Physiotherapy is a branch of rehabilitative medicine aimed at helping patients maintain, recover or improve their physical abilities. Physiotherapists work with patients whose movements may be undermined by ageing, disease, environmental factors, or sporting hazards. A physiotherapist seeks to identify and maximise quality of life and movement potential through prevention, intervention (treatment), promotion, Habilitation, and rehabilitation.
- Habilitation means making somebody fit or capable of doing something.
- Rehabilitation means making somebody fit or capable of doing something they can no longer do properly or at all, but used to be able to – i.e. restoring an ability or abilities.
- Promotion means the process of enabling people to increase control over and improve their health.
Physiotherapy is a clinical health science
Physiotherapy is not alternative therapy. It is a clinical health science. Physiotherapists study medical science subjects, including anatomy, neuroscience and physiology in order to acquire the health education needed for prevention, diagnosis, treatment, rehabilitation, etc., of patients with physical problems.
A qualified physiotherapist is an expert in the examination and treatment of people with cardio-thoracic, Musculoskeletal and neuromuscular diseases; focusing on conditions and problems that undermine patients’ abilities to move and function effectively.
Physiotherapy is based on science
Physiotherapy is science-based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery. The exercise of clinical judgment and informed interpretation is at its core.
What does a Physiotherapist do?
Physiotherapists use their training and skills to treat a wide range of physical problems linked to different systems in the body, including:
- Neuromuscular systems – concerned with both nerves and muscles. Nerves include the brain, spine and nerves throughout the body. Neuromuscular refers to neuromuscular junction – where nerves and muscle fibres meet, and also includes neuromuscular transmission – the transfer of information, impulses, from the nerve to the muscle.
- Musculoskeletal systems – an organ system that gives us the ability to move using our muscles and bones (muscular and skeletal systems). The Musculoskeletal system gives us form, movement and stability. The Musculoskeletal system includes our bones, muscles, cartilage, tendons, ligaments, joints, and other connective tissue.
- Cardiovascular systems – include the heart and the circulatory systems. The circulatory system carries nutrients and oxygen via blood vessels to the tissues of the body and removes waste and carbon dioxide from them.
- Respiratory systems – include organs that are involved in breathing, such as the lungs, bronchi, trachea, larynx, throat, and nose.
When arriving to see a physiotherapist, you may have concerns as to what will happen over the course of your session. You may also wonder why and what the therapist is doing. In general physiotherapists will utilise the following treatment modalities and tailor these to meet your needs:
Manual therapy consists of a variety of hands-on intervention techniques ranging from soft tissue mobilisation, joint mobilisations to joint manipulations. Manual therapy is a highly effective treatment method that can provide pain relief, improve range of movement and improving function.
Physiotherapists use various techniques to have an effect on the soft tissue. Deep friction techniques, Myofascial release and Trigger point therapy are the common techniques used by our therapists to breakdown scar tissues, improve the extensibility of the soft tissues, enhance circulation and encourage drainage.
The most common techniques are from Maitland and Mulligan. Varying degrees of passive mechanical pressure is directed at a particular joint, encouraging a specific movement in a specific direction. The movement aims to improve joint mechanics and/or correct joint positional faults. It also stimulates mechanoreceptors which helps to reduce pain. Because of their knowledge of joint kinematics, physiotherapists are able to facilitate small movements in joints to have a big effect in the overall range of movement.
Joint manipulation is characteristically associated with the production of an audible ‘clicking’ or ‘popping’ sound. This sound is believed to be the result of a phenomenon known as cavitation occurring within the synovial fluid of the joint which is the rapid release of trapped gases in a high pressure environment similar to uncorking a Champagne.
Maitland technique has classified this manoeuvre as a high velocity low amplitude movement. This technique is also commonly seen in the traditional barbershops, thai massages and chiropractors. It is known to provide good short term relief. There can also be rare complications that arises from this technique especially to upper cervical spine. The rapid rotary movement of the neck has the potential to shear an artery supplying blood to the brain, hence this technique is only performed by experienced and qualified physiotherapist with a prior assessment of the client to ensure safe effective and appropriate application of technique.
Which technique works best for me?
Your physiotherapist will have to perform a consultation and physical assessment to determine the cause of the problem before choosing the appropriate technique that works best. It is also important to determine the pain pattern in terms of severity, irritability and nature of pain.
Sometimes, it is a combination of a number of these techniques over a certain time frame which is required to achieve the best results.