It is normal to feel nervous about your first pelvic health physiotherapy appointment. Here is what you can expect…
Your pelvic health physiotherapist will greet you in the waiting room and take you to a private room where others can’t overhear.
Most initial pelvic health physiotherapy appointments take one hour which allows enough time to really listen to your story.
Subjective history
First, we will ask what your main concerns are as well as your goals. Depending on your answers, we will then follow up with more specific questions about:
- bladder and bowel function
- prolapse symptoms
- sexual concerns
- pregnancy and birth history
- musculoskeletal symptoms
- lifestyle factors such as sleep and exercise
- gynaecological history and your menstrual cycle
- general health and medications
These are personal topics and we’ve only just met! We will only ask questions that are relevant but you can let us know if there is anything you don’t feel comfortable talking about. There is never ‘too much information.’ We have heard it all before!
Physical examination
Once we have taken a thorough history, we will explain the potential causes of your symptoms using diagrams and models. At this point, your pelvic health physio may suggest an internal vaginal or rectal exam.
As the pelvic floor muscles are located inside the pelvis, an internal exam often provides the most information about your pelvic floor.
We will always ask for your permission before performing an internal exam. There is no pressure to say yes, particularly at the first appointment. You can always think about it and decide later.
You can read more about what is involved in an internal exam here.
If you don’t feel comfortable having an internal exam, there are alternatives such as real-time ultrasound. This is an external assessment where the probe is placed either on your lower tummy or perineum. It can be helpful as you can see your pelvic floor muscles on a screen.
We will discuss the pros and cons of every assessment to help you decide.
If indicated, your pelvic health physio may also ask you to fill out a bladder or bowel diary before your next appointment.
Treatment
After the physical exam, we will discuss our findings and come up with a treatment plan together. A key part of our treatment is always education based on the latest evidence.
We will provide information on all of the treatment options available so you can choose which option(s) is best for you. This may include:
- simple lifestyle changes to manage your symptoms (e.g. fluid and fibre advice)
- an individualised home exercise program
- manual therapy such as massage and joint mobilisation
- a pessary fitting
You will most likely walk away with some kind of ‘homework.’ We know time is often a barrier and will help you find ways to make it work with your routine. If you’re worried you won’t remember what we said, don’t be! We send an email summary so you can refer back to it later.
Plan
We then organise a time to follow up. This may be within 1 or 2 weeks or longer depending on your concerns and goals.
Follow up appointments are usually 30-45 minutes in length. We generally start each review by asking if you have any questions and if there is anything in particular you want to focus on that day.
The number of sessions required will be different for everyone but we will give you an estimated timeframe. If your concern is more chronic in nature like pelvic pain, our aim is to empower you with all of the tools to manage independently.
With your permission, we will communicate with your GP and other members of your health care team if needed so we can work collaboratively to help you reach your goals.
You should walk out of the first appointment with a clear understanding of what is going on in your own body and a plan going forward.
frequently asked questions
Pelvic health physios are autonomous primary care practitioners meaning you don’t need a referral from your doctor.
Wear something comfortable you can move freely in!
Of course! Most pelvic health physios understand how hard it can be to find childcare so you can attend an appointment. Babies and children are usually more than welcome to come along. At All Women’s Health, our friendly admin team are always on stand-by for cuddles should bub get upset and we need to get through an assessment!
Initial pelvic health physiotherapy appointments range from $200-$285 for the hour. At All Women’s Health, an initial appointment is $240. Follow up appointments are $175 for an extended consultation (45 mins) and $130 for a standard consultation (30 mins).
Pelvic health physiotherapy appointments are not covered by Medicare unless you have a Team Care Arrangement. This is a plan which allows you to access 5 allied health sessions in a calendar year. Medicare then subsidises the cost of the appointments. Speak to your GP to see if you are eligible.
If you have physiotherapy on your extras cover, you can use your private health insurance to receive a rebate. The amount will vary depending on your provider.
Hopefully this helps answer your questions and reduce any fears you may have about seeing a pelvic health physiotherapist.
If you are ready to book your first appointment, you can book online here.
Not in Brisbane? Reach out via the contact form or email me at [email protected] for recommendations in your area. Otherwise, go to https://choose.physio/find-a-physio and refine your search to Women’s, Men’s and Pelvic Health.
Courtney x
P.S. If you have seen a pelvic health physio before, tell me what your first appointment was like! Comment below.
