Frequently Asked Questions (FAQ)

Here are some common Frequently Asked Questions (FAQ) about treatments at Metamed. If you do not see your question answered please use the contact form to ask for further information.

Osteopathy
Pelvic Floor Physiotherapy

Osteopathy

Do I need a referral to see an Osteopath?

No. As a primary healthcare practitioner you do not need a referral to see an Osteopath. ACC claims for musculoskeletal injuries can also be filed by an Osteopath. If you are unsure if you will be eligible please use the contact form and leave your phone number to discuss your situation.

Is my appointment covered by ACC?

If you have sustained a musculoskeletal injury due to an accident, in most cases you will be able to lodge an ACC claim at the time of your appointment. If you have lodged a claim with your GP (please check if codes claimed for can be treated by a physical therapist) or have had treatment from another therapist (Osteo, Physio, Chiro or Acupuncturist) please bring relevant paperwork with you to your appointment (claim number and date of claim).

If you have had treatment with another therapist other than an Osteopath you are still eligible to use the same claim number for Osteopathic treatment.*

ACC covers part of the cost of treatment, there is a gap to pay. Please click here for treatment rates.

If your claim is rejected or invalid you will be required to pay the difference for your appointment.

*Claims are valid for use for 12 months from date of claim.

What treatment methods are used?

An integrative approach is taken with treatment utilising a variety of skills and treatment techniques appropriate for your individual concerns.

Soft tissue massage
Fascial release
Muscle Energy Technique (MET)
Joint manipulation- articulation and high-velocity manipulation otherwise known as ‘cracking’
Cupping
Herbal Medicine
Psychosomatic Therapy
Prescriptive exercises and stretches

Can Osteopaths treat pregnancy-related issues?

Osteopaths are able to safely treat pregnancy-related issues such as back pain, joint pain and instability (sacro-iliac dysfunction, pubic symphysis dysfunction), headaches/migraines, general tension, indigestion/heartburn. Pregnancy doesn't have to be uncomfortable. A custom made pregnancy pillow allows you to lay face down during treatment.

Post-natal care is also very effective in helping your body adjust to your new role as a mum and the possible strains of feeding and carrying your newborn.

What if I need X-Rays?

Osteopaths are able to refer for imaging such as x-rays and ultrasound. If the area requiring imaging is due to an ACC-related injury part of the cost may be subsidised. You will need to call your local imaging centre for prices as these vary.

How many treatments will I need?

The number of treatments needed is highly variable dependent on the type of injury, how long you have had it, and other lifestyle factors. Your Osteopath will discuss this with you during your appointment.

Generally, you will notice a change within 3-5 treatments (if not sooner). Your progress is reviewed at each treatment. If you are not responding to treatment a change in approach or further referral may be required. Your Osteopath will discuss this with you so you have a full understanding of your situation. The aim is to get improvement with the least amount of treatments. In general, the first few treatments are closer together in time frame with the aim to spread treatments out as soon as possible and have you independent of treatment.

What does an Osteopathy appointment involve?

During your initial appointment extra time is allowed to gather detailed information about your presenting complaint and your medical and lifestyle history. A thorough physical examination is then performed which may include testing your range of motion in certain joints, and more specific neurological and orthopaedic testing dependent on your presentation. This allows us to form a working diagnosis and therefore how your treatment is approached.

Your Osteopath will explain the diagnosis to you and discuss different treatment approaches which may be appropriate. In some cases referral back to your GP or another practitioner may be required.

Up to an hour is allowed for the initial consultation. This allows for a thorough understanding of your condition and for treatment to take place.

Follow up appointments may be required to achieve best results. Our aim is for you to become independent and not have to rely on treatment on a frequent or regular basis. Return appointments are up to 30 minutes or extended 45-minute appointments are available for more complex cases. Your progress is reviewed every treatment and treatment adjusted accordingly. Some conditions may improve quicker with a prescription of specific exercises which your Osteopath will advise you of.

Will I need to undress?

As Osteopaths do a thorough assessment of the body it is easier to see how the body is moving without some clothes on. As there is a hands-on approach to treatment using techniques such as massage, cupping and stretching, it is easier to work with certain areas exposed. Areas not being worked on will be kept covered and warm. If you are uncomfortable getting undressed we will do our best to treat what we can.

What is the difference between structural and cranial osteopathic treatment?

Structural treatment involves more direct techniques such as soft tissue massage, joint articulation, manipulation etc…

Cranial treatment is sometimes referred to as being indirect- it uses a very gentle contact with subtle movements to influence tension and fluid movement throughout the body.

Dr Jin offers structural treatment. It is important to note that structural treatment can also be applied gently and is suitable for children and elderly.

What is the difference between Osteopathy, Chiropractic, and Physiotherapy?

Every practitioner within each industry has their own unique way of treating, therefore it is difficult to describe what the difference is between the three modalities. If you have seen different therapists before you have probably experienced this.

Osteopathy Australia states that it is ‘not the role of any health professional to try and define what another health care professional is, and what they do. For further information about Chiropractic please visit the Chiropractic section on the ReMed website or see the following sites.

Chiropractic visit: http://chiropractors.asn.au

Physiotherapy: http://physiotherapy.asn.au

If you wish to find out more please use the contact form and leave your name and number to discuss this.

Can I claim private health insurance?

Yes, this is dependent on the type of cover you have with your provider. Rebate amounts differ between providers and the extent of your cover- please contact your health insurance provider for details. All appointments are required to be paid in full on the day. A receipt will be issued via e-mail which can be used to lodge a claim with your insurance provider.

Pelvic Floor Physiotherapy

What is Pelvic Floor Physiotherapy?

Pelvic Floor Physiotherapy is a special interest field of Physiotherapy, aimed at assisting those with pelvic floor dysfunction back to optimal pelvic health and continence.

Do I need a referral?

No. You can make your appointment without a referral. ACC and private appointments are available. Please see the contact page for details.

What does a Pelvic Floor Physiotherapy appointment involve?

During your initial appointment, extra time is allocated to gather detailed information about your presenting complaint, bladder and bowel function, medical, gynaecological and surgical history, birthing history, sexual function, dietary habits, toileting behaviours, and lifestyle.

A thorough physical examination is then performed which includes assessment of posture, breathing mechanics, musculoskeletal testing, and if appropriate may include an internal vaginal or rectal examination. This examination is performed by observing and/or palpating the perineal region including the vagina and/or rectum. This evaluation will assess skin condition, reflexes, muscle tone, length, strength and endurance, scar mobility and function of the pelvic floor region. (note: your therapist will explain the procedure completely and only proceed if you are happy to).

This allows us to form a working diagnosis. Your Pelvic Floor Physiotherapist will explain the diagnosis to you and discuss different treatment approaches which may be appropriate. In some cases, referral back to your GP or another practitioner may be required.

Up to an hour is allowed for the initial consultation. This allows for a thorough understanding of your condition and for treatment to take place.

Follow up appointments may be required to achieve the best results. Return appointments are up to 30 minutes or extended 45 minute or 60-minute appointments are available for more complex and chronic problems. Your progress is reviewed every treatment and treatment adjusted accordingly. Some conditions may improve quicker with a prescription of specific exercises which your Physiotherapist will advise you of.

Why would a Physiotherapist be doing vaginal or rectal exams?

Physiotherapists are experts at working with the musculoskeletal and neuromuscular systems of the body. With additional specific training, this makes pelvic floor physiotherapists well placed to assess and treat muscles groups, including the pelvic floor. The muscles of the pelvic floor are found at the opening of the vagina (in women), urethra, and rectum. Thoroughly assessing the function of the pelvic floor is possible with an examination performed with one finger (gloved) inserted into the vaginal or rectal canal. There is a strong anatomical basis for this seemingly unconventional exam. Pelvic physiotherapists train in both internal and external evaluation and treatment techniques and current medical research backs this approach.

An internal assessment is the “gold standard” for a comprehensive assessment of the pelvic floor. Some patients may be hesitant at first but then choose to go ahead with internal assessment. However, for patients that are not comfortable with an internal examination, there is no obligation to do so. Pelvic Floor Physiotherapists can assess the function of the pelvic floor by using external observation and cueing. A surface EMG (electromyography) biofeedback test can be used to assist this examination.

How will I feel after an internal examination?

Most people feel fine after an internal vaginal examination, no different than after a pap smear test usually. If treatment involves extended internal bodywork, releasing the pelvic floor muscles and trigger points, then some people can experience some aching after treatment (like after a massage!), but this generally resolves within a few hours. Some people can feel thirsty, have headaches, and feel tired after internal bodywork, especially if the muscles are chronically tight. Listen to your body and rest as you need to. It's important to hydrate with plenty of water. It is recommended that after an internal examination you drink a large glass of water, and empty your bladder as standard care. You will be provided with detailed aftercare instructions after your treatment.

Is it ok to have an internal examination when pregnant?

There is no evidence that internal vaginal examinations during pregnancy cause miscarriage. However, Pelvic Floor Physiotherapists may not examine internally during the first 12 weeks of pregnancy if there is a history of unstable pregnancy or miscarriage, due to the higher risk of miscarriage in the first 12 weeks.

If I am leaking urine, can’t I just do my ‘kegel’ exercises (pelvic floor strengthening) and I will improve?

This really is a very common misconception. Urinary incontinence is a failed system, not just a failed muscle. To remain continent, people need a fully functioning system including muscle groups that are strong but flexible and can coordinate how to tighten when they need to and relax when they need to. Assessment with a Pelvic Floor Physiotherapist involves looking at theses muscle groups including the pelvic floor muscles, abdominals, hip muscles, lumbar spine and diaphragm as well as breathing mechanics and how the function as an integrated system. Sometimes pelvic floor muscles can be shortened and irritated, and this can also lead to incontinence just as much as having a weak pelvic floor. Your Pelvic Floor Physiotherapist will advise you of the individualised exercises that are required to help your specific problem.

I constantly feel the urge to empty my bladder can pelvic floor physiotherapy help?

Yes. Bladder training and pelvic floor muscle exercises can help reduce these distressing symptoms. Also advice about how to modify your lifestyle and diet can help improve symptoms.

Is Pelvic Floor Physiotherapy treatment necessary if a person has already had surgery OR is planning to have surgery?

To help patients get to optimal health, Physiotherapists usually work very closely with surgeons. Surgery can repair a structural problem, but it is equally vital to restore muscular control and function to accomplish the best results after surgery. Research has shown that physiotherapy prior to and after surgery improves patient outcomes as well as reduces the need for future surgery. Pelvic Floor Physiotherapy can also help after procedures like vaginal botox, to help with restoring muscle function, retraining of the complex core system including the breath, and optimise sexual functions.

If a person has a diagnosed “medical cause” of his/her pain, will Physiotherapy help?

Some diagnoses have a musculoskeletal connection. To give an example, endometriosis in women causes serious pelvic pain and can produce severe trigger points, connective tissue restrictions, and muscular restrictions in the muscles of the pelvis. Sometimes, in the case of a laparoscopy, removing the endometrial tissue does not ease the pain. This is due to the soft tissue restrictions that may remain. In the end, a multidisciplinary approach to treating pain proves to be the best to help people recover optimal health.

Are peoples daily habits related to pain, urinary or bowel dysfunction?

It is a common misconception that longstanding habits are not a primary cause for certain problems, even if the problem is new. Often habits such as eating processed food, drinking coffee or sugary soft drinks, exercising too vigorously, straining to pass urine or bowel motions or long periods of sitting at a computer can strongly influence a person’s symptoms. It is essential for your Physiotherapist to evaluate all of your habits to help you comprehend the habits you can modify to improve your health.

I have tried “kegel exercises” and they did not work for me, will Pelvic Floor Physiotherapy still be able to help?

Rehabilitation for the pelvis requires much more than strengthening the muscle groups. Restoring function and improving muscular support around the pelvis are crucial. So is improving behavioural/dietary habits and re-training the body to perform movements that allow for optimal organ support and structural performance.

With that said, there is a large body of evidence that supports pelvic floor strengthening exercises to help with pelvic floor dysfunction such as incontinence and pelvic organ prolapse.

What can I expect to gain from treatment?

Expect improved control, higher self-esteem, better sex, improved continence, increased confidence, better natural lubrication, improved sensation in the vagina and much more!

I have a pelvic organ prolapse, is there anything that can be done conservatively without surgery?

There is strong evidence that treating prolapse (Grade 3 or less) conservatively with pelvic floor physiotherapy (for up to 6 months) can significantly improve or even reverse prolapse and symptoms. Grade 4 prolapse (outside of the vagina) usually needs surgical intervention to resolve.

Can my children come to the appointments?

While we strive to be family friendly it can be beneficial for Mums to focus completely on the treatment if children are not present. There is often lots of new information to absorb and if internal treatment is required we want you to be as relaxed as possible. However we will do our best to accommodate the needs of your family.

Is my appointment covered by ACC?

Pelvic floor / perineal injuries covered by ACC are usually only after instrumental deliveries (forceps and ventouse), or trauma caused in an accident ie. broken pelvis. Generally ACC only covers treatment 12 months from the date of injury. If an ACC claim has expired there is a possibility of having it reactivated. Your practitioner can discuss this with you.

If you have sustained a musculoskeletal injury due to an accident and it has affected your pelvic floor function, in most cases you will be able to lodge an ACC claim at the time of your appointment. If you have lodged a claim with your GP or have had ACC covered treatment from another therapist (Osteopath, Physio, Chiropractor or Acupuncturist) please bring relevant paperwork with you to your appointment (claim number and date of claim).

ACC covers part of the cost of treatment, there is a gap to pay. Please click here for treatment rates. You will be required to pay the full private fee until you have provided this information and it is confirmed to be valid. If you need assistance understanding if you are eligible for ACC please get in touch.