Most people don’t really know what to expect at their first pelvic floor physio appointment, so it’s normal to feel nervous. At Exhale, we see a range of clients who may be experiencing issues with bladder and bowel control, prolapse, constipation, pelvic pain, post gynaecological surgery and sexual pain.
Initial physio appointments will last about an hour and the majority of this time is spent discussing your history and providing education about pelvic health. The initial appointment is usually broken into 4 sections:
At the start of the appointment you will do the majority of the talking. The physio will want to know your symptoms and how they have been impacting your life. Your physio will prompt you by asking specific questions along the way – this might include questions about your bladder, bowel, menstruation, muscle and joint pain, sexual function, medication, exercise and general health.
Pelvic floor physiotherapists are trained to be sensitive to how personal and intimate these topics and this part of your body can be. At Exhale we practice trauma informed care and have done extensive training in this area to ensure you feel comfortable and safe during your appointments.
Most importantly, the physio will want to define what your goals are from treatment, and more holistically – from your life. Getting to understand your history is an important time for your physio to begin formulating a diagnosis and treatment plan in line with your goals.
After we have delved into your history, your physio will give you a run-down on pelvic anatomy and some possible hypothesis of what may be happening. This is often done using models and diagrams, as research shows if people better understand their condition they are more likely to improve.
At the conclusion of the history taking and education session, a physical examination may take place with your consent. This could involve an external spinal and pelvic girdle assessment, an ultrasound assessment and potentially an internal exam (on consenting adult patients only). For women, this will be a vaginal examination and for men and some women, the exam is done rectally. The internal examination helps your physio assess the strength and flexibility of your pelvic floor muscles, ligaments and fascia.
The full examination helps us determine if your symptoms are from muscles and joints (somatic), from organs (visceral) or from nerves (neuropathic) or a combination of these things. It is important to know that many clients prefer not to have an internal exam at their first appointment and this is not a barrier to effective treatment. Patients are welcome to bring a support person to this appointment.
After the examination your physio will discuss your diagnosis and develop a treatment plan to help you achieve your goals. As primary care providers, physiotherapists are also trained to recognise conditions that may require further medical referral.
Your Exhale physio will ensure you leave your first appointment feeling educated, strong and empowered regarding your pelvic health.