What happens in your first physiotherapy session

If you have never seen a physiotherapist before, it is natural to wonder what will happen. The first session is mostly about understanding your problem, and partly about starting to fix it. Here is what to expect.

Before you go

What to wear: loose, comfortable clothes that let the physiotherapist see and move the area that hurts. For a knee or hip, shorts or loose track pants. For a shoulder or neck, a loose top or a vest.

What to bring:

• any doctor's notes, prescriptions or referral letter

• scan or X-ray reports (the report matters more than the films)

• a list of medicines you take

• if it is a home visit, a clear space to move in

Arrive a few minutes early to fill in your details.

Step 1: the conversation

The physiotherapist will ask about your problem in detail. Expect questions like:

• Where exactly does it hurt? Does the pain spread anywhere?

• When did it start, and how? A fall, a sudden movement, or gradually?

• What makes it worse, and what makes it better?

• Is it worse in the morning, at night, or at the end of the day?

• What can you not do now that you could before?

• Any other health problems, past injuries or surgery?

They will also ask some safety questions, such as about unexplained weight loss, fever, or numbness, to make sure physiotherapy is right for you and nothing needs a doctor first. Answer honestly, even if a question seems unrelated.

It helps to think about what you want to get back to: climbing stairs without pain, playing with your children, sitting through a working day, a sport. That becomes the goal of your treatment.

Step 2: the examination

Next, the physiotherapist will look at how you move. They might:

• watch you walk, stand, bend or reach

• measure how far a joint moves

• test the strength of your muscles

• gently press around the painful area

• do specific tests to find out which structure is involved

Some movements may bring on your usual pain for a moment. That is useful information. Tell them if anything is too painful, and they will stop or change the test.

Step 3: what is going on

The physiotherapist should explain, in plain words, what they think is causing your problem, how long it is likely to take to improve, and what the plan is. If anything is unclear, ask. A good physiotherapist is happy to explain.

Step 4: the first treatment

Most first sessions include some treatment. Depending on your problem, that might be:

• hands-on treatment, such as joint mobilisation or soft tissue work

• exercises, done with you so you learn them properly

• electrotherapy, such as TENS, IFT or ultrasound, in some clinics

• advice about posture, rest, ice or heat, and what to avoid for now

Step 5: your home programme

You will usually leave with a few exercises to do at home. These matter as much as the sessions themselves. Make sure you know:

• how many times to do each one, and how often

• what it should feel like

• what to do if it hurts

Ask the physiotherapist to watch you do each exercise once before you leave.

Step 6: the plan from here

Before you go, agree:

• how often you will come, and for roughly how long

• when your next session is (book it before you leave)

• what the fee is, and how to pay

Questions worth asking

• What do you think is causing my pain?

• How long should it take to improve?

• What should I avoid doing for now?

• What should I do if it gets worse?

• How will we know it is working?

Finding a physiotherapist

You can search for physiotherapists near you by area and treatment on PhysioDesk Reach, see their fees, timings and reviews, and call or message them directly. Many offer home visits.

This article is general information, not medical advice. If you have severe or worsening pain, numbness, weakness, or problems with bladder or bowel control, see a doctor promptly.