Preparing for Your First Pelvic Physio Appointment: What You Need to Know

Wondering what will happen in your first pelvic physiotherapy appointment? You're in the right place. It's not unusual to feel nervous leading up to the appointment. This post will help prepare you for what the appointment actually looks like.

A pelvic physio treats muscles, tissues and nerves in and around the pelvis. Each component has a specific role in peeing, pooing, having sex, supporting your organs and birthing a baby.

Common pelvic floor issues include:

• Frequent need to wee

• Leakage of urine, stool or gas

• Incomplete emptying of urine

• Straining with bowel movements

• Treating haemorrhoids or fissures

• Pain with sitting

• Pelvic pain

• Diastasis recti

• Pelvic organ prolapse

• Birth preparation

What to really expect at the appointment?

Step One: Pre-Assessment Questionnaire

Completing this prior to the session helps give us insight on how your symptoms have been affecting you and your quality of life. The more specific you are, the better we can help you. One of the most important questions is what you are expecting out of the session. Its important to get an overview of how you're doing as well as the reason you're coming to see us.

Step Two: Let's Chat!

When you arrive, we will discuss anything highlighted in the pre-assessment questionnaire and spend time educating you on your pelvic floor muscles and how & why you may be leaking, having pain or struggling with heaviness in your vagina. We also will discuss the impact of sleep, stress and anxiety on physical well-being and what the latest research says.

Step Three: Let's Assess

After getting the details, the physio will perform an assessment, which typically includes the following:

• Looking at your posture and body mechanics 

• Checking your abdominal wall for tenderness/trigger points

• Assessing for diastasis recti/abdominal separation

• Assessing breathing and pressure management

• Assessing external hip muscles (buttocks, inner thighs) and abdominal, low back and hip strength coordination and endurance

• Observing and assessing the pelvic floor muscles externally

Step Four: Assess internally

Next we will perform an internal vaginal and/ or rectal exam with your consent. These assessments differ from a gynae appointment as there is no speculum or stirrups and we are assessing your pelvic floor muscles, not your reproductive organs.

While you lie comfortably on your back with bent knees, a therapist inserts a gloved, lubricated finger into your vagina. The therapist will be checking the muscles for function, tone and tenderness as well as treating them.

An internal rectal exam is for problems such as constipation, tailbone pain or rectal pain. These are also for those that cannot tolerate a vaginal internal exam or do not have a vagina. This is done while you're lying on your side with your knees bent.

At any moment in the session, you may decline an internal exam. Your consent is of utmost importance to us!

Step Five: Let's create a personalised plan for you!

After the assessment, we’ll let you know what we found in your exam and how it relates to any symptoms you are experiencing. You will receive education and exercises to start at home and discuss what your next therapy sessions will address.

We will then schedule your follow up appointments to ensure you're progressing well. Therapy isn't a quick fix - it takes time and commitment but the results are always worth it!

Thank you for trusting us with your care. Looking forward to helping you thrive.

Gemma & Kayla, trusted physios ready to help on your journey to pelvic wealth!