Physiotherapy is the most commonly referred healthcare professional by GPs. We are experts in the diagnosis and treatment of musculoskeletal injuries such as low back pain, whiplash, shoulder pain, elbow pain and so many more. As well as being able to deftly manage injuries sustained whilst competing on the sporting field such as ACL ruptures, MCL sprains, ankle sprains, hamstring or calf strains, and shoulder dislocations just to name a few.
Physiotherapists can act as first-contact practitioners, meaning that as a private paying client you do not need a referral. If you are wanting to access WorkCover, Medicare, DVA, or Third Party Insurance claims you will need a referral from your GP, and then I deal with everything else from there.
There are many practitioners who can manage musculoskeletal injuries such as chiropractors, osteopaths, and massage therapists, so why did I choose to become a physio? I became a physio following my experience as a client and I appreciated the range of services that a physiotherapist can provide from hands-on care to a thorough exercise program and educating me through what has happened, how it happened, and what we need to do to fix it. It’s not that these other professions can’t do it, I must admit I’ve never seen a chiropractor or osteopath previously simply because I have never felt the need. In my experience as a client and as a physiotherapist, I believe our profession is well-equipped to rehabilitate any musculoskeletal injury to its peak performance.
I honestly see mobile physio being the future of physiotherapy delivery. Not only is it so much easier for clients to access – I mean you haven’t got to go anywhere, who doesn’t love that right? But it cuts down on my costs which means it can become more of a cost-efficient delivery of service for clients. This enables me to be able to perform extended consults as a standard that benefits everyone, I can perform a more thorough assessment and diagnostic process, leading to improved outcomes.
I personally love mobile physio, I find that the environment is much more relaxed and comfortable. The old clinic rooms that I used to work in with 3/4 walls and you can hear the conversation next door should be long gone. Truly private and individualised treatment is the ultimate benefit of mobile physiotherapy. We can meet you whenever, wherever. Whether that be at home, at the office, at your gym, or at your local sporting field, wherever you need me, I can be there.
Sports physiotherapy is so much more in-depth than just physio for people that play sports. It takes a deep understanding of the athlete and their sport, I’ve learnt a lot about sports ranging from cricket to Irish dancing, and from ballet to the intricacies of rugby union. Understanding the athlete, the role they play within their team, and the playing style of their team. Or understand the dancer and the intricacies of their dance style, I may not be able to perform a Fred Astaire, but I know what one is.
When working with athletes I will spend a fair amount of time on the initial consultation to get an understanding of all of this. We will also be working together to determine the goals for rehabilitation, particularly whether there is a certain date, game, or performance that we are working towards. This allows us to map out the best avenue to getting back to 100% for that particular day. Sports physiotherapy takes a lot of planning more than anything else, without this legwork early on in the piece, it becomes a rush towards the end.
Having previously suffered injuries through my time as a teenager playing basketball to now getting the odd injury here and there due to running and triathlon, I know how frustrating it can be to have to sit down and rest for a bit. I think physios can sometimes be the worst patients for each other. But sometimes taking some time to rest and recuperate is the best option, but in the ideal world, I like to keep all of my athletes doing something to keep them engaged in their sport or with their team.
Sometimes this can get referred to as “normal physio” by clinicians, it forms the bulk of a lot of clinicians’ caseloads and a lot of it should be our bread and butter. This often includes the management of back pain, neck pain, shoulder pain, and a lot of the common aches and pains people report. What I think can be forgotten by some physios is that even though a lot of the people coming to clinics for the management of these injuries aren’t athletes, they are still people who have things they love to do in life. Whether it be going hiking on weekends, playing in the backyard with their kids, taking up photography, computer gaming, or playing an instrument. All of these things are things that bring certain people enjoyment and happiness, take it away from someone and you can have a big impact. So whilst athletes are often always reminded of needing goals, we too need to work towards goals for clients with everyday aches and pains. I recall seeing a client last year who suffered from sciatica and his goal was simply to be able to play in the backyard comfortably with his children, a simple but achievable goal we both worked towards.
In these cases, expert hands-on treatment is often one of the backbones of the treatment pathway. A lot of these presentations respond well to specifically chosen soft tissue releases, joint mobilisations, or other adjunct treatments such as dry needling or taping. When coupled with an individualised exercise program for an engaged client who is well-educated on what is happening powerful things can happen.
Dry needling is one of the more common adjunct treatments physiotherapists perform. It is slightly different to acupuncture, something I am not trained in. In essence, acupuncture works on what is known as the meridian system, to my understanding, it is certain points working together to create a certain effect. Dry needling is a little different. It works more based upon “western medicine” principles, essentially we find what feels to be a muscle knot, or a motor point in the muscle, essentially an area where there is an increase in tension. The needle is inserted into this area with the aim of reducing muscle tone, the mechanism of how this is meant to work we aren’t entirely sure of yet, but dry needling can have some fantastic short-term results. Common potential side effects could include feelings of tiredness or fatigue afterwards, or feelings of a dull ache sensation where the needle has been inserted.
These are some of the most common treatment techniques that I use with clients of almost any presentation. If clients are presenting with areas of increased joint stiffness such as through their thoracic spine, elbow, ankle, knee, or any joint, chances are joint mobilisations will have a good effect. Often we will be working within the joint plane of motion, or on occasion, we may do what is called a mobilisation with movement. This is where we produce a glide on the joint as you move the joint through the range of motion, I find these can work exceptionally well for knees, ankles, and elbows.
Often clients have a love-or-hate relationship with these. This will often take place in the form of trigger point releases or massage of a specific muscle that we will target following our objective assessment. Releasing muscle tone can create improvements such as improving range of motion, reducing sensations of stiffness, reducing tenderness or pain to touch, and improving function. Like most techniques, I’m ok with some soreness during treatments such as tissue releases, but I don’t want something to be too sore, I find often that leads to clients tensing up and can often have the opposite effect of what we are wanting.
Exercises seem to be the bane of most of my client’s treatment programs. Often people don’t find them exciting, or they are tired when they get home from work, or sometimes they just simply forget. I get it, life gets busy, and doing calf raises often isn’t fun. But doing the exercises that are programmed will get results, I’m confident in it. Exercise programs should be specifically tailored to you, your goals, what you enjoy doing, and what you have the time to do. The best exercise to choose is the one that gets done. If you tell me you hate the gym, I’m probably not going to write you a gym program. But if you tell me you love pilates, great, let’s have a look for some pilates classes or whether we can build you an at-home pilates program to do. I want to build you a long-lasting exercise program that you enjoy doing because that is what will get you the long-term results you want.