Assessment
All treatment is based on a thorough and ongoing assessment from which a specific treatment plan will be developed for, and with, you.
Hearing your story
Your experience with us will begin with this vital part of the assessment - hearing your story from your perspective. It is very important that we understand the journey that has brought you through our door and what your goals and expectations are of us. We will direct the telling of your story by asking specific questions that help us understand your primary complaints (symptoms of meaning to you that you would like to be rid of) and your thoughts and beliefs about your experience. This will also help to establish the meaningful tasks that form the basis of our physical examination.
Analysing your meaningful task
What is a meaningful task? It is anything from an activity, posture, thought, or belief that aggravates your symptoms or that you find difficulty doing and, once again, has meaning to you. For example, if your back pain is aggravated by sitting for long periods of time, we will choose tests that assess how you sit and how you move from standing to sitting and from sitting to standing, because it is 'how you do it' that helps us figure out why you are unable to do it well!
If running a marathon is your goal and running hurts your feet, assessing how you sit is not going to have much meaning, is it? There are literally hundreds of tests we could do, and choosing the right ones, at the right time, allows us to 'cut to the chase' pretty quickly. Meaningful task analysis (key component of The Integrated Systems Model (Lee & Lee 2007 ) allows us to make sense of your story and find things that are relevant to treat. Once we figure out what is going on, meaningful task analysis also helps you to know why certain activities are hurting you. We are all about empowering you with knowledge and motivating you to make the changes necessary for better health. Knowledge and awareness of what is going on is half the battle of changing things
Further specific tests
Depending on what we see/feel as you perform your meaningful task (activity that provokes your symptoms and/or have difficulty performing), we will then choose tests that specifically assess the relevant joints, muscles, fascia, nerves and/or organs (bladder, liver, esophagus etc.) to determine where the problems are that are contributing to your overall story.
Ultrasound imaging
We are one of only a few clinics in British Columbia able to offer you the opportunity to have ultrasound imaging as part of both your assessment and treatment (biofeedback tool). This tool provides valuable insight into how the deep muscles of the lumbopelvic region are working (as well as the fascia which connects the deep muscles) for those with mid, or low back pain, pelvic girdle pain, impairments of the trunk and/or or stress urinary incontinence or pelvic organ prolapse (i.e. falling uterus, bladder or rectum). We do NOT do diagnostic medical ultrasound imaging and we use this tool primarily for assessment and training of the muscles of the musculoskeletal system, in particular the low back and pelvis.
Ultrasound imaging involves sending safe sound waves into the body, which then reflect off the various tissues. The reflections are then collected and displayed as images on the screen. Ultrasound imaging allows observation of movement of the muscles (and the fascia) as they occur in real time. It is a fantastic way to observe the deep muscles of your trunk (pelvic floor and deep abdominals) to see if they are functioning well. We call this tool the 'Lie Detector Test' since it often reveals things that our hands can't feel. This is especially true when there has been a significant stretch to the abdominal wall and/or pelvic floor resulting in a separation in the midline of the abdomen, also known as a diastasis rectus abdominis or stretch of the pelvic floor fascia.
You may be asked to book a special appointment for imaging of your pelvic floor and/or pelvic organs (bladder, uterus). To see these structures, your bladder needs to be moderately full. Empty your bladder (void) one hour before your appointment and then be sure to drink 500ml of water during this hour.