As a physiotherapist, I pride myself in giving my patients the very best in rehabilitation, injury prevention, and performance-based treatment. However, I often find patients don’t always know what this looks like. So what does good treatment look like when it comes to physiotherapy? What should you expect from your physiotherapist to help you achieve your movement/health goals?
I'd suggest that there are three things that make for good, effective treatment:
Education: More important than you might think!
As a physiotherapist, I am privileged to have people entrust me with their bodies, and ask for guidance on how to manage their physical health. This starts with education on their pain, injury or performance needs (basically whatever brought them in for help). As a minimum, education should give you an idea of what you can do, what you want to avoid, and how to help yourself move forward. Education should also encourage and empower you with the knowledge that your efforts will get you better. Education clarifies your perception of hope.
Be wary though, not all education is created equal! There is evidence that poor education does not enhance recovery (ref, ref), while positive and encouraging education improves recovery (ref, ref). With this in mind, make sure that the education you get from your health practitioner isn’t anxiety and fear provoking. If it does let them know that what you just heard scares you; go on to talk more about it so that you demystify what’s going on. This will forestall you from filling in unknowns with your all your worst fears. Your recovery will go much better if you know what to expect and if you aren’t distracted by anxiety about the unknown.
Hands-On Care: To get you moving better!
If education instills knowledge and hope, then hands on therapy can show you that this hope can be a reality. Possibly the most important thing of all in hands-on care is the use of the test re-test approach to show you that your pain or symptoms can be improved (i.e. some movement hurts to start and then doesn’t after hands on treatment). This shows you that you can get better! And most often, get better fast!
So what does hands on care look like? In physiotherapy it takes the form of soft tissue work, moving joints, stretching, and things like IMS or dry needling to help you move better and have less pain... “But what about those “tingly machines” (TENS and IFC) or “magic wands” (Ultrasound)?” Well, these modalities may be helpful early on if the pain is very intense, but these machines should be a very small part of good treatment, and should give way to a focus on movement and exercise as quickly as possible. In my experience it is rare that we need these machines, and most often we can find a way for a movement to help ease your pain and symptoms. Hands-on care helps identify what movements those might be.
You also might be asking, “why does hands on care (like soft tissue massage or adjustments) take away my pain for a while, but then it comes back again?” We know that the effects of hands-on care are only temporary (between 5 minutes and 24 hours; ref), but the realization that your pain and symptoms can improve quickly can last much longer. This is obviously intoxicating for both patients and therapists, and can become the focus of treatment in some cases. But our goal is lasting change, which means we can’t just stop at education and hands-on care…
Exercise: For lasting change!
Exercise is medicine! If it was in pill form, everyone would be taking it three times daily! In rehabilitation, exercise is what changes pain, injury, and performance long term. It helps rebuild your tissues, improve your heart and lungs, improve your strength and, just as importantly, helps you build confidence in your body and movement again.
Physical therapy sessions should always include exercise; it is the part of your treatment that will make a lasting change. The best part is you can do it yourself – what better gift is there in this process than knowing how to improve pain, injury, and performance yourself? Your physiotherapist can guide you and advise when and how to push into things, and when to pull back.
The end goal of physiotherapy is to provide you with the tools and knowledge to achieve your goals, move better again, and lead a strong, happy, and healthy life. All our physiotherapists at Tall Tree are here to help you in this way. So if you have any nagging pains, acute injuries, challenges returning to the active things you love to do in life, or just want to improve your performance and movement, give us a call and let’s get started today!