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Pelvic Care Directory

First visit guide

What to expect at your first pelvic floor visit

It's normal to feel nervous. In Ontario, a physiotherapist must get your informed consent before doing an internal exam. Here's how a first visit usually goes, though every clinic works a little differently.

Step 1Medical and symptom history (no exam yet)

Your physiotherapist starts with a conversation.

You'll talk about what brought you in. You may be asked about your bladder, bowels, sexual health, any pregnancies or births, and pain. You decide what you share. No physical exam happens during this part.

You can pause or stop at any time.

Step 2Informed consent and your options

You decide which assessments you're comfortable with.

Your physiotherapist will explain what an internal exam (vaginal or rectal) involves, why they're suggesting it, and its risks and benefits. They may use diagrams or models. An internal exam isn't required, and they need your informed consent before doing one. If you say no, they can talk with you about other options.

You can pause or stop at any time.

Step 3External and optional internal assessment

The assessment goes at your pace.

Your physiotherapist may look at things like your posture, breathing, hips, back and abdomen. If you've agreed to an internal exam, they'll usually use a gloved finger to check how your pelvic floor muscles feel and work. Tell them right away if anything hurts or feels wrong. Only a physiotherapist rostered with the College can do an internal exam. It can't be passed to an assistant.

You can pause or stop at any time.

Step 4Your treatment plan

You'll talk through next steps together.

Your physiotherapist will explain what they found and suggest a plan based on your goals. It may include exercises to do at home and follow-up visits. Ask any questions you have, and take the time you need to decide.

You can pause or stop at any time.

Good to know

  • First visits often take about an hour or longer. Ask your clinic how much time to plan for.
  • You don't need a referral to see a physiotherapist, but some insurance plans ask for one before they'll pay.
  • If you'd like someone with you, ask your clinic before your visit.

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This guide is general information, not medical advice. Your physiotherapist can tell you what applies to you.