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The Spectrum of Physiotherapy: Where can it help you?

The Spectrum of Physiotherapy: Where can it help you?


Taylor Goedhart, Physiotherapist | June 18, 19

Orthopedic physiotherapy is probably the kind of physiotherapy that comes to mind when you think of seeing someone for an injury. Did you know that there are also physiotherapists that work in the fields of pediatrics, geriatrics, oncology, cardio-respiratory, neurology, and even animals? Have you ever wondered about which physical therapy is right for you, or the situation you may find yourself in to need one? Read along and I will enlighten you! 

My name is Taylor and I am a physiotherapist with experience working with outpatient orthopaedic patients doing post-surgical rehab at the University of Alberta Hospital. Next, I worked in the cardiorespiratory field of physiotherapy with Heart, Lung, and Liver transplants at the U of A hospital. I’d love to share how certain physiotherapists can better assist and highlight care for your situation, based on my experience!

Generally, Physiotherapists are “regulated primary health care providers” who assist people to restore, maintain and maximize their strength, function, movement, and overall well-being. Your Physiotherapist is trained to have an in-depth knowledge of how the body works. This includes specialized hands-on clinical skills to assess, diagnose, and treat symptoms of illness, injury and disability. Today, I will break down all facets of what a physiotherapist should consist of. From how to know if they have the proper training, why you don’t need a doctor’s note to see one, and the different styles of Physiotherapists available to suit your needs.

So what does it mean to be a “regulated” health care provider?

Why is it important that my physiotherapist is “regulated?” The term “regulated” means that only those professionals who have proven to obtain the appropriate schooling and are registered within the profession may call themselves “physiotherapists” or “physical therapists” or use the abbreviation “PT”. Note*: “Personal Trainer” is not a protected or regulated profession, and they are NOT legally allowed to use the abbreviation “PT”.

"Primary Health Care Provider" means they often are/can be the first point of contact that a patient has within the health-care system. This means that you do not need a doctor’s referral to see a physiotherapist. The role of primary health care providers is to mobilize and coordinate services and resources to promote health, prevent illness and manage chronic disease.

Note* Your health insurance may request a doctor’s referral for physiotherapy billing purposes.

Where do Physiotherapists work, and what are the different types?

When most people think of physiotherapy, they often think of it in a sports medicine or a sport rehabilitation setting, which leads them to believe that only high-level athletes, or those who have been injured while playing sports need physiotherapy. Although this is a large and important area of physiotherapy, there are many other areas of healthcare that physiotherapists can work. For example:

· Orthopedic/Musculoskeletal: treatment focuses on restoring function of muscles, tendons, joints, ligaments, and bones.

· Pediatric: treatment is specific to the needs of infants, toddlers, children and adolescents with developmental, neuromuscular, or skeletal disorders.

· Geriatric: treatment is focused on the specific needs of older adults, such as arthritis or osteoporosis, joint replacements, balance disorders, or Alzheimer’s disease.

· Cardiorespiratory: specialized treatment focused on prevention, rehabilitation, or compensation for people with disease that affects the heart and/or lungs. Such diseases might include: asthma, pneumonia, COPD/emphysema, heart disease, or a previous heart attack.

· Neurologic: treatment that specifically focuses on injury or disorders affecting the brain or spinal cord, such as traumatic brain injuries, spinal cord injuries, multiple sclerosis (MS), Parkinson’s disease, or Cerebral Palsy.

· Pelvic Health(for both men and women!): mainly focused on issues related to the female reproductive system, but also with issues relating to the pelvic floor that affect both men and women. Pelvic Health Physiotherapist can help with urinary incontinence, frequency, or urgency; internal pelvic pain; abdominal diastasis; low back, pelvic girdle, or tailbone pain.

· Pain: treatments specifically designed to help with understanding and overcoming Chronic Pain.

· Oncology: treatment spans from early diagnosis to end of life care. Oncological Physiotherapists are involved in maintaining and restoring range of motion during and after radiation therapist or resection surgeries. They also help with managing cancer-related pain, lymphedema, and weakness

· Animal Rehab: A specialized division within the Canadian Physiotherapy association. They are a group that is passionate about the physical health and function of canine and equine patients, in the context of sport and performance, post-surgical, or in old age.

What should a Physiotherapist do for YOU?

Regardless of the kind of physiotherapist you see, the same principles apply in regards to your care. If you have never seen a PT before, here is a sample of what could happen!

Assessment: Physiotherapists will start by taking a detailed history, and use a variety of specific physical tests and measures, as well as other questionnaires or surveys. They will then analyze that information and use their clinical reasoning to establish a working diagnosis. If the physiotherapist is unable to determine an exact diagnosis, or feels that other healthcare providers should be involved in your care, they will refer to the appropriate healthcare provider for treatment, imaging, a second opinion, or anything else you might require. Once a diagnosis is reached, the physiotherapist will then work with you to establish a treatment plan that is consistent with your goals and current level of health and function.

Treatment: Physiotherapists will incorporate different aspects of treatment that are supported by the best research evidence available. The 4 categories of treatment that a physiotherapist will employ are: Education, Exercise, Manual Therapy, and Modalities.

  1. Education: Giving patients the knowledge about their body and injury is one of the most powerful tools a PT can use. Patients who are educated will have a greater understanding of the condition and why a specific treatment is being used. This will leave YOU better equipped to take an active part in the treatment process. Education may focus specifically on the injury, but can also include anatomy, biomechanics and ergonomics to modify job duties, and general health information (example:smoking cessation, sleep hygiene, pain management strategies, nutrition) that can also contribute to healing.
  2. Exercise: Exercises are proven to help decrease recovery time after surgery, as well as prevent future injury, which is why most physiotherapists implement them for a well-rounded rehabilitation. These programs should be personalized, and designed around strength, mobility, and function. Additionally, it should be focussed around specific patient goals, and the link to those goals should be clear. Exercise programs can start very basic with singular muscle activation or retraining exercises, and progress all the way to a person’s highest capacity of function, or returning people to specific job tasks. Now remember, this will look very different depending on the patient. One person’s highest capacity may involve them being an Olympic Athlete, where as other patient’s goals may be to climb the stairs in their home safely and pain-free.
  3. Manual Therapy: This utilizes and involves specific hands-on techniques, including but not limited to manipulation/mobilization, soft tissue massage, myofascial or trigger point release, manual stretching, muscle energy techniques, and tactile muscle cueing. The techniques are used to treat soft tissue and joint structures for the purpose of modulating pain; increasing range of motion (ROM); reducing or eliminating soft tissue inflammation; inducing relaxation; improving contractile and non-contractile tissue repair, extensibility, and/or stability; facilitating movement; and improving function.
  4. Modalities: These include a variety of treatments that can be used in addition to the other treatments above, and should not be used as the sole focus of treatment. Modalities include treatments such as: dry needling, hot packs, ice, ultrasound, TENS and IFC electrical modalities, Electrical Muscle Stimulation, LASER, or taping. These treatments can be helpful in the acute stages of an injury, and are used to manage symptoms of pain, swelling, and biomechanical dysfunction. However, they are not long-term solutions and should not be used in isolation.

Thanks for reading, and stay FIT Lethbridge!

- Taylor