FAQs

The things our patients often want to know

At The CoreGood Institute, we specialise in the diagnosis and treatment of common pelvic floor issues such as incontinence, prolapse, back pain, and erectile dysfunction

We are skilled in diagnosing and treating pelvic floor issues so it’s likely we’ve heard or seen almost everything before. You don’t have to feel embarrassed – you’re not alone.

Here are some of CoreGood Physiotherapy’s most frequently asked questions (FAQs).
Hopefully you’ll find the answers you’re looking for here but, if you don’t, please contact us.

General Questions

What can I expect to gain from Pelvic Health Physiotherapy?

Expect improved control and reduced symptoms of prolapse, higher self-esteem, better sex, improved continence, increased confidence, better natural lubrication, improved sensation in the vagina, improved ability to gain and maintain an erection, better control of the timing of ejaculation, improved core stability, reduced back pain and much more!

Is an internal exam necessary?

Whilst the pelvic physiotherapists at CoreGood Physiotherapy are all trained and skilled in assessing the pelvic floor both vaginally and rectally, an internal assessment is not always required. RTUS biofeedback is a useful tool to assess correct pelvic floor function and is performed through the lower abdomen whilst fully clothed. However RTUS is not an assessment of strength or type and degree of prolapse.
The therapist may recommend an internal assessment if:

  • information gained from the assessment leads to a more accurate diagnosis of your particular condition
  • there is significant benefit to you due to the likelihood of improved therapy outcomes
  • the information gained from doing so is invaluable
  • it forms an integral part of your therapy such as scar tissue mobilisation or muscle trigger point release

This assessment is performed only when there is the upmost rapport and it is absolutely justified to address the presenting problem. Best practice protocols are always followed to provide a safe and supportive environment for both patient and clinician. You are entitled and encouraged to have a support person present. You can never offend the clinicians at CoreGood Physiotherapy by declining any treatment or assessment recommendation. It is your right to decline any assessment or treatment technique for whatever reason.

Is it just for women or also for men?

Everyone has a pelvic floor and we all need to make sure it’s healthy. There are many conditions that are common to both women and men, and certain conditions that are unique to women or men. But they can all be diagnosed and treated at the CoreGood Physiotherapy.

Do I need a referral?

You don’t need a referral to be seen by the team at CoreGood Physiotherapy.

Is there any point seeing you if I'm planning to have surgery or have already had surgery?

Absolutely. At CoreGood Physiotherapy we work very closely with surgeons to help patients achieve the quickest, and best possible recovery. Research has shown that physical therapy both before and after surgery improves patient outcomes as well as reducing the need for future surgery.

Is my lifestyle contributing to my pain, or urinary or bowel dysfunction?

Quite possibly. There are certain lifestyle factors that can contribute to pelvic floor issues. Things like drinking coffee, eating fried food, exercising too vigorously, or sitting at a computer for long periods of time can strongly influence a person’s symptoms. At CoreGood Physiotherapy we’ll talk with you about your lifestyle and give you advice on ways to make changes to reduce your symptoms.

I do my pelvic floor exercises, that should keep me good, shouldn't it?

Possibly. If you are doing your Kegels exercises correctly, this will be extremely beneficial. However, research proves that 50% of woman who do their Kegels exercises don’t produce a contraction effective enough to make any improvement and, worse still, 25% do a manoeuvre that will actually worsen their problem. At CoreGood Physiotherapy we can help you make sure you are exercising correctly and we offer alternative treatments that can be more effective.

What is involved in an initial pelvic health consultation appointment?

Your initial one hour consultation appointment with the Pelvic Health Physiotherapist will allow us to:
Gain a thorough understanding of your condition
Develop and agree a treatment plan that is best suited to you
Provide advice about exercises, diet and lifestyle changes that you can make, and
Carry out an initial treatment session.
Our initial assessment includes analysis of posture, breathing mechanics and non-invasive assessment of your pelvic floors function and coordination with biofeedback and real time ultrasound tools.
When appropriate, a trial of PelviPower Magnetic Field Training or Acoustic Wave Therapy (men) is included as part of your initial appointment with no additional charge.

Like any treatment option, you can decide if you wish to incorporate PelviPower Training and/or Acoustic Wave Therapy (men) into your treatment plan.

How many treatments will I need?

After assessment of your condition we will be able to recommend the amount and frequency of treatments necessary to achieve the best, long lasting outcome.
As with all medical treatments, we monitor your progress and you have the right to stop treatment at any time.

YOU CAN CHOOSE TO PROCEED:

With PelviPower Training:

There are many of advantages with PelviPower Training:

  • It is the most effective solution as PelviPower training combines Magnetic Field Training with non-invasive PelviPower Bio-Feedback-Training
  • This simple and painless training has a stronger effect than conventional pelvic floor exercises or independent training
  • The intensity of PelviPower Magnetic Field Training produces results in a much shorter time and research indicates that the results tend to last longer
  • It is impossible to train incorrectly and you do so in your every day clothes
  • Unlike conventional bio-feedback that requires the placement of sensors and probes, PelviPower Bio-Feedback-Training is completely non-invasive and you remain fully clothed
  • Because strengthening the pelvic floor improves awareness of it, contracting these muscles in your day to day activities becomes easier
  • Whilst we encourage you to practice coordinating your pelvic floor in day to day activities, prolonged sessions of individual training at home is no longer absolutely essential
  • Other positive side effects include reduction in cellulite and back pain
  • Depending on your symptoms, 10 to 20 training sessions are recommended
  • A free follow-up appointment with the Pelvic Health Physiotherapist is included on the completion of a full course of training sessions

When PelviPower Training is not possible:

A targeted and more intensive training on the PelviPower Bio-Feedback-Trainer, combined with a professionally trained home training program, will be required.
There are several advantages of PelviPower Bio-Feedback-Training over just going it alone with a home training program:

  • It overcomes the issue that despite best intentions, home exercise routines are frequently not done
  • Improved pelvic floor function requires an awareness of one’s ability to gradually increase tension, hold with optimal force and endurance, gradually decrease tension and be able to relax and release the pelvic floor fully. It is difficult to achieve and maintain this ability without bio-feedback
  • Many patients, even with good and precise instruction, cannot ideally implement pelvic floor training and this makes success uncertain. The PelviPower Bio-Feedback-Trainer helps remedy this
  • Research shows that without assessment and correction, only half of women correctly recruit their pelvic floor and 25% perform a Valsalva effort that can promote incontinence and prolapse. Ensuring that you are practicing the correct technique from the outset optimises success
  • Correct breathing in coordination with the pelvic floor is learned through the visualisation on the display
  • The assessment and training occur in an upright position which is not only more convenient but is also a position that is more applicable to your pelvic floors action in day to day activities
  • PelviPower Bio-Feedback-Training is revolutionary in that it does not require any setup with vaginal or rectal sensor probes, and you remain completely dressed in street or sports clothing.

Depending on your condition, 2-3 workouts a week is optimal then less frequent follow-ups as you progress.

If training is only applied until the symptoms subside (<10), the initial symptoms shall rapidly return after stopping the training. In order to retain the acquired training success, it is necessary to perform a longer training phase so that the “muscle memory” is changed.

It takes time to change behaviour, strengthen muscles, change muscle memory and co-ordinate body systems to improve function.

With this option your results are directly related to your commitment to biofeedback and home training sessions and following the advice given. The greatest success occurs when you are an active participant in your treatment program.

PelviPower

How can I be sure PelviPower Training works?

High quality independent research published in the American Journal of Urology confirms the effectiveness of PelviPower Magnetic Field Training.
You can learn more here.

Is it true that I don’t have to undress for PelviPower training and that treatment does not involve attaching or inserting probes or such like? How is it possible that I don’t have to contribute actively to the training and can I do anything wrong

Through the use of magnetic waves, transmission-free signals are transported into the muscles. Magnetic waves can pass through the body without resistance. This makes it possible for patients to stay fully dressed without changing clothes for training. The patient takes a seat in the comfortable and individually adjustable training chair and allows the technology to do its work. During treatment, the muscles in the pelvic floor will rhythmically contract and relax without the patient being required to do anything at all. The treatment is so simple that there is literally nothing that a patient could do wrong. During treatment, patients may also read, use the phone or do similar things.

What advantages does pelvic floor training on the PelviPower have compared to classic pelvic floor training?

The most important advantages are that the PelviPower training does not require any effort from the patient and that it has a stronger effect than classic pelvic floor exercises or than is possible through independent training of the pelvic floor. What’s more, the training produces noticeable results in a much shorter time. It also strengthens all of the muscles in the core of the body, which can result in a marked improvement in muscular coordination in this area of the body.

How long does it take to notice an improvement in muscle tone? How many PelviPower training sessions are required before I will notice an improvement?

Most users tend to notice the benefits of PelviPower training fairly quickly. The rate of improvement is different for every patient, although most patients report an improvement after around the 5th session, some earlier and some later. Overall, the first few treatment sessions tend to produce improvements quickly, while the subsequent sessions continue to strengthen and tone the muscles with each passing session.

What happens if the scheduled number of sessions is not enough? What is the therapy fails to produce the anticipated results?

Very few patients do not respond to PelviPower training. But even a 20-session training series may fail to produce the anticipated results in extremely rare cases. Practical experience has shown for instance that patients who have undergone surgery to raise the urethra and the sphincter mechanism or a radical hysterectomy may be significantly less likely to benefit from therapy. The same applies to patients who have suffered damage to the relevant muscle nerves; in this case the therapy would not have the desired effect and would not be advised because of the poor to absent prospects for success. However, every patient will be seen by their therapist over the course of the treatments to discuss the results so far. If training has not been successful, an advisable option would be to change the settings used. The settings are then optimised in consultation with the therapist; the patient will also be monitored over a suitable period.

How long do the effects of PelviPower Training last? Will I have to come back for more therapy in future once I have completed my training?

There is no single answer to this question. Firstly, the persistence of the effects of PelviPower training depends on the ‘condition’ in which the patient is discharged, and secondly on whether the patient is able to take up independent training themselves or physical exercise. The results will last much longer if the patient is able to do so after therapy. The aim is always to achieve this goal, as the patient may then no longer need any additional PelviPower therapy, even at an advanced age. If the patient is unable to train or exercise independently in any reliable form, experience has shown that they will benefit from repeating the training 6 to12 months after the initial therapy, at least every now and then, even just once a month.

Would it help if I exercise my pelvic floor by myself as well? Would that contribute to the therapy’s success and would the effect last longer?

To date, there is no evidence that performing additional pelvic floor exercises speeds up treatment success. However, patients should start exercising their pelvic floor muscles themselves as early as possible. The PelviPower therapy enables patients to feel their pelvic floors earlier and more distinctly than with standard exercises. One benefit is that the patient quite quickly and purposefully develops improved body awareness of their pelvic floor muscles and can therefore train independently to stabilise the success of the treatment over time.

Is PelviPower Training also used in rehab after a Prostatectomy?

Yes, PelviPower is used to treat postoperative urinary incontinence and other conditions during rehabilitation after a prostatectomy. This takes time. The chances of success can be significantly improved if you start treatment soon after surgery. PelviPower therapy is not recommended for patients suffering from an enlarged prostate and the associated hypersensitivity.

Can PelviPower Training be used as a preventative measure? I don’t have any complaints, but might training help prevent any problems in future?

Yes. In principle, PelviPower training is also suitable for use as a preventative measure. This is because PelviPower therapy is capable of significantly strengthening the pelvic floor muscles in a very short period of time, depending on the initial state. Furthermore, training on the PelviPower can also contribute to toning and tightening the buttocks.

Will my body cope well with PelviPower Training?

Patients tend to report that they tolerate therapy well to very well. The therapy is not strenuous in any way, but still stimulates blood circulation. Patients tend to experience the increase in blood flow to tissues that is induced during and after a training session on the PelviPower as pleasant and persistent.

What happens if I feel a sudden need to urinate during PelviPower treatment?

In principle, emptying the bladder prior to treatment is recommended, but not necessary. Due to the muscle stimulation provided during treatment, it is very rare for patients to feel a sudden urge to urinate. However, if a patient ever does need to visit a toilet, it is no problem to pause the PelviPower treatment then continues from the same point when the patient returns from the toilet.

What happens if I cannot keep an appointment? Will I Jeopardise my training success?

In the early stages in particular, regular training is important for building muscle. It is essentially the same as when you start working out in a gym or, when you start physiotherapy. Only by regular exercising can a forced muscle build-up be achieved. If an appointment cannot be kept, a session should ideally be arranged for the following day. If a missed appointment cannot be integrated within the further training plan, it can be added on at the end.

Are there any health restrictions? When is it not permitted to use PelviPower Training?

Yes, there are health restrictions that are defined as absolute contraindications. PelviPower training must not be used during pregnancy, on people wearing electronic or metallic implants in the area between the knee and neck, e.g. insulin pump, pacemaker, defibrillator, hormone-releasing IU, hip joints made of metallic alloys, on patients with metallic screws, nails etc. in the area from 10 cm of the thigh above the knee up to the lower abdomen, or on patients with epilepsy or severe cardiac arrhythmias. In the case of surgery or radiation, the therapy may only be carried out 4 weeks after the treatment. Treatment may also cause discomfort in cases of fever, acute urogenital system infections and painful haemorrhoids. Sensitivity to treatment may also be greater than normal during menstruation, at least temporarily. In these cases, please always ask the therapist for advice on treatment. These restrictions do not apply to the PelviPower biofeedback trainer.

Is there any age limit for treatment? Is PelviPower training also beneficial at an advanced age?

There are no age restrictions. Quite the contrary. The training method is offered by a lot of facilities for older people in particular, because of the higher incidence of urinary incontinence. So it is not rare to encounter patients aged 85 and older who are successfully using PelviPower training. As age increases, people tend to become less and less agile and may even lose mobility. In these cases especially, PelviPower training provides an efficient option and has the potential to help people regain some quality of life.

Incontinence

Am I the only one?

No, you’re not alone and so much can be done. As many as 2 in 3 people do not report incontinence issues to their health care provider. So while it’s common, it’s certainly not ‘normal’. Everyone deserves a pelvic floor they can rely on. And we can help you achieve this.

Is leaking and feeling less during sex inevitable and normal after you’ve had kids?

Research shows that over 50% of people think that urine leakage is a normal consequence of having children or getting older. Yes, it’s is very common, but it is not normal. It’s a consequence of a group of muscles becoming weak and dysfunctional. We specialise in strengthening and coordinating these muscles so that the cause of the incontinence is dealt with.

I don’t have a problem with leaking, why should I care?

Prevention is better than cure. The risk of developing incontinence is 34% as an older woman and 22% as an older man. After the age of 30, 2% of the pelvic floor muscle cells die every year, making it progressively weaker as we age. Proper training of the pelvic floor muscles is well proven to treat and prevent leakage, prolapse, sexual and pain issues. Good pelvic floor muscles are not only about continence and improved sex. Your pelvic floor takes the load off your other pelvic and low back muscles, helping to prevent back and groin injury and improving your day to day performance whether you are swinging a golf club or picking up the washing.

Surgery will cure my problems, won't it?

Not always. Once you’ve had incontinence surgery, the risk of needing further surgery is 29%. And sometimes, other surgery can lead to pelvic floor problems. For example, hysterectomy results in a 40% increased risk of incontinence and this risk increases with age (the risk is more than 60% in woman who are 60 or older). If you’ve had gynaecological surgery it’s even more important that you are recruiting your pelvic floor in the right way and keeping these muscles in optimal condition (your pelvic floor muscles protect the ligaments and tissues that your surgeon has repaired).

Isn't it cheaper to just 'manage' the problem?

No. The average person suffering with incontinence issues spends $1,900 each year on incontinence protective products alone, without factoring in other expenses and the loss of freedom and lifestyle. It’s considerably cheaper to treat and resolve the issue, not to mention being able to lead a much more active, enjoyable lifestyle.

Erectile Dysfunction

I’m getting older, I guess my erectile function is going to decline?

Not at all! Medical research proves that pelvic floor exercises are an extremely effective long term resolution for erectile dysfunction. 75% of men improve, with 40% being completely cured after 3 to 6 months of training – that’s more effective than Viagra! What’s more, pelvic floor muscle training with PelviPower is much more effective and rapid than doing Kegels exercises at home.