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What to expect in your Initial Pelvic Floor Physiotherapy consultation

Updated: Oct 10, 2023

Taking care of our bodies should always be a priority - and that includes paying attention to areas we may not often think about - like the pelvic floor❗ Pelvic floor physiotherapy is a specialised area of physio that focuses on assessing and treating conditions related to the pelvic floor muscles. If you are considering booking or have just booked your first appointment with a pelvic floor physiotherapist, it's natural to have questions about what to expect. This blog is aimed to give you some guidance in what to expect in your first appointment.

1️⃣ Ample opportunity to discuss your issues:

Your physiotherapist is very interested in your individual concerns/ issues. They will ask you quite detailed questions surrounding your symptoms, medical history and questions involving the pelvic organs - including the bladder, the bowel, and your reproductive system. Your pelvic floor physiotherapist will welcome your input to the conversation, however, you also have the opportunity to let them know if you are uncomfortable with answering intimate questions.

2️⃣ Physical Examination:

There are many ways to assess the pelvic floor muscles and it is important for your pelvic floor physiotherapist to make sure you are well-informed of each assessment technique. Pelvic Floor Physiotherapists are committed to ensuring your experience is comfortable and informative, so please ask questions as you need to. The gold standard of assessment for pelvic floor muscles is via an internal vaginal or rectal examination. This is a gentle assessment, where a lubricated gloved finger is inserted into the vagina or rectum to assess the pelvic tissues and musculature. No pain should be experienced, however if you are uncomfortable, you have the opportunity to remove your consent to the examination at any time.

If an internal examination is not the assessment for you, your pelvic floor physiotherapist may suggest an external examination or an real time ultrasound assessment of your muscles instead. The external pelvic floor muscle examination involves assessing the muscles visually, and potentially with gloved fingers around the pelvic area, but not internally. This is very similar to how other muscles in the body are assessed. This can be a clothed assessment or unclothed assessment depending on what you are comfortable with. Real Time Ultrasound assessment is another clothes-on assessment where an ultrasound machine is placed over the lower region of your abdomen to visualise your bladder - which sits above your pelvic floor muscles. You may be able to see your pelvic floor muscles contract in the correct direction and relax in the correct direction as well.

Any form of assessment is helpful in assessing your pelvic floor muscles and starting you on a Treatment Plan within this first session.

3️⃣ Education and Treatment Plan:

Based on the findings from your examination, your pelvic floor physiotherapist will explain the anatomy and function of the pelvic floor muscles and report how your symptoms relate to your pelvic floor muscles. They will help you understand any dysfunction or imbalances in your pelvic floor muscles and how they may be contributing to your symptoms. Following this, your pelvic floor physiotherapist will discuss with you an individualised treatment plan tailored to your goals and symptoms.

Your treatment plan may include pelvic floor exercises, education surrounding your pelvic organs and will often involve addressing the health and strength of your overall body

In your treatment plan, your physio will guide you through how many and how often is recommended to see your pelvic floor physiotherapist in order to achieve your goals.

Attending your first pelvic floor physiotherapy appointment can be a transformative step towards better pelvic health. By taking that first step to book your appointment, you have already taken proactive steps to improving your pelvic floor function and overall well-being. By knowing what to expect, you can approach treatment with a sense of reassurance 🙌

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