No, Physiotherapists are considered Primary Health Care Providers, meaning Physiotherapists have the expertise to assess patients directly. However, if you have extended health insurance through your workplace it may require you to have a doctor’s referral for reimbursement of physiotherapy services. You may check by simply calling your extended health insurance or your employer. We always encourage our patients to involve as many as their providers in their treatment plans. With your permission, we will include your doctor and utilize them for any follow-up procedures/tests when necessary.
Your first physiotherapy appointment begins the unique process, Your Path to Improved Health. The first visit involves Clarifying Your Injury/Complaint step.
The initial assessment is an integral piece of your Path to Improved Health. This is your opportunity to discuss why you are visiting our facility with your professional, skilled physiotherapist.
At GWHA we offer extended first visit time appointments so that you can sit back and relax and share your story.
Our assessment includes:
- a detailed review of what brings you to the clinic and your relevant medical history
- a full physical examination that may include a range of motion, strength, orthopaedic and other specialized tests (you may be required to wear shorts or a gown for better visibility)
- At GWHA if you are being seen for a pelvic health concern, you will likely be asked to participate in an internal pelvic assessment
We get asked this question all the time! Your first assessment is when your physiotherapist wants to get to know you better so we start by asking you questions about what is happening so we get a better bigger picture and the bigger idea of what brings you in for physiotherapy. To answer the question in short, NO, your first assessment or your follow-up treatment sessions don’t always need an internal examination. We can work on your connective tissue, the trigger points, work to assess the joints and work some of the nerves. However, when we do an internal assessment, it helps complete the picture and adds that missing piece of the puzzle so we can treat you as a whole, instead of specific aspects of your body.
During the pelvic floor assessment, we give a detailed review of pelvic floor anatomy so that our clients understand key muscles and areas of concern.
- We observe and palpate the general state of the pelvic floor with gentle palpation
- Assessing for areas of thickening, tenderness or other symptom reproduction
- Ensuring that the vaginal tissue has normal mobility
- We assess through manual palpation the tone of the pelvic floor muscles
- Assessing for pelvic floor muscles that may be “tight” or have “trigger points”, which often are painful
- Assessing for weak pelvic floor muscles
- Assessing the coordination of the pelvic floor with breathing
- Assessing the ability to relax the pelvic floor
- Assessing the ability of the pelvic floor to counter downward forces that are created with activities like a cough or sneeze
- Observing and assessing the pelvic floor for areas of prolapse
- Other unique areas that are assessed at our Women’s Health focused area of practice include:
- Integrity of the abdominal muscles (looking for the presence of Rectus Diastasis) to close adequately and generate the necessary core stability force
- Symmetrical positions of the sacroiliac joints (SIJ)
- Following your assessment, your physiotherapist will explain your treatment plan and clarify timelines involved for recovery, as well as discuss any outstanding concerns
- This is often an opportunity to highlight any other resources that may be useful to accelerate recovery.
If you just gave birth to your baby and are wondering whether or not to come to see your pelvic floor physiotherapist. You don’t always have to wait until the six-week mark. If you are feeling pain while you’re moving around the bed, feeding the baby or especially when you’re getting into a position to hold the baby, your physiotherapist can definitely help you with that. We might not do an internal examination before that six-week mark but we can definitely help you get back to going about your everyday life.
Whether you’re on your period or not coming to pelvic floor physiotherapy is always a good idea. It is not a contraindication or is not something that stops us from providing you with the best care possible. It comes down to your comfort level, if you are comfortable with us working alongside you when you’re menstruating, then we are comfortable working with you as well.
If you are more comfortable not coming in during your period or just like to take that day for yourself we completely understand and we can always reschedule your appointment.
Physiotherapists help you when you are in the discomfort of having a UTI. We may not always do we go in internally when treating you when you’re experiencing a UTI. We use a lot of the tool sets that we have for treating clients externally such as connective tissue rolling and soft tissue release to help you reduce your discomfort. So, the next time around when there is a UTI present make sure to go visit your physiotherapist.
It is entirely up to you whether we’re not your family member wants to accompany you to your appointment. As a physiotherapist, we will ask if you are consenting to have your family member present as we talk about some personal stuff. If you’re completely OK with having your family member listen to your subjective and objective history as well as your medical history you’re totally welcome to bring them in. If not then it’s better if they wait in the waiting area.
Many extended health care policies do provide physiotherapy coverage. However, we always recommend that you contact your provider to determine whether or not you are covered and the amount which your provider will cover you for. Some insurance companies will allow us to bill them directly. However, we do have specific guidelines which must be followed in order to do so. Otherwise, you are billed directly and provided with a detailed statement for you to submit to your insurance provider for reimbursement. Most of our sites allow our clients 30 days to remit to their insurance company before our payment is expected.
OHIP does not cover any physiotherapy services.
If there are any concerns with funding, we encourage you to discuss this with your physiotherapist. Many conditions that we see are successfully treated in a timely cost-effective manner. In order to expedite a quick recovery, we always give home exercises.
Pelvic physiotherapy is provided exclusively by a Registered Physiotherapist and falls under the same as umbrella as physiotherapy.
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