What is Online Physiotherapy (or Telehealth)?

Online physiotherapy is physiotherapy that is conducted via online video calling. Instead of seeing your physio in person, in a physical location you meet them online. It may seem strange at first, but online physiotherapy is actually very similar to what you might find in the clinic. During the initial appointment no matter online or in-person, your first appointment will consist of a friendly conversation between you and the physio. The physio will ask some specific questions and some general questions in order to make hypotheses about what might be going on with you. Broad question help the physio get to know you more and to learn about you as a person. Knowing about you in general can help the physio make a treatment plan better suited to your needs. Specific questions are to help the physio narrow down what could be contributing to the cause of your issue.

Despite the recent boom of online physiotherapy due to the COVID-19 pandemic, online physiotherapy services have actually been around for a while. Mostly it was offered as an innovative way to provide access to care for rural populations. This was a wonderful thing. But what we are realizing more and more, which the pandemic has now really shone a light on, is that it also provides access to the best care, to everyone all around the world. The more physios who go online the more choices that people will have to choose a care-provider that suits them. This is revolutionary when you think about it. Compared to being stuck only with the options that you have within a few square kilometres from your house or office, with online physio you can find the care that works for you when you need it.

Being the burgeoning niche that it is, online physio is being to referred to in many different ways. You might hear such terms as telerehabilitation, telehealth physio, telemedicine, telehealth, virtual physiotherapy, but do not worry, they are all the same. Telehealth is actually just an umbrella term that encompasses all kinds of medical-type appointments in an online or virtual way. Online doctor’s appointments and talk-therapies will also fall under the category of telehealth. The rest of the terms are used to differentiate from each other and indicate that it is specific to physiotherapy appointments. Rest assured, it does not matter how it is called, the concept is always the same.

Physiotherapy is a diverse profession with many influences from bio-medicine, psychology, ergonomics, sport & fitness, and general health & wellness. Every physio has their own style and is influenced by their post-educational courses, their own interests & beliefs and to what applies to the demographic of patients that they treat. Online physiotherapy will be just as diverse as physiotherapy in the clinic and will take many forms.

Online physiotherapy is a great option for all kinds of people. Outside of the traditional model of hands-on physiotherapy, online physiotherapy provides an approach based more on education & advice, coaching, and self-management techniques. Unlike the old-fashioned models of physiotherapy which promote passive treatments and short-term fixes, modern physiotherapy promotes self-efficacy (self-efficacy refers to an individual's belief in his or her capacity to execute behaviours necessary to produce specific performance attainments (Bandura, 1977, 1986, 1997)) and long-term results.

Here are some of the advantages of having physiotherapy online:

- access to care for those in rural areas

- time-efficiency for busier people

- access to experts who may not be in your geographical area

- cut down on travel time to and from appointments

- waste less time sitting in crowded waiting rooms

- effective – online physiotherapy is just as effective as face-to-face physiotherapy

- easier access to the physio through, email and chat box

- quick 15 minute appointment option if you want to just check in and ask a few questions

- ability to be assessed quickly if you have an acute injury

How does it work?

How the actual appointments work will be up to you and your physio. Some will offer free consultations to help you decide if that practitioner is the right choice for you before starting treatment. Initial consultations will always have a history taking component followed up with questions and discussion. After that, the required amount of sessions will change depending on what your physio thinks is right for you and what you have agreed to together. I currently offer follow-up appointment times of 15, 30, and 45 minutes which allows me to be flexible in the way I treat depending on the patients' needs. Sometimes more time is necessary and sometimes just a quick 15 minutes to get your questions answered can help you keep on track. You decide! That’s the beauty of it!

Physiotherapists of all kinds, be it online or in-person have a wide-range of skills to offer. Some of the ways in which you might benefit from having an online session with your physio could range advice, exercise programs, education to self-management techniques.

Advice

There are many, many ways in which your physio can advise you. Your physio will also be looking for ways to help you in your daily life and throughout your rehabilitation journey. Advice might be tips and tricks to alleviate acute pain, or suggestions for how you can manage chronic pain. Advice can also come in the form of referrals. Perhaps the physio thinks there are other health professionals that might be better equipped to help you and can add value to your life or rehabilitation. Advice can be on how often to exercise, for how long, and which types.

Exercise programs

Exercises and exercise programs will vary for many reasons. Being active and doing exercise is almost always beneficial! We physios love promoting active lifestyles and are trying to find ways to help people become more active. Exercise has so many benefits to you health like; lowering blood pressure, decreasing weight, alleviating stress, improving mood, increasing mobility, strength and/or cardiovascular fitness. Exercise can expose you to new things and help you grow, it can improve your social life if you join a club and make new friends for example. Many people express that exercise boosts confidence and helps them do more of the things that they love. Exercises given to you by your physio could be just a couple of exercises that are adapted as necessary, or it could be a full blown program with sets/weights and reps. This all depends on what your needs are what the physio has to offer.

Education

Education does not have to be as formal as it sounds! Education is an ongoing process where the physio will share their expertise with you. While you are on your rehabilitation journey different concepts will be more or less relevant to you and that is where the physio is an expert in knowing when and how much information to give, to you help you on your way. Sometimes this will be in the form of detailed information about why you might hurt or what you can expect in your rehab. Other times it will be a tidbit here and there. Hopefully this never comes to you as a lecture, but more as a collaborative conversation between you and your physio.

Self-management Techniques

This can range from self-massage to mindfulness. Your physio will help you find ways to manage your pain or your injury at home and in your daily life. This is so important since you only see your physio for such a small amount of time out of your week. Imagine that you see your physio for 30 minutes 1 day per week, than you need strategies to help you get through the rest of the 167.5 hours of the week that you live through. Relying on your physio to get relief from your pain, although potentially helpful at first, is never an area where we want to stay for long. We want you to become autonomous over your own body and life and to learn how to manage on your own! Ultimately this leads to feeling more confident, strong, and independent!

Will my insurance cover it?

You can always check with your insurance provider if treatment will be covered by an online physiotherapist. Different physiotherapy governing bodies have different rules as well as different insurance companies. Some may require that you are working with a physiotherapist licensed in your area in order to be reimbursed.

Many physiotherapist around the world have been moving more and more away from working directly with insurance companies. The way that insurance providers cover treatments are based on short-term, financial goals and they actually (a lot of the time) reward physios for keeping clients around longer with treatment approaches that mostly only work in the short term. This ultimately keeps patients coming back again and again. A great benefit for financially driven physiotherapists and terrible for insurance companies. Insurance companies try to compensate for this by lowering session amounts and prices., but physiotherapists are growing tired of insurance companies dictating how much they earn and what kind of treatments get covered. It’s restrictive and leaves little room for creativity on the part of the physio. Most physios want to break from the headache of insurance and administration so they can spend more energy on working with their clients and having the freedom to work on more long-term sustainable goals.

Is Online physiotherapy the future?

When people/companies realize how much work they can actually get done without having to pay for physical offices life as we know it is gonna change. I think naturally more people will move away from the cities into bigger home with more space around then. When this happens they will rely on online services to access care they may not have access to. Virtual appointments are the future because they are efficient, convenient, easy, and cheap. You won’t have to waste time getting from one place to another or waiting in the waiting room once you get there. You get to access care from the comfort of your home and don’t have to plan your whole day around your appointment that you need to get to. It’s cheaper since you won’t be paying for transport, gas or wasting time that could otherwise be spent on your own work. You benefit because you will have more time to spend doing the things you love, like spending more time with your family.

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