Physiotherapy is a science-based profession, with most university degrees lasting 3 years. Once graduated, physiotherapists must register with their regulatory body, the Health and Care Professions Council (HCPC)
Physiotherapists look at a patient holistically, reviewing both their health and wellbeing in relation to their daily lives. This also includes educating and advising patients on how to avoid recurrence of problems. Ergonomic advice along with suggestions on changes to daily activities also aid in the physiotherapist's ability improve patients' symptoms and overall wellbeing.
Physiotherapists are trained to diagnose and treat many different conditions. There are broadly four types of complaint: -
The Physiotherapist will take a detailed case history, and use a variety of orthopaedic, neurological and functional tests in order to formulate an accurate diagnosis and treatment plan so that you achieve the best outcome. You may be asked to remove items of clothing during the exam in order to help with the assessment, if you are uncomfortable with this then please inform the practitioner. A wide variety of approaches may be used by the physiotherapist in order to get the best outcome, these include:
A 24-year-old male presented to our Physiotherapist with a history of recurrent left shoulder dislocations, having sustained five in the previous six years, leading to keyhole surgery a year ago. He wanted to return to the gym and to playing cricket but currently felt unable as concerned about further dislocation. By working on targeted exercises to strengthen the musculature around his shoulder to improve stability, resulted in him achieving his goals in four sessions with a further three working on a concurrent neck issue prior to discharge. This allowed him to return to pre-season training with his cricket team.
A 39-year-old female presented to our Physiotherapist with a long-term history of lower back pain with her current episode having lasted for the last 6 months. Previously she had discomfort only when sitting but this had now progressed to a burning sensation when walking. She had a video physiotherapy consultation previously with a different clinic but had not found it effective. Through clinical assessment it was determined that she had irritation of the Sciatic nerve as a result of muscular tightness and lack of spinal mobility. With re-education of the nerve through movement, manual therapy, and stretching & strengthening exercises to relieve and support her lower back were able to reduce her pain levels and greatly improve the mobility in her spine in five sessions.
As you can see, there are many areas of the body that physiotherapy can help with, however, it is not unusual for physiotherapists to also help with Asthma and other respiratory conditions, as well as neurological conditions such as Multiple Sclerosis and Parkinson's (3). Being able to work in a multidisciplinary team is one of the basis of physiotherapy education, therefore, they are ideally placed to work with many conditions presented to them, being able to interpret a wide range of medical test results. Through targeted treatment and specific physical therapy, the physiotherapist will aim to get the patient back to optimum health.
Headaches can be divided into 3 categories, with the majority not being associated with other causes. These are known as primary headaches and more common on women. Cervicogenic headaches, known as secondary headaches, due to it occurring as a result of another disorder, often present to physiotherapists. The physiotherapist will take a detailed case history in order to conclude whether it is a primary or secondary type headache and the best form of treatment going forwards. Headaches he been shown to be successfully treated using manual therapy within the neck region and base of the skull, along with exercise prescription for the neck and postural/ergonomic advice.
Neck pain is a common complaint and may be caused by disc herniation, osteoarthritis, rheumatological conditions, whiplash associated disorder, poor posture/biomechanics, to name just a few. Lifestyle factors may also impact progression of symptoms as well. Recurrence of pain ranges from 22.8% (1) to 63% (2). Depending on the cause of the symptom, the physiotherapist may carry out joint and soft tissue techniques, along with advice on exercises to perform.
Shoulder pain and discomfort within the shoulder region is very common and will affect most people at some point in their lives. Some of the common causes are-Rotator cuff problems, Frozen shoulder, Acromioclavicular joint dysfunction, Shoulder instability, Osteoarthritis and Referral. Age can also have an impact on the presenting cause of the problem as well. Through detailed examination, the physiotherapist will formulate their diagnosis and treat with a variety of techniques along with specific rehabilitation exercises in order to provide the correct care. They may also suggest a scan, such as ultrasound imaging in order to better understand what is happening to the shoulder and aid in the diagnosis.
Without proper elbow function our daily activities can be significantly impaired, from brushing our teeth to being able to open jars and even hold a bag. The two most common conditions presenting to a physiotherapist are tennis elbow and golfers’ elbow. Tennis elbow affects the lateral, or outer aspect of the elbow and effects the common tendon that deals with wrist extension. Golfers elbow occurs on the medial aspect, or inside of the elbow and affects the common tendon that deal with wrist flexion. Both of these generally occur due to over use of the muscles and are not specific to golf or tennis. Other conditions such as arthritis and nerve entrapment may also occur around the elbow region. The physiotherapist may initially start the treatment plan with a combination of soft tissue, electrotherapy or even dry needling. Rehabilitation exercises along with activity modification will also be given in order to aid in the recovery.The wrist is made up of multiple bones, joints, ligaments and tendons. Pain in this area can occur due to forms of arthritis, such as osteoarthritis and rheumatoid arthritis as well as repetitive strain and carpel tunnel. More often, pain occurs as a result of an injury leading to a sprain or even fracture. Computer and mobile phone use, as well as racquet sports are some of the causes of these issues and can not only affect someone's work productivity but also their hobbies and activities. A physiotherapist will be able to exam the area and conclude the best form of management going forward, which may include soft tissue work, joint mobility work, using strapping or taping to support and stabilise the area as well as specific stretches and exercises.
This may be caused by poor posture, but also due to the attachment of the ribs, may also be caused by problems in rib function. Dysfunction in this area can also be caused by bony changes due Osteoporosis, Spondyloarthritis, or other red flags which the Osteopath would look for signs of within their examination. The treatment would involve hands on techniques such as soft tissue work of the surrounding musculature, stretching, spinal joint mobilization in restricted areas. If deemed safe and necessary, they may also perform a spinal manipulation (click) as well.
There are several reasons why someone may suffer from Lower back such as instability, arthritic changes, osteoporosis and degenerative disc issues. Disc bulge AKA slipped disc/herniated disc occurs when inner aspect of the disc can start to herniate the outer aspect, which can irritate the surrounding tissue and nerves. This can occur anywhere along the spine but is most common in the lower back, giving the symptoms into the leg and foot, commonly known as sciatica. Under the NICE guidelines, manual therapy along with exercise prescription, which physiotherapists work closely with, is recommended for lower back pain with or without sciatica. By working closely with the patient, the physiotherapist can develop and progress a tailor-made rehabilitation program to help with reducing pain and improving health and function.
Hip Pain can occur due to multiple reasons such as overactive/underactive musculature within the region. Another reason for problems within the hip could be due to arthritic changes and rheumatological conditions. Through examination and testing, the physiotherapist would be able to aid in the diagnosis of this and may suggest further imaging and other tests. Treatment may involve soft tissue work of the muscles, articulation and mobilization of joints within the area as well as looking at improving movement and stability from the feet to the lower back. Specific strengthen and stretching exercises would also be given so treatment and recovery would be as effective as possible.
Being the biggest joint in the body, the knees deal with significant load through our lives and are therefore at added risk in damage. There are many structures within the knee that can become irritated or damaged within the knee. They may also become arthritic as well with time. The physiotherapist will use various orthopaedic and functional tests in order to diagnose what the cause of knee pain may be. Once this has been decided, and if deemed suitable, they will then put together a treatment plan based on evidence which may involve manual therapy techniques such as soft tissue massage along with specific rehabilitation exercises. They may also give advice on lifestyle changes to help with pain relief and recovery. If need be they may also suggest a scan on the area as well.
The Foot and ankle joint must be mobile as well as stable and strong. There are many bones, joints and connective tissue within this area that gets significantly loaded daily. If foot function is not correct, then this can have an effect further up the body, as well as even being able to move around comfortable. Causes of foot or ankle pain may include sudden changes in activity, poor footwear, arthritis and trauma. By examining the foot and surrounding structures, the physiotherapist can get an understanding of what is causing the pain and how it may be resolved. The physiotherapist may also observe how your foot is functioning whilst walking, running or even squatting. Once a diagnosis has been reached, a treatment plan would be put in place, which may include, manual therapy, electrotherapy, orthotics and exercises.