What is Physiotherapy?

The UK has over 31,600 practising physiotherapists according to the statistics website Statista. This has almost doubled from pre-2000 levels. Given that around 33% of people in the UK live with a long-term, life-limiting health condition, physiotherapy does not always come to mind for many when it comes to treatments.

Just 5% of people visit a physical or occupational therapist at least three times a year and 19% will visit once a year. Let’s look at what physiotherapy is and how all kinds of people can benefit from it.

What is physiotherapy?

The College of Physiotherapists of Ontario defines physiotherapy as “treatment to restore, maintain, and make the most of a patient’s mobility, function and well-being”. Essentially, physiotherapy works to restore someone’s function and movement when they have suffered an illness or injury or have a disability. It also works as a preventative measure too.

Physiotherapy is not just one thing. It encompasses a range of techniques and is thought of as a holistic treatment, directly involving the patient and empowering them to work towards goals themselves. Additionally, physiotherapy does not always treat a specific area; it can also take a whole-person approach. Physiotherapy aims to maximise the patient’s comfort and quality of life.

When is physiotherapy used?

Physiotherapy is largely used as a treatment but can also be used as a preventative tool. Most people seek treatment from a physiotherapist for rehabilitation after an injury as a result of running or sports activities or as a result of occupational reasons such as repetitive strain injuries.

The NHS refers patients to physiotherapists as a treatment for their condition. This is often alongside other treatments including medication and surgical intervention.

Physiotherapy is also used after other treatments have been conducted such as following surgical procedures. Physiotherapy also forms part of palliative care for those who are suffering from life-long or life-threatening medical conditions as well as a way of managing pain.

What is the purpose of physiotherapy?

Physiotherapy is a holistic approach that facilitates recovery from many conditions. It aims to encourage participation in one’s own recovery and help a person remain as independent as possible.

Depending on the condition, the physiotherapist may aim to treat a patient to full recovery from their condition such as after an injury or surgery. However, for other conditions, the purpose of physiotherapy is to improve movement, pain and quality of life for as long as is possible.

What does a physiotherapist do?

Physiotherapists are degree-educated professionals who use their skills and knowledge to improve health conditions. Some physiotherapists work in particular health specialisms and some are also involved in research, service management and education.

Physiotherapists work in a variety of settings including hospitals, community clinics, GP surgeries, workplaces, sports teams, clubs and charities, and in private clinics within the community. Essentially, a physiotherapist has studied the science of movement and is highly trained in pinpointing the cause of an injury or condition as well as knowing how best to alleviate it.

Physiotherapists treat the person as a whole and empower them to be involved in their own care. They do this through raising awareness of aggravations and alleviations of the person’s condition as well as providing education and plans for self-treatment.

Physiotherapy treatment can include:

Advice and education

Physiotherapists aim to inform their patients of the reasons behind their condition and explain how changing certain aspects of their life can help improve their condition. This can include advice about posture, techniques for lifting heavy objects to prevent injury and sleep position advice.

Manual therapy

This is where physiotherapists relieve pain and stiffness using their hands by manipulating parts of the body and facilitating movement. Massage therapy is often used to release tension and muscle stiffness. Manual therapy also improves blood circulation and can help fluid drain effectively from areas of the body. It also works by promoting relaxation.

Tailored exercise and movement

Physiotherapists usually create personalised exercise and movement plans to assist with their patient’s mobility and general health and to begin to strengthen parts of the body that will help improve the patient’s condition. This could be a plan for home exercises and/or participation in group exercise programmes.

Hydrotherapy

Hydrotherapy is often used by physiotherapists when a patient is particularly immobile or is struggling with severe pain. The warm water in hydrotherapy supports the patient’s body weight and allows muscles to relax which allows for smoother and less painful movements. The water provides resistance to support the person in getting stronger gradually.

Ultrasound treatment

Therapeutic ultrasound is where high-frequency sound waves stimulate cell activity and blood circulation. This aims to reduce spasms and pain and also speeds up the healing process. Ultrasound is often used to treat deep tissue injuries.

Electrotherapy such as Transcutaneous Electrical Nerve Stimulation (TENS)

A TENS machine is a small device that is battery operated. It delivers an electric current to an area affected by pain to relieve the pain. Other forms of electrotherapy include inferential electrotherapy (IFT) which uses low-frequency electric currents to stimulate the muscles and increase blood flow.

This is sometimes preferred to TENS by some patients who dislike the feelings that TENS machines produce. Electrical muscle stimulation (EMS) is also used to target muscle tissue to stimulate motor neurones and cause muscle contractions. This helps to prevent as well as treat muscle atrophy (wasting away).

Acupuncture

This is a treatment where small, fine needles are placed in the skin at certain points on the body. Acupuncture aims to promote recovery and reduce pain. It should be noted, however, that the National Institute for Health and Care Excellence (NICE) recommends acupuncture only for migraines and tension-type headaches.

What conditions do physiotherapists treat?

Physiotherapy does not have many restrictions in terms of a form of treatment. It is a useful treatment for almost everybody regardless of age or health condition.

It is used to treat physical conditions including the following:

Musculoskeletal conditions:

• Back pain.
• Neck issues such as whiplash-associated disorder.
• Shoulder injuries.
• Knee or hip replacements.
• Soft tissue injuries.
• Sports injuries.
• Arthritis.
• Repetitive strain injuries.
• Post-amputation conditions.

Nervous system and brain conditions:

• Movement problems following a stroke.
• Multiple Sclerosis (MS).
• Parkinson’s disease.
• Traumatic brain injury (TBI).
• Guillain-Barré syndrome.
• Spinal cord injuries.
• Alzheimer’s disease.
• Post-polio syndrome.
• Microcephaly.
• Cerebral palsy.
• Charcot-Marie-Tooth disease (CMT).

Circulatory and heart-related conditions:

• Post-heart attack recovery.
• Cardiovascular disease.
• Angina.
• Peripheral vascular disease.

Respiratory conditions:

• Chronic Obstructive Pulmonary Disease (COPD).
• Cystic fibrosis.
• Asthma.
• Chronic bronchitis.
• Bronchiectasis.
• Emphysema.
• Pleurisy.
• Pneumonia.
• Pneumothorax.
• Pulmonary Emboli.
• Respiratory failure.
• ARDS.

Women’s health issues:

• Childbirth injuries.
• Bowel and bladder problems including stress incontinence.
• Symphysis pubis dysfunction (SPD).
• Abdominal diastasis.
• Caesarean section recovery.
• Peroneal tears.
• Pelvic floor weakness.
• Carpal tunnel syndrome.
• Pregnancy-related sciatica.
• Mastectomy.
• Hysterectomy.
• Breast reconstructive surgery.

Cancer-related problems:

• Pain.
• Fatigue.
• Swelling.
• Stiffness.
• Loss of muscle strength.

How does physiotherapy help with musculoskeletal conditions?

Musculoskeletal conditions are any conditions that affect the muscles, skeleton and soft tissues such as ligaments and tendons. According to Top Doctors, there are over 200 types of musculoskeletal disorders, and in 2011, almost seven million people saw a physiotherapist for treatment for their musculoskeletal condition.

When treating a musculoskeletal condition, a physiotherapist will use a range of techniques to help restore the patient’s movement and function. This will include teaching them different exercises as well as how to practise movements and find other ways of performing everyday tasks.

This kind of physiotherapy may include:

• Manual therapy.
• Hydrotherapy.
• Electrotherapy.
• Kinesiology taping.
• Soft tissue treatment.
• Advice and education.
• Home exercises.
• Group exercise programmes.

How does physiotherapy help with neurological conditions?

Neurological physiotherapy is bespoke physiotherapy that involves treating people who have movement and function disorders stemming from the nervous system within the body. This may mean that they have poor balance, muscle weakness, muscle spasms, muscle tremors, loss of function and also decreased sensation.

Neurological physiotherapy works to give the neural pathways a reboot and help the brain make new connections to bypass the old, damaged ones. This is largely through repeated exercises and actions.

The physiotherapy used in treating and/or managing a neurological condition will largely depend on the condition and how it affects the nervous system. However, anyone who suffers from poor coordination, balance, issues with gait, those who struggle to walk and self-care and those with vision problems will benefit from neurological physiotherapy.

The aims of neurological physiotherapy are often slightly different to other types of physiotherapy due to the nature of the conditions that it treats.

The aims may include:

• Rehabilitation.
• Slowing down physical deterioration.
• Helping children reach developmental milestones.
• Maximising a person’s potential.

This type of physiotherapy may include:

• Gait re-education.
• Balance training.
• Posture correction.
• Movement encouragement.
• Manual therapy such as strengthening and stretching.
• Hydrotherapy.
• Electrotherapy.
• Advice and education.
• Home exercises.
• Collaborating with occupational therapists and podiatrists to aid with equipment that may be beneficial.

How does physiotherapy help with circulatory and heart-related conditions?

Conditions such as cardiovascular disease and post-cardiac event recovery are also often treated with physiotherapy alongside other treatments such as medication and surgical intervention.

Cardiac-related physiotherapy can help to restore muscle strength, balance, core stability, walking ability and exercising capabilities. Physiotherapy with such conditions has many benefits as it reduces the risk of further complications of the disease such as respiratory problems and allows the person to return to their previous fitness and ability levels.

This type of physiotherapy may include:

• Exercises and increasing stamina with physical activity.
• Muscle-strengthening exercises.
• Flexibility exercises.
• Integrating exercise into the patient’s daily routine.
• Weight management.
• Pain management.
• Sensory massage and stimulation.
• Supporting with symptoms during exercise such as angina or breathlessness.
• Breathing exercises.
• Movement encouragement.
• Manual therapy such as strengthening and stretching.
• Advice and education.
• Home exercises.
• Support with equipment if needed such as rails, stools or walkers.

How does physiotherapy help with respiratory conditions?

Physiotherapy for respiratory conditions is highly dependent on the condition and its severity.

Treatment may involve:

• Breathing technique training including controlling breathing rate and relaxation breathing exercises.
• Physical conditioning and exercise tolerance to improve overall health and reduce breathlessness.
• Secretion clearance including postural drainage, effective coughing techniques and manual assistance such as shaking, vibrations and percussion.
• Advice and education including allergen and environment information, medication management, and disease progression.

How does physiotherapy help with women’s health conditions?

Physiotherapy is an effective treatment option for women’s health conditions. Women experiencing pregnancy and childbirth often need physiotherapy during pregnancy or as a part of their recovery in the post-natal period.

Likewise, women who have endured surgeries including hysterectomies and breast surgeries such as mastectomies and breast reconstruction as a result of cancer treatment can also benefit from physiotherapy.

Women’s health physiotherapy may include:

• Pelvic floor strengthening exercises.
• Electrical stimulation.
• Biofeedback.
• Support belt provision.
• Bladder retraining exercises.
• Transverse abdominis strengthening exercises.
• Hydrotherapy.
• Lower limb conditioning and strengthening.
• Upper limb conditioning and strengthening in the case of breast surgeries or carpal tunnel syndrome.
• Pacing advice.
• Walking adaptations if needed.

How does physiotherapy help with cancer treatment and recovery?

Most people who have cancer will likely need some form of physiotherapy in their rehabilitation. It can not only aid recovery but can also help people become stronger in preparation for surgery or radiotherapy treatment. Physiotherapists also provide palliative care for those whose treatment has not been successful.

Oncological physiotherapy treatment may include:

• Mobilisation including stretches.
• Management of symptoms.
• Management of fatigue.
• Core stability exercises.
• Balance exercises.
• Cardiovascular exercises.
• Breathing exercises.
• Home exercise programmes.
• Posture management.
• Advice and education including for family and carers.
• Positioning.
• Equipment provision where appropriate.

The takeaway

Physiotherapy is a highly skilled field of medicine that helps to treat a wide variety of medical conditions. It offers benefits to most medical conditions, whether someone has recently given birth, has had an injury playing football, has cancer, or has recently had a heart attack.

Physiotherapy for most conditions is available on the NHS. There are also many specialist private physiotherapy clinics across the whole of the UK.