The Questions I Wish I Asked as a New Pelvic Health Physio

Starting out in pelvic health physiotherapy is both exciting and overwhelming. You've completed your training, you're eager to help people, and then reality hits. The complexity of cases, the emotional weight of the work, and the gaps between textbook knowledge and clinical practice can feel enormous.

Looking back on my early years, there are questions I wish I'd asked sooner. Not because I lacked the training, but because some lessons only make sense when you're in the thick of it. If you're a new or aspiring pelvic health physio, these reflections might just save you some of the trial and error I went through.

"How Do I Know When NOT to Treat?"

Early on, I was so focused on helping everyone that I didn't always recognize when a patient needed referral rather than treatment. I learned the hard way that persistent pain without improvement, psychological trauma beyond my scope, or red flags I wasn't confident managing all warranted a different approach.

Knowing your limits isn't a weakness. It's professional responsibility. Building a network of GPs, gynaecologists, colorectal specialists, psychologists, and pain consultants became just as important as my treatment skills.

The lesson: Your scope of practice has boundaries for a reason. Refer early, refer often, and never be afraid to say "I think you need additional support."

"What Do I Do When Internal Examinations Feel Awkward?"

Nobody talks enough about how uncomfortable it can be at first to perform internal assessments. The training prepares you technically, but not always emotionally. I remember feeling nervous, worrying about patient comfort, second-guessing my findings, and wondering if I was doing it "right."

Here's what helped: slowing down, communicating constantly, normalizing the process for patients, and remembering that my discomfort was temporary but their care wasn't optional. With time and supervision, confidence came.

The lesson: Feeling awkward is normal. Practicing with mentorship, asking for feedback, and prioritizing patient communication makes all the difference.

"How Do I Talk About Sex Without Blushing?"

Sexual function is a huge part of pelvic health, but it took me a while to discuss it comfortably. I'd dance around the topic or wait for patients to bring it up, which meant many people left without addressing a major concern.

Learning to use direct, clinical language while remaining warm and empathetic changed everything. "Are you experiencing pain during penetration?" became easier than vague questions about "intimacy."

The lesson: Your comfort level sets the tone. If you're matter-of-fact and professional, patients feel safe to be honest.

"What If My Treatment Isn't Working?"

I used to take it personally when patients didn't improve. I'd question my assessment, wonder if I'd missed something, or feel like I was failing them. The truth is, pelvic health is multifactorial. Sometimes progress is slow. Sometimes patients aren't ready for certain interventions. Sometimes there are contributing factors beyond my control.

I learned to reassess regularly, adjust treatment plans, collaborate with other professionals, and have honest conversations with patients about progress and expectations.

The lesson: Not every case follows a linear path. Adaptability and communication matter more than perfection.

"How Do I Manage the Emotional Load?"

Pelvic health physiotherapy involves trauma, pain, fertility struggles, grief, and deeply personal stories. I wasn't prepared for how much I'd absorb emotionally. Compassion fatigue crept up on me before I realized I needed boundaries.

Supervision, peer support, and my own therapy became essential. So did learning when to hold space for emotions and when to gently redirect focus to functional goals.

The lesson: You can care deeply without carrying it all. Protect your mental health as fiercely as you protect your patients' dignity.

"Why Didn't I Ask for Help Sooner?"

Pride, imposter syndrome, fear of looking incompetent—these all kept me from reaching out when I was struggling. I thought I should have all the answers because I'd done the training. But training is just the beginning.

The physios who thrived weren't the ones who knew everything. They were the ones who asked questions, sought mentorship, attended peer groups, and acknowledged when they needed guidance.

The lesson: Asking for help is a sign of professionalism, not weakness. The best clinicians are lifelong learners.

"What About Business Skills?"

Clinical skills are crucial, but nobody tells you how much you'll need to understand about marketing, billing, patient communication, time management, and professional boundaries. Whether you're working privately or in the NHS, navigating the business side of practice is essential.

I wish I'd asked more about how to structure consultations, how to communicate value to patients, how to market ethically, and how to avoid burnout while building a caseload.

The lesson: Being a great clinician isn't enough. Understanding the business of healthcare makes your career sustainable.

The Questions You're Asking Right Now Matter

If you're in the early stages of your pelvic health career and you're asking these kinds of questions, you're already ahead of where I was. Curiosity, humility, and a willingness to learn are your greatest assets.

You don't have to figure it all out alone. The path is clearer when you have guidance, support, and someone who's been where you are now.

Ready to Take the Next Step?

If you're asking some of these questions now, you don't have to figure it out alone. My mentorship programme was designed for this exact stage—bridging the gap between qualification and confident, sustainable practice.

👉 Learn how to join and get the support you deserve.