The Physio Treatment Triangle!

Are physiotherapists really making the most of their treatment sessions today? Do we as clinicians tend to over complicate presentations we encounter and are the patients getting the most of their time with us?.........In an ideal world we would love to spend more time with our patients to get a better grasp of whats going on in terms of their pain or movement disorders, however we only have limited time in some cases, its precious, therefore we must be experts at time management and identifying key points put across to us from patients. There are many different ways of treating patients BUT are we really focusing our energy on the right ones........

A day in the life of a MSK Physio

The most important part of our treatment appears to be 'advice & education' we offer. Our advice and knowledge allows the patient to take ownership of their own pain or disability. The patient can then learn to treat themselves and this avoids the whole reliance on therapists to 'fix' them. If we can communicate effectively with an individual and build up a strong rapport then we are on track to a good starting point.

Secondly, comes 'general movements'- can a patient sit, stand, turn, twist, reach, lift , pull, push etc. If not we focus our treatment on this.

Thirdly, comes 'resistance training', we load their affected area with either weights, bands, belts, body weight etc. Where the pain is stemming from we can target this area. The aim is to strengthen to improve function, biomechanics, reduce pain and injuries.

Fourth, comes 'manual therapy', where we can apply massage, mobilisations, mobilisations with movements (MWM's), manipulations etc. Patients love this because they are getting the 'hands on' they were expecting when they arrive into Physio. If we do fail to ask at the beginning of the session what their expectations are, then we are off to a bad start. What can often happen is that we fail to ask our patients what they expect from the days session, therefore if we wrap things up with some simple advice and exercises they feel rather disappointed. We can save time, energy and confusion by ensuring to ask 'what are your expectations of Physio today?' and 'what do you hope to achieve from physiotherapy?'. From my own experience it is often the case that a patient is even unsure of why they were referred to Physio, they just go because they were advised to by a local GP or healthcare practitioner. In other cases, they come to get some 'manipulation' to 'rid of their aches and pains'.

Fifth, there is the option of 'electro-therapy' in some clinics and hospitals, this is not so commonly used in practice to date due to lack of strong evidence to prove its effectiveness in clinical settings. From 1-5 we should be making appropriate clinical decisions based on the specific individual in front of us. There is no one standardised treatment for a patient, each and everyone of us differs and this is vital to remember. From number 1 which is at the bottom of the pyramid- use MORE OF, to number 5 at the top-use LESS OF! Improve your clinical practice, keep it simple and don't overcomplicate things! Helping you to help yourself.

#physio #advice #educate #bestpractice