Your first visit & FAQ
Practical answers, before you book.
Preparing for your appointment, what treatment is like, insurance, ongoing care, pregnancy, and pediatric visits.
Before your visit
What should I wear?
Wear comfortable clothing that you can move easily in. Soft, flexible clothing such as leggings, athletic pants, shorts and a comfortable T-shirt or top works well. Please avoid jeans, belts, restrictive clothing that does not move well, dresses and skirts, as well as jewelry or accessories that may get in the way of assessment or treatment. Clothing stays on throughout your appointment — you will not be asked to undress for assessment or treatment.
Do I need to prepare anything before my first appointment?
Complete your intake and health history before your visit. Relevant information about previous injuries, health history, work, activities and current concerns helps provide context for what your body has experienced and adapted around. If you have relevant imaging or reports, you are welcome to bring them, but you do not need to arrive knowing what is causing your symptoms — understanding what may be contributing is part of the assessment.
Do I need a doctor's referral?
Generally, you can book directly with an Osteopathic Manual Practitioner without a physician referral. Some extended health insurance plans have their own reimbursement requirements, so check your individual policy if you plan to submit your appointment through insurance.
I've never had osteopathy before. What should I expect?
We begin with a conversation about what you are experiencing, relevant health and injury history, and aspects of everyday life that may matter — including work, activity, sleep and repetitive demands on your body. From there, I assess how different areas of your body move and relate to one another. Treatment is guided by what we find rather than by a predetermined routine for a particular symptom. You do not need to understand osteopathy before you arrive — I will explain what we are doing as we go.
Can I eat before my appointment?
Yes. You do not generally need to fast or make special dietary changes. You may find it more comfortable to avoid a particularly large meal immediately beforehand, especially if we will be assessing the abdomen, ribs or diaphragm.
Can I receive osteopathic treatment while pregnant?
Osteopathic care can be adapted to pregnancy. In my practice, I typically avoid treatment during the first trimester. After the first trimester, treatment is generally considered appropriate when there are no medical concerns or contraindications, with positioning and techniques adapted to your stage of pregnancy and comfort. Please let me know that you are pregnant and how far along you are — osteopathic care does not replace appropriate prenatal or medical care, and pregnancy-related concerns may require consultation with your physician or midwife.
During your appointment
Will treatment hurt?
Treatment is not based on forcing your body through pain. Some areas may already be tender or sensitive, and certain techniques can involve pressure, stretching or movement that you can feel. Please tell me what you are experiencing — your comfort provides useful information and treatment can be changed at any point.
Do you use cracking or high-velocity manipulation (HVLA)?
No. I do not perform HVLA (high-velocity, low-amplitude) manipulation — the rapid, controlled thrust techniques that can create a cracking or popping sound. HVLA falls outside my scope of practice. My treatment uses other hands-on osteopathic techniques and movement selected according to what I find during assessment, how your tissues respond, and what is appropriate and comfortable for you.
Will you only treat the area that hurts?
Not necessarily. Where you feel a symptom gives us important information, but it does not always tell us where the broader pattern begins. Movement in one region can influence how another manages load and motion, so assessment may include areas beyond the symptomatic location. That does not mean everything I find needs treatment — I am looking for relationships that appear relevant to the pattern we are working with.
Why are you assessing an area that doesn't hurt?
The body is very good at adapting. If one area loses movement, another may begin moving differently to compensate — sometimes without producing symptoms there at all. Looking beyond the symptomatic area helps me understand how your body is distributing movement and forces as a whole.
Will you explain what you're doing?
Yes. I want you to understand what I am assessing and why something may be relevant. You are welcome to ask questions at any point — if you are uncomfortable, uncertain or simply curious, please tell me. Treatment should feel collaborative.
Do I have to consent to every part of treatment?
You remain in control of your care throughout the appointment. You can ask questions, decline a technique, change your mind or ask me to stop at any point. Treatment can always be adapted.
Insurance & professional information
Is osteopathy covered by insurance?
Many extended health benefit plans in Canada include coverage for services provided by eligible Osteopathic Manual Practitioners, but coverage varies by insurer and individual plan. Your insurer may have requirements regarding practitioner education, professional association membership, referral or annual limits. If you plan to claim treatment, confirm your coverage directly with your insurer — you will receive a receipt to submit where eligible.
Can you direct bill my insurance?
If direct billing is not offered, payment is made at the time of your appointment and you will receive a receipt to submit to your insurer for reimbursement where your plan provides coverage.
What are OSTCAN and the OAO?
OSTCAN — Osteopathy Canada — is a national organization representing provincial osteopathic associations whose practitioner members meet established educational and professional standards. The Ontario Association of Osteopathic Manual Practitioners (OAO) is an Ontario professional association and a member association of OSTCAN. Your individual insurance coverage should always be confirmed directly with your insurer.
Is osteopathy regulated in Ontario?
Osteopathic manual practice is not currently a regulated health profession in Ontario. Professional associations establish educational and professional requirements for their members, while insurance companies determine which practitioners and associations they recognize for reimbursement. For a deeper explanation of osteopathy in Canada, education standards and insurance recognition, see the related article in the journal.
Is an Osteopathic Manual Practitioner the same as an osteopathic physician?
No. In Canada, an Osteopathic Manual Practitioner provides manual osteopathic assessment and treatment and is not a medical doctor. In the United States, a Doctor of Osteopathic Medicine (DO) is a fully licensed physician. The professions have historical connections but different education, scopes of practice and regulatory frameworks.
After treatment & ongoing care
How will I feel after treatment?
Everyone responds differently. You may notice changes immediately or more gradually. Some people feel relaxed or notice easier movement, while others experience temporary soreness or simply notice that their body feels different following treatment. If something after treatment concerns you or feels significantly different from what we discussed, please contact me.
Should I exercise after treatment?
It depends on you, the treatment and what we have been working on. Normal gentle movement is often appropriate. In some situations I may suggest temporarily modifying an activity or allowing your body time to respond before returning to strenuous exercise. We will discuss anything relevant before you leave.
How many appointments will I need?
There is no predetermined number. Some people respond quickly and return only when something changes or they feel they need support. Other patterns have developed over a longer period and may benefit from gradual treatment over time. Treatment frequency depends on what we find, how your body responds and what makes sense for you — I do not believe in booking you into care you do not need.
Do I need regular maintenance appointments?
Not necessarily. Some people choose to incorporate osteopathic treatment into their broader approach to health and movement. Others come for a particular concern and do not return unless something changes. There is no requirement to remain in ongoing treatment.
Can osteopathy work alongside other healthcare?
Yes. Physiotherapy, massage therapy, chiropractic care, medical care and other services may sometimes complement osteopathic care. Let me know what other care you are receiving so I can understand the broader picture, avoid unnecessary duplication and refer appropriately when needed.
When might osteopathy not be the right care?
Not every symptom is an osteopathic problem. Sometimes your history or assessment suggests that medical investigation, rehabilitation or another healthcare professional is more appropriate. If something appears to fall outside my scope of practice or I believe another form of care should be involved, I will tell you.
Children & families
Do you treat babies and children?
Children are welcome in my practice. I have pursued continuing education in pediatric osteopathic care and continue to develop my study in this area. Assessment and treatment are adapted to the child's age, development, presentation and comfort. A parent or guardian is involved in their child's care and consent.
What does an osteopathic appointment look like for a child?
It may look quite different from an adult appointment. Children do not always want to lie still on a treatment table, so assessment and treatment can adapt around their age, comfort and ability to participate — changing positions, taking breaks, interacting with a parent or allowing movement during the appointment. The child helps set the pace.
Can I stay with my child during their appointment?
Yes. A parent or guardian should be present and involved in pediatric care. I want both you and your child to feel comfortable with what is happening.
I'm not sure if my concern is something you work with. Should I still contact you?
Yes. You do not need to decide whether your symptoms "qualify" for osteopathy before reaching out. Tell me what you are experiencing, what you have noticed and what you are hoping to change. If osteopathic assessment seems appropriate, we can start there. If I think another kind of care would make more sense, I will tell you.
Still wondering about something?
Ask.
Book Your Assessment
Or email bfreitasosteopathy@gmail.com.