What happens in your first physiotherapy session

Bring any relevant medical reports, including X-rays, MRI scans, blood tests, and prescriptions from your doctor. If you have been referred by an orthopaedic surgeon, neurologist, or any other specialist, bring their referral notes. For online sessions, having digital copies of these reports ready on your phone or laptop is sufficient.

Wear comfortable, loose-fitting clothing that allows your physiotherapist to see and assess the affected area. For back pain, a T-shirt and shorts or track pants work well. For shoulder problems, a sleeveless top. For knee issues, shorts. Avoid tight jeans or restrictive clothing.

Write down your key concerns and questions. When did your pain start? What makes it worse? What makes it better? What activities are limited? What treatments have you already tried? Having these answers ready ensures that nothing important is missed during the consultation.

Your physiotherapist will start by asking you detailed questions about your problem. This is not small talk; it is a critical part of the assessment. Your answers help narrow down the possible causes of your pain before any physical examination begins.

Expect questions about when and how your problem started (sudden injury or gradual onset), where exactly you feel pain (and whether it travels to other areas), what activities make the pain worse or better, how the pain affects your sleep, work, and daily activities, what treatments you have tried so far, and your general health and medical history.

Be honest and specific. "My lower back hurts" is less helpful than "I feel a sharp pain on the right side of my lower back that shoots down to my knee when I bend forward or sit for more than 20 minutes." The more precise your description, the faster your physiotherapist can identify the cause.

After understanding your history, your physiotherapist will examine you physically. For in-person sessions, this involves observation (your posture, how you move), active movements (they ask you to move in specific directions while they observe), passive movements (they move your joint while you relax), and specific tests (standardized clinical tests that help identify the problem).

For online sessions, the assessment is adapted to what can be observed via video. Your physiotherapist will guide you through specific movements and positions, asking about what you feel at each point. Research shows that video-based assessments are reliable for most musculoskeletal conditions, particularly when combined with a thorough subjective history.

The assessment is not painful by design, but your physiotherapist may ask you to move into positions that reproduce your symptoms. This is intentional and necessary. Understanding which movements cause your pain and which direction makes it better or worse is essential for designing the right treatment plan. You will never be asked to push through severe pain.

After the assessment, your physiotherapist will explain what they believe is causing your problem, in plain language. This is your diagnosis. A good physiotherapist will explain not just the "what" but the "why": why this problem developed, what factors are contributing to it, and what the natural course of the condition is.

They will then outline a treatment plan, including what exercises and treatments they recommend, how many sessions they estimate you will need, what you can expect in terms of recovery timeline, and what you can do at home between sessions.

This is the right time to ask questions. Do not hesitate to ask about anything you do not understand. Why am I doing this exercise? Is this condition serious? Will it get worse? Can I continue working or exercising? When will I feel better? Your physiotherapist should answer all of these clearly and honestly.

Most physiotherapists will start you on 2 to 4 exercises during the first session. These are typically gentle movements aimed at reducing pain and beginning to restore normal movement. Your physiotherapist will demonstrate each exercise, have you practice it while they watch and correct your form, and explain how many repetitions and how often to do them.

Do not expect to receive 10 exercises on day one. Starting with a few key exercises and doing them well is far more effective than receiving a long list that overwhelms you. As you progress, exercises will be added and modified at subsequent sessions.

You should leave your first session with a clear written or digital exercise program. If your physiotherapist tells you exercises verbally without providing a written reference, ask for one. Trying to remember exercise instructions after a session is unreliable, and incorrect exercise technique can slow your recovery.

Start your exercises the same day or the next morning. Do not wait for pain to reduce before beginning. The exercises prescribed at the first session are specifically chosen to be safe at your current pain level. Consistency from day one is important.

It is normal to feel some soreness after your first session, particularly if muscles that have been underused are now being activated. This soreness typically resolves within 24 to 48 hours and is different from your original pain. If your symptoms significantly worsen after the first session (beyond mild soreness), contact your physiotherapist to discuss whether the exercises need to be modified.

Note any changes you observe between your first and second sessions. Did any exercise feel particularly helpful? Did anything make your symptoms worse? Did you notice you could do something you could not do before? This feedback helps your physiotherapist refine your program at the next session.