Most people book their first physio appointment with only a vague idea of what is about to happen. They know something hurts. They know a physio might help. Beyond that, you might have questions that feel slightly awkward to ask over the phone such as, will I need to take my clothes off? Is it going to hurt? Do I need a referral from my GP first? Should I have brought my scans?
None of those questions are silly, and all of them have straightforward answers. We walk through exactly what happens at your first physio appointment, from the moment you arrive to the plan you leave with. It covers what to bring, what to wear, how long the session takes, and what happens afterwards.
Do you need a referral to see a physio?
No. In Australia you can book a physiotherapy appointment directly, without seeing a doctor first. According to Healthdirect, the national government-funded health information service, you do not have to see your doctor for a referral to see a physiotherapist.
There are a few situations where a referral does apply, these include a Medicare care plan for an eligible chronic condition, treatment funded through a workers compensation claim, and treatment for Department of Veterans’ Affairs clients. If none of those apply to you, you can simply book a physio appointment directly from their website.
What to bring and what to wear
What to bring
Bring your referral if you have one, along with any scans, X-rays or specialist reports relating to the problem. Bring your private health card (such as Bupa, NIB, HCF, etc…) if you intend to claim on the day, and a list of any medications you take.
It also helps to bring anything physically connected to the injury, if practical and portable. For example, runners often bring their shoes. People with foot pain sometimes bring their orthotics. If your problem shows up during a particular activity, the equipment involved in that activity can tell your physio something useful.
What to wear
Wear clothing you can move comfortably in. Your physio needs to watch how you move, and jeans or a fitted work outfit make that harder.
If the problem is in your lower back, hip, knee, ankle or foot, shorts are ideal. If it is in your neck, shoulder or upper back, a singlet or a shirt that can be loosened at the collar works well. You will not be asked to undress beyond what is needed to assess and treat the area in question, and you can ask for a gown or a towel at any point.
We understand that most people may be coming by before or after work, or during their lunch break so it’s not always possible to be in loose and comfortable clothing, so do not stress if you come in your work clothes.
Wearing loose comfortable clothing that you can move around freely in is ideal
What happens during the appointment
The conversation comes first
Your first appointment always begins with a conversation, and that conversation usually runs longer than people expect. Your physio will ask what hurts, when it started, what makes it worse, what makes it better, and how it is affecting your sleep, your work and the things you enjoy doing.
Most of the diagnostic work happens here as the physiotherapist learns the pattern of your symptoms, the way the problem began, and the way it behaves across a day all narrow the possibilities considerably before any actual physical therapy begins.
Your physio will also ask what you want to get back to as that answer shapes the plan, because returning to a desk job and returning to a half marathon are different goals with different paths.
The physical assessment
Next comes the hands-on part of the assessment. Your physio will look at how you move, test the strength and range of the joints and muscles involved, and check whether nerves are contributing to your symptoms. Only what is relevant gets assessed. A knee problem does not require an examination of your shoulder, though it may well involve looking at your hip and ankle, since problems rarely stay neatly inside the area that hurts.
Explaining what is going on
Once your physio has gathered enough information, they will talk you through what they have found in plain language. This is the point at which most people relax. Pain that has no name is unsettling. Pain that has a name, a mechanism and a plan is a problem to be worked on. If your physio is uncertain, they will say so, and they will explain what would need to happen to become more certain. Not every presentation resolves into a tidy diagnosis on day one.
Treatment on the day
Most first appointments include some treatment, though what that looks like varies. It commonly involves hands-on techniques, some initial exercises, advice about what to do and avoid in the coming days, or a combination of the three.
Your plan
The physiotherapist will often give you a plan and some small exercises for you to do between appointments. That plan typically covers what happens next, roughly how many appointments a presentation like yours tends to involve, what you will do between sessions, and what signs would suggest the plan needs adjusting. Sometimes they might give you written instructions, or the plan can be emailed to you for easy reference.
How long does the first appointment take?
An initial consultation normally runs for 30 minutes. That is usually enough time for the history taking and full assessment. Follow-up sessions run anywhere from 30 to 60 minutes and focus on treatment and progression rather than assessment. Arriving five to ten minutes early gives you time to complete your paperwork without cutting into your session.
Will it hurt?
This is the question people most often want to ask and least often do. During the assessment, your physio may deliberately reproduce your symptoms for a moment. This is not carelessness. Recreating the pain in a controlled way is often how the source of it gets identified, and your physio will tell you before they do it.
Treatment itself is generally comfortable. Some hands-on techniques produce a firm or achy sensation while they are being applied. Some exercises feel like effort, though none of it should feel like something you need to endure in silence. You can ask your physio to stop or ease off at any point, and doing so does not compromise your treatment.
What happens after your appointment
You will usually go home with something to do. This might be a small number of exercises, a change to how you sit or sleep, or a temporary adjustment to your training. It is common to feel some soreness in the day or two after a first appointment, particularly after a thorough assessment – this is normal and to be expected.
Some things, though, warrant a doctor rather than a physio. Healthdirect advises seeking urgent care for back pain if you develop problems controlling your bladder or bowel, numbness around the groin or genitals, weakness or numbness in your legs or feet, a fever, unexplained weight loss, or if the pain follows an accident. If any of those apply, contact a doctor or call an ambulance rather than waiting for a physio appointment.
Otherwise, most people book their follow-up before they leave, because the timing of the second session is part of the plan rather than an afterthought.
Painful movements may be recreated so the physiotherapist knows what and how something might be causing pain
When physio is not the whole answer
Sometimes an assessment points somewhere other than physiotherapy, or somewhere in addition to it. Your physio may suggest exercise physiology if your goal involves longer-term conditioning or they may also refer you back to your GP for imaging, medication review or a specialist opinion such as a podiatrist for example.
It is worth knowing that imaging is not always necessary or helpful. For example, the Australian clinical guidance from the RACGP is clear that scans are not needed for most cases of acute low back pain and are only recommended where there is a strong clinical suspicion of a serious underlying cause. Unnecessary imaging can even do harm, through radiation exposure and by picking up incidental findings that lead to worry and further tests without improving recovery. Healthdirect makes the same point for patients, noting that scans and X-rays usually do not show the cause of the pain or change how it is treated. A good physio will tell you when a scan is genuinely warranted and when it is not and will refer you appropriately if it is.
Frequently asked questions
Do I need a referral to see a physio?
No. In Australia you can book a physiotherapy appointment directly. A referral is only required in specific funding situations, such as a Medicare care plan for an eligible chronic condition, a workers compensation claim, or treatment as a Department of Veterans’ Affairs client.
When would I actually need a referral for physiotherapy?
A referral matters when someone other than you is paying, because the funder sets the rules. For a Medicare care plan, your GP has to set the plan up first and refer you before the subsidised sessions can go ahead. For a workers compensation injury, treatment is tied to an open claim, so you need your claim details before booking. For Department of Veterans’ Affairs clients, treatment is arranged under a valid referral linked to your entitlement. Outside these situations you do not need a referral, and if you turn up without one for a standard private appointment, nothing changes about the care you receive.
What should I wear to my first physio appointment?
Wear clothing you can move in. Shorts suit a lower back, hip, knee or ankle problem. A singlet or an adjustable shirt suits a neck or shoulder problem. You will not be asked to undress beyond what the assessment requires, and a gown or towel is available.
How long does a first physio appointment take?
An initial consultation normally runs for 30 minutes, covering the history taking and full assessment. Follow-up sessions run anywhere from 30 to 60 minutes and focus on treatment and progression. Arriving a few minutes early leaves time for paperwork.
Will I get treatment on the first visit?
Most first appointments include some treatment. This commonly involves hands-on techniques, initial exercises, or advice about activity in the coming days. What is appropriate depends on the assessment findings, so treatment is not guaranteed on day one.
Does private health insurance cover physio?
Physiotherapy is commonly covered under extras policies, though the rebate varies considerably between funds and policies. Annual limits, waiting periods and whether the fund pays a percentage or a set amount all affect what you get back. Check with your fund before booking.
How many physio sessions will I need?
This varies with the condition, how long it has been present, and your goals. Your physio will give you an estimated range at the first appointment and revise it as they see how you respond. Anyone who promises a fixed number before assessing you is guessing.
Booking your first appointment
A first physio appointment is mostly conversation and assessment. You will be asked a lot of questions, examined carefully, told what your physio has found, and given a plan. Nothing will happen without it being explained to you first, and nothing will happen that you have not agreed to.
If you are ready to get started, you can book an appointment at our Sydney CBD clinic on Bathurst Street, a short walk from Town Hall and directly next to the Gadigal Metro Station.
