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We fall short of clarity even in our name...what do you call us…well Physio is easy here in Canada but if you are in the USA this means nothing. You have to say Physical Therapist to be slightly better understood as to what we do as a profession. But still fundamentally there is a lack of understanding as to what our role is in the healthcare system.
I hear all the time, I have _(fill in the blank)_ pain and I need a Massage or I have back or neck pain and I need to see my Chiropractor. Very rarely do I hear I have ____ pain and I need to see a Physio to get help.
So I ask myself why are people not thinking about Physiotherapy as being on their list of professionals that can help with____ pain.
Has the Physiotherapy Association failed to make the message clear as to how integral Physios are? Have Physios failed themselves in not being able to convey their wide array of scientifically proven abilities? Have other professions done a better job at marketing themselves as the “expert” at ____ pain? How do we change the conversation to include Physiotherapy as part of the list of “experts” at helping with____ pain?
The fundamental underlying problem is that we as a Physiotherapy profession have such a broad scope of skills and vast areas of practice. Most people, even Doctors, do not know exactly what we can do and how varied it is. Here is just a simple list of some of the areas we Physiotherapists can practice in:
Private Clinics - that is the clinic down the street that might also be a multidisciplinary clinic, meaning they might have a mix of Massage Therapists, Chiropractors, Kinesiologists, Acupuncturists, etc.
ALL Physio’s can:
Assess and diagnose injuries
Determine a proven treatment plan
Improve Quality of Life
Treat vertigo and balance
Needle trigger points/’knots’ in muscles
‘Crack’/manipulate joints
Use massage techniques
Perform acupuncture
Manage Sports Injuries
Pre and post surgical rehab i.e. hip replacement, ACL repair
Help with pelvic pain and loss of bowel/bladder control
Go inside you mouth and help with jaw pain
And the list goes on for Private Practice skills.
Hospital Work (Public Practice Settings ie. paid for by Healthcare)
Physio’s work in:
Spinal Cord Rehab
Post Surgical Rehab
Burns and wounds management and care
Cardiorespiratory rehab
Heart and Lung Rehab
Emergency Rooms
Community Outreach
Stroke Rehab
Pediatrics (like, Children’s Hospital or Queen Alexandra Centre)
Neonatal Intensive Care
Scoliosis
Cystic Fibrosis
Juvenile Arthritis
…
Again the list goes on and on as to the list of all the things that we can do. Our profession prides ourselves on continuing education and maintaining evidence-based practice which is why we are continually ‘morphing’ our profession and losing the clarity of exactly what it is we do.
Our fundamental principle that covers all areas of practice is that we are always physical movement ‘experts’. Meaning, whatever condition, injury, illness and/or surgery (pre or post) a patient is living with, we are the professional in charge of figuring out how to get you back to optimal movement.
In the Private Clinic setting Physiotherapists’ main responsibilities are taking information from the patient to determine a diagnosis, to create the problem list, to facilitate goal setting and to create & implement a plan to reach those goals.
It is very simple. You go to a Physio to find out what is going on and how to fix it.
So why is it so confusing?
For a couple reasons:
Our Profession holds us to extremely high ethical standards and so it should! But with this comes some limitations that start to make our expertise unclear;
For example;
we are for the most part not able to call ourselves an ‘expert’ at anything!
we are not allowed to use testimonials to convey our success
we are not allowed to endorse a product that we passionately feel works
we are not allowed to ask for reviews (Google, Facebook, etc.)
All of these are in place so that we do not mislead the public in anyway. But many of these factors make it difficult to lead the public in our direction as well. Therefore, our profession gets stuck in the Classic ‘Catch 22’. Our Profession morphs over time with changes in research, advances in medicine, stresses on the healthcare system to spread out the workload, etc. Our profession started out as Nurses and morphed into its own regulated, recognized healthcare profession, Physiotherapists.
If you look at the other successful professions in our industry you will notice that they have positioned themselves as ‘experts’ at something with little room for morphing.
Chiropractors: experts at ‘cracking’ joints and fixing back and neck pain... but did you know that most Physiotherapists can do this as well? However we are not allowed to say we can ‘fix’ anything...but we can say that we can improve ____ pain or quality of life.
Registered Massage Therapists: experts at massage which is easy to visualize and very clear...but did you know that Physiotherapists learn numerous soft tissue/massage techniques and most of us use them in our treatments every day?
Kinesiologists: experts at exercise for rehabilitation...but a large portion of Physiotherapy training is in exercises for improving movement. This one most patients do seem to know, as they always ask for ‘Homework’ ie. exercises to do at home and we love to prescribe them!
Acupuncturists: experts at using needles in traditional holistic ways to treat the whole body… but did you know that many Physiotherapist learn acupuncture and/or dry needling, too?
Nurses: experts in day-to-day patient care, the status keeper of all the pieces of a patient’s current healthcare needs...but did you know that Physiotherapist have some overlap in this area as well with wound care, suture/staple removal, suctioning airways, etc.
Firstly, why just access one professional when there is room for all the professions to have their niche technique and be successful at helping you reach your goals, ie. spread the love! We are all better off having each other to rely on for second opinions, a different approach and a focused expertise that a patient might need.
Secondly, there are times when you may need a longer session of treatment in just one of these areas and then you would go to see the ‘expert’ for that technique. For example, you might see your Massage Therapist for the soft tissue work on your painful calf from running, while you also see your Acupuncturist for stress management and calf inflammation control, while you see your Physio for run retraining techniques and hands on ankle work and your Kinesiologist for strength and conditioning exercises to return to running.
The big thing that Physiotherapists can do above all the other professionals and more inline with Doctors, as we are also Primary Healthcare professionals, is that we can give a Physiotherapy Diagnoses for physical conditions. For example we can say, “you have a Full ACL tear in your Right knee” or “you likely have a disc bulge at L4-5 causing your sciatica”. We have more time with you to explain the situation and promote the optimal recovery. We are also trained in knowing when to refer to the Doctor and what questions to ask in order to rule out ‘big scary things’ like cancer, heart conditions, diabetes, etc. that might be masquerading as back pain, arm pain, shortness of breath, etc.
We are the professionals to be trusted with knowing what you need, who you need, how we can help and when you need what. Call us the ‘Triage Professional’ that has the ability to take in all the information and integrate it into one cohesive treatment plan that will likely include the use of many of the professionals mentioned above and more.
Find a Physiotherapist in your community and ask them how they can help you reach your next goal or tackle that long standing ____ pain or movement limitation! Just remember we are the experts at nothing...because we aren’t allowed to say it, but we are the best generalists at improving all movement related goals!