In my experience, the best results are obtained when clients feel comfortable with their treatment. I always obtain my clients’ consent before any assessment or treatment begins and clearly explain what I am doing and why I am doing it throughout. Treatment options are always discussed and agreed with clients beforehand, especially if I think any equipment will be necessary.
Treatment normally consists of an initial appointment lasting approximately an hour and, if required, follow up appointments lasting 45 minutes.
Pregnancy-related conditions (see Conditions treated): I will take a detailed history from you at your first appointment, followed by assessment and treatment. This may involve removing some outer clothing, unless you would rather not. Treatment may include:
- advice on pain management
- postural and back care advice
- teaching gentle exercises and stretches (including core stability and/or pelvic floor (PF) muscle exercises) and advice on exercising safely during and after pregnancy
- manual therapy (ie hands on treatment), where appropriate
- advice on lifting techniques and transfers (including standing up from sitting, getting in and out of bed, and turning in bed)
- advice on delivery positions, if antenatal
- support belts and mobility aids, if necessary
If further physiotherapy is required, I will discuss this with you at the end of the appointment.
Gynaecological problems: it usually takes an hour during the first appointment to gather all the information required and to give appropriate advice. I do not routinely carry out an internal examination (to assess the state, tone and strength of your pelvic floor) (see The pelvic floor) until your second appointment, and then only if you agree. This is the best way for me to work out what your problems are and to decide on your treatment options. Understandably some clients are anxious about having an internal examination. As a woman who’s gone through this myself, I know how they feel! However, I have been performing vaginal examinations on a regular basis for some years now and I have never had any complaints. You are welcome to bring a chaperone with you, if that would make it a less daunting prospect. (I would also add that I do not use a speculum when carrying out an examination.) Hopefully I will have gained your trust and confidence by the time an examination is necessary. But, if you simply do not want to be examined, I am happy to treat you without one.
Treatment options include:
- teaching correct PF exercises and designing an exercise programme to strengthen the PF muscles
- bladder and bowel re-education
- dietary and lifestyle advice, including how to exercise without aggravating symptoms
- prolapse management advice
- biofeedback and electrotherapy, if necessary
Treatment for gynaecological problems usually takes 3 to 4 sessions, sometimes more if the problem is complex.