Physio Appointments

As a physiotherapist, we understand that attending pelvic floor appointments can feel daunting for patients. This guide will help patients understand what we do during appointments, how they can prepare, and what questions they might want to ask. We are trained to discuss these issues professionally and with sensitivity.

Professional therapy consultation for pelvic health concerns

Types of Appointments

GP (General Practitioner) Visit

Your GP is usually your first point of contact and can:

Assess your symptoms and medical history
Perform basic examinations
Rule out infections or other conditions
Provide initial treatment recommendations
Refer you to specialists if needed

Pelvic Floor Physiotherapist

A specialized physiotherapist who can:

Assess your pelvic floor muscle function
Teach you proper exercise techniques
Provide hands-on treatment
Help with pain management
Guide you through rehabilitation
Vaginal dilation therapy - progressive stretching techniques for vaginal stenosis or muscle tension
Muscle trigger point release - targeted manual therapy for pelvic floor muscle knots and tension
Birth canal stretch - specialized techniques to prepare and restore birth canal flexibility
Kegel therapy sessions - guided pelvic floor strengthening with proper technique instruction

Specialist Doctor (Urogynaecologist/Urologist)

A doctor specializing in pelvic floor disorders who can:

Perform detailed assessments
Order specialized tests
Discuss medical and surgical treatment options
Provide ongoing specialized care

Before Your Physio Appointment

Prepare Information:

Symptom Diary (3-7 Days)

Track:

Times you urinate and amounts (if possible)
Episodes of leaking - what triggered it, how much
Bowel movements - frequency, consistency
Fluid intake - what and how much you drink
Activities that worsen or improve symptoms

Medical History:

Previous pregnancies and deliveries
Surgeries, especially pelvic, abdominal, or back
Current medications (bring a list or the actual medications)
Other medical conditions
Family history of similar problems

Questions to Consider:

Write down questions beforehand. Examples:

What might be causing my symptoms?
What treatment options are available?
How long might treatment take?
Are there things I should avoid?
Will my symptoms get worse if untreated?
When should I expect to see improvement?

Practical Preparation for Patient:

Wear comfortable, easy-to-remove clothing if an examination might be needed
Bring a urine sample if requested (your GP’s office will provide a container)
Arrive with a comfortably full bladder if tests are planned
Bring a trusted person for support if it makes you more comfortable
Don’t douche or use vaginal products before the appointment

What to Expect for the Physio Appointment

Building a Therapeutic Relationship

Working with a pelvic floor physiotherapist involves an intimate therapeutic relationship that requires trust, respect, and understanding. As your physiotherapist, we understand the vulnerability involved in pelvic health care and are committed to:

Creating a calm, supportive environment - maintaining a professional yet compassionate atmosphere
Being confident and reassuring - providing steady guidance through what may feel overwhelming
Supporting patient comfort - prioritizing your emotional and physical wellbeing throughout treatment
Maintaining non-judgmental care - understanding that every woman’s anatomy is unique and different
Respecting individual differences - recognizing that all bodies are normal and deserving of respectful care
Building trust gradually - allowing the therapeutic relationship to develop at your pace
Encouraging open communication - creating space for questions, concerns, and feedback

We recognize that intimate healthcare can feel vulnerable, and our role is to make this experience as comfortable and therapeutic as possible. Every patient deserves dignity, respect, and individualized care.

Therapy Session Duration

A complete pelvic floor physiotherapy session usually takes 45-60 minutes, depending on what therapeutic interventions are needed. This allows adequate time for:

Comprehensive assessment and discussion
Physical examination and evaluation
Therapeutic interventions and treatments
Patient education and home program instruction
Progress monitoring and treatment planning

Initial Discussion (15-30 minutes)

As Your Physiotherapist, We Will Ask About:

When symptoms started and how they’ve changed
Specific symptoms - frequency, severity, triggers
Impact on your life - work, exercise, social activities, relationships
Previous treatments you’ve tried
Medical and surgical history
Medications and supplements
Lifestyle factors - diet, exercise, smoking, alcohol

We Encourage Patients to Be Honest About:

How symptoms really affect your daily life
Your concerns and fears
Previous experiences with healthcare
What you hope to achieve from treatment

Physical Examination

Regular Physical Appointments Are Essential

Physical examinations should always be conducted regularly as part of comprehensive pelvic floor therapy
Regular assessments allow us to monitor progress and adjust treatment plans
Consistent physical evaluations ensure optimal therapeutic outcomes
We will explain what each examination involves and why it’s necessary
Patients can always ask questions about what will happen
Patients have the right to decline any examination
Patients can request a chaperone be present

If an Examination Is Needed:

External Examination:

Visual inspection of the external genital area
Checking for signs of irritation, infection, or prolapse
Assessment of pelvic muscle tone

Internal Examination (If Appropriate):

Usually done by a specialist rather than at your first GP visit
Vaginal examination to assess muscle strength and coordination
Check for prolapse or other structural issues
Assessment of pelvic floor muscle function

What Patients Should Know:

We provide privacy to undress and a gown or sheet for covering
The examination should not be painful, though may be uncomfortable
Patients can ask us to stop at any time
We will explain what we’re doing throughout the process
The examination usually takes 10-15 minutes

Specialized Therapeutic Techniques

Proper Muscle Dilation

As physiotherapists, we perform muscle dilation techniques to address vaginal stenosis, muscle tension, and tissue restrictions:

Progressive stretching - gradual increase in tissue flexibility over multiple sessions
Gentle manual techniques - using appropriate pressure and positioning
Patient comfort monitoring - ensuring the process remains therapeutic, not painful
Education on home techniques - teaching patients safe self-dilation methods
Progress tracking - documenting improvements in tissue flexibility and function

Therapeutic Dilation with Professional Dilators

We use specialized medical dilators during therapy sessions:

Graduated sizing - starting with appropriate size and progressing gradually
Proper lubrication - ensuring patient comfort and tissue protection
Controlled insertion technique - maintaining patient control and comfort
Duration management - appropriate timing for therapeutic benefit
Patient education - teaching proper use for home practice
Sterile technique - maintaining hygiene and safety standards

Kegel Exercise Therapy

We provide guided kegel therapy sessions with proper technique instruction:

Muscle identification - helping patients locate and isolate pelvic floor muscles
Proper contraction technique - teaching correct muscle activation patterns
Progressive strengthening - gradually increasing intensity and duration
Coordination training - integrating with breathing and core muscles
Functional application - relating exercises to daily activities
Home program development - creating personalized exercise routines

Trigger Point Massage Therapy

We perform targeted manual therapy for pelvic floor muscle knots and tension:

Trigger point identification - locating areas of muscle tension and spasm
Manual pressure techniques - applying appropriate therapeutic pressure
Sustained pressure therapy - holding pressure for optimal tissue release
Progressive release - gradually increasing pressure as tissues respond
Patient feedback integration - adjusting technique based on patient response
Follow-up care - monitoring tissue response and healing

Specialized Care for Pregnant Mothers

Birth Canal Stretching Techniques

For pregnant patients, we provide specialized birth canal preparation:

Perineal massage - gentle stretching of perineal tissues
Birth canal flexibility training - preparing tissues for childbirth
Positioning education - teaching optimal positions for delivery
Partner involvement - training partners in supportive techniques
Safety protocols - ensuring all techniques are pregnancy-appropriate
Timing considerations - implementing techniques at appropriate gestational stages

Prenatal Pelvic Floor Preparation

Muscle strengthening adapted for pregnancy
Relaxation techniques for labor preparation
Breathing coordination with pelvic floor function
Postural education for pregnancy-related changes
Pain management strategies for pregnancy discomfort

Discussing Results and Next Steps

As Your Physiotherapist, We Will:

Explain what we found (or didn’t find) during the assessment
Discuss possible causes of the patient’s symptoms
Outline treatment options we can provide
Provide written information or resources
Schedule follow-up appointments as needed
Make referrals to other specialists if appropriate

Treatment Options Might Include:

Conservative treatments - exercises, lifestyle changes
Physiotherapy referral - for specialized pelvic floor training
Medical treatments - medications, devices, or procedures
Further testing - if diagnosis is unclear
Watch and wait - if symptoms are mild and not bothersome

Common Concerns and Reassurance

”What if the examination is painful?”

Examinations should not be painful
Some discomfort is normal, especially if you’re tense
Let your examiner know if you’re experiencing pain
You can ask them to stop or pause at any time
Relaxation techniques like deep breathing can help

”What if I leak during the appointment?”

This is completely normal and expected
We as physiotherapists are used to this happening
Facilities are prepared with protective coverings
It won’t embarrass us as your physiotherapist
It can actually be helpful for diagnosis

”What if I find it too embarrassing to talk?”

We as physiotherapists discuss these issues daily
We are trained to be sensitive and professional
Patients can bring notes to help remember what to say
It’s okay for patients to feel embarrassed - this is normal
The more honest patients are, the better we can help

”What if they can’t help me?”

Very few pelvic floor problems are untreatable
Even if initial treatments don’t work, there are usually other options
Sometimes it takes time to find the right approach
Specialist referrals can provide access to advanced treatments
Support and symptom management are always available

Questions Patients Can Ask Their Physiotherapist

About Your Condition:

What is causing my symptoms?
Is this condition common?
Will it get worse if untreated?
Are there any serious complications I should watch for?

About Treatment:

What are all my treatment options?
What would you recommend for someone like me?
How long does treatment typically take?
What are the success rates?
What are the risks or side effects?

About Follow-up:

When should I expect to see improvement?
When should I come back?
What warning signs should I watch for?
Who should I contact if I have questions?

After Your Physio Appointment

Follow Through:

Start recommended treatments we discussed
Keep follow-up appointments even if feeling better
Contact our office with any questions or concerns
Keep tracking symptoms to monitor progress for us

If Patients Aren’t Happy:

Patients have the right to seek a second opinion
We can provide referrals to specialists if needed
Patients can change healthcare providers if needed
Patient comfort and satisfaction with our care matters to us

Special Considerations

For Men:

Male pelvic floor specialists are available if preferred
Prostate examinations may be part of the assessment
Don’t assume pelvic floor problems are “women’s issues”

For LGBTI+ Individuals:

You have the right to respectful, inclusive care
You can ask about providers experienced with LGBTI+ health
Your sexual orientation and gender identity are relevant to your care

Language and Cultural Considerations:

Interpreters can be arranged if needed
You can request a provider of the same gender if preferred
Cultural sensitivities should be respected

Remember

Physio appointments are the beginning of our partnership in helping patients feel better, not a test they need to pass. As physiotherapists, we want to help patients improve their quality of life. We encourage patients to be patient with the process, honest about their symptoms and concerns, and to ask us questions freely.

Taking this step to seek help shows courage and self-care. Every patient deserves to feel comfortable and confident in their body, and we’re here to support that journey.

For more information about what to expect, visit The Pelvic Floor Society patient resources and speak with your GP about referral options in your area.