What do Physiotherapists Do?

A physiotherapist’s primary role and focus is to restore functional movement after an injury, disease, or even disability has adversely affected your mobility. Physios work as part of a multi-disciplinary team, working with doctors and nurses to supplement their treatments.

Physiotherapist assessments

Throughout your care any medical professionals who see you will contribute to a set of notes which document both your medical history and the steps taken in your treatment so far. A physiotherapist has access to these notes, but will also carry out their own assessment geared towards how your movement and the mechanisms behind it are affected. Based on these findings, a treatment plan will be made to restore functionality at a rate a suitable for you.

The sessions should include taking a medical history for the sake of comprehensively accounting for all symptoms present. At this point the therapist is ascertaining your suitability for physical therapy and the nature of the treatment that would be given. You will be asked questions about the condition, normally focussing on what you’re experiencing in the affected areas, i.e. stiffness, pain, and range of motion. The physio will often ask you to rate things like pain on a scale of one to ten to determine the severity of your injury. The most important thing to bear in mind at this stage for you as a patient is to answer the questions honestly. Your therapist is a professional and so you should feel confident that they will respect your answers and treat them with due discretion.

The physiotherapist will then go onto assess you by means of manipulations and movements designed to test your range of motion, and will ask you where you are experiencing your pain and/or stiffness. Take comfort in the fact that this assessment is rooted in about 100 years of research and literature, and so even if some of what you are asked to do might strike you as strange, it is for your benefit.

What is a physiotherapist looking for during the assessment?

As mentioned above, establishing pain, stiffness, and range of motion are largely what the physiotherapist is looking for, but this is only part of what a trained professional therapist is observing throughout your assessment.

A physio will be observing your posture and movement throughout the session, looking for any abnormalities in either department that you yourself might not be aware of, but that are contributing to your condition in some way. You will be examined for any observable signs of abnormality as well, including signs of swelling, discoloration, and asymmetry. A physio will also palpate the area, meaning examine by gentle exploratory motions on your skin, to distinguish anything out of the ordinary, for example a noise in your joints called crepitus, deformity, heat, or tenderness.

The therapist will often also examine an unaffected part of your body. What this means is if you have a knee injury, they will often have a look at your other knee to establish a baseline from which to reach their conclusions. Everyone’s body is different, and so it is important that your therapist establishes what is normal for you in terms of your physiology.

What does a physio do with the diagnosis from assessment?

Once a physiotherapist has established the specifics of your condition, s/he will begin to discuss what they think are the best possible routes of treatment for you. This may sometimes involve a referral to another healthcare professional, but will often involve a plan to improve your functional movement over a certain period of time. Your therapist will discuss your options, and suggest what s/he thinks would suit you best. Your treatment is likely to involve some adjustments to your lifestyle and a regime of exercises and appointments suited to you and realistic goals that you want to achieve.

Broadly speaking, a physiotherapists roles, always rooted in restoring or developing healthy and functional mobility, involve:

• Evaluating and hence strengthening the musculature of the affected area, and also increasing coordination and endurance in both the ailing muscles and surrounding supporting structures. Joints for example are composed of a number of different bones, ligaments, tendons, and muscles, if one of these is affected, rehabilitation doesn’t only focus on the distressed component, but the network around it to facilitate the best possible recovery as well as lowering the risk of future injury.
• Improving balance and posture, particularly if the injured area is influenced by these. Injury has an unfortunate habit of causing habitual changes like posture (e.g. leaning to one side if the other is injured), which has a negative effect on balance and hence functionality. Part of recovery is restoring healthy balance and posture to prevent further injury.
• Using a range of techniques for pain relief, including using heat and cold both superficially and deeply, hydrotherapy, electrophysiotherapy, and a host of massage methods. Pain is often the most debilitating aspect of physical injury, and physiotherapy can supplement drug treatments or work in their stead if there are complications that prevent the use of stronger pain killers.
• It’s not widely known that physiotherapists play a role in evaluating your home environment and improving its accessibility and suitability for you and your condition. Having developed an understanding of your particular situation, a physio is well suited to making recommendations on how to best improve your quality of life at home. A practice particularly important to patients suffering severe injuries or disabilities that will take an extended period of time to rehabilitate.

These objectives are carried out by physiotherapists as part of a team, working closely with other healthcare professionals both in and out of hospital.

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