What to Expect at Your First Pelvic Floor Physiotherapy Appointment

Booking a pelvic floor physiotherapy appointment is an important step in looking after your health, but it’s completely normal to feel a little unsure about what the session will involve.  Here is an overview of what your session may look like. Remember that your physio can tailor a session to suit your needs.

A Supportive Conversation

Your appointment will begin with a chat about your symptoms, medical history, and lifestyle. This might include questions about bladder or bowel habits, pain, pregnancies or surgeries, and even your daily activities. The goal is to build a clear picture of what’s happening and how it impacts your life.

This conversation is also a chance for you to share your goals. Do you want to run without bladder leaks? Sit comfortably without pelvic pain? Regain confidence after childbirth? The more your physiotherapist understands your priorities, the better they can tailor your treatment.

Physical Assessment

There are many ways to assess the pelvic floor, including internal examinations and assessment over underwear. Your physiotherapist will discuss the assessment options that are most appropriate for you. You can then make an informed decision about which option you feel the most comfortable with. Remember that if you change your mind during the assessment, you can let your physiotherapist know and they will stop the assessment.

·         Internal vaginal examination:  a gloved finger is inserted into the vagina to assess how strong the pelvic floor muscles are. Your physio will also assess for pelvic organ prolapse, muscle tension and coordination.  Internal assessments provide the most information about the health of your pelvic floor. They are done gently and with care and you are able to stop the assessment at any point.

·         Internal rectal examination:  a gloved finger is inserted into the rectum to assess how strong the pelvic floor muscles are and how well they relax. It provides valuable information about strength, coordination, and tension, particularly if you have bowel problems, pelvic pain, or post-prostate surgery.

·         Abdominal ultrasound: A small ultrasound probe is placed on your lower stomach to show the bladder and how it moves when you contract your pelvic floor. You can see the screen in real time, which makes it easier to learn how to contract correctly. However, this type of assessment does not provide information on muscle strength, muscle tension or assess prolapse.

·         Perineal ultrasound: An ultrasound probe is placed on the skin of the perineum. This gives a clear picture of how the pelvic floor muscles move when you squeeze, relax, or bear down. It’s a great option if you’d like visual feedback in a non-invasive way and is helpful when recovering from a prostatectomy.

·         External perineal examination: This involves observing and gently feeling the perineum, the area between the vagina and anus in women, and between the scrotum and anus in men. The physiotherapist may ask you to contract or relax your pelvic floor muscles so they can assess movement without going inside the body. This method provides less information about the strength of your pelvic floor compared to internal examinations.

·         External examination over underwear: For clients who prefer not to undress, the physiotherapist can begin with an assessment over clothing. While this provides less detail than other methods, it can still give useful insights into breathing patterns, abdominal activation, and general pelvic floor awareness.

 

Creating Your Treatment Plan

Once the assessment is complete, your physio will explain their findings in clear, simple language. Together, you’ll set goals and develop a personalised treatment plan. This may include:

• Pelvic floor muscle training: either strengthening or relaxation exercises.
• Hands-on therapy to release tension or address scar tissue.
• Biofeedback or ultrasound to help you visualise your muscles in action.
• Deferral strategies to help with urgency.
• Education about healthy bladder and bowel habits.

Your plan will be tailored to your specific needs; with practical steps you can take straight away.

A Judgment-Free Space

One of the biggest worries people have before their first consult is embarrassment. It’s reassuring to know that pelvic floor physiotherapists work with these issues every single day. To them, talking about bladder leaks, bowel concerns, or pelvic pain is just part of their role. You’ll be treated with compassion, respect, and complete confidentiality at every step.

  Your first pelvic floor physiotherapy appointment is designed to understand your concerns, assess how your body is working, and create a clear plan to help you move forward. Far from being something to fear, it’s a positive and empowering step toward feeling stronger, more comfortable, and more in control. Book your first appointment online today.

 Please refer to our services page "Women's Health" to locate your nearest women's health physiotherapist.