 Poster: A snowHead
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Over the many many years of using physiotherapists, chiropractors, osteopaths and sports massage therapists, for various injuries, I'm often curious as to the treatments they individually use?
Of course chiropractors, osteopaths tend to concentrate on manipulation but it seems to me at least that physiotherapists have a number of treatments that they prefer?
The most common treatment that I've come across is the use of Ultrasound, this is usually performed after the physio has examined the injury and has performed various investigations with his hands kneading the area around the injury, stretching around the area to see how much range of motion you have and the like.
Then usually out comes the machine and on go the sticky patches and cables with bravado kicking in as you tell the physio to turn it up some more as you can take it 
However, I've also been with physiotherapists who do not have an Ultrasound machine in their treatment room, in a few instances they use acupuncture and like the physiotherapist I'm currently seeing use the session to work with their hands and stretch the ligaments/muscles around the area.
The guy I'm seeing has me nigh on screaming out in pain as he works his knuckles deep into my tissue and then presses my leg over his shoulder to stretch and gain a better range of movement.
I have to say the above protocol whilst more painful than Ultrasound, I think produces better results, though a lot does rely on the patient to carry on with exercises at home before the next session, though that's the same with various treatments used.
So what are SnowHeads experiences etc?
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Hmm i recall getting ultrasound treatment q while ago last time was probably 8 or 9 yrs ago I think it was. Haven't had any recently despite lots of physio for different issues.
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@Hells Bells, yes you're right, the sticky pads are Electrical Stimulation Therapy, the big machine on wheels, and then they also work with a more classic ultra-sound applying gel and then working the area with the "sonar stick".
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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My late FIL was an osteopath and physioterrorist and used both machines. I've had the ultrasound on a ligament injury on my hand, hubby has had the other on back injuries.
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You'll need to Register first of course.
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| Weathercam wrote: |
So what are SnowHeads experiences etc? |
erm...
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Currently having treatment by a physio on my neck. Very much a get the fingers in and try not to scream.
Hr also stretches and twists the neck. It wouldn't surprise me if my head comes off in his hands one day.
My movement and comfort increases with each session though
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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You name it - and I've tried it.
Not all Physios are created equal (as with everything). Good ones often have extra strings to their bow, like Dry Needling/Acupuncture or can do some basic Osteopathic adjustments.
I have found them good for Acute, rather than Chronic injuries....and I like the fact they give you the understanding to treat yourself through exercises and stretching etc
For getting scar tissue removed from tight/weak muscles - I would rather see a Physical Therapist, who specialise in Myofascial Release/Trigger Point therapy.
Here is one person whose methods I use when tight or sore: https://www.diyjointpainrelief.com/
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Not all Physios are created equal
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Very true. IME the younger physics tend to be better. The quality of training is now better and they tend to be a lot more up to date with research.
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but mostly his treatment consists of telling you what exercises and stretches to do, and taking you through them to be sure you are doing them right.
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A bad physio tries to treat the problem. A good physio identifies and treats the causes of the problem. There is a certain irony when somebody recommends a practitioner they see regularly - if they were any good you wouldn't see them that often!
The hard evidence for some of the more "exotic" treatments is pretty poor. They tend to impress the lay person much more, so good for business perhaps. The thing is the vast majority of injuries will heal without intervention, it's impossible for a person to know if any treatment they received actually sped up the process. There's also a huge placebo effect, especially regarding pain reduction.
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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@boarder2020, A good physio makes a huge difference. The injury normally will heal BUT a lot of the long term issues are created due to muscles compensating for the injury.
Where you don't have full range of motion you get shortened muscles, become weaker etc as a result. The physio exercises target those. I have had far more experience of this than I would like buy it made a massive difference to my long term recovery
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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The person I see uses electro therapy - not sure how well it works though there is some evidence it helps with pain relief, acupuncture - was pretty dubious, it worked well for a short period the first time but subsequently not so much, only had it on my hands which are affected by osteoarthritis for which there is little or no treatment possible, IDD therapy - this is a machine that gently stretches the back, I had a badly herniated disk / sciatica / loss of feeling in the lower leg & ankle, it has healed up a lot better than was expected (went to see a back surgeon) so I guess it has worked though it could also be the exercises he used / has shown me. The main treatment is various stretching and manipulation. I had a damaged meniscus (skiing) which has pretty much healed up, partly through the knee waggling exercises he showed me but also cycling. For my back he has got me doing daily knee rolling exercises which have dramatically helped, rarely get any back twinges at all now, really worthwhile.
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[quote="boarder2020"]
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The hard evidence for some of the more "exotic" treatments is pretty poor. They tend to impress the lay person much more, so good for business perhaps. The thing is the vast majority of injuries will heal without intervention, it's impossible for a person to know if any treatment they received actually sped up the process. There's also a huge placebo effect, especially regarding pain reduction. |
The wife did the electro stuff at the local physio but it seems like a bit of a scam to me. She liked it. Wire someone up to a machine for 20 minutes while the "physio" goes off for a fag break or to play angry birds on their phone or to flirt with the builders installing the acquagym. Kerching.
It was a physio who told me it was snake oil. Ok he didn't exactly say that but he said the same as you, for a lot of stuff the injuries will heal: 3 months with physio, 13 weeks without. For some stuff you need to do some special exercises - for example I broke my wrist, the doctor said no physio but use a wrist strengthener, the physio I consulted said the doctor was correct and I should take my time and not do any physio as it might make things worse by being too aggressive. Then there is a small percentage where structured physio is necessary.
The French are mad keen on medical treatment of any sort and especially homeopathy.
and on a final bomb shell: snake oil actually worked !
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You know it makes sense.
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| boarder2020 wrote: |
| ...A bad physio tries to treat the problem. A good physio identifies and treats the causes of the problem. ... |
In my case the causes of the problem are invariably a fairly hard crash, which I reckon the physio has little influence over 
The only ultrasound thing I came across was some machine which helped get rid of bruising, which it did pretty much in real time.
The placebo effect there was zero as I didn't know what it was supposed to do nor did I particularly care.
My own physio experience is broadly that the NHS's prime focus is on getting fat/ old people "mobile" again.
Their goal is to get you off your very large bottom. Not relevant to athletic people, then.
On the few occasions I've busted something, I have found a sports injury specialist, and paid them for advice and exercise suggestions.
I never visited anyone twice, because I don't need them to stand over me once they've told me what I need to do. I guess then I regard
the professional advice regarding rapid recovery extremely useful; I don't much care about anything else people buy from them.
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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| NickyJ wrote: |
@boarder2020, A good physio makes a huge difference. The injury normally will heal BUT a lot of the long term issues are created due to muscles compensating for the injury.
Where you don't have full range of motion you get shortened muscles, become weaker etc as a result. The physio exercises target those. I have had far more experience of this than I would like buy it made a massive difference to my long term recovery |
You can't say a good physio makes a huge difference with any kind of certainty. You don't know what would/wouldn't happened if you didn't use a physio. People heal at different rates and there are lots of confounding variables - diet, sleep, age etc. It's also very injury dependent - clearly there are some cases where a physio is much more useful than others.
In terms of weakened and shortened muscles, it's not rocket science - stretch and strengthen through resistance training. From a sporting point of view (excluding impact) most injuries have some kind of underlying cause - usually weakness or imbalance. By far th best approach is to work with a decent strength coach to fix this stuff and decrease risk of injury in the first place.
My PhD is in shoulder rehabilitation. I can tell you following dislocation the vast majority of physios will focus on strengthening rotator cuffs. These exercises do work somewhat, but not because of increased strength of rotator cuffs. If instead they focused on the cause of instability (scapular dyskinesis) there would be much better outcomes.
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Poster: A snowHead
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@boarder2020, one of my recent physio treatments was after subacranial decompression surgery. I couldn't use it for anything for a long time. I would have not got back to full range without her help.
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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| NickyJ wrote: |
| @boarder2020, one of my recent physio treatments was after subacranial decompression surgery. I couldn't use it for anything for a long time. I would have not got back to full range without her help. |
I'm pretty familiar with it, impingement is one of the more common shoulder problems. I've seen countless people make a full recovery from SD surgery with just a basic self rehabilitation program using therabands and stretching. I've also seen people who with all the physio rehab in the world don't ever get their full range of motion back. It's quite possible you got a better and/or quicker recovery through physiotherapy, but you absolutely can't say for sure with any certainty, it's just speculation.
The other thing is the surgery in itself is arguably a perfect example of placebo effect. Plenty of research showing SD surgery leads to no better outcomes than placebo surgery and exercise therapy https://pubmed.ncbi.nlm.nih.gov/30647053/ I would question if it's even ethical to carry out that procedure.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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Here's another example of what I'm getting at:
For shoulder impingement guided self training program leads to similar results compared to traditional physiotherapy - https://www.sciencedirect.com/science/article/abs/pii/S1058274604000485
The suggestion that results with physios are much better comes from anecdotal experiences with no control group. When you actually do a well designed study, the physiotherapy results don't seem as impressive (or in this case at all better).
I'm not trying to say physiotherapists can't help. But they are not magic, and there definitely seem to be some areas where they are more or less useful.
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@boarder2020, have you experienced the pain yourself? The calcium build was so severe (on both shoulders they went at different times). They couldn't see it all on the ultrasound. They sent me for x-ray. They did a steroid injection which allowed my one shoulder to be pain free for a while then it built up again.
I have had friends who have had same surgery but no psysio after. It stopped the chronic pain BUT without physio they never regained full ROM. As the physio never materialised on NHS i paid for it myself. I struggle to follow these instructions via other means than being shown, why I need ski lessons rather than just watching others and videos. In addition, she gave me various massages to help release the muscles in addition to guiding through the right exercises for my situation, where I personally was getting stuck.
Believe what your like i know me, I know how I learn they have without a doubt made a difference to my outcomes. This includes and ACL recon, both shoulders and various cartilage issues and surgeries. 3 weeks post op for latest
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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@Weathercam, I would imagine your different experiences would have arisen because of the different post-registration training your Physio will have had and the preferences they have. Some like to go for manipulations and mobilisations, some acupuncture, some Ultrasound etc etc. You should hope that they are using the most up to date, evidence based treatment approaches for the condition. Acupuncture for example is not the be all and end all for a lot of conditions. Likewise K-tape, or as I like to call it, sticky tape.
Having worked with them for nearly 20 years, my impression is that contemporary approaches are for the patient to have some control over management of the condition, which can be a bit of a leap of faith for some if you are expecting to be healed by the clinician.
If you find you are getting into lots of repeat sessions, and a sense of having to depend on the 'magic hands' to treat you, I would take my cash elsewhere. If you are getting treatment and advice on exercises to carry out to manage your problem and are having a dialogue then I would say that is good.
Personally, if I had a sports injury, I would see a sports specialist physiotherapist. I would not go near any of the other bone crackers or charlatans, massage therapists et al. As someone above said, there is a lot of snake oil out there. And in the UK, a physiotherapist is at least a protected title and register with the HCPC which has actual teeth if your therapist is cack.
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You'll need to Register first of course.
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| NickyJ wrote: |
@boarder2020, have you experienced the pain yourself? The calcium build was so severe (on both shoulders they went at different times). They couldn't see it all on the ultrasound. They sent me for x-ray. They did a steroid injection which allowed my one shoulder to be pain free for a while then it built up again.
I have had friends who have had same surgery but no psysio after. It stopped the chronic pain BUT without physio they never regained full ROM. As the physio never materialised on NHS i paid for it myself. I struggle to follow these instructions via other means than being shown, why I need ski lessons rather than just watching others and videos. In addition, she gave me various massages to help release the muscles in addition to guiding through the right exercises for my situation, where I personally was getting stuck.
Believe what your like i know me, I know how I learn they have without a doubt made a difference to my outcomes. This includes and ACL recon, both shoulders and various cartilage issues and surgeries. 3 weeks post op for latest |
As I said before I know somebody that had SD surgery, did zero rehab and made a full recovery. I also know somebody that spent lots of time and money and never got back full ROM. If those people met they would quickly come to the conclusion that physiotherapy is worse than doing nothing for recovery. This is the problem with anecdotal evidence, which is all you have.
I suspect the physiotherapy did help you, but unless you have a time machine to go back and test out a different treatment, you can not say with any certainty how effective it was. For all we know it could have just been a placebo effect - which is why there is a need for quality randomised control studies that test out physiotherapy interventions Vs placebo interventions or even better best alternative interventions. Once you get a proper designed study, with decent sample sizes, suitable control group, accurate pre-post measures, long term follow up etc. you can start to make a more informed conclusion.
This isn't a case of me choosing to "believe what I want". I'm referencing scientific papers, and not just any - rcts and meta-analysis which are at the very top of the hierarchy of evidence.
Regarding not being able to follow instructions, I can empathise that for complicated movements like skiing where it's hard to visualise what your body is doing instruction is vital for many. However the general rehab exercises for SD surgery are ridiculously simple, I struggle to believe anyone could not do the vast majority of them as prescribed. Here's an NHS guide, im failing to see anything that would require input from a professional for
https://www.google.com/url?sa=t&source=web&rct=j&url=https://www.worcsacute.nhs.uk/patient-information-and-leaflets/documents/patient-information-leaflets-a-z/2513-subacromial-decompression-advice-and-exercises&ved=2ahUKEwirsPHygOT2AhVNe8AKHZNeBagQFnoECAgQAQ&usg=AOvVaw2p1s5EeO7RwC3yWovmttUz
There is plenty of evidence physiotherapy isn't that effective for things. For example for tennis elbow physiotherapy looks good in short term, but after 52 weeks there was no difference between the physiotherapy treatment approach and a wait and see approach (medical for "let's just ignore it and hope it goes away").
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@MarjMJ, no all my experiences are down to being in different places at different times over 40 odd years of sport, plus ten years ago I did around 5 websites for different physios and osteopaths and one highly regarded knee surgeon, plus a very good friend is an Osteo too.
My observations are purely made on what a physio might actually have in his treatment room and how he treats the injury.
Last year in the Summer when I was back in the UK I saw two different physio's for Achilles and Calf issues one used the Electro stimulation a lot, but I was not too impressed, then I switched to Paul Frawley* who I suspect knows a little bit more than our resident "expert" on here 
*Paul has worked with the Rugby Football Union for 18 years with various age groups and for the last 10 years as a Clinical Soft Tissue Therapist/Rehabilitator with the England Senior Rugby Union Team.
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@Weathercam, the profession has evolved a lot so this you may be seeing. We certainly threw out loads of some of the weirder electrotherapy kits as nobody could even remember using them or knew how to.
Some have their 'favourite' modalities, some don't update as much as they could, and some are at the front of their fields. Hence variability. There isn't a rule book for 'must have kit X, Y, Z'.
I would agree that all PT are not created equal and like hairdressers or mechanics, you can scout around a long time to find the right one. My experience of private PT was not great - and I twigged it pretty quickly as they weren't keen on giving out exercises for me, but were happy for me to keep going back for trigger point and cranio-sacral stuff (former passable, latter bunkum). So I stopped going and did exercises.
So it sounds like you found someone you felt you could trust with relevant appropriate experience, so I think we are agreeing here.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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| davidof wrote: |
| Weathercam wrote: |
So what are SnowHeads experiences etc? |
erm...
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I'm of this opinion also. Manipulation, stretching and target exercise is the only thing that's got me better
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Agree with previous comments of 'not all PTs are created equal' just as we are all different. I've been doing regular physio for almost 40 years in Canada & in Luxembourg with 1 year as an outpatient in a REHAB center (5hrs/5days a week) following PKR (partial knee replacement), obviously result was not as expected & I worked my axx off & also tried every treatment on offer following diagnosis of suspected PTSD from original accident & CRPS/algodystrophy. Physiotherapy, ergotherapy/OT, aquatherapy, electrostimulation of various forms as well as treatment through the National Centre of Pain including bi-weekly IV osteoporosis meds to help bone density, Neurofeedback treatment (interesting), high doses of curcuma(tumeric), thc & cbd in various forms . Conclusion: during the different stages of rehabilitation, different treatments helped in varying degrees. Longterm: staying positive, acceptance & adapting, keeping the weight down & staying fit, and finding a PT that 'works' for you. I've lost count of how many PTs I've had but now I've been with mine for 20+ yrs, we're best of friends, travel & even go skiing together. She mainly uses her hands for deep tissue massage but also has various machines. It's worth the search to find who's best for you. Best of luck!
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snowHeads are a friendly bunch.
snowHeads are a friendly bunch.
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| MarjMJ wrote: |
| .....So it sounds like you found someone you felt you could trust with relevant appropriate experience, so I think we are agreeing here... |
Certainly agree, but that was back in the UK but I spend 70% of the year out of the UK, so it's compliquée, hopefully now found someone good here.
One reason why French residency was appealing and not just to do with Brexit was getting into the French Health Care system, here getting things like new knees and hips and ensuing treatment is way better/faster than in the UK when you're in your 60's.
Mate in his mid 40's had major shoulder surgery and his rehab was nigh on 5 hours a day at the major centre here inc water therapy in the pool, whereas on the NHS post ACL construction the physio was an absolute joke of once a week and the first session was form filling, I went private immediately and even then ended up doing what was needed myself that's why probably I have knee issues again 11 years later
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And love to help out and answer questions and of course, read each other's snow reports.
And love to help out and answer questions and of course, read each other's snow reports.
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@Weathercam, nail on head. More the system than the professionals themselves. They know that 3 x 20 minute sessions are no good or not enough. They know how the body heals, they know how the body changes across the lifesspan, and that leaving things too long is no good.
@Oceanfalls, all your longterm comments are spot on.
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Physiotherapists are cheap compared to doctors - the NHS definitely needs more of them. But British patients are often sceptical of physiotherapy, and lazy. After I had my first baby (you were in 8 days in those days) a physio came around the ward every day. Most of the women just groaned at her approach and did the absolute bare minimum and stopped as soon as she'd gone. Won't have stopped them complaining years later about the shape that having kids had left them in.
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You know it makes sense.
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@pam w, that is all too true. The times I have needed to use a physio I have tried to follow the exercise regime as much as possible and seem to have had good outcomes (not sure any of the electric gizmos make much difference). I know plenty of folk (not just in UK) who seem to think that "rehab" after an injury or surgery means going to a physio twice a week (for however long the insurance will pay for it) and not bothering otherwise. Unsurprisingly they often end up with problems of one sort or another!
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Otherwise you'll just go on seeing the one name:
Otherwise you'll just go on seeing the one name:
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NHS post ACL construction the physio was an absolute joke of once a week
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The NHS has extremely limited funds. Physiotherapy tends to stretch to getting you back to a stage where you can get by in normal life (i.e. dress yourself, walk up a set of stairs etc.). I'd like it to be a lot better too, but right now we need to accept it's not in a position to focus on getting people back into athletic shape.
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But British patients are often sceptical of physiotherapy, and lazy
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I'm not sure they are sceptical of physiotherapy. IME they don't maintain rehab programs, but drop out rate of most interventions is high across the world (how many people can maintain a healthy diet to control weight for example). Drop out rate is considered such a problem (even for relatively easy rehab programs) it's considered normal practice to do psych questionnaires/interviews post intervention around maintenance and how it could be modified to decrease drop out. I've seen examples where the vast majority of participants said they would continue the intervention, none of them mentioned the fact had a huge impact on massively important health variables, the overwhelming reason for continuing was they physically looked better!
There's a whole area in behavioural economics about this kind of stuff, and how you can make people do healthier behaviours, which is very interesting. A lot comes down to the fact as humans we are good at making long term decisions, yet bad at implementing them in the short term (classic example being diet and exercise, we all know we should do them, we all plan to do better, yet we still pick chocolate over fruit today). It's easy to think it's just "lazy" or "stupid" people that don't know or care about health, but most of my PhD subjects were university staff (so reasonably intelligent and motivated) yet the majority never did their original rehab programs.
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who I suspect knows a little bit more than our resident "expert" on here
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Yeah who needs a PhD in this field when you can be a website designer for a few physios I guess the papers I've referenced are all wrong too. As I've said before I'm not saying physios are useless. I'm simply saying they are not magic and for some areas the evidence suggests they are not particularly useful. For instance shoulder instability physiotherapy is way behind surgery in terms of effectiveness. On the other hand for SD surgery mentioned further up this thread after 5 years there's no difference in outcome between surgery and physiotherapy. I.e. you need to pick your treatment based on the injury.
The other issue as this thread shows, is that there are clearly some "bad" physios still using at best "outdated" and at worst "debunked" techniques. The problem is 99% of people using a physio have no clue, and their recommendations of "good" physios mostly comes from their perceived personal outcome and/or the physios personality. The two might even be linked, as this study shows how you perceive your physios personality may effect your outcome https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-015-1225-1
Basically, short of an RCT it's impossible to know how effective your physio is. Best you can do is see if they follow best practice guidelines based on current literature. We all recover at different rates so even with a great physio doing all the right things your rehab may take longer than others with a worse physio.
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Poster: A snowHead
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@boarder2020, you read that wrong
I was suggesting an England Rugby Physio might know more than you, as he might have perhaps more hands on experience of professional sports people rather than your tendancy to continually regurgitate your text books and research papers
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Obviously A snowHead isn't a real person
Obviously A snowHead isn't a real person
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Well, when I said that the post-delivery women on the ward with me were "lazy" that was short-hand. Who knows what a psychological questionnaire would have have unearthed about their motivation, or lack of it, but they couldn't be arsed to do the exercises the physio was giving them, even when they were in hospital with nothing much else to do all day. And unlike some of the physio people have after shoulder surgery or injury (which can be very painful) the stuff you have to do after childbirth isn't painful in the least - or even strenuous. Indeed, it's essential NOT to do strenuous abdominal exercises till the muscles begin to knit together properly. Most of the women were younger than I was and most of them were never going to have flat stomachs again despite the best efforts of an excellent, NHS-financed physio.
Being the age I am I have lots of friends with replacement parts - knees and hips, mostly. The ones that do their physio properly are in a minority. These are well educated, well off, middle class people (many of whom have paid for private surgery). I find it hard to understand. They will pay, a bit begrudgingly, for private physio (whereas they pay up willingly for surgery) but not do any of the exercises in between their appointments.
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Well, the person's real but it's just a made up name, see?
Well, the person's real but it's just a made up name, see?
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@pam w, I also find that mindset incredibly as well. The surgery is just one step in the process to get back to full mobility IMO. My friend who is now a pilates instructor and has been helping with lots of suggestions to achieve stretches etc around my injuries was observing the same to me, that I was apparently one of the rare ones who followed the physio instructions.
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You need to Login to know who's really who.
You need to Login to know who's really who.
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@pam w, @NickyJ, yes I go with that as well!
I know quite a few friends who have done their ACL to varying degrees, including my daughter, and most did no prehab prior to their surgery and then maybe only one physio session a week, with no concentrated effort to strengthen the leg, needless to say most did not ski again, and one managed to do the ACL again.
My daughter still skis, but wears a brace, and has absolutely no confidence in hiking down steep forest paths.
I also think that in terms of skiing, many who have "done" their ACL, the ones I know, were not regular participants in sport, so they just did not have the necessary mindset to follow a strict discipline of rehab.
That said, I also have one friend who did his ACL and surgery was not an option as he was over 65, so he racked up the km on the bike and is now skiing with the aid of a brace, but he was sporty!
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Anyway, snowHeads is much more fun if you do.
Anyway, snowHeads is much more fun if you do.
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@NickyJ, hoping to reply to NickyJ: mindset is a huge part but it's walking on thin ice, how much can I improve vs how much do I have to accept. Sadly sometimes the bits of the body just don't work. Acceptance isn't easy nor are the options: to give up hiking bcs downhill just not possible? No, I took the family to a ski resort in summer, walked up hill with crutches/walking sticks & took chairlift down, went on walking holiday w'my PT & learned to walk 'backwards' downhill on easy paths, zigzag slalom-style, or sidestep.. Getting back on a bike with less than 90 ° flexion not possible but found an 'adapted' pedal by Hase.de (HASE Pedal Pendulum ) I even gave up eating meat on advice of a naturopath long before vegetarianism was popular. Only thing I didn't accept graciously was 'no more skiing': I wear a brace & try not to fall.. After 35+ yrs, I now only 1/week physio but cycle to work & exercise daily with specific strength exercises that I've learned from various physios. BTW I tore my knee apart, bone & ACL when my ankle got caught in a machine when falling from a beam.. Always thought I was lucky that my fall was broken mid-flight... Stay positive & never give up!
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You'll need to Register first of course.
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@boarder2020, you speak the truth. I taught 100s of pre-reg physios in my career - the vast majority of them were fantastic and some I wouldn't have let them touch the cat. NHS rehab is as you say aimed at getting you back to basic activities of daily living. So it is perhaps unsurprising to be disappointed if a patient is expecting more in that context. I think that the general public expect PT to be all hands on, bits of kit and bone crunching, and it isn't. It's about therapeutic exercise where the patient has input and responsibilities too. I like that you also highlighted the importance and difficulty of compliance. Understanding of motivations is key. And also being able to manage patient expectations - having that discussion with the person.
Interviewing prospective students was always interesting as if they couldn't identify that PT worked across ranges of ages, conditions, systems and with a wide variety of other healthcare professionals with patient at the core, we really didn't want them. If they only thought physio was about sport, it was always a red flag and a 'thanks very much, go away and think about it a bit more'. Similarly the undergrads were always asking for more classes in massage etc, and the clinicians in NHS practice would say 'we don't ever have time to do that'.
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Similarly the undergrads were always asking for more classes in massage etc, and the clinicians in NHS practice would say 'we don't ever have time to do that'
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I had some good (i.e. painful) sports massage from an NHS physio who worked extra hours in a private clinic to supplement his salary. He seemed to specialise in helping young people regain their mobility after acute trauma - road accidents etc.
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My Dad had excellent NHS physio following his fall and subsequent hip replacement. I don't think they expected so much assistance, but she said her job was to get him back to doing what he was able to do before the fall. All helped by my stubborn and determined father despite Parkinson's disease.
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You'll get to see more forums and be part of the best ski club on the net.
You'll get to see more forums and be part of the best ski club on the net.
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Just come back from ultrasound scan appointment with NHS. Injury happened 17th January. Carried on skiing all week. Went home. Not as mobile. Both shoulders seized up. Ibuprofen and voltarel gel. Could not move arms sideways without pain. Got on with life thinking it would get better. It hasn't. Can't see GP as no appointments available. Phone then E-consult. GP recommended ultrasound and gave link to exercise for arthritis. Ultrasound appointment was today (ouch). Results will take a week to go to GP. It is all v slow and I am worried about a physio making me do any exercise in case I make whatever hurts worse without knowing exactly what it is I have done. All I do know is that it does help if I keep both shoulders as mobile as possible in the meantime. Letting the arm hang and gentle rotations etc. Beginning to wonder if I should have gone for x-ray on return home. Fed up. Who to see to do examination and/or ultrasound and talk directly to you (the patient) rather than these separate, weeks apart appointments?
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At the risk of sounding rather heartless, @Oblos, if you can afford to go skiing, you can afford to see a physio privately. And possibly should have done right away - good people available in and around ski resorts. You neglected your injury for ages. But having said that heartless stuff, I do hope you now manage to get more mobile.
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