Measuring what your pelvic floor is doing, instead of assuming what it should be doing.
Why We Measure
Understanding what’s limiting your function is the foundation of effective rehabilitation. Rather than relying on assumptions, we can often measure how your pelvic floor is functioning and use that information to personalise your rehabilitation.
That matters more than it sounds. The default advice for almost every pelvic symptom in New Zealand is to strengthen the pelvic floor. For some people that is exactly right. For others the muscle is already working too hard, cannot relax, or is firing at the wrong moment, and more strengthening makes the symptom worse rather than better.
Without measuring, there is no way to tell those people apart. They describe the same symptom in the same words.
What We Can Measure
Real-time ultrasound
Real-time ultrasound isn’t valuable simply because it gives us another measurement. Its biggest advantage is that you get to see the movement too.
If the pelvic floor moves correctly, you can connect what you’re seeing with what you’re feeling. If it doesn’t, we can change your breathing, technique, effort or position and immediately see whether the movement improves.
It is non-invasive, done through the skin, and it is the reason most people at CoreGood do not need an internal examination.
How real-time ultrasound works →
MAPLe high-definition EMG
MAPLe (Multiple Array Probe Leiden) is a high-definition pelvic floor EMG system designed to measure electrical activity from different regions of the pelvic floor. Unlike conventional biofeedback, which provides an overall picture of pelvic floor muscle activity, MAPLe shows how individual muscle regions are contributing.
It can distinguish left from right, and superficial from deep, which matters when a symptom is coming from one region while the rest of the muscle is working normally.
Your history, in detail
The longest part of a first appointment is not a device. It is a conversation about symptoms, bladder and bowel habits, fluid intake, breathing, movement, previous surgery, medications, sport, work and what you actually want to get back to.
No instrument tells us which of those matters most in your case. Both together do.
What happens at your first appointment →
What Measurement Cannot Do
It cannot tell you the cause on its own. A measurement describes what a muscle is doing. Why it is doing that comes from your history, your examination and clinical reasoning.
It cannot predict your outcome. Nobody can. What improvement is realistic depends on what is contributing to your symptoms, how long they have been present, your overall health and your own goals.
It does not replace judgement. Technology supports clinical reasoning here. It does not replace it. Where an assessment tool adds nothing to the decision in front of us, we do not use it.
It is not compulsory. Every part of an assessment is optional, and you can decline any of it at any point without giving a reason. That includes an internal examination, which most people here do not need.
What Changes When We Look
The plan sometimes inverts. Someone arrives having done pelvic floor exercises daily for two years without improvement, and the finding is a pelvic floor that cannot let go. The work becomes relaxation, breathing and downtraining, which is the opposite of what they were doing.
Effort gets redirected. A muscle that is strong enough but slow to respond does not need more strength. It needs timing, so the exercise changes from long holds to fast, well-timed contractions before a cough or a lift.
Progress becomes visible. Measuring the same thing at the start, part-way through and at the end shows whether the programme is working, which is the difference between rehabilitation and hoping.
Common Questions
How do you know whether my pelvic floor is weak or tight?
By assessing it rather than inferring it from your symptoms. Weakness and overactivity can produce very similar complaints, including leakage, urgency, pain and difficulty emptying. Real-time ultrasound and, where appropriate, MAPLe HD EMG let us look at how the muscle actually behaves at rest, during a contraction and while it lets go.
Do I need an internal examination?
Most people at CoreGood do not. Real-time ultrasound is done through the skin and answers many of the same questions. Where an internal assessment would genuinely change the plan, it is offered and explained, and you can decline it. Nothing happens without your consent.
Is this different from the biofeedback I have used before?
Conventional biofeedback gives an overall picture of pelvic floor activity. MAPLe measures separate regions of the muscle, which is what allows a left-right or superficial-deep difference to be seen at all.
Will you use every device on me?
No. Assessment is guided by what the decision requires. If a tool will not change what we recommend, using it would only add cost and time.
Does ACC cover the assessment?
That depends on whether your condition is an accepted injury rather than on which assessment tools are used. Fees and ACC cover are set out in full here.
Start With Understanding What Has Changed
An assessment is not a commitment to a programme. It is how you find out what is actually going on.
Or book a free 15-minute discovery call if you would rather ask a few questions first.
Take the First Step
You don't need to know exactly what's wrong before asking for help. If you would rather ask before you book, start with a free 15-minute discovery call. It is a phone conversation, not a sales call, and there is no obligation to book anything afterwards.