Why have an appointment with a Physiotherapist?
Recently I have been thinking about what sets Physiotherapists apart from other rehabilitation/sports massage/remedial therapies? What do I as a physiotherapist look at and consider when I see a patient for the first time? What does my training and experience bring to each and every individual that comes through my door and on the subsequent visits they make?
An initial assessment from a physiotherapist should be considering the origin of the structures causing the problem. What are the presenting symptoms? pain, stiffness, weakness, cramping, pins and needles, numbness? How irritable is this condition? Is this joint, muscle, bone, cartilage? Is there nerve involvement? These are some of the things I am trying to establish on your initial visit. However, the most important questions physiotherapists ask sometimes don’t directly relate to your symptoms at all. Put simply we have been taught to screen for any more serious pathologies. For example; is there a more central nervous system problem causing that leg weakness? Is this something massage, manual therapy and exercise can help or do I need to get the patient to have further medical investigations? Is this a growth or age-related issue?
Training as a physiotherapist is a very holistic process. We have been taught to look at the whole person. This is why we ask about all of our patients past medical history including mental health, I sometimes think patients get the impression we’re being nosy! That respiratory condition that is considered irrelevant to a patient is of significance to us when we’re looking at necks, shoulders and backs. We are considering what is the breathing pattern and could it be contributing to the posture and function of the neck posture, muscles and rib cage? Is it even having a knock-on effect though the whole movement chain and impacting on running technique?
Physiotherapy is a three year degree, which includes 1000 hours of clinical training around a broad range of specialities. We cover the more well known aspects of physiotherapy; learning how to treat those problematic backs and necks and the rehabilitation post fractures. But it may surprise you to know we are all educated and have experience in the treatment of neurology, respiratory and vascular conditions. This makes us a profession who have sound knowledge and experience for medically screening patients’ and I am very proud to have been able to utilise these skills on occasion to refer patients back to their GP for successful management of more serious pathologies.
My main aim as a physiotherapist in the musculoskeletal setting is getting to the root cause of the condition a patient is presenting with. No quick unsustainable fixes, but a cost-effective management plan. My patients never leave the treatment room without some form of ‘homework’ to do whether it’s rehabilitation exercises, a progression or reminder of the exercises I’ve prescribed. I am keen for my patients to understand why I’m giving specific exercises and aim to relate this to their particular movement dysfunction. I believe this is a key in gaining and maintaining improvement. This often links to the advice and other self management strategies patients have been given. For example explaining why sitting cross legged feeds into that tight hip? Which stretches am I giving to combat that? It really does become a team effort with my patient at the centre.
The majority of individuals pursue a physiotherapy degree with a view to working within the NHS in the first instance on graduating. We are not taught any business acumen during our training. Therefore, the skills and knowledge required in the practice of running a private physiotherapy business are something that has to be nurtured and developed. As physiotherapists, our primary aim will always be improving our patients’ conditions in the most cost effective and efficient way. This requires a fine balance to achieve in a world full of marketing offers and incentives, as there is no prescriptive number of sessions or advice for conditions that we treat and therefore may be perceived as being expensive. What you can be sure of though is that a good physiotherapist will never ‘over treat’ or recommend courses of treatment that will not benefit you or your clinical need. Our aim is for you to understand what has happened, how to improve and how to prevent recurrence – so physiotherapy is great value for money in the long run too!
A Quick Summary
· Physiotherapists have a professional qualification you can trust.
· We partake in regular continuing professional development demonstrating competency of treating the client groups we come into contact with.
· Physiotherapists have to by law be registered with the Health Care Professionals Council (HCPC) so always check out the qualifications of who you see, their regulatory body and the experience they have.
· I am very proud to be a Physiotherapist. It is a protected title and this is for a very good reason. Unless an individual has a physiotherapy degree they can not claim to be a physiotherapist.
