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How does Physiotherapy work?

Physiotherapist with gentleman doing exercise

Physiotherapy is a key part of the UK's healthcare system and supports millions of people to get back to being the best versions of themselves. Physiotherapists work both in the NHS and privately in a huge array of areas! Whether you've got back pain, had a stroke, heart attack survivor or a professional athlete, a physiotherapist will be an integral part of your recovery.

There are a few different areas that physiotherapists specialise in:

  • Musculoskeletal/Pelvic health physiotherapy: Where we treat conditions affected by bones, muscles, ligaments, nerves etc

  • Neurological Physiotherapy: Working with people who have had a stroke, spinal chord injury, parkinsons etc

  • Respiratory Physiotherapy: Working with people in Intensive care, who have heart conditions, cystic fibrosis etc.

This post is going to look at how Musculoskeletal (MSK)/Pelvic health Physiotherapy works, as that is what we offer here at Emily the Physio.

What do MSK physiotherapists treat?

Musculoskeletal physiotherapists are experts at knowing every bone, muscle, joint, ligament, nerve within the body and how they interact together during movement. If something is not performing as it should, it can cause pain or functional problems for the client. A common list of pathologies that MSK physiotherapists treat are:

  • Back pain

  • Whiplash

  • Sciatica

  • Tennis Elbow

  • Hip/Knee arthritis

  • Fractures

  • Post surgery

  • Dislocations

  • Muscle strains

  • Ankle/Knee sprains

  • Neck pain

  • Wrist/Hand injuries

  • And so so much more!

How do MSK Physiotherapists know what's the problem?

There are a variety of tests you can do on the body that research has shown to be highly effective to determine the cause of discomfort. A very simplified example of this is if we think that a muscle may be damaged, we may get you to contract that muscle. If it is weak or painful, it gives us a clear indication this could be the problem. We perform the same tests that orthopaedic consultants do within hospitals. The answers to these tests along with your answers to our questions at the beginning of the appointment give us a clear indication of what is going on.

How does Physiotherapy work if I don't have a scan first?

Scans are useful AFTER having seen a medical professional such as a physio, GP, consultant etc. Any professional that refers onwards for a scan should only be referring to confirm a potential diagnosis, and only if that diagnosis needed medical intervention (such as surgery, injections etc). So for example, if I suspect someone has a fractured leg then I would recommend an X-ray to confirm this suspicion. Then they would be seen by the appropriate orthopaedic team and given the correct treatment needed such as surgery for pins/plates or a cast. If everyone had a scan for any pain that they had then:

  1. X-ray, ultrasound and MRI lists would be through the roof!

  2. Everyone would experience huge amounts of unnecessary radiation from X-ray machines

  3. A huge financial strain on the NHS that is already struggling to cope with demand

In actual fact the below diagram is a more common way to look at the likelihood of receiving different types of treatment for your pains. (Please bare in mind this is generic and not specific to each person/problem).

Infographic showing the need for treatment

The largest cohort at the base of the pyramid are people with pains that will go away on their own. As you go up the pyramid it shows a smaller and smaller number of people requiring that treatment option. It would be silly and medically dangerous to jump everyone from the bottom of the pyramid straight to scans and surgery, as the majority won't need it and would be better off with a more conservative approach. This isn't me sharing my opinion, this is backed up by masses and masses of research!

What do physiotherapists do?

As mentioned above, physiotherapists are experts at normal body function and movement. Our aim of treatment is to try and rectify any problem that causes a change to your function, and may cause you other symptoms like pain, stiffness, weakness, balance issues etc. Some treatment modalities used within clinic are:

  • Joint mobilisations (moving your joints, occasionally causing a click)

  • Soft tissue work (such as massage)

  • Acupuncture

  • Cupping

  • Electrotherapy (like ultrasound, laser, lymphatouch etc)

  • Strapping/Taping

  • and more!

Physiotherapists will also give you homework to complete. Our ethos is that for the 45 minutes you are in clinic we can only make a small change to that joint if nothing else is done. However if you complete small changes and exercises then that joint is worked multiple times a day/week! This gives faster, more effective and longer lasting results.

This would include:

  • Strength programmes

  • Stretching routines

  • Core activation/control work

  • Pelvic floor work

  • Lifestyle alterations

  • Outdoor rehab

  • Nutritional changes

  • Sleep advice

  • Stress management

  • Breath work

  • and more!

Give me an example of how physiotherapy works!

Lets say John comes in with an arthritic knee. Its causing him issues with playing tennis. As a physiotherapist we would do 2 things:

In clinic we would :

  • give him treatment to help reduce the inflammation in his knee that causes pain

  • reduce the inflammation within the surrounding muscles which causes those muscles to switch off

  • treat any other muscles that may be compensating and getting fatigued, such as back muscles that may be getting sore because of his limp.

  • Work on his knee joint range of movement with manual stretches and techniques

At home we would advise:

  • movements to maintain the new joint movement we've given him

  • exercises to improve strength around the joint to support the joint further

  • Self massage to continually reduce the swelling within the knee

  • Ice/heat advice to aid recovery after activity

  • Lifestyle changes to reduce the risk of the knee becoming sore

  • Graded return to tennis

  • Stress management advice as stress causing a heightened pain response

  • Nutritional advice to reduce the inflammatory encouraging foods, and increase the anti-inflammatory foods

If you would like to give physiotherapy a go and see if we can help you why not book in today!


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