What to Expect From Your First Physio Appointment

I get it. You’ve never been to a physio before, you’re not sure what’s going to happen, and you’re probably wondering if I’m going to make you do something painful or embarrassing. You’re not alone — about 30% of my first-time clients tell me they’ve been putting off booking because they didn’t know what to expect.

So let me walk you through exactly what happens in your first appointment, from the moment you arrive to what you’ll leave with. No surprises, no corporate waffle — just an honest breakdown of what I’ll ask, what I’ll test, and why it matters.

The whole thing takes about 45-60 minutes. You’ll spend roughly half that time talking to me and half having a physical assessment. And yes, I might treat you on day one if it’s appropriate — but I’ll get to that.

What to Wear and Bring

Let’s start with the practical stuff. Wear something comfortable that lets me see and access the area you’re having trouble with. If it’s your knee, wear shorts. If it’s your shoulder, a vest top or loose t-shirt works. If it’s your lower back, I’ll need to see your spine, so shorts or leggings and a sports bra or crop top for women, shorts for men.

I know it feels a bit awkward — you’re meeting someone for the first time and I’m asking you to strip down to your gym kit. But I can’t assess your movement, alignment, or muscle activation through jeans and a hoodie. And trust me, after 7 years doing this and over 5,000 patients, I’ve seen it all. There’s nothing to be embarrassed about.

If you’re not sure what to bring, don’t stress. The most important thing is showing up and being ready to talk honestly about what’s going on.

The Subjective Assessment: What I’ll Ask and Why

The first 20-30 minutes is what we call the subjective assessment. This is where I ask you a lot of questions about your injury, your symptoms, and your life. It might feel like I’m overcomplicating things, but I’m building a picture of what’s causing your pain and what factors are making it worse.

Here’s what I’ll ask:

• When did it start? Acute injuries (you rolled your ankle last week) are different from chronic problems (your shoulder’s been niggling for two years).
• What were you doing when it happened? This helps me understand the mechanism of injury.
• Where exactly is the pain? Point to it. Show me with one finger if you can. Vague, widespread pain tells me something different from sharp, localised pain.
• What makes it better or worse? Does it hurt when you walk, run, sit, sleep, lift, reach overhead? This narrows down the structures involved.
• What does it feel like? Sharp, dull, burning, stabbing, aching? Different pain types point to different tissue problems.
• What do you want to achieve? Get back to running? Play with your kids without pain? Sleep through the night? Your goals shape the treatment plan.

I’ll also ask about your medical history, previous injuries, and any red flags (unexplained weight loss, night pain, bowel/bladder changes, numbness that’s spreading). Most of the time it’s nothing serious, but if I spot something that needs further investigation, I’ll refer you appropriately.

And yes, I might ask about your sleep, stress levels, or work setup. It’s not small talk. Poor sleep and high stress lower your pain threshold and slow healing. If you’re sat at a desk for 10 hours a day with terrible posture, that’s contributing to your neck pain. I need to know.

The Physical Assessment: What I’ll Test

Once I’ve got the full story, we move to the physical assessment. This is where I test your movement, strength, and function to see what’s actually going on in your body.

Here’s what I might do:

• Range of motion: I’ll ask you to move the painful area through its full range — bending, straightening, rotating. I’m looking at how far you can move, where it hurts, and whether the movement is smooth or restricted.
• Strength testing: I’ll resist your movement to test the muscles around the joint. Weakness or pain on resistance tells me which structures are involved.
• Special tests: These are specific clinical tests designed to isolate particular injuries. For example, if I suspect a rotator cuff tear, I’ll do tests that stress those tendons. If it’s your knee, I might test your ACL, meniscus, or patella tracking.
• Palpation: I’ll feel the area with my hands, checking for swelling, heat, muscle tension, trigger points, or areas of tenderness.
• Functional movement: I’ll watch you squat, lunge, walk, or do whatever movement is causing you trouble. This shows me how your whole body is moving and compensating.

Sometimes I’ll compare the painful side to the other side. If your left shoulder moves beautifully and your right one doesn’t, that’s useful information.

And yes, some of it might be uncomfortable. I’m not trying to hurt you, but I do need to reproduce your symptoms to confirm what’s causing them. If something’s painful, I’ll stop and modify the test — but I need you to tell me.

Why I Ask About Things That Seem Unrelated

This is the bit that catches people off guard. You’ve come in with knee pain, and I’m asking about your sleep, stress, and whether you’ve been sitting more than usual. Or you’ve got shoulder pain, and I’m checking your neck and upper back.

Here’s why: pain is complex, and your body is a system, not a collection of isolated parts.

Poor sleep increases pain sensitivity. Stress raises muscle tension and inflammation. Dehydration affects tissue health. A desk job with forward head posture contributes to shoulder impingement. A stiff thoracic spine restricts shoulder movement. Weak glutes cause knee pain.

If I only look at the area that hurts, I’m missing the bigger picture. And if I don’t address the contributing factors, you’ll get temporary relief but the problem will come back.

I’ve worked with runners who came in with “runner’s knee” that turned out to be caused by tight hip flexors from sitting all day. I’ve seen desk workers with shoulder pain that was actually coming from their neck. The body’s connected, and I treat it that way.

Diagnosis vs. “We Need More Information”

By the end of the assessment, I’ll give you my working diagnosis. Most of the time, I can tell you exactly what’s wrong and what we need to do about it. But sometimes, I can’t be certain after one session.

That doesn’t mean I don’t know what I’m doing. It means your symptoms are complex, there are multiple possibilities, or I need to see how you respond to treatment before I can narrow it down.

For example, if you’ve got shoulder pain, it could be tendinopathy, impingement, or referred pain from your neck. I’ll have a strong suspicion, but I might need to treat it for a week or two and see how you respond before I can confirm.

If I think you need imaging (X-ray, MRI, ultrasound), I’ll tell you. Sometimes a scan is essential — if I suspect a fracture, a significant tear, or something that won’t show up on physical assessment. Other times, it’s not necessary. Most musculoskeletal pain doesn’t require imaging, and scans often show “abnormalities” that are completely normal for your age and activity level.

If you’ve already had a scan and it’s come back “normal” but you’re still in pain, don’t worry. Scans don’t show everything — they miss muscle imbalances, movement dysfunction, nerve sensitivity, and fascial restrictions. I’ll figure it out.

And if I find something outside my scope — something that needs a specialist, a GP, or a different type of treatment — I’ll refer you. I’m not here to keep you coming back unnecessarily. I’m here to get you better.

Will You Treat Me on Day One?

Sometimes, yes. Sometimes, no.

If your problem is straightforward and I’m confident in the diagnosis, I’ll start treatment in the first session. That might be soft tissue work, joint mobilisation, taping, or giving you exercises to start immediately.

But if your presentation is complex, or if I need to rule out red flags, I might hold off on hands-on treatment and focus on the assessment. I’d rather spend 60 minutes getting the diagnosis right than rush into treatment and make things worse.

I’ll always explain what I’m doing and why. If I’m treating you, I’ll tell you what I’m aiming to achieve. If I’m not, I’ll tell you why and what happens next.

What You’ll Leave With

After your initial assessment, you’ll have a clear picture of what’s going on and what we’re going to do about it. You won’t leave confused or wondering if it’s “all in your head.”

You’ll also get honest advice about whether you need follow-up appointments. Some people need a full course of treatment — maybe 4-6 sessions over a few weeks. Others need one or two sessions and then they’re good to manage it themselves. I’m not going to string you along with unnecessary appointments.

If I think you’d benefit from diagnostic ultrasound imaging to get a clearer view of what’s happening, I’ll explain why and book that for your next visit. And if you’re already improving and just need a follow-up treatment session to fine-tune things, I’ll tell you that too.

You’re in control. I’ll give you my professional recommendation, but the decision is yours.

Cost and Time Commitment

Let’s talk money, because I know it matters. Your initial assessment is £75 and takes 45-60 minutes. Follow-up treatments are £60-70 and take 30-45 minutes, depending on what we’re doing.

I don’t do packages or pressure you into booking multiple sessions upfront. You book one session at a time, and we reassess as we go. If you’re not improving, we change the plan. If you’re doing well, we space out the sessions or discharge you.

Some people see significant improvement after one session. Others need a few weeks of treatment. It depends on the injury, how long you’ve had it, and how well you respond to treatment. I’ll give you a realistic estimate based on what I see, but I can’t guarantee timelines — bodies don’t work that way.

If you’re wondering how many sessions you’ll need, I’ve written a whole post on how many physio sessions you’ll need — it breaks down the factors that affect recovery time and gives you realistic expectations.

Still Nervous? That’s Normal

If you’re still feeling anxious about your first appointment, that’s completely normal. Most people are — especially if they’ve never been to a physio before or if they’ve had a bad experience elsewhere.

But here’s the thing: I’m not going to judge you, hurt you, or make you feel stupid for not getting it sorted sooner. I’m here to listen, figure out what’s wrong, and give you a clear plan to fix it.

And if you’re worried about pain during the assessment, tell me. I’ll modify what I’m doing. If you’re not comfortable with a particular test or treatment, say so. You’re in control of what happens, and I’ll respect that.

The worst thing you can do is let fear stop you from getting help. Most injuries don’t get better on their own — they just adapt and compensate, which creates new problems down the line. The sooner we address it, the easier it is to fix.

If you’re ready to book, get in touch. If you’ve got questions, message me. I’d rather answer them now than have you turn up nervous and unsure.

You’ll be fine. I promise.