What is physiotherapy?
Updated: Nov 19, 2020
What is Physiotherapy?
Physiotherapy is an allied health-care profession that typically works with people who are experiencing pain (short-term or long-term) or with those who are experiencing some kind of disability or impairment in the normal functioning of their body. Typically someone will come to the physio when they are unable to perform an activity that they enjoy due to some kind of restriction. This restriction might be pain, but it might also be an injury of some kind or more specific limitations in their movement capacities for some other reason. The aim of physiotherapy is to help someone get back to functioning in the way that they would like and to also help educate about the body in terms of rehabilitation and the recovery processes.
Different physiotherapists depending on their individual post-graduate training will lead them to have different interests, specialities and methods for treatment patients. These methods may include a variety of “hands-on”, “hands off”, active, or passive treatment techniques. “Hands-on” techniques may include massage, mobilisations, manipulations (cracking), while “hands-off” might include taping or dry-needling, but could also include education, graded activity, or exercise for example. Passive techniques encompasses all treatments where the patient is having something done TO them as opposed to active techniques where the patients will be actively participating in the rehabilitation, for example with exercises.
Who is physiotherapy for?
Physiotherapy is for anybody seeking advice and guidance on how to move better or learn more about their pain. It is for anyone who wants to learn more about what is normal about pain, posture, and recovery or what to expect when having had an injury. It is also for those who have a physical disability and want to optimise their movement quality. Physiotherapy can be for top-athletes, amateur athletes or just someone with questions about their performance. Physiotherapists can offer help to the elderly looking to prevents falls, and for children who may be developmentally delayed. This list is not exhaustive by any means but is meant to show you how diverse a population the physiotherapists of this world actually serve.
Physiotherapists are also a great starting point for many people with questions about their general health related to movement and mobility.
You can think of the physiotherapist almost like the GP in the sense that we can help you directly or we can help refer you to the right person for help. Physiotherapists are skilled in identifying when perhaps other disciplines might be helpful for you including but not limited to; nutritional counselling, personal training, psychology, surgeons, or occupational therapy, to name a few.
Never hesitate to reach out to your physiotherapist for your health and wellness questions. You physiotherapist will be able to work with you to reach your goals or point in the right direction if needed.
Do I need a referral from a Doctor?
That is a great question. In the last decade or so, more and more counties have begun to move more towards “Direct-access physiotherapy”. This means that you do not need to get a referral from the doctor first. However this changes per country and sometimes has other stipulations depending on insurance coverage and rebates. For examples, in some countries if you have had a surgery than you may have the right to more physiotherapy coverage form your insurance company but in order to receive this coverage you would need a referral. This is something you need to check in the country that you live.
When you see a physiotherapist in a “direct-access” country your physiotherapist is the first contact you have with the medical profession. This means that physiotherapists in these countries have more responsibilities in terms of being able to assess if someone is having a serious health complaint or not. In this situation, physiotherapists must be able to determine if a patient needs to be referred back to their general practitioner for more medical investigations. In order to do this physiotherapists will perform what is called a “screening” for all patients who come in without a referral.
Physiotherapists will perform what is called a “screening” for all patients who come in without a referral.
A screening is a quick assessment that a physiotherapist performs via a series of specific questions that help the physiotherapist decide immediately if you need to first go to your doctor or need to be referred somewhere else before continuing with the physio-therapeutic consult or treatment plan. This screening takes only 5-10 minutes and can be done as a stand alone thing or as part of the overall assessment. Sometimes screenings take place during a rehabilitation that is already underway if for example a patient starts to develop new symptoms that don’t quite fit into what a physio would consider a normal part of recovery. This screening can also be done via an intake form, in-person, or over the phone.
Knowing what insurance coverage you have for physiotherapy can sometimes be confusing. Most physiotherapists will have at least general knowledge about how the main insurance companies in your area work and others may know a lot more. But ultimately this something that is your responsibility as a patient to know. Many physiotherapists in the Netherlands for example are moving more and more away from working directly with insurance companies since these companies don’t always have the physiotherapist's or the patient’s best interest at heart. Information about your own personal insurance plan, in most countries, is not available to the physio, especially not without consent from the individual. It is always a good idea to call your insurance provider to check what coverage you have and what the conditions are surrounding it.
Specialisations within the field
Every country is slightly different in how they organise the fields of specialisation within the profession. Some countries have specific courses or certificates to help you specialise while some countries like in the Netherlands have specific degrees that you much achieve in order to work as a specialist physio within a certain demographic of patients.
In the Netherlands all physiotherapist will complete their basic or “entry-level” training at a professional collage and receive a degree in physiotherapy. Some programs will receive a Bachelor’s Degree in Science while others not. It differs from school to school however, the curriculum generally looks the same. With these basic qualifications physiotherapists can work in a variety of settings with a spectrum of patients. Entry-level physios have a general understanding of most conditions and will learn more on the job.
In order to become a specialised physiotherapist in the Netherlands you required to obtain a masters degree in the specific field that you woud like to work in. As a master’s qualified physio you are still allowed to see all types of patients but generally you will focus more on what you have learned in your degree. In contrast, general physios are not restricted from treating the patients that fall under the specialised categories, they just won’t be compensated as well by the insurance companies. Non-specialised physios on paper may have more knowledge and/or experience that specialised physios, but of course that is not always the case. Master's level physios come with a base-line assurance that they are educated in the field that they have studied. Although, this also depends on what you believe to be adequate education. Some examples of the specialised physios we have here in the Netherlands are: paediatric physios (kindertherapie), geriatric physios (geriatrie), sport physio (sport fysio), manual therapists (manuele therapie), and psycho-somatic therapists (psychosomatische therapie).
Every physio, whether general or specialised, will have their own interests in terms of types of patients they like to treat or feel they have a better connection to. Although it can be tempting to go with a specialist, it’s not necessarily always a better choice. It’s important for you to feel comfortable with your physio, to feel heard and to be taken in as part of the decision making process. If you don’t feel that you have that and you’re not happy with the care you are receiving than it might be a good idea for you to reach out and see if there is a better fit for you out there.