Physiotherapy aims to improve your mobility by using physical methods such as massage, manipulation and exercise.
There are a number of conditions that physiotherapy is used to relieve or treat. These include conditions affecting the joints, muscles and bones after injury. It can also help with conditions that affect your lungs, heart circulation, nerves and brain. Physiotherapy is often used to improve the range of joint movements and strengthen muscles. It can also help you recover from surgery.
Anyone can have physiotherapy, and it can take place in a number of different settings and locations. This includes hospitals, outpatient clinics, homes, schools, hospices, workplaces and fitness centres.
On this page we will explore what physiotherapy can help with and what happens in a session. We will also take a look at the techniques used and the misconceptions associated with the therapy.
What can physiotherapy help with?
Physiotherapy can help with a number of conditions. Common complaints include:
Abdominal conditions - Including irritable bowel syndrome (IBS), spastic colon and colitis.
Chest problems - Including surgical and medical issues such as cystic fibrosis, pneumonia and asthma.
Circulation problems - Including ulcers, deep wounds, cardiac rehabilitation and Raynaud’s disease.
Fractures - The therapy aims to improve the rate of healing and help you gain full function in recovery.
Gynaecological conditions - Including post-surgery rehabilitation, salpingitis and stress incontinence.
Injuries - Including sports related injuries such as tendon, cartilage and ligament damage. Also work-related conditions such as repetitive strain injury (RSI).
Joint problems - Including stiffness, pain, swelling, injury and arthritis.
Neurological problems - Including ME, multiple sclerosis, shingles, stroke, nerve injuries and head injuries.
Obstetrics - Including treatment for back pain during pregnancy and ante and post-natal exercises.
Paediatrics - Including walking and postural problems for children.
Post-surgery - The therapy can be used for rehabilitation purposes after orthopaedic surgery. For example, knee and hip replacements.
Spinal problems - Including sciatica, prolapsed discs, stiff neck and lumbago.
Physiotherapists will have a general grounding in all of these areas. However, some may choose to specialise in a certain condition. For example, if you are looking to recover from a serious sports injury, it may be beneficial to look for a physiotherapist that specialises in the rehabilitation of such injuries.
What happens during a session?
In your first session you will discuss your problems with your physiotherapist. Then what you want from the therapy, such as increased movement in a certain joint. Your physiotherapist will need your medical history. This will help determine any previous health worries or injuries that may affect the treatment.
Your physiotherapist will then begin to examine the areas of your body that you are having problems with. They may require you to remove your clothing around the area of investigation. However, you should feel comfortable so you can request a male or female therapist if you prefer.
After the examination, your physiotherapist will suggest the course of therapy to undertake. They will give you an overview including what they will do, how they will do it and how many sessions you will need. When treating an illness, your physiotherapist may advise you on how to minimise the effect of the illness on daily life. For injuries, they will advise you on how to prevent them from recurring.
Depending on the problem, your physiotherapist will use a range of different techniques. They include:
To improve circulation, your physiotherapist may use massage. This can be used to drain excess fluid from your lymphatic system. Using their hands with light pressure, they will carry out a number of slow movements.
Massage can also be used to complement other types of physiotherapy. For example, to relax your muscles and reduce pain, your physiotherapist may focus on your ligaments, tendons and muscles. They may use stroking and kneading movements. The movements may have differing amounts of pressure for the desired effect.
For more information on massage therapy, please visit our dedicated fact-sheet.
When your physiotherapist is using manipulation, they will move your specific joint in a very precise manner. It is common for them to move it further than it usually would. In order to do this, they may apply a small amount of pressure. The use of manipulation aims to reduce stiffness and pain. A qualified therapist should always do this as wrong movements can cause further damage.
These exercises are employed to help you regain or improve your ability to walk. Typically, the process starts with you trying to walk while holding on to bars for assistance. After a number of sessions you may move on to walking with less assistance, such as a walking stick or frame. Once your physiotherapist has made the decision, you may move on to navigating stairs and kerbs.
Motion exercises are used to increase your range of motion. Stroke, staying stationary for long periods of time or injury can all affect your flexibility. You also lose your range of motion as you age. The exercises used will differ depending on the severity of your case and the reason for your lack of motion. They do, however, tend to incorporate repeated moves and stretches to increase your movement.
Exercises to strengthen muscles
The exercises employed to strengthen your muscles will enable you to exercise for longer. In some instances, they are also used to strengthen your core. The muscles in your core are integral for maintaining balance and good posture. These exercises typically include resistance training.
Co-ordination exercises aim to improve your balance and co-ordination. The movements that are often used in this type of exercise are repeated a number of times. For example, you may be asked to repeatedly pick up something and put it down again. These are particularly helpful for brain injuries or stroke.
Transfer training incorporates exercises for the easy transition from one position to another. For example, from lying in your bed to sitting on a chair, or from sitting to standing. This is integral for some to regain their independence. Your physiotherapist will teach and assist you in a number of techniques to achieve this.
This is carried out either in a specialised hydrotherapy bath or in the shallow end of a swimming pool. The exercise is based around the resistance of water. It pushes against your body as you do the exercises. It aims to relieve pain and improve circulation.
For more information on hydrotherapy, please visit our dedicated fact-sheet.
This uses a small electric current that makes your muscles contract. It doesn’t hurt - the sensation is often described as ‘tingly’. There are a number of different kinds of electrotherapy, including:
Transcutaneous electrical nerve stimulation (TENS). TENS sends a mild electrical current to stop the nerves sending pain signals to the brain. This instead encourages endorphins (natural painkilling hormones) to be released.
Ultrasound. High frequency sound waves treat deep tissues by promoting blood circulation.
Laser therapy. Narrow beams of light help reduce pain and muscle spasms. This isn’t suitable during pregnancy, for cancer patients or those taking certain kinds of medication.
Shortwave diathermy. An electromagnetic field which generates heat in the body’s tissue. This can help reduce swelling, strengthen tissue and reduce pain.
Interferential therapy. Electrical pads are placed on the affected areas of your body to stimulate your nerves. The aim of this method is to temporarily reduce swelling and encourage blood flow.
Biofeedback. Electrical pads are used to monitor your balance, muscles and posture.
Functional electrical stimulation (FES). FES employs the use of electric pulses to move your muscles if the supplying nerves are damaged.
The gentle movement and stretching of Pilates can be incorporated into exercise programmes as part of the treatment.
Your first session will last around an hour. Subsequent sessions will last around 30 to 45 minutes. Your physiotherapist may also do some diagnostic tests to assess your strengths and weaknesses. This will help them better evaluate your condition.
For more information on Pilates, please visit our dedicated fact-sheet.
Acupuncture within physiotherapy
A growing area of interest within the physiotherapy industry is medical acupuncture. Many physiotherapists are now training in acupuncture to form an integrated approach to pain management.
Acupuncture involves the insertion of fine, sterilised needles into certain points of the body. Part of traditional Chinese medicine (TCM), this practice dates back as far as 1000 years BC. It is based around the idea that blocked energy or 'qi', can cause illness. Chinese acupuncture aims to relieve these blockages and thus restore balance within the body.
Western medical acupuncture on the other hand is based on clinical research. It suggests the practice eases pain by stimulating the brain and spinal cord. Physiotherapists tend to incorporate medical acupuncture (rather than Chinese acupuncture) into their treatment plan to help manage pain for those with musculoskeletal issues.
For more information on medical acupuncture, please visit our dedicated fact-sheet.
There are a number of common myths that surround physiotherapy. Here we look to address a selection of the most common ones:
I need a referral to see a physiotherapist
You will not need a referral from your GP to see a private physiotherapist. Though if you are looking to claim your session back on health insurance, some may require a doctor’s referral.
The therapy is painful
Many people think that physiotherapy will be painful. That is not the case. Occasionally you may experience a brief amount of pain. This is typically when the physiotherapist assesses you and tests pain boundaries. They are aware of what will cause pain and will always notify you about the possibility. Any discomfort will be a part of the healing process. You just need to remember that your therapist's goal is to get you better, not to prolong the injury or make it worse.
It is only good for sports injuries
Physiotherapy is often associated with sports injuries and treating athletes. This is because the majority of teams have a specific role for a physiotherapist. However, its uses extend far beyond the sports field. It can be used for everyone, for a variety of conditions.
Physiotherapists are the same as personal trainers
Physiotherapists and personal trainers or fitness advisors are not the same profession. Although physiotherapists will most likely know a great deal around the subject of health and fitness, they predominantly focus on remedying injuries or pain.
Choosing private physiotherapy
In private physiotherapy you are generally seen quicker than those registered with the NHS. You will have the opportunity to choose a slot that fits around work and family commitments. You may also experience a more personalised experience of treatment and even longer sessions. With private physiotherapy you will be able to choose your physiotherapist. This means you will be able to find out what qualifications and experience they have.
What training and qualifications should therapists have?
All physiotherapists need to be registered with the Health and Care Professions Council (HCPC) to practise. To gain approval from the HCPC, all physiotherapists need to complete an approved BSc degree or graduate diploma in physiotherapy.