What happens during a pelvic floor physiotherapy assessment?

Why the first appointment is longer

Your initial pelvic floor physiotherapy assessment is typically longer than follow-up sessions — usually 60 minutes — because it covers ground that is impossible to rush. The physiotherapist needs to understand not only your current symptoms but the full context that surrounds them: your medical history, lifestyle, goals, and how your symptoms affect your day-to-day life.

At our Maple Ridge clinic, no part of the assessment is assumed or skipped. A thorough first visit leads to a more accurate diagnosis and a more effective treatment plan.

Part 1: History taking

The session begins with a structured conversation. You do not need to prepare anything in advance; your physiotherapist will guide you through the relevant areas. Common topics include:

• Your primary concern — what brought you in, and how long it has been present.
• Bladder and bowel habits — frequency, urgency, leakage, difficulty emptying, or any changes you have noticed.
• Pain and pressure symptoms — location, timing, what makes them better or worse.
• Reproductive and obstetric history — number of pregnancies and births, delivery type, any complications.
• Surgical history — particularly any pelvic, abdominal, or prostate procedures.
• Medications and relevant medical conditions — including conditions that may affect the nervous system, connective tissue, or hormonal status.
• Activity level and posture — how you move day to day, your exercise habits, and your occupation.
• Your goals — what a successful outcome looks like for you.

Nothing you share is off-limits or embarrassing. Pelvic floor physiotherapists hear these details every day; the conversation is clinically focused and non-judgmental.

Part 2: Physical assessment

After the history, the physiotherapist will perform a physical assessment. What this involves varies based on your symptoms, history, and comfort.

Postural and movement assessment

The pelvic floor does not work in isolation. Your physiotherapist will observe your posture, breathing pattern, hip mobility, and how your trunk and pelvis move together. Problems with any of these can directly affect pelvic floor function.

Abdominal assessment

An assessment of the abdominal muscles — including checking for diastasis recti (a separation of the abdominal muscles, common after pregnancy) — is often part of the evaluation, since the deep abdominals and diaphragm work directly with the pelvic floor.

External pelvic assessment

An external assessment of the perineum and pelvic region can provide useful information about muscle tone, tissue integrity, and sensitivity without requiring any internal examination.

Internal pelvic floor assessment (if appropriate)

Depending on your symptoms and what you and your physiotherapist agree is appropriate, the assessment may include an internal examination. This is not routine for all presentations. It is always explained in advance, fully optional, and performed only with your explicit consent.

For more information about what internal assessment involves and when it might be recommended, see our article: Do pelvic floor physiotherapy appointments always require an internal examination?

Part 3: Your assessment findings and plan

Before you leave your first appointment, your physiotherapist will explain:

• What the assessment findings show — in plain language, not technical jargon.
• What is contributing to your symptoms and why.
• What treatment will involve, and in what order.
• A realistic indication of how long improvement typically takes for your presentation.
• Your home exercise program or any self-care steps relevant to your condition.
• When your next appointment should be and how often you are likely to need treatment.

You will not leave your first appointment confused or without a plan. Clarity is part of what we aim to give you at the end of every initial visit.

What to wear and how to prepare

• Wear comfortable, loose-fitting clothing that allows easy movement and access to the lower abdomen and hips.
• No referral is required to book an initial assessment at our clinic — you can self-refer directly.
• A bladder diary in the days before your appointment is not required, but can be helpful if bladder symptoms are your primary concern. Your physiotherapist can provide a template if needed.
• Bring a list of any current medications if you find that helpful.
• There is no need to prepare specific answers; the conversation is guided by your physiotherapist.

Frequently asked questions

Do I need a referral?

No. In British Columbia, physiotherapy does not require a physician referral. You can book directly.

Will the assessment be painful?

The assessment is designed to be as comfortable as possible. If any part causes discomfort, you tell your physiotherapist and the assessment is adjusted immediately. Your comfort guides the pace throughout.

How long is the first appointment?

Initial assessments at our clinic are typically 60 minutes. Follow-up appointments are generally 30–45 minutes.

Can I bring a support person?

Yes. You are welcome to bring a support person to any appointment. Please let us know in advance so we can arrange the room appropriately.