This is a question I am often asked, and I understand why people are unsure. I often see people for back pain and during the treatment they will say they saw a physio for a shoulder issue. I say why did you not come to see me, and they say, “I thought you only did backs.”
The public still mostly perceive osteopaths and chiropractors as people who just treat backs or joints and physiotherapists who treat muscles and ligaments.
There are a lot of crossovers between the professions, but physiotherapy has a broader spectrum in that they cover a lot more areas, namely musculoskeletal (MSK) respiratory, orthopaedic and neurology. However, most of the conditions that present to private practice involve musculoskeletal issues, so all three professions are apt to treating MSK conditions.
I try and keep things simple and explain to patients the mechanism of what I want to achieve. With lower back pain, for example, I feel it’s important to not only treat the affected muscles but also the joints where the muscles attach to as one affects the other. If I just treat the tight painful muscles and don’t address the spinal mechanics, then the joint lack of movement will cause the muscle to stay in a contracted state. Similarly, if I just adjust the spinal segments involved and not the tight muscles of the area, then the tight muscles will cause the joint to become restricted again. Think of a tent whereby the poles are the skeleton, and the tent cover is the soft tissues attaching to the poles.
So, the long and short of it is, one affects the other, therefore get your hands dirty and treat both to resolve the injury efficiently and in a shorter time frame.
Treating all kinds of injury, not just sports related
Now with any profession, there is the good and the bad, so from a personal point of view, my practice has been built on recommendation of which I’m proud. In clinic, most issues I see are lower back and neck. I work in professional sport namely rugby, so I’m dealing with sports injuries a lot, therefore, I treat all types of injury. I’m also trained in injection therapy so, if necessary, I can inject corticosteroids and lubricants for arthritic joints.
The mechanism of an injury may be different, but the tissues involved, and the treatment approach will be the same for a sportsperson and an office worker. The only difference is the outcome whereby the office worker will be happy with being pain free, but the sports person needs to be rehabilitated back to playing their sport.
So, to clarify, treatment is treatment and rehab is rehab
It frustrates me when I see a patient who has been having physio treatment through the NHS and they have been given a sheet of exercises to do with little to no hands-on treatment. Often, they have 2 to 3 weeks between treatments.
I know the NHS is inundated with long waiting lists but is it not better to start a treatment plan and see the patient through weekly so they have continuity in treatment which in turn should resolve their symptoms quicker?
Exercises in my eyes are a rehabilitation tool for patients to do between their treatments, so as a practitioner, I treat the patient in the treatment session and then prescribe home exercises for their rehab.
On a final note, all the three professions work similarly so it doesn’t matter who you see as long as the end result is achieved.