Pelvic Floor, Uncategorized
Your First Pelvic Health Physio Appointment
Oct
At your first pelvic health physiotherapy (pelvic floor physio) appointment, your physiotherapist will talk through your symptoms and history, look at how your body moves, and agree a plan with you. An internal examination is only done if it is relevant to your concerns and you consent to it. Here is the full walk-through, so nothing comes as a surprise.
What Is Pelvic Health Physiotherapy?
Pelvic health physiotherapy supports concerns involving the pelvic floor and surrounding areas. This includes pelvic pain, painful sex, bladder and bowel symptoms, pelvic girdle pain in pregnancy, postpartum recovery, diastasis recti, returning to exercise and changes around menopause.
Your first session is about understanding you: your symptoms, your history and what you want to achieve. If painful sex is your main concern, you may find Why Pain During Sex Happens and What to Do About It helpful to read.
How to Prepare for Your First Appointment
- Wear comfortable clothing you can move in.
- Note your main symptoms, when they started, and what makes them better or worse.
- Bring a list of medications and any relevant reports or scans.
- Write down your questions and what you hope to get from treatment.
- Consider your short and long term goals.
- If it would help you feel at ease, ask beforehand about bringing a support person.
No time or capacity to prepare? That is completely fine. Simply arriving is the most important part, and if that is all you do, you have done well. Your physiotherapist is trained to guide the conversation and ask the questions that help build a picture of your symptoms and any patterns. Furthermore, you do not need to understand your symptoms, and you do not need to have the answers.
What Happens in the Initial Assessment?
1. We talk first. Your physiotherapist asks about your symptoms, health history, pregnancies and births if relevant, and your bladder, bowel and sexual health. Importantly, you share only what you are comfortable sharing.
2. We look at the whole picture. This often includes how you breathe, move and hold your body, and the strength and movement of your back, hips and abdomen. Pelvic symptoms can be influenced by muscles, habits and how your body responds to stress, so the wider view matters.
3. An internal assessment, only if appropriate. If it is relevant to your concerns, your physiotherapist will explain what it involves and ask for your written consent first. (We usually schedule this for the second session). Internal examinations can be vaginal or rectal depending on your presentation and what you are comfortable with. In an effort to be comprehensive, you will likely be assessed in lying down as well as standing to ensure we have a functional representation of your pelvic symptoms.
4. We make a plan together. We will discuss what we found, in plain language, and agree on next steps.
What Happens After Your Assessment?
By the end of your first session, you should leave with:
- A clear explanation of what may be contributing to your symptoms.
- A treatment plan shaped around your goals.
- Practical strategies to try at home, such as breathing, down training techniques or movement.
Pelvic floor exercise is not one-size-fits-all. Pelvic pain does not automatically mean you need to strengthen, and it does not always mean you should only relax either. Early research in women with endometriosis-associated pelvic pain suggests that learning to both activate and relax the pelvic floor may help more than relaxation alone, although larger studies are needed. That is why an individual assessment matters: it shows what your pelvic floor is actually doing, so your programme can be built around you. You can read more in Pelvic Floor Tension: Should You Stretch or Strengthen?.
Common Questions About Your First Visit
Will my first pelvic health appointment be painful?
Assessment is not supposed to be painful nor is it something you should have to push through. If anything is uncomfortable, say so and it can be adjusted or stopped.
Is it embarrassing to see a pelvic floor physiotherapist?
It is okay to feel a little uncomfortable at first, this may be your first pelvic exam and we as physio’s perform these assessments every day. Your physio will assure you that they are comfortable and there is no need to feel embarrassed, as the session progresses through the verbal assessment and education, patients typically feel comfortable. These are everyday conversations in pelvic health care. You will not shock your physiotherapist, and there is no wrong thing to say.
Can I see a pelvic health physiotherapist during pregnancy or after birth?
Yes. Pelvic health physiotherapy is relevant before and after birth.
Do I need to shave or prepare?
No. Come as you are.
What if I have my period?
Patients typically avoid scheduling sessions if they are on day one or two of their period due to discomfort or flow. If you are comfortable, you are welcome to schedule at any point in your cycle. You will remove the pad/tampon prior and then your physio will likely have menstrual products available for after the session if needed.
How do I know my physiotherapist is registered?
Physiotherapists in South Africa should be registered with the HPCSA, and you can check this before any appointment. Our step-by-step guide, Is your Health Practitioner Registered in South Africa, shows you how. Note; not all physiotherapists are trained in pelvic health assessment and treatment, feel free to ask your physio about their background and training.
Taking the First Step: Book Your Appointment
Seeking help for pelvic symptoms takes courage. A first appointment is a chance to be heard, ask questions and decide, at your own pace, what happens next.
If you’d like to see me in person in Salt Rock, Ballito or for a virtual session, you can book an appointment here: Book your appointment.
