What is Physiotherapy? Let’s Change the Way We View It

5 Mar, 2023

It seems most people think physiotherapy or physical therapy (if you’re from the states) is coming into clinic and getting some sort of rub or manipulation (manipulating what exactly?) or getting strapped back together or getting stuck with needles or electrodes, I’ll give you a rubber band with some generic exercises and stretches aaannnddd “see ya next week.” (That was a run-on sentence, I know). I have heard from a lot of patients that they do not feel heard or listened to. In many instances you will see therapists treating for 20-30 minutes or even treating for 20-30 minutes bouncing between multiple patients! No wonder people feel like they are not getting the attention they deserve! More importantly, in my opinion, physiotherapy has been considered something you participate in when you’re “broken.”

Traditionally, physiotherapy has been quite hands-on, but physiotherapy literally means “physical therapy.” Allied Health Professionals Australia describes the role of physiotherapists as such:

“Physiotherapists are experts in the structure of the human body and its movement. They work with people of all ages to treat a broad range of health conditions including sports injuries and musculoskeletal conditions as well as chronic health conditions such as diabetes, obesity, osteoarthritis and stroke. Physiotherapists are involved in the assessment, diagnosis, planning and management of patient care. They help patients with chronic disease management, provide lifestyle modification and self-management advice, prescribe aids and appliances, prescribe and supervise exercises for both patients and carers, and provide health promotion education, occupational health assessments and injury prevention activities.”

From <https://ahpa.com.au/allied-health-professions/physiotherapy/>

Now, if you are not in the healthcare industry, were you aware of this? Physios can help you in a variety of areas with individuals of all different conditions and backgrounds! It takes about 17 years for research to be globally recognised and implemented into practice. If it takes this long for people in our profession to catch on to what’s up-to-date, it’s no wonder the general public’s view on physiotherapy is even more behind on the times!

In a world where we are so used to convenience and instant gratification, it’s hard to blame people for expecting physiotherapy and health to be the same. However, I feel it is my responsibility and the responsibility of everyone else in the health industry to shift this mindset of the general public. When you have a flat tire, you just replace it and happy days. If the wheels on a car are out of alignment, take it to the shop and it’s realigned straightaway. Good as new. If we want to purchase a product, we are a few clicks away with online shopping. If you are sick, you go to the doctor get a shot or take a pill and you’re good (sometimes). We seem to think the human body has quick fixes to it as well. It’s human nature to chase after shiny objects (i.e. new fads in health such as diets and exercise programs). We want the magic pill. After all, who the hell has the time to fix themselves?

Unfortunately, the human body just doesn’t work like that. It’s not a machine where parts can be replaced and it’s good as new. “But, what about joint replacements and surgery?!” Sorry to be the bearer of bad news, but unlike a machine, you can’t just replace something in the body and be 100% back to normal. It takes time and consistency in rehabilitation after a replacement to get there. Muscles become inhibited due to pain, swelling ensues which stiffens the joint, joint awareness is altered due to nerve endings being severed, movement patterns are altered; the entire function of the area has to be retrained and restored. If you think about it, when you get antibiotics for being sick, you’re not directly changing the body, you’re killing something off that’s in the body. “But if I have high cholesterol, I get medication for it and it’s fixed.” No. No it’s not fixed. Because if you were to come off of it, BOOM goes your cholesterol. The medication is just masking the issue. It’s a band-aid fix, and you are led to believe that you must be reliant on it. The question is, what’s actually is causing your health issues, i.e. pain? And therein lies the permanent solution to your problem. If you can find the root cause of an issue, you can usually come up with a solution.

The human body is an adaptable organism. It is constantly changing whether you realise it or not; millions of cells die off and are replenished on a daily basis. It can change positively or negatively depending on what it is being exposed to. It is the job of a physiotherapist to use this feature of adaptability to change the human body in a positive manner. We utilise one of the most effective techniques to do this – exercise.

Although massage and passive techniques feel good in the moment, exercise, if utilised correctly, will be the main driver of permanent change. What causes change with anything in life? Stress. Not comfort. We tend to stay in the same place when we’re comfortable. There is no need to go anywhere else. Stress is what forces us to move. What the hell does this have to do with physiotherapy? Well if you combine stress with this principle of adaptability, the right dosage of stress will cause the body to adapt in a positive manner. Consistently expose the body to the right amount of stress for long enough and viola, permanent change. You do not go to the gym one day and wake up the next day with a six-pack. You don’t build a successful business overnight. You don’t put $100 bucks into stocks one day and become a millionaire the next. You don’t get married after the first date (unless you’re delusional). The same principles apply to physiotherapy, rehabilitation, exercise and health in general. It amazes me that people will pay a personal trainer for months of training in order to change their body, but they expect to be fixed in one session at physiotherapy when it’s injured!

With that being said, people must understand, I do not fix you. (Hold up, keep reading!) In fact, no one should be trying to fix you. That creates a reliance on someone else or a modality. It robs an individual of being able to control their situation. Subconsciously, it takes away the power from the individual. What we do is show you how to fix yourself! “Now why would I pay good money for you to have me fix myself?” – Because that is an empowering, and long-lasting experience. By showing you how to fix yourself, we are facilitating independence and self-efficacy. We are showing you how to take control of your own health. When you learn how to fix yourself, the power shifts back to you. This not only changes you physically, but mentally. If there is one proven means to do this, it is exercise. The combination of the body’s ability to adapt to stress and tailored exercise will bring about the permanent solution, not the band-aid fix.

On to the next shift in thinking that needs to occur: You only go to physiotherapy when you’re “broken” right? WRONG! Physiotherapists are movement experts, and specifically, musculoskeletal physiotherapists should be masters of injury prevention as well as injury rehabilitation. Instead of being reactive with your health, why not be proactive? I believe this has been very much underpromoted in our profession. “You don’t have pain, you don’t have to see me.” We constantly review risk factors for injuries and pathologies, yet we don’t take it upon ourselves to promote that we can identify and mitigate those risks until the damage occurs. Maybe some physios have become complacent with their job. Maybe others want to do the bare minimum and work their 9-5 and go home like any other profession. Maybe some have the mindset of, “Meh, that’s not my job.” I can’t speak for others, but all I can say is that I don’t subscribe to such a mindset.

A lot of us have actually come from a personal training and strength and conditioning background in order to master all aspects of exercise, physical activity and to get people performing their best while overcoming any condition. What I’ve realised is many of us who come from this background do not promote our knowledge, skills and expertise in areas of higher-level performance and usually stick to beginning and intermediate stage rehabilitation once we enter this profession. I cannot understand why that is. Maybe it’s because the design of the system separates these fields instead of meshing them together. Why would you not want consolidate all that skill and knowledge into one? This is what I do. I integrate the areas of physiotherapy, exercise physiology, personal training and strength and conditioning to get optimal results for patients in an efficient manner. I take the best of all worlds and unite them as my style and approach to physiotherapy. I enjoy giving patients exercises that are outside of the box so they are not mundane and boring. I tailor my exercises so they are transferrable to the skills and tasks individuals need to complete outside the doors of the treatment room i.e. sport, work, hobbies and home life. I want a physiotherapy session to be something someone looks forward to coming to, instead of an obligation that is boring. Ultimately, I hope to show all who walk through my doors that they are capable of doing more than they believe through physiotherapy and exercise.

This is my passion. I hope to change the landscape of physiotherapy and shift the way the general public views it.

And remember, YOU’RE NOT BROKEN, YOU JUST HAVEN’T BEEN BUILT.