Physiotherapy Q&A

Jon Swan is a clinical services manager and physiotherapist based at The Harbour Hospital. John Mackey is a senior physiotherapist based at The Alexandra Hospital. David Hurley is a physiotherapy outpatient team lead based at The Priory Hospital and The Edgbaston Hospital.

We spoke to these three experts to understand what physiotherapy is and what it can offer people. They explain the basics of the discipline as well as the different situations in which physiotherapy can be used, the various approaches offered by our teams, and what you can expect when you come for physiotherapy with Circle Health Group.

What is physiotherapy?

Jon Swan: Physiotherapists help people affected by injury, illness or disability through movement and exercise, manual therapy, education and advice. The profession helps to encourage development and facilitate recovery, enabling people to stay in work while helping them to remain independent for as long as possible.

John Mackey: Physiotherapy is a profession that deals directly with people and their physical impairment or disability. Its main focus is to work together with patients to identify their physical challenges and educate patients regarding these challenges. Once this has been achieved, the therapist can begin to rehabilitate the patient in a way that is appropriate to that patient.

David Hurley: Physiotherapy is a science based profession which is delivered by specially trained and regulated practitioners who aim to improve health and wellbeing through prevention of injury and restoration of movement and function following injury or disability.

What are the reasons for having physiotherapy?

Jon Swan: There are a number of reasons for having physiotherapy. Patients often see a physiotherapist following orthopaedic and spinal surgery. They may also need physiotherapy following an acute injury or for a longer term problem such as back pain. Physiotherapists cover a wide range of other clinical areas including women's health, men's health, neurology and respiratory conditions.

John Mackey: You may choose to have physiotherapy because you are experiencing pain, reduced range of movement or functional limitations. This may include difficulty walking safely, getting up out of chairs or higher level limitations, such as noticing limitation in sport or during physically demanding tasks.

David Hurley: Physiotherapy can be beneficial in any stage of life to improve health and wellbeing. It can be helpful with treating pain whether lower back pain or pain following a sudden injury to the leg or arm. Also we can have a role in managing longer term conditions and also in preparation for sporting events. We can also offer specialist services such as women's and men's health, as well as respiratory outpatients and shockwave therapy.

What does a physiotherapy session involve?

Jon Swan: Initially physiotherapy involves an assessment session with both questions and a physical assessment. Treatment sessions involve a variety of techniques depending on the nature of the problem. These can include mobilisation of joints and soft tissues, exercises, taping and education. Some clinics have specialist rehabilitation such as the AlterG treadmill and Watt Bike.

John Mackey: A session will normally begin with being greeted by a physiotherapist and being taken through to a consulting area. Here the physiotherapist will ask a number of questions regarding the patient's problem and generally about their health. Normally there will be a discussion of goals and some agreement of both realistic short term and long term goals and how they will be reached. Once this has been completed the rehabilitation will begin under the physiotherapists guidance.

David Hurley: The session involves answering some questions in order to obtain a detailed history of events, followed by a physical examination. We consider how whole body moves and how this may relate to your symptoms. We would therefore request that clients wear appropriate loose fitting clothes / shorts, to allow a thorough examination.

Throughout, we aim to keep the client at the core of the process through discussion of findings, education, empowerment and participation in their goal setting and treatment.

What are the main physiotherapy techniques?

John Mackey: Physiotherapists have a host of skills and techniques they may use based on their understanding of the current evidence based practice and their own experience. A physiotherapist may use hands on skills such as soft tissue release techniques, joint mobilisation or manipulation techniques. Physiotherapists are also specialists in prescribing therapeutic exercise. Other techniques may include acupuncture and electrotherapy such as ultrasound.

David Hurley: Joint and soft tissue mobilisation, joint manipulation, tailored exercise therapy, acupuncture, shockwave therapy, Pilates, electrotherapy, muscle stimulation and postural education.

What are the benefits of having physiotherapy?

Jon Swan: Within physiotherapy we aim to optimise a patient's function and minimise pain. We aim to get patients back to what they enjoy doing whilst understanding about their condition and recovery.

John Mackey: Physiotherapy can benefit patients by improving confidence and self-management strategies regarding a patient's condition. It gives you an opportunity to learn about and care for your body from a specialist. Other benefits such as eliminating or reducing pain, as well as increasing functional ability are also possible. Patients can also benefit from improved sports performance and injury prevention strategies that are often being employed in elite sports. Patients may also be interested to have their biomechanics assessed in order to further aid injury prevention in the future.

David Hurley: All our interventions are chosen to suit the individual needs, but in general the benefit is restoration of movement and function through reducing pain, improving movement and increasing strength in order to improve or maintain health and wellbeing.

How many sessions are usually needed?

Jon Swan: This varies depending on the condition involved but most conditions can normally be treated in 6-8 sessions with many patients needing less than that.

John Mackey: Most patients gain immense benefit from 6 sessions of physiotherapy but this can be different from patient to patient and needs to be considered on a case by case basis.

David Hurley: The number of sessions needed vary depending on the pathology / disability / injury we are treating, however after the initial assessment we would outline a treatment plan that would include expected timeframes and number of sessions.

What are the alternatives to physiotherapy?

Jon Swan: This depends on the nature of the condition. Some patients are happy to manage with advice and education. If conditions to do not improve then some patients need referral on to a consultant.

John Mackey: Alternatives to physiotherapy may depend on what your problem is. Some people may see an osteopath or a chiropractor for similar conditions, while others may discuss their problems and receive treatment from sports therapists, and acupuncturists. It is advisable to see a Physiotherapist first to identify the main problem and be directed to alternatives to ensure they are appropriate and safe.

David Hurley: The main alternative to physiotherapy is surgical intervention.