Physio, what does it mean?
Physio is short for physiotherapist (physical therapist is the term used in the U.S.A. and some other countries) or physiotherapy . For the meaning of each term click the link below:
What does a physio do?
Musculoskeletal physiotherapy, which is also known as orthopaedic physiotherapy is a combination of many techniques used to treat conditions such as back pain, sprains, strains, arthritis, incontinence, bursitis, posture problems. It can be used for sport and workplace injuries or help with reduced strength, mobility and flexibility. Following surgery, physiotherapy is used to improve rehabilitation.
There are however many forms of physiotherapy e.g. respiratory, neuro and paediatric etc. but at our clinics we generally only have musculoskeletal physiotherapists.
Physio, what to expect?
On your first visit, your injury/pain will be assessed through lots of questions, the physiotherapist asking you to perform various movement to identify where and when it hurts and some palpation (experienced physiotherapists can tell a lot about the nature of your condition using their hands and the feel of your tissue - blind physiotherapists, yes they do exist, tend to be particularly good at this).
You will then be treated using various techniques, also known as modalities.
You may be asked to undress in order to be examined and treated properly.
At the end of the session you will be given exercises. If they are difficult or complex you will be taught how to do them properly before the session is completed.
Physio, what clinic?
One of ours, of course! But seriously, our advice would be to choose a clinic where the physio's are experienced, use hands-on techniques and have a good reputation. Word of mouth is often a great way to decide, so ask your friends and family for recommendations. The vast majority of our customers discover us this way.
How did physiotherapy start?
Physicians like Hippocrates and later Galen are believed to have been the first practitioners of physical therapy, advocating massage, manual therapy techniques and hydrotherapy to treat people in 460 BC. After the development of orthopedics in the eighteenth century, machines like the Gymnasticon were developed to treat gout and similar diseases by systematic exercise of the joints, similar to later developments in physical therapy.
The earliest documented origins of actual physiotherapy as a professional group date back to Per Henrik Ling, "Father of Swedish Gymnastics," who founded the Royal Central Institute of Gymnastics (RCIG) in 1813 for manipulation, and exercise. The Swedish word for physiotherapist is sjukgymnast = someone involved in gymnastics for those who are ill. In 1887, PTs were given official registration by Sweden's National Board of Health and Welfare.
Other countries soon followed. In 1894, four nurses in Great Britain formed the Chartered Society of Physiotherapy. The School of Physiotherapy at the University of Otago in New Zealand in 1913, and the United States' 1914 Reed College in Portland, Oregon, which graduated "reconstruction aides." Since the profession's inception, spinal manipulative therapy has been a component of the physical therapist practice.
Modern physiotherapy was established towards the end of the 19th century due to events that had an effect on a global scale, which called for rapid advances in physical therapy. Soon following American orthopedic surgeons began treating children with disabilities and began employing women trained in physical education, and remedial exercise. These treatments were applied and promoted further during the Polio outbreak of 1916. During the First World War women were recruited to work with and restore physical function to injured soldiers, and the field of physical therapy was institutionalized. In 1918 the term "Reconstruction Aide" was used to refer to individuals practicing physical therapy. The first school of physical therapy was established at Walter Reed Army Hospital in Washington, D.C., following the outbreak of World War I. Research catalyzed the physical therapy (U.S. term) movement. The first physiotherapy research was published in the United States in March 1921 in "The PT Review." In the same year, Mary McMillan organized the American Women's Physical Therapeutic Association (now called the American Physical Therapy Association (APTA). In 1924, the Georgia Warm Springs Foundation promoted the field by touting physical therapy as a treatment for polio. Treatment through the 1940s primarily consisted of exercise, massage, and traction. Manipulative procedures to the spine and extremity joints began to be practiced, especially in the British Commonwealth countries, in the early 1950s.
Around this time when polio vaccines were developed, physiotherapists became a normal occurrence in hospitals throughout North America and Europe. In the late 1950s, physiotherapists started to move beyond hospital-based practice to outpatient orthopedic clinics, public schools, colleges/universities health-centres, geriatric settings (skilled nursing facilities), rehabilitation centers and medical centers. Specialization for physical therapy in the U.S. occurred in 1974, with the Orthopaedic Section of the APTA being formed for those physical therapists specializing in orthopaedics. In the same year, the International Federation of Orthopaedic Manipulative Physical Therapists was formed, which has ever since played an important role in advancing manual therapy worldwide.
Are physiotherapy expenses tax deductible?
There are a couple of reasons why the HMRC do not allowed as a tax deduction.
1. The expense is not “wholly and exclusively for the purposes of the business” - the test which HMRC apply when claiming expenses.
2. Duality – this treatment is of personal benefit as well as a business benefit to, for example, the self-employed builder with back pain. Since there is a personal benefit, it is not allowed as a tax deduction.
Similar rules apply toi rivate health insurance.
If your business (or employer) chooses to pay for these health related services it is classed as a benefit and you will be taxed as receiving a benefit in kind, which will then appear on your P11D.
Are physiotherapy doctors?
No, they are not the same. The training for the professions is different.
However, all physiotherapists can give medicines advice to their patients. This is an expectation of reasonable physiotherapy practice for many conditions. They can also supply and administer medicines to patients under either a Patient Specific Direction, or a Patient Group Direction.Physiotherapists who have additional prescribing annotations to their HCPC registration may prescribe all licensed medicines - including seven controlled drugs - which are within the scope of physiotherapy prescribing practice.
Injection therapy is the administration of medicines, and other selected products, to intra- and extra-articular tissues and joint spaces by invasive injection. Injection therapy also includes aspiration of joint spaces.
There are two types of prescribing for physiotherapists:
Are physiotherapy services VATable?
According to HMRC, if you are a health professional in the uk your services are exempt from VAT when both of the following conditions are met:
1. The services are within the profession in which you are registered to practise.
2. The primary purpose of the services is the protection, maintenance or restoration of the health of the person concerned.
For the purposes of VAT, medical services (including medical care and treatment) are restricted only to services which fulfil the second condition above. This includes the diagnosis of illnesses, the provision of analyses of scans or samples and helping a health professional, hospital or similar institution to make a diagnosis.
Physiotherapists are are registered under the Health Professions Order 2001.
Are physical therapy and physiotherapy the same?
It seems to simply be a difference in nomenclature as opposed to techniques, ethos and purpose.
That said, there can be a lot of differences between how physiotherapists approach musculoskeletal problems. A lot of that has to do with training. In the UK, private physiotherapy clinics may have a more hands on approach compared with certain NHS physiotherapy departments but this too can vary a lot.
Before you attend a physiotherapy clinic, it may be worth asking what kind of approach the physiotherapists have; is it a hands-on or mainly exercise based, for example?
What happens when physiotherapy doesn't work?
If after a number of physiotherapy sessions it becomes clear that the problem you have is still not resolving (this is rare), there are a number of things that may occur.
The physiotherapist may refer you to your GP or to a consultant depending on how you initially came to the clinic.
If further exploration of your condition is needed, we may refer you to your GP or a consultant (via letter) and enquire as to whether they think an X-ray or MRI may be useful. The GP or consultant may agree that this is a good route to explore and organise this for you.
(*important note X-rays and MRIs are not always conclusive and do not necessarily shed any light on the condition - movies and TV series can dramatise these procedures, making them out to be the be-all and end-all in diagnostics. They are often pretty useful though.)
The physiotherapist may refer you directly to a consultant or a surgeon, especially if you have private health insurance.
On the whole, we believe it is best to go down the route of conservative treatment first, such as physiotherapy, and if that doesn't work, then consider other options.
Can you have physiotherapy when you are pregnant?
Your body undergoes a lot of changes during pregnancy and is under 'abnormal' pressures which can cause discomfort and pain, especially in your lower back due to natural postural adjustments or pelvic girdle pain. After a thorough assessment, there is a lot that physiotherapists can do in order to alleviate your pain and help you to maintain healthy pain-free function. For example, soft tissue release for muscles that are overworking and joint mobilisation can bring swift relief. Certain exercises can also help prevent further discomfort and pain.
If you have any concerns about your particular situation, please do not hesitate to contact us.
How can physiotherapy help Arthritis?
There are a numer of ways a visit to a physio can be useful if you suffer from arthritis, here are a few:
Type arthritis into an internet search engine and you will get literally thousands of pages of information. However, a lot of it will not be relevant to you or to your particular scenario.
If you suffer from arthritis, you want to know how you can optimise (we use that word a lot) your lifestyle without aggravating your condition or making it worse. Most of the literature is pretty generic and we all present differently due to our unique biomechanics, genetics, lifestyle etc.
An expert physio will be able to assess your particular problem, let's say it is a hip problem. They will be able to tell, from your current mobility, strength, flexibility, age etc what treatment and exercises would be appropriate for you to maintain and even improve your fitness and functionality without causing further pain or harm.
Physiotherapists have a unique set of very specific skills which are directed towards your biomechanical functionality and complement the work of other expert medical professionals. GPs have a huge knowledge base, which covers a wide variety of medical matters, consultants conversely, have a much narrower field of expertise that goes very deep and sometimes involves surgical expertise.
You would not want to see a physio about a viral infection, a GP for major surgery (unless it is for a referral) or a consultant about a common cold. Each has its place in the triage system.
If you have arthritis and want to work out what kind of activity you should and should not be doing, based on your circumstances, then a physiotherapist will help educate you as to what will be best for you (after a thorough assessment).
Managing arthritic pain and discomfort:
Outside of medications, which other medical professionals may advise on, there are other things physiotherapists can advise on which may help manage arthritic pain.
A very simple method is through managing the temperature of the area of discomfort. Sometimes an ice pack may help cool and soothe hot, swollen joint (a bag of frozen peas wrapped in a tea towel NOT directly placed on the skin can be used. N.B tinned peas won't work, there is no magic in the peas, it's the temperature and flexibility of a pack of frozen peas which makes them useful ;0)
Alternatively, heat may help to relax and soothe tired and aching and sore muscles. Hot water bottles are great for this - not too hot and NOT placed directly on the skin.
Splinting is another useful strategy for swollen or painful joints. If you have rheumatoid arthritis and have flare-up, your physio may be able to advise what kind of temporary splint would be useful and where to source one from. Our physiotherapists in Huntingdon and Cambridge can direct you to some excellent suppliers or source the ideal product for you.
A TENS (transcutaneous electrical nerve stimulation) device is a small electronic unit which transmits low-level electrical pulses to your nerve endings via pads placed on your skin. It is a form of electrotherapy and works by interfering with pain messages that are sent to the brain, subsequently altering your perception of the pain. You will probably sense a tingling which you will most likely find soothing.
Acupuncture has been shown to to relieve arthritic pain. Though there is some debate around it, it is believed the relief occurs by influencing (diverting or changing) pain signals which are sent to the brain from the affected tissues. Acupuncture can stimulate your body’s own pain-relieving hormones (endorphins and encephalins), bringing about pain relief, which may initially only last a short time when you begin treatment. Repeated treatment (usually weekly for six or eight sessions) has been shown to give long-term benefit, up to several months. .
Strengthening, Stretching and Mobilising
Arthritis causes joint stiffness and often muscle weakness. Our physiotherapists will be able to assess your muscle strength and the range of movement in your joints. From there, they will be able to advise on particular stretches and exercises you can perform at home in order to keep your joints working optimally. During the treatment session, they will also be able to use their hands-on skills in order to release and lengthen shortened and 'knotted' muscles and help your soft tissue to be in great condition through various forms of manual therapy.
Access to a swimming pool or hydrotherapy pool where you can perform exercises in warm water may also help. Many with lower limb problems may find it easier to move in water due to the water supporting your weight and taking strain off the joints enabling you to move your joints and muscles without straining them.
Exercise is another way to manage your pain if it is done intelligently and in a graded manner.
Grading involves starting slowly and increasing in progressive, small steps. As you build the exercise up, you will strengthen muscles around your joints (which may take some pressure off them) and increase your fitness. Your general fitness can have a huge effect on your overall wellbeing. The increase in stamina through the exercise programme will help improve your overall quality of life. All of this can be done without an increase in pain, if it's done gently with consideration. Consistent exercise also stimulates production of endorphins, the body's natural pain-relieving hormones.
Don't over-do it! Though exercise is great, it must be done with wisdom and discernment. Overdoing it will make your pain worse, however, not doing enough will too. Our physiotherapists at our Cambridge and Huntingdon wellbeing clinics can advise you on how to best increase your activity at a rate best for you. You can enjoy being busy but it needs to be balanced with rest. This exploration of where the balance lies, takes time, patience and a discipline of awareness.
Mindfulness Meditation is a very simple practice which a person how to relate to their pain and discomfort differently. Studies have shown arthritis sufferers who have attended an eight week mindfulness course report a better quality of life through an ability to be aware of their pain and an increased emotional resilience - they become less reactive, less affected by the pain and thus report to feeling better.
We offer mindfulness training at both the Cambridge and Huntingdon Physiotherapy Clinics.
For more information please click here
Fitness and Functionality. Being active is very vital when you have arthritis. You may be afraid that exercise is going to make your pain worse or cause more damage to already sore joints. However, your joints have evolved to be dynamic and not static. The muscles, tendon, ligaments and fascia around your joints become weaker or stiffer or shortened if they’re are too static. This may ultimately reduce your mobility and independence, through causing your joints to become unstable. Exercise will not only increase your general fitness but will also help you to maintain a healthy body weight, improve your general mobility and make you feel more self-confident - endorphins are released when we push our bodies.
What is important, is that is that you find a form of exercise which you enjoy, that way, you'll be motivated to do it regularly. Discuss this with one of our physiotherapists and they will help you to put together a programme which is ideal for you.
What do physiotherapists study?
In the UK a physiotherapist qualifies by gaining a Bachelor of Science degree in Physiotherapy. The degree usually takes three years and involves learning the theory and clinical practice, which is developed while on placement in hospitals throughout the UK. So a physiotherapy student will already have some experience of what the job involves prior to graduation. During the course the students learn all about human anatomy, physiology, biomechanics, biochemistry etc. as well as the latest research in treatment techniques for a wide variety of conditions.
Are physiotherapists doctors?
No. Physiotherapist's field of expertise is less broad than that of a doctors. Physiotherapist's diagnoses are respected by doctors and consultants and they work within the triage system, referring patients to each other. They are considered medical practitioners too but they are not doctors.
Physiotherapy equipment questions
What tools and equipment do physiotherapists use?
Most musculoskeletal physio's will use a variety of tools and equipment ranging from the complex - electrotherapy such as ultrasound and electrophoresis - to the more simple such as massage tools e.g 'gua sha' (a hand held massage tool) and seat belts (a strap that resembles a seat belt which assists the physio when performing spinal mobilisations - sounds much worse than it really is!).
The standard piece of equipment is the the plinth, or physio bed, as it is commonly known. The physio plinth is adjustable for height and we use three-section beds which allow a greater range of flexibility for the physio to apply treatment. The beds are comfortable enough to lie on for a treatment session but firm enough to offer resistance. This may be needed when the physio is using pressure for example, for soft tissue release.
This is one of the reasons why a visit to the clinic is preferable over home visits; rarely are beds or couches the right combination of being firm enough and comfortable for high quality treatment.
Our team of expert physiotherapists try to help you to get to optimal function i.e. your biomechanics working as efficiently as possible, and not simply pain free. To this end, our physiotherapists will use exercise equipment to enable strengthening and flexibility. Our site in Cambridge at the Cambridge Rugby Club has a great gym where we work alongside Ben Fitches. Ben is the strength and conditioning coach for the Club's first team and an excellent trainer - he allows us to use some of his superb equipment.
If you want to get fit and strong and live around Cambridge, we cannot recommend him highly enough.
Our site in Huntingdon has a studio which we use for more expansive movements which are not be possible in a treatment room.
What is ultrasound? What is ultrasound used for?
Technically speaking, ultrasound is acoustic (sound) energy in the form of waves, having a frequency above the human hearing range.
With regard to physiotherapy, an 'ultrasound machine' produces waves by means of mechanical vibration in the metal treatment head. The head is moved over the skin surface in the region of the injury, which transmits the energy into the tissues. This is thought to reduce the healing time of certain soft tissue injuries, possibly through the increased production of collagen (a protein component in soft tissue such as tendons and ligaments) and/or beneficially influencing the body's inflammatory response to promote healing.
Physiotherapy treatment questions
What are physiotherapy treatments?
See our information page by clicking here
What are physiotherapy modalities?
Physiotherapy modalities are techniques (see above), tools and systems a physiotherapist will use as part of your treatment programme.
Modalities should be considered as an adjunct to an active treatment programme in the management of injuries and pain . They should never be used as the sole method of treatment.
So, during treatment with one of our experienced physiotherapists, you may receive treatment in the form of soft tissue release, trigger point therapy, acupuncture and fascial release. You will then, most likely, be given exercises and stretches which form a home based strengthening programme.
There are many kinds of treatment modalities.
How much are physiotherapy sessions? How much do they cost?
For more information on the cost of physiotherapy sessions, please click the link below for our FAQs page and scrolling down to HOW MUCH DOES IT COST?:
It is our aim to deliver the highest standards and the best value. Our prices are always competitive but we will never be the cheapest physiotherapy service around. We think you will feel the difference and, after receiving excellent treatment, consider your trust in us well placed.
How long are physiotherapy sessions?
Generally, for single body part injuries/pain, initial assessments last 45 minutes and follow-up sessions last 30 minutes. We give a little extra time for the first appointment to allow for a thorough examination and treatment.
We do offer 30 minute initial assessments but these sessions do not involve any treatment. You will receive an assessment of your condition and a diagnosis but that is all.
We also offer longer follow-up sessions if a person has multiple injury/pain sites e.g. shoulder and knee pain. This is a more cost effective way of treating both injuries/pain sites at the same time. *Independent assessments are usually required for each body part.
How does physiotherapy help?
There are many specialisms under the umbrella of physiotherapy, such as neuro-physiotherapy, respiratory-physiotherapy, paediatric-physiotherapy.
Our clinics in Cambridgeshire (Cambridge and Huntingdon) have a team of musculoskeletal physiotherapists. As the name suggests, they are experts in the skeletal structure of the body and the musculature of the body and the interplay of both of these elements. This incorporates biomechanics, the involvement of the nervous system and how it affects movement and pain, other soft tissue such as ligaments, tendons. We also train our physiotherapists in the understanding of fascia, the connective tissue which, with the skeletal structure, supports the structure and movement of the body and is interwoven throughout all the structures of the body.
Our physiotherapists use their knowledge of the body in order to help you to have pain free, full function through various treatment types and through optimisation of your movement patterns. This enables you to get on with your life with the fitness (and by fit we mean your ability to perform your tasks efficiently) you require and not have to be distracted by your body/pain.
Physiotherapy training questions