through the vaginal opening and focuses primarily on the front part of the pelvic floor.

We use it for example for:

• painful sexual intercourse
• lower abdominal pain
• painful menstruation
• endometriosis
• difficulties with getting pregnant
• difficulties after vaginal birth (e.g. after a cut or injury to the perineum)

Rectal examination

The examination is performed through the rectum and focuses more on the back and sides of the pelvic floor and the coccyx area..

We often use it for:

• coccyx pain
• sacral and SI joint pain
• long-term back pain
• certain types of painful menstruation
• difficulties with getting pregnant

This technique is also part of Ludmila Mojžíšová'smethodology, which is used in the treatment of functional sterility.

How the examination is carried out

The examination itself is always carried out sensitively and with an emphasis on the patient's comfort. The physiotherapist works in gloves and uses lubricating gel. The examination is carried out with one or two fingers.

During treatment, we monitor, for example:

• the tension of the pelvic floor muscles
• the sensitivity of individual structures
• the ability to activate and relax the muscles
• the reaction of the tissues to pressure

The examination may also include therapeutic treatment, during which the physiotherapist relaxes overworked or painful muscles.

The patient can ask for a break at any any time and we communicate with each other the entire time.

What positions do we use during the examination

The position varies depending on the type of examination.

Vaginal examination

The examination is most often performed lying on the back.

For greater comfort, the patient is always given a disposable skirt.

Rectal examination

The examination is usually performed in the position of all fours on the forearms.

For greater comfort, the patient is always covered with rebozo scarf of blanket.

Is examination painful?

For some patients, the examination may be sensitive, especially if the pelvic floor muscles are tense or have been overloaded for a long time.

However, the physiotherapist always works very gently and adapts the intensity of the pressure to the current tissue reaction.

Slight discomfort during the treatment is possible, but it should not be significantly painful.

What to do after examination

After the treatment, we recommend:

• take it easy that day
• get more rest
• drink enough
• avoid strenuous physical activity (such as going to the gym or running)

The area may be more sensitive for one or two days, which is a normal tissue reaction.

Individual approach is the basis

Every patient is different, and not every internal examination needs to be performed in the first visit.

At SPINEZIO physiotherapy we always first perform a detailed examination and, based on the findings, together we choose the procedure that is most suitable for you.

The entire treatment is carried out with maximum respect, explanation of individual steps and emphasis on your comfort.

Author of the article:

Mgr. Michaela Horká, physiotherapist SPINEZIO