No, you don’t and there are tons of techniques that can be used to help you externally. There are lots of things to work on without doing a hands-on assessment. However, having an internal exam from a trained pelvic floor physiotherapist will provide the most information about your specific pelvic floor issue allowing a more complete understanding to move forward with a treatment plan. If you have concerns, discuss them with your pelvic health physiotherapist and they will work with you to be sure to plan the assessment and interventions best suited for your needs.