Physiotherapy

About physiotherapy

Physiotherapy uses physical techniques, such as exercise, manual treatments (for example, manipulation and massage) and electrotherapy, to help increase your mobility. Physiotherapy is often used to treat or relieve conditions affecting your muscles, bones and joints or after an injury. However, it can also be helpful in treating conditions that affect your nerves, brain, heart, circulation and lungs, for example stroke, cancer and Parkinson’s disease. It can also be used to help you recover after surgery or to improve your range of motion (how much and in which directions a joint can move) and strengthen your muscles.

Physiotherapy is carried out by a physiotherapist – a health professional who specialises in maintaining and improving movement and mobility. Your physiotherapist will discuss your care before carrying out your procedure. It may differ from what is described here as it will be designed to meet your individual needs.

The number of physiotherapy sessions you need will depend on what you're being treated for, what you want to achieve and how well you follow the exercises you're given. Your physiotherapist will discuss with you how many sessions you're likely to need.

When is physiotherapy used?

As well as helping to improve the symptoms of a number of specific conditions, physiotherapy can be used to help treat some general health issues. These are usually musculoskeletal problems (affecting your muscles, bones and joints) including:

  • back pain
  • neck pain
  • whiplash
  • work-related problems, such as repetitive strain injury (RSI)

Physiotherapy can be used to help improve the symptoms of a number of conditions. These include musculoskeletal conditions such as osteoarthritis or osteoporosis, but also many others that affect different parts of your body. Some of these are described here.

  • Conditions that affect your breathing, for example asthma. Your physiotherapist will show you breathing exercises and talk to you about your posture and lifestyle. If your child has cystic fibrosis, he or she will have chest physiotherapy, which uses different techniques to help loosen and clear the sticky mucus in his or her lungs. This stops it blocking the airways and reduces the risk of an infection and damage to his or her lungs.
  • Conditions that affect your nervous system, for example cerebral palsy or multiple sclerosis. A physiotherapist can help you to increase your physical independence and maintain fitness, flexibility and strength.
  • Women’s health conditions, such as incontinence. A physiotherapist can recommend exercises to help reduce your symptoms.
  • Exercises can be developed to help you improve your movement after a stroke or surgery.

Where can I find a physiotherapist?

All physiotherapists must be registered with the Health Professions Council (HPC). This means they have completed approved standards of training and follow the HPC rules of professional conduct. To find a registered physiotherapist in your area, contact the Chartered Society of Physiotherapy or search their website.

There are a number of ways to get an appointment with a physiotherapist. Your GP may refer you to an NHS physiotherapist or you may wish to look for a private physiotherapist.

About the procedure

Your physiotherapist will ask about your symptoms and may examine you. Working with you, he or she will create a programme of treatment that will be most helpful for you. The aim of a physiotherapy programme is to treat not only your symptoms, but also, if possible, the underlying cause, although this is mainly for conditions affecting your muscles, bones and joints. This means you may be less likely to develop the problem again.

The exercises or techniques your physiotherapist suggests will depend on why you're having physiotherapy. However, there are a number of different techniques your physiotherapist may try.

Range of motion exercises

These exercises focus on increasing how flexible you are. Your range of motion can be affected if you have an injury, have had a stroke or if you have had to spend long periods of time resting in bed. You may also lose flexibility as you get older. The exercises will be different depending on why your range of motion has been affected and the severity of your condition, but they often include stretches and repeated movements of your joints to increase how much you can move them.

                                                      Range of motion exercise

Muscle-strengthening exercises

These exercises are used to increase the strength of your muscles and how long you can continue exercising. They are also used to improve ‘core stability’ – the strength of the muscles in your abdomen (tummy). This is important for maintaining good posture and balance. Unless your muscles are very weak, these exercises are likely to include resistance training (moving your muscles against some kind of force), often using stretchy bands, weights or your own body weight.

                                              Muscle-strenghtening exercise

Ambulation exercises

Ambulation exercises are designed to help you improve or regain your ability to walk. Training usually starts with you walking while holding onto a set of parallel bars. As you progress and gain strength, you may be able to try walking with an aid, such as a walking frame, crutches or a walking stick. Once your physiotherapist is happy that you can walk well on a flat surface, you will need to work on climbing stairs or stepping up and down from kerbs.

                                                         Ambulation exercise

Co-ordination exercises

These exercises are designed to help you improve your co-ordination and balance. You will usually be asked to repeat a certain movement that uses a number of joints or muscles, such as picking up something. They are particularly helpful if you have had a stroke or brain injury.

Conditioning exercises

These combine range of motion, muscle strengthening and ambulation exercises to improve your heart and lung function. You may be given these exercises to do if you have had a long period of bed rest.

Transfer training

Transfer training means learning how to move safely from one position to another, for example, from sitting to standing, or from your bed to a chair. Being able to do this without help from someone else is important for maintaining your independence. Your physiotherapist will teach you techniques so that you can do this on your own or with help from someone who cares for you.

Massage

Your physiotherapist may use massage to improve your circulation by draining excess fluid from your lymphatic system. He or she will use his or her hands to carry out a range of slow movements using very light pressure.

Massage may also be used to complement other physiotherapy you’re receiving. For example, your physiotherapist may focus on your muscles, tendons and ligaments to help to reduce any pain you have and relax your muscles. He or she will use movements, such as kneading and stroking, with varying degrees of pressure.

                                                                Massage

Manipulation

During manipulation, your physiotherapist moves a joint very precisely, sometimes further than it would usually. He or she may apply a small amount of force to the joint in order to do this. Manipulation may help to reduce pain and stiffness but should always be done by a qualified practitioner as it can cause serious side-effects.

                                                                  Manipulation

Hydrotherapy

Hydrotherapy is a set of exercises carried out in a warm water pool. The water helps to support your joints while you're exercising. Hydrotherapy may reduce your pain, increase your movement and help you to relax.

Electrotherapy

Electrotherapy is a general term for therapies that use electrical equipment to help reduce your pain and encourage your muscles or tendons to repair. They are often used in combination with other physiotherapy treatment. Some of these are described here.

  • Biofeedback uses electrical pads placed on your body to monitor the activity of your muscles, posture or balance.
  • Interferential therapy is when electrical pads are placed on your body to stimulate your nerves. This aims to encourage blood flow and may reduce swelling for a short time.
  • Laser therapy involves using a concentrated beam of light to try to help reduce swelling and pain.
  • Transcutaneous electrical nerve stimulation (TENS) uses mild electrical pulses to stimulate your nerve fibres and block the pain signals to your brain.
  • Ultrasound uses sound waves and is usually used to produce an image of the inside of your body but it can also be used in physiotherapy. The sound waves enter your tissues where they vibrate and create heat, which encourages blood flow and promotes healing.
  • Functional electrical stimulation (FES) uses electrical pulses to move your muscles if the nerves that supply them have been damaged.

Acupuncture

Acupuncture is a complementary therapy that typically involves inserting fine needles into your skin at defined points. Your physiotherapist may use it with other techniques to help to relieve pain and reduce the symptoms of certain conditions.

As with every procedure, there are some risks associated with physiotherapy. We have not included the chance of these happening as they are specific to you and differ for every person. Ask your physiotherapist to explain how these risks apply to you.

Video

See our video related to this topic:

  • Posture

Will I need to get undressed during my physiotherapy appointment?

Answer

Your physiotherapist will discuss with you what will happen during your treatment, including whether you will need to undress at all, as well as about any pain you might have. He or she is likely to ask you to sign a consent form to say you have been informed and give your consent for the procedure to go ahead.

Explanation

At your first appointment, your physiotherapist will want to look at the area of your body that is causing your problems. He or she may also want to see the muscles or joints working. For example, if you're having problems with your lower back, your physiotherapist may want to examine this area and also the rest of your back or hips. Likewise, if you have problems with your knees, your physiotherapist will want to look at them while you walk. You won’t be asked to remove more clothes than is necessary, but you may need to undress to your underwear – you may wish to wear a similar alternative such as a sports bra and shorts. You can choose not to undress but this may influence how effective your treatment is because it’s more difficult for your physiotherapist to see what is causing the problem.

If you’re having problems that you think are caused by doing a certain movement or activity, your physiotherapist is likely to want to see you do this. It’s important to bear this in mind when you go to your appointment. For example, if you have pain when you run, take your trainers as your physiotherapist may wish to see you run.

You should be able to request a chaperone to be present during your appointment if you would like.

Does physiotherapy hurt?

Answer

You may feel a bit sore for the first couple of days but this will usually settle.

Explanation

Your physiotherapist will discuss with you any pain you may have during or after your treatment session. Physiotherapy shouldn't cause you any long-term pain, but you may feel a bit sore straight after your appointment and for the first couple of days. This may be because:

  • you’re using muscles that you haven't used for a while
  • stiff joints have been mobilised
  • tissues have been stretched

Any pain should settle, but if it doesn't get any better, talk to your physiotherapist about changing your treatment.

If you’re feeling sore, try not to take any over-the-counter painkillers. Keep a record of how long your pain lasts as it's useful for your physiotherapist to know.

What is the difference between physiotherapy and osteopathy?

Answer

Both physiotherapy and osteopathy treat similar problems, but the way in which they do so is different.

Explanation

Physiotherapy uses physical techniques such as exercise, manual treatments (for example, manipulation and massage) and electrotherapy to help increase your mobility. It can be used to treat or relieve a range of conditions affecting different systems of your body. In addition, it can help you recover after an injury or surgery, to improve your range of motion (how much and in which directions a joint can move) and strengthen your muscles.

Osteopathy is used to diagnose, treat and prevent a variety of health conditions. It focuses on your joints, muscles and ligaments (musculoskeletal system) and the effects that problems with these can have on your general health. Osteopaths believe that strengthening your musculoskeletal system, in particular your spine, helps your body to heal itself and prevent illness.

Osteopathy is often more ‘hands-on’ than physiotherapy. During a treatment your osteopath will use a variety of mostly gentle, manual techniques to increase how much you can move your joints. These include massage and manipulation.

Whether you see a physiotherapist or an osteopath should be your decision. The aim of physiotherapy and osteopathy is the same, but the techniques are often different so it will depend on what suits you best.