Physiotherapist – what does that mean?
Sure, you may have heard the word physiotherapist or physical therapist before – but the title alone does not exactly give an exact idea of what we do. The idea of this blog is to help you understand what a physiotherapist does, and then you will be able to know if you want our help!
In Australia, a physiotherapist is a person who has a degree in physiotherapy. Different universities have different pathways, for example at POGO there are clinicians with a Bachelor of Physiotherapy, or others who had a Bachelor of Exercise Science and a Masters of Physiotherapy. We then need to register with a national board called AHPRA, and from there we are allowed to treat patients. A physiotherapy degree covers A LOT of science. As you can imagine we study anatomy, physics (so we can understand how forces affect different tissues), chemistry, neurophysiology, biomechanics, psychology and much more. From a private practice point of view, the areas we put most into use are biomechanics, biochemistry, physiology and anatomy, and then we put all these things into practice in terms of specific injuries and conditions.
Probably the biggest area that physiotherapists are trained in is assessment. We are first contact practitioners, which means you do not need a referral to come and see a physiotherapist. Because we are first contact practitioners, we need to be able to identify when your issue or injury is something we can help with, or if we need to refer you on (for example send you to your GP for scans, blood tests etc). When you see a physiotherapist, they will do a very thorough assessment. An assessment involves TALKING to you, getting your side of the story, hearing every intricate detail that you think is important. We will ask you questions and delve deeper to really get a clear story. When we talk to you and hear what you have to say, this is what we call the subjective assessment. After the subjective assessment, we will perform an objective assessment, this is when we LOOK at you and run through different tests that help lead us to your diagnosis. The objective assessment is when we ask you to touch your toes, bend your knee as far as you can, we test strength, we see how many calf raises you can do in a row. Depending on your injury, your physiotherapist will look at all sorts of things to work out exactly what is going on.
The reason it takes a physiotherapist 4-5 years to get their degree is because we need to be able to know your diagnosis. We need to be able to group together our subjective and objective assessment to define your diagnosis. Let’s be really honest here, the human body is complicated! Sometimes we need extra tests (eg scans or blood tests) to really get clear on your diagnosis. From your assessment we are able to define the contributing factors to your diagnosis, and it is these contributing factors that we treat.
Goal setting and time frames
In the medical world we use a term called prognosis, this describes what the outcome of your injury will be and how long it will take to resolve, if it will resolve at all. The reason we are so thorough in assessment and so clear on diagnosis, is because this guides our prognosis. When you see your physiotherapist they will be able to say if you should expect to back up and running in 6 weeks or if you need to prepare yourself for a 12 month recovery. It is very difficult to set goals for yourself without ideas of time frames and prognosis. It is important along the way to set smaller goals for yourself to keep you motivated and with the end goal in sight.
Physiotherapists are trained in hands on therapy. The way I think of hands on treatment is like the tools in a tool belt. Different tools are needed for different jobs, just like different techniques are used for different injuries. Hands on treatment can range from soft tissue work (massage) to joint mobilisation and joint manipulation. Physiotherapists may use electrotherapy such as shockwave or TENS which are things which can help with pain. Tape is a common treatment which can be used to help with pain and function. The idea of treatment in a physiotherapist’s mind is never to “fix” an injury, we use hands on treatment to help facilitate your body’s natural healing and getting you back to moving pain free. For example, when you have reduced pain, you can do your exercises more effectively, or you can get out of bed in the morning and return to your normal activities.Physiotherapists are trained in hands on therapy. The way I think of hands on treatment is like the tools in a tool belt. . #performbetter @pogophysio Click To Tweet
Physiotherapists are highly trained in exercise prescription. When we prescribe exercises, we are thinking about a multitude of factors
- What goals are we trying to reach (eg decrease pain, increase strength, increase power, increase endurance, activation etc)
- What is the risk vs benefit of this exercise
- How many sets and reps do we need of this exercise
- Is this exercise going to flare up a different injury or area
- Is the exercise going to activate the highest number of muscle fibres for this person
- What exercise is this person most likely to be compliant with
- Does this person need gym, pool, pilates, weights, kettlebell etc
Physiotherapists use exercise as medicine. You would not come to a physiotherapist for exercise for weight loss, that is not what we are trained in (but it might be a happy side effect) but we are trained in injury management, injury minimisation and progression of exercise.
As physiotherapists, we know our scope of practice – what this means is we know what we can do and what we cannot do. If we think you need pain medication – we will send you for a review with your GP. If stress is a major factor in your pain, we will discuss if a psychology review could benefit you. If we are worried you have rheumatoid arthritis, we will send you to your GP for blood tests and referral to a specialist. If we think you need potential surgery, we will ask your GP to refer you to a knee/hip/back etc specialist. We know what we are good at – and we know what we are NOT good at. We will not give you diet plans, medication advice, life advice. What we will give you is a diagnosis, the treatment that you need, exercises to help you and help plan how to get you back to your physical best.
Emily Georgopolous (APAM)
Featured in the Top 50 Physical Therapy Blog
Click here to book an appointment with Emily.