What is physiotherapy? Massage? Exercise? Rehabilitation? Stretches? Prodding and poking? Manipulation?
Over the years Physiotherapy has utilised all of these to treat a variety of people.
What many patients are not aware of is that in the past 10 years the Physiotherapy profession has been going through somewhat of a reform.
With the emergence of high-class research and evidence, and dedicated professionals passionate about developing their practice we can now say, with some confidence what physiotherapy is, and what physiotherapy definitely Is NOT
Physiotherapy is NOT massage. Now don’t get me wrong, massage is a relaxing and calming way to relieve stress and muscle aches and pains. However, it has no long-lasting effects after the time you get up from the therapist’s bed and walk out of the clinic. It does not remove, waste products’, aid recovery or ‘realign muscles’.
Massage therapy adds heat to tissue and that is about it. With any modality that adds heat to the bodies structures, it will invariably feel nice, just like using a hot water bottle. So the next time your physio or chiropractor say you need several sessions of massage please question their clinical reason for doing so.
Physiotherapy is not Prodding, Poking and Clicking things in and out of place or releasing trigger points. Palpation and hands-on therapy should be for assessment purposes only, and this is a very effective means of diagnosing certain conditions. Just like massage, there are no long term benefits from hands-on therapy. Many of my clients tell me that they have been told their pelvis is out of alignment, their back has a curve (which is normal) and that they need multiple sessions of manipulation to realign their joints. Let me be clear, there is absolutely no evidence to support this treatment method, there are hundreds of scientific journals that refute these claims and as a profession, we have tried to educate many professionals about these outdated practices and harmful messages, that many private professionals still try to peddle.
Physiotherapy is an active and progressive form of rehabilitation.
Do the following statements sound familiar?
“I saw the physio for 6 sessions and it felt better after the session but the pain has come back again”
“The physio gave me an exercise sheet and discharged me”
“each session the physio would tell me my posture was contributing to my pain and I should sit up straight to help my back pain”
Far too often people who access Physiotherapy are not educated on their condition and how to improve their symptoms. This is in part due to inexperienced and ill-informed professionals. I would challenge anybody currently, or who may potentially visit a physiotherapist or other allied healthcare professionals to explain the current best evidence for treating back pain, shoulder pain or knee pain.
Physiotherapy IS exercise therapy.
Mechanotherapy is a fancy theory to essentially suggest that to get a structure stronger- use the structure. For example, if you have a weak muscle strengthen it. If you have a stiff joint, use it, and if you have an injured ligament, us the ligament within reason.
It makes sense, that to recover from injury we must train our bodies to complete previous, painful tasks again without pain. To many physiotherapists do not address this and simply provide short term, ineffective, superficial reductions in symptoms.
Although exercise is seen as ‘fobbing’ someone off or not providing ‘proper’ physiotherapy it is the only way to build long term recovery and return to function whilst minimising the future reoccurrence of injury.
It requires patients to become an active part of their recovery and to engage with physiotherapists throughout their rehabilitation. This is often not, what a patient wants when going to see a physiotherapist and disengages with treatment and has poor outcomes.
Physiotherapy requires patient education and effective rehabilitation from a strong research basis. Recovery invariably requires the management of several factors and you should always understand what these factors are and how, together with your physio, you will be able to tackle these
Question your therapist, ask them their understanding of what they are doing for you. You wouldn’t keep returning your car to a mechanic whose repairs fail time after time.
This is your health, the most fundamental and important part of life. You have every right to question and seek clarification you have a responsibility to provide yourself with the best care possible.
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I would be happy to continue to dispel some more physio myths.