An important part of any relationship including the one between you and your health care practitioner (in this case Physiotherapist), is managing expectations. In this blog post Oakville Physio Kristina delves into what is Physiotherapy, and what to expect out of Physio.
What is Physiotherapy?
You have been referred by your Doctor for Physiotherapy and have never been before… So what is Physiotherapy?
Physiotherapy (a.k.a. Physical Therapy) is:
- Treatment of physical injuries, disease or deformity that include bony, muscle, ligament, tendon, or nerve tissue
- Physiotherapy can be an alternative to medication and surgery, though it can be done in conjunction with medication (e.g. pain killers, muscle relaxers, anti-inflammatories), as well as pre and post-surgery to help with healing and return to daily activities
Treatment is often a combination of three approaches to care:
1. Manual Therapy – Hands-on techniques to mobilize joints and nerves, release muscle and tissue tightness, restore range of motion and relieve pain
2. Exercise Therapy – While the hands-on techniques are important, the effects of therapy are maintained and enhanced by exercises for stretching / strengthening / movement and muscle control that the Physiotherapist prescribes for home. After all, since you cannot be at Physiotherapy every day and you need muscle activity in order to regain muscle strength after injury, doing exercise therapy is an important part of the therapy!
3. Other External Modalities – While they may prove beneficial, such modalities are an adjunct to both manual techniques and exercise programs, e.g. use of machines such as Ultrasound for tissue healing or TENS for pain relief (these are often more effective in the acute stages of injury), postural and supportive taping of muscles and joints, use of acupuncture, use of heat and ice therapy
Is All Physiotherapy the Same?
There are different fields of Physiotherapy:
- Orthopedic – most often found in private clinics, e.g. muscle or joint pain and injuries
- Cardiorespiratory – usually in hospitals and Cardiac Rehabilitation. Private practice Physiotherapists may also assist in percussions, or “chest Physio” with pneumonias etc to help clear mucous.
- Neurological – usually in hospitals for treatment of neurological conditions, e.g. stroke, traumatic brain injuries, spinal cord injuries, etc. Many outpatient clinics also provide support and additional rehabilitation for patients with Parkinson’s disease, Multiple Sclerosis, stroke, traumatic brain injuries, and spinal cord injuries. Outpatient clinics may also treat these populations to help them increase their strength and function as well as treat musculoskeletal injuries.
- Pediatric – for more specialized treatment of pediatric conditions. Some clinics, such as ours treat infants with torticollis, infants with delayed gross motor skills, and children and youth with a variety of injuries.
- Geriatric – in hospital, long-term, private practice, or home care settings
- Vestibular – can be found in private practice, for treatment of vertigo symptoms most commonly due to BPPV
- Concussion – can be found in private practice
- Motor Vehicle Accident – often see in the orthopedic setting based on the kinds of injuries
How is Physiotherapy different from Massage Therapy, or Chiropractic?
Massage Therapy is a manual manipulation of soft tissues (muscle, connective tissue, tendons, and ligaments) for reducing stress and anxiety, relaxing tight muscles, rehabilitating injuries, and reducing pain. While Physiotherapists will also utilize soft tissue release techniques to reduce muscle tightness, Massage Therapists use a variety of specialized techniques to go more in-depth and treat the soft tissues specifically. Some RMTs also have extra training in joint mobilizations and exercise therapy.
Chiropractic is the treatment of mechanical disorders of the musculoskeletal system and their effects on the nervous system. There is an emphasis on manual treatments, including spinal adjustments and other joint and soft tissue manipulation. There can be some overlap between physiotherapy and chiropractic manual therapy techniques, though chiropractors will focus more often on adjustments.
What should you expect from your Physiotherapy first appointment?
Any first physiotherapy session should always be an initial assessment and will be of longer duration than follow-up sessions.
The purpose of the assessment is to:
- Determine what movements or provocation tests reproduce symptoms / cause pain
- Determine range of motion limitations, muscle tightness, functional limitations, abnormal movement patterns, etc.
- Diagnose the dysfunction if not already diagnosed by radiographs or other form of imaging
- Create appropriate individual-specific treatment plan that takes patient’s goals into account
The appointment usually includes treatment after the assessment. Your physiotherapist will likely initiate a light home exercise program to start, which will progress based on patient’s tolerance and progress through the rehabilitation program.
Can I be sore after the assessment?
After the assessment, due to the hour-long stimulation, the first introduction to treatment, and the necessary testing of different structures to determine the problem areas, you may be a bit more sore.
This additional soreness usually lasts the rest of the day and should be gone by the next morning.
Sometimes there is no additional soreness, and sometimes, if the pain is more acute and the tissues more sensitive, it can be more intense and last for a longer duration. This is important information for your physiotherapist so that on your next session they can modify their approach based on your individual tolerance!
How long does Physiotherapy take?
Physiotherapy is basically rehabilitation. While some injuries heal quickly and on their own, others need help to heal and return to daily activities. This means that for rehabilitation to be effective, you will often need more than one or two sessions.
Length of Rehabilitation Varies Based on:
- the kind of injury,
- how long it has been going on for,
- level of pain and limitations e.g. waking up with a kink your neck might take a few sessions to treat, while rehabilitation for a rotator cuff tear can take approximately six months
- how involved a person is in their own treatment. It is important to be consistent with your self care and advised exercises. It is important to communicate with your Physio regarding how you are progressing and how consistent you are with your exercises.
Usually, you would attend physiotherapy more often and more regularly (e.g. twice per week) until pain and function begin to improve and the home exercise program prescribed is helping. Then sessions taper down until the issue is resolved and patient has received education and instruction on preventative measures to avoid the same issue recurring in the future.
You are now ready for your first Physio appointment!
Registered Massage Therapy Association of Ontario. (2018). What is Massage Therapy? Retrieved from https://secure.rmtao.com/
World Federation of Chiropractic. (2009). Definitions of Chiropractic. Retrieved from https://www.wfc.org/website/