You prepare for physiotherapy by bringing three things, wearing one kind of clothing, and arriving in one particular state. Bring your imaging reports, referral letter if you have one, a written list of your medications and supplements, and your benefits card. Wear loose, stretchy clothing that lets us reach the area we are treating, along with flat supportive shoes. Arrive 10 to 15 minutes early, after a light meal and a glass of water, with your symptom history written down.

That is the short answer. The longer answer covers what to write down about your pain, what to tell us before you arrive rather than during your session, what happens minute by minute during a first assessment, how your body responds in the 24 hours afterward, and why the quality of your preparation shapes your recovery far more than most patients expect.

How Do You Prepare for Physiotherapy?

You prepare for physiotherapy in three parts: what you bring, what you wear, and how you arrive. Each part removes a different obstacle from your first session. Documents remove guesswork from your history. Clothing removes barriers from the physical examination. Arriving early and fed removes the rush from the first 10 minutes, which is when we gather the information that shapes everything after it.

Those three parts exist because a first appointment is an assessment before it is a treatment. The assessment depends on information, and most of that information comes from you rather than from a chart. Patients who arrive with their history organized routinely get more treatment time in the same appointment slot, because the history-taking portion moves faster and lands more accurately.

Accuracy in that first hour carries real weight. In a review of 122,723 low back pain patients within the Military Health System, Childs and colleagues reported in BMC Health Services Research that only 24 percent received early physiotherapy that followed active-treatment guidelines, and that group recorded 60 percent lower total low-back-pain-related costs over two years. A separate review of nearly 980,000 American adults, published in the same journal, found only 11 percent started physiotherapy within two weeks of their symptoms beginning. Starting well and starting early both matter, and preparation is the part of that equation you control. Our physiotherapy in Markham begins with a movement and functional assessment, so the better your inputs, the faster we reach a working plan.

What Do You Need to Bring to Your First Physiotherapy Appointment?

You need to bring your imaging reports, your referral letter if a physician gave you one, a written list of every medication and supplement you take, your extended health benefits card, and the contact details of any other practitioner involved in your care. These five items cover the documented half of your history. The written half, your symptoms, you supply yourself, and that gets its own section below.

Bring the actual reports rather than a summary from memory. An X-ray, MRI or ultrasound report tells us what structures were imaged, what the radiologist measured, and what was ruled out. A patient recalling that a scan showed “something in the shoulder” gives us almost nothing to work with. Reports also prevent duplicate investigation, which is one of the quieter costs of poor preparation.

Medication lists matter for a similar reason. Anti-inflammatories mask pain response during testing, muscle relaxants change tone, blood thinners change which manual techniques are appropriate, and supplements interact with all of it. Write the list down rather than reciting it, including dosages and how long you have taken each one.

Here is the full checklist, in the order it is worth assembling:

1. Imaging reports and results. X-rays, MRI scans, ultrasounds, bone density reports, and any specialist letters relating to the area.
2. Referral letter, if you have one. Not required in Ontario, but useful when a physician has a specific post-operative or diagnostic instruction.
3. Medication and supplement list. Prescription and over-the-counter, with dosages, covering anything taken in the last month.
4. Extended health benefits card. Bring it to your first visit so coverage is confirmed on the spot.
5. Claim details, if applicable. WSIB claim numbers or motor vehicle accident file information, including adjuster contact details.
6. A list of your other practitioners. Family physician, surgeon, specialist, chiropractor, so findings can be shared at your request.
7. Glasses, hearing aids, braces, splints or orthotics you currently use. We assess how you function with the equipment you actually live with.
8. Your written symptom history. The single most valuable item on this list, covered in detail below.

Assemble the stack the evening before rather than the morning of. Patients who leave it to the morning arrive rushed, and rushed patients forget the imaging report almost every time. If you are unsure whether a document is relevant, bring it anyway and let us decide. You can always call ahead and book your appointment with a question attached about what your particular case needs.

Do You Need a Referral for Physiotherapy in Ontario?

No, you do not need a referral for physiotherapy in Ontario. Physiotherapists in Ontario are primary care practitioners, which means you can book directly without a physician sending you. Direct access exists precisely so that musculoskeletal problems reach assessment quickly rather than waiting in a queue behind a referral.

Referral requirements do still appear in one place: insurance policies. Some extended health plans reimburse physiotherapy only when a physician has requested it, so the referral is a billing document rather than a clinical one. Check your specific policy wording before your first visit, because the requirement varies between carriers and even between plans from the same carrier. Patients in Markham are often surprised by this distinction, and it is worth five minutes on the phone with your benefits provider.

Supply is not the barrier it once was either. The Canadian Institute for Health Information reported 21,683 physiotherapists employed in direct patient care across Canada in 2024, an increase of 1,008 in a single year, and a national supply of 30,776 licensed physiotherapists. Density rose from 6.3 to 6.8 physiotherapists per 10,000 population between 2020 and 2024.

How Should You Describe Your Symptoms to a Physiotherapist?

You describe your symptoms to a physiotherapist by answering six specific things: when it started, how it started, where exactly it sits, how it behaves across a 24-hour day, what makes it worse and better, and how intense it is on a scale of zero to ten. Those six points are the clinical reasoning skeleton every assessment hangs on, and a patient who arrives with them written out has effectively done the first 15 minutes of the appointment already.

Onset and mechanism come first because they separate categories of injury. A shoulder that started hurting the morning after a moving day behaves differently from a shoulder that has crept up over eight months at a desk. Write the date as closely as you can recall, and write what you were doing when you first noticed it, even if the activity seemed harmless.

Location needs precision rather than region. “Back pain” covers a dozen structures; “a band across the lower back that sometimes shoots down the back of the left thigh to the knee” points at a specific pattern. Trace the path with a finger before you come in, and note whether it stays put or travels.

Behaviour over 24 hours is the point competitors almost never explain, and it separates inflammatory patterns from mechanical ones. Note what the first 30 minutes after waking feel like, what happens by mid-afternoon, what happens after sitting for an hour, and what happens overnight. Overnight pain that wakes you is a different signal from pain that only appears at the end of a long day.

Aggravating and easing factors turn that pattern into a testable hypothesis. List the three activities that reliably worsen it and the three positions or actions that reliably settle it. Our our physiotherapists use those lists to design your loading, which is why they feed directly into any exercise rehabilitation plan we build for you.

Intensity closes the picture. Give three numbers rather than one: your pain at its best, at its worst, and right now. A single average number hides the range, and the range is what we track to measure whether treatment is working.

What Should You Wear to Your First Physio Appointment?

You should wear loose, stretchy clothing that exposes or allows easy access to the area being treated, along with flat supportive shoes. Athletic wear works best: gym shorts, leggings, track pants, a t-shirt or tank top. Avoid jeans, dress trousers, work clothing, restrictive waistbands, bulky jewellery and anything that will not stretch when you move.

The reason is simple mechanics. A physiotherapy assessment involves watching joints move through full range, palpating tissue directly, and often treating on the same visit. Denim does not bend where a hip needs to bend, and a stiff waistband hides exactly the lumbar segment we need to see. Clothing that restricts movement produces a restricted assessment, and a restricted assessment produces a weaker plan.

What counts as appropriate clothing shifts with the body region involved. The table below sets out the practical version for the areas we assess most often at our clinic.

Area being treated	What to wear	What to avoid	Why the access matters
Low back and pelvis	Loose shorts or leggings with a low, soft waistband; a shirt that lifts freely	Jeans, belts, high rigid waistbands, one-piece garments	We palpate lumbar segments and watch spinal movement from the ribs to the hips
Neck and upper back	A t-shirt, tank top or sports bra; hair tied back	Turtlenecks, hooded tops, scarves, necklaces	Cervical rotation, shoulder blade position and upper rib motion all need a clear view
Shoulder	Tank top, sleeveless shirt or sports bra	Fitted sleeves, thick sweaters, shoulder-strap bags	Rotator cuff testing requires the whole shoulder girdle to be visible and free
Hip and groin	Athletic shorts above mid-thigh	Long trousers, compression tights, tight denim	Hip range testing takes the joint through positions long trousers block
Knee	Shorts that sit above the knee	Full-length leggings, jeans, knee-length skirts	We compare both knees for swelling, alignment and kneecap tracking
Foot and ankle	Shorts or rolled-up trousers, plus the shoes you walk in daily	Boots, high heels, tight socks	Gait analysis needs the ankle visible and your usual footwear on hand

Footwear deserves its own note. Bring the shoes you actually walk in most days rather than a clean pair, because wear patterns on the sole tell us how you load your foot. That same information feeds decisions about custom orthotics when the assessment points that way.

Do You Have to Remove Clothes for Physio?

You do not have to remove clothes for physio beyond what gives access to the area being treated, and you are always asked first. Most assessments happen fully clothed when patients arrive in suitable athletic wear, which is the entire reason we give clothing guidance in advance.

Where access is genuinely needed, for instance exposing the lower back or a shoulder, we explain what we need to see, why we need to see it, and what we intend to do before anything happens. Draping and gowns are available at every visit. You can decline any part of an examination at any point, and consent is confirmed as we go rather than assumed once at the start.

Should You Wear a Bra to the Physio?

Yes, wear a bra to the physio, and a sports bra is the better choice for neck, shoulder, upper back or rib assessments. A sports bra leaves the shoulder blades and upper thoracic spine accessible while keeping you covered, which removes the need for gowning during most upper-body work.

Underwire bras with wide bands sit directly over the mid-back segments we often need to reach, so a racerback or cross-back sports bra usually works better. If your appointment involves the lower body only, wear whatever you would normally wear to exercise.

What Should You Tell the Clinic Before Your Appointment?

You should tell the clinic before your appointment about anything that changes whether physiotherapy is the right starting point or changes how we handle you physically. That list is short and specific: recent surgery and its post-operative protocol, a fall or accident where the area has not yet been imaged, fever alongside your pain, new or spreading numbness, weakness that is getting worse rather than better, unexplained weight loss, pregnancy, and any bleeding disorder or blood-thinning medication.

A red flag in physiotherapy means a sign or symptom that suggests your problem may need medical investigation before or alongside hands-on treatment. Red flags are not a reason to avoid physiotherapy. They are a reason for a phone call first, so the right assessment happens in the right order and your appointment is booked with the right practitioner and the right amount of time.

Pregnancy is worth flagging early for a different reason. It changes positioning, changes which techniques are suitable, and may point toward pelvic floor therapy as part of the plan rather than a general musculoskeletal approach. Post-surgical cases are similar: bring the surgeon’s written protocol, because timelines for weight-bearing and range differ between procedures and between surgeons performing the same procedure.

Telling us in advance also protects your appointment time. A 45-minute slot spent discovering an unhealed fracture is a slot that produces no treatment, whereas the same information given on the phone lets us plan around it before you arrive.

What Do They Do at Your First Physio Appointment?

At your first physio appointment they take a detailed health history, run a full movement and functional assessment, explain the findings, usually begin treatment, and send you home with an exercise programme. Our initial assessments run 45 to 60 minutes, which is longer than follow-up visits because the assessment portion carries most of that time.

The session moves through a predictable sequence:

• History. Your six symptom points, your medical background, your medications, your work setup, your activity level, and what you want to get back to doing.
• Observation. How you stand, how you sit, how you walk, how you get up from a chair, and how you hold the painful area at rest.
• Active movement testing. You move the joint yourself while we measure range and watch quality, direction of restriction, and where symptoms reproduce.
• Passive and manual testing. We move the joint for you, palpate tissue, and test specific structures to narrow down which ones are involved.
• Strength and control testing. Muscle strength, balance, coordination and the way you distribute load between limbs.
• Functional testing. The specific task that matters to you, whether that is a squat, a stair, a overhead reach, or a running stride.
• Explanation and goal setting. We tell you what we found in plain terms, what we think is driving it, and how long a reasonable timeline looks.
• Treatment and home programme. Manual therapy, joint mobilization, soft tissue work or exercise, followed by the programme you take home.

Every step feeds the next, which is why the physiotherapy assessment comes before any technique is chosen. Working in a multidisciplinary clinic in Markham means the explanation step sometimes ends with a second recommendation, and chiropractic care or another discipline gets folded into the plan when the findings point that way.

What Are Some Good Questions to Ask a Physiotherapist?

Good questions to ask a physiotherapist are the ones that turn a diagnosis into a plan you can actually follow. Write them down before you come in, because first appointments carry a lot of information and questions are the first thing patients forget.

The strongest six are these. What exactly is causing my symptoms, in plain language? What is a realistic timeline for improvement in my case? How often should I be coming in, and for how many weeks before we reassess? What should I stop doing right now, and what can I keep doing? How will we know the plan is working, and what measurement are we tracking? What happens if I am not improving on schedule?

Ask about the home programme specifically as well. How many days a week, how many repetitions, what resistance, and what level of discomfort is acceptable while doing it. Vague home programme instructions are one of the most common reasons patients stop doing them, and a five-second clarification at the clinic prevents three weeks of guessing at home.

How Will You Feel After Your First Physiotherapy Session?

After your first physiotherapy session you will commonly feel mild muscle soreness, general tiredness, and sometimes a temporary increase in stiffness that settles within 24 to 48 hours. This response is normal and expected. Your tissue has been loaded and tested in ways it has not been loaded in weeks or months, and your nervous system has been busy for an hour.

Tiredness after physiotherapy happens because assessment and treatment demand real physical and neurological work. Muscles that have been guarding an injured area finally release, previously avoided movement patterns get used again, and manual therapy drives a local circulatory and neural response. Patients frequently describe the feeling as similar to the day after a first session back at the gym.

What If You Feel Very Stiff or Sore After a Session?

If you feel very stiff or sore after a session, gentle movement and hydration settle it faster than rest does, and you should tell us at your next visit so the dosage gets adjusted. Soreness that peaks within 24 hours and fades by 48 is an expected training response. Soreness that intensifies past 48 hours, or that comes with swelling, sharp pain or new numbness, is something to phone us about rather than push through.

Adjustment is routine and expected. Treatment dosage is set from an educated estimate at visit one and refined once we see how you respond, which is exactly why the report you give at visit two is so useful. Supporting work such as massage therapy or laser therapy sometimes gets added at that point to manage tissue response between sessions.

Do’s and Don’ts After Physiotherapy

The do’s after physiotherapy are to drink water, keep moving gently, do your prescribed exercises, apply whatever heat or ice your physiotherapist recommended, and sleep well that night. The don’ts are to skip the home programme, to add extra repetitions beyond what was prescribed, to test the injury with a heavy or high-risk activity, and to sit completely still for the rest of the day.

Water and movement both support tissue recovery after manual therapy, and a short walk usually eases post-session stiffness faster than an afternoon on the couch. Keep the walk easy. The goal in the first 24 hours is circulation rather than training.

Adding extra repetitions is the single most common mistake motivated patients make. More is not better in the early phase, because the prescribed dose is calibrated to what your tissue currently tolerates rather than to what you wish it tolerated. Exceeding it produces a flare that costs you a week.

Why Preparation Changes Your Physiotherapy Results

Preparation changes your physiotherapy results because the largest variable in your recovery is not the hour you spend in the clinic, it is the work you do in the days between visits. Home exercise adherence is where physiotherapy outcomes are won or lost, and the research on adherence is sobering.

A systematic review summarized in JMIR mHealth and uHealth found average adherence to prescribed home exercise programmes of 67 percent across 12 studies, with non-adherence in rehabilitation estimated as high as 50 percent. A separate pooled review of 23 studies, reported in Patient Preference and Adherence, put adherence as low as 21 percent. Adherence also decays: in an eight-week home programme study published in JMIR, adherence fell from 86 percent in the first two weeks to 57 percent in the final two, and a prospective cohort of older adults found a mean adherence rate of 65 percent that declined over time.

The decay is predictable, which makes it manageable. A Dutch multicentre cluster randomized trial across 58 primary care physiotherapy practices, analyzed in BMC Health Services Research, tracked three adherence trajectories among low back pain patients: 45 percent stable, 43 percent increasing, and 12 percent declining. Patients whose adherence held or grew were the ones with clear, specific, written instructions and a scheduled time to do them.

That is preparation applied forward. Block the time in your calendar the same day you receive the programme. Write down the frequency, repetitions and resistance rather than relying on memory. Ask for a demonstration before you leave. Structured physiotherapy treatment and a structured week at home are two halves of the same plan, and the CDC identifies physical therapy as an important first-line option for managing pain without high-dose prescription medication, which only holds when the prescribed work actually gets done.

How to Prepare for Follow-Up Physiotherapy Sessions

You prepare for follow-up physiotherapy sessions with a short report rather than a document stack: how the last session felt afterward, how many days you completed your exercises, which exercise gave you trouble, what activity has improved, and what has not changed. Two minutes of that report redirects a whole session.

Wear the same category of clothing you wore to the assessment, because follow-ups are usually more active than the first visit rather than less. Bring water. Eat something light an hour or so beforehand for the same reason you did the first time, since sessions involving sustained exertion go poorly on an empty stomach.

Post-surgical follow-ups carry one addition. Bring any updated instruction from your surgeon after each check-in appointment, because weight-bearing status and range restrictions change at defined milestones and your programme changes with them. Where pain limits your ability to complete the prescribed work, techniques such as medical acupuncture are sometimes added to keep the plan moving on schedule.

Frequently Asked Questions

How Long Is a Physiotherapy Session?

A physiotherapy session runs 45 to 60 minutes for an initial assessment and typically 30 to 45 minutes for follow-up visits. The first appointment is longer because history-taking and the full movement assessment occupy most of it. Arriving 10 to 15 minutes early protects that time, since paperwork completed in the waiting room is time not taken from your assessment.

How Many Physiotherapy Sessions Will I Need?

Most patients see meaningful improvement within six to ten sessions, though the number varies with the nature of the injury, how long it has been present, and the goal you are working toward. Your physiotherapist gives an estimate after the initial assessment and reassesses regularly so the plan stays accurate as you progress.

What Are the Four Main Types of Physiotherapy?

The four main types of physiotherapy are musculoskeletal or orthopaedic physiotherapy, neurological physiotherapy, cardiorespiratory physiotherapy, and paediatric physiotherapy. Musculoskeletal physiotherapy covers joints, muscles, tendons and bones, and is the type most patients attending an outpatient clinic receive. Preparation guidance is broadly the same across all four, with clothing and access adjusted to the area being assessed.

Should You Eat Before Physiotherapy?

Yes, eat before physiotherapy, and keep it light. A small meal or snack about an hour before your appointment supplies energy for exertion without leaving you heavy during floor work or manual therapy. Drink water beforehand as well, since hydrated muscle tissue responds better to stretching and soft tissue work than dehydrated tissue does.

Can You Drive After Physiotherapy?

Yes, you can drive after physiotherapy in most cases, since treatment does not involve sedation or anything that impairs alertness. Two situations call for a ride instead: treatment to the neck or shoulder that temporarily limits your ability to check blind spots, and any session that leaves your driving leg noticeably weak or sore. Ask your physiotherapist directly if either applies to your visit.

When Should You Call the Clinic Before Booking Physiotherapy?

You should call the clinic before booking physiotherapy when you have fever alongside your pain, new or spreading numbness, weakness that is worsening, unexplained weight loss, a recent accident where the area has not been imaged, or surgery within the past few weeks. A short conversation confirms the right starting point and the right length of appointment.

What Does a Physiotherapist Assess at the First Visit?

A physiotherapist assesses your movement range, muscle strength, joint mobility, balance, coordination, posture, gait and functional capacity at the first visit, alongside a detailed history of your symptoms and medical background. Palpation of the affected tissue and specific structural tests narrow the findings down to the structures driving your symptoms. A full range of rehabilitation services can then be matched to what the assessment shows.

The Bottom Line

Preparation for physiotherapy comes down to three things you can finish the night before your appointment. Gather your imaging reports, medication list and benefits card. Lay out loose athletic clothing that gives access to the area being treated, with the shoes you actually walk in. Write down your six symptom points, your questions, and anything the clinic should know before you arrive. Then eat lightly, drink water, and get there 10 to 15 minutes early.

What follows that first session matters just as much. The research is consistent that home exercise adherence drives outcomes, and adherence decays without structure, so block the time, write down the exact prescription, and report honestly at every follow-up. Preparation is not a one-time task before visit one; it is a short habit that repeats before every session and keeps your recovery moving on schedule. If you are ready to get started, the team at KC Rehab in Markham is glad to answer a preparation question before you come in, and you are welcome to reach us at (905) 205-1668.