Physiotherapy 101: All You Need To Know

by Brenna Ng

Medically reviewed by Brenna Ng, AHPC Registered Physiotherapist (Singapore)

Physiotherapy is a form of treatment that helps to restore, maintain and maximise strength, function, movement and overall well-being. Through the use of exercise and technology, physiotherapists help people regain muscle strength, joint mobility and joint position sense after an injury or when undergoing rehabilitation from conditions such as Parkinson’s disease and stroke.

What Do Physiotherapists Do?

Physiotherapists are allied health professionals who have an in-depth knowledge of how the body works and specialised hands-on clinical skills to assess, diagnose and treat injury and disability.

Trained to pinpoint the root cause of injuries and other ailments, a physiotherapist will first assess your holistic health and wellbeing, before determining the kind of movements and exercises you can and should do to aid in recovery, taking into consideration a multitude of factors including your individual needs, conditions and mobility.

There are various approaches that a physiotherapist may use to treat and manage your condition, including movement and exercise, manual therapy and hydrotherapy. 

Here are some of the common treatment methods and techniques physiotherapists use:physiotherapy techniques

Movement and Exercise

After assessing an individual’s condition, mobility and ability to do physical activity, your physiotherapist may prescribe a set of physical exercises you can safely do at home to increase the range of movement of your joints, strengthen muscle, and improve balance and coordination. This can help in injury prevention and recovery, as well as managing chronic conditions.

Manual Therapy

An injury may cause our joint movements to be limited. As such, physiotherapists may perform manual therapy, defined as “Skilled hand movements intended to produce any or all of the following effects: improve tissue extensibility; increase range of motion of the joint complex; mobilize or manipulate soft tissues and joints; induce relaxation; change muscle function; modulate pain; and reduce soft tissue swelling, inflammation or movement restriction.” 

Treatment may include mobilising joints in specific directions and at varying speeds to help regain movement or passive movements of the affected joint. These are movements performed by someone else and not ourselves but are within our control as we can stop it anytime by tensing up our muscles. 

Another technique is manipulation, a passive, high velocity, low amplitude thrust applied to a joint within its anatomical limit to restore optimal range, function and reduce pain. However, this is more common in osteopaths and chiropractors as compared to physiotherapists. 

Manual therapy is a specialised form of physical therapy delivered with skilled hands as opposed to using a machine and is valued and effective in the management of injury and pain.

Hydrotherapy

Commonly used to treat rheumatological, orthopaedic and neurological disorders, hydrotherapy involves exercising in a warm shallow pool with a temperature of 33-36ºC. 

There are several benefits that are unique to hydrotherapy. Firstly, the warmth of the water aids in muscle relaxation and eases joint pains. Secondly, being underwater also supports our weight, allowing our joints and muscles to move with minimal stress. Furthermore, water resistance against our movement can boost muscle strength. 

With hydrotherapy, individuals are able to participate in exercises which they would not have been able to perform out-of-water without over-stressing joints. This approach could be especially useful for individuals with arthritis. 

Dry Needling

Some physiotherapists may use dry needling, where a fine needle or acupuncture needle is inserted into the skin and muscle. It is targeted at myofascial trigger points and can be performed on a superficial or deep tissue level, treating pain and restoring muscle activation. Dry needling has been deemed helpful in alleviating pain and restoring muscle activation and strength in conditions such as low back pain and stroke

However, just like any other approach, the effectiveness of dry needling varies from person to person and on the skill of the therapist to accurately locate myofascial trigger points. Individuals on medication, have diabetes, or are pregnant, may have to consult a medical professional prior to undergoing dry needling. 

Ultrasound

When we think of ultrasound, pregnancy is often the first thing that pops into our mind. However, besides its more widely known application of generating images of the womb, ultrasound can be used in physiotherapy as well

The therapeutic effects of ultrasound can be subdivided into: thermal and non-thermal. 

One way physiotherapists use ultrasound is to provide deep heating to soft tissues, increasing blood circulation and therefore promoting healing and reducing pain. Furthermore, it has also been postulated to improve the rate of healing and enhance the quality of tissue repair. 

Cavitation, a non-thermal intervention, uses ultrasound energy to cause rapid contraction and expansion of microscopic gas bubbles around injured tissue, accelerating the healing process. 

Ultimately, the effectiveness of ultrasound has been reported to be largely dependent on the dosage of which it is administered. Individuals with thromboembolic diseases, cardiac pacemakers, fragile skin or sensory impairments should consult a medical professional prior to receiving ultrasound treatment. 

Common conditions that physiotherapists may treat with ultrasound include carpal tunnel syndrome, shoulder pain, tendonitis, ligament injuries and joint tightness. 

Traction

Traction is a manual technique of ‘stretching’ and ‘distracting’ the spine to relieve pressure and change the disc-nerve interface of vertebral discs that are causing pain. It is commonly used to treat herniated discs, sciatica, degenerative disc disease, pinched nerves, and many other back conditions.

Although the effectiveness of mechanical traction in treating pain (i.e. acute or chronic non-specific low back pain), is debatable, many physical therapists still frequently use it as an additional modality or an adjunct.

Who Needs Physiotherapy?

Physiotherapy is suitable for all ages and can benefit you at any time in your life. While it is commonly associated with musculoskeletal issues, you don’t have to be injured for physiotherapy to benefit you. Physiotherapy extends beyond that and can actually help with managing long-term medical conditions such as asthma, preparing for a sporting event or even childbirth.

Physiotherapists can help to improve various conditions:

  • Amputee Rehabilitation
  • Neurological: stroke, multiple sclerosis, Parkinson’s, spinal cord injuries, vestibular dysfunction, traumatic brain injuries, neuromuscular diseases, cervical myelopathy
  • Neuromusculoskeletal: falls, balance disorders, back pain, neck pain, knee painarthritis, muscle strain, sports injuries, whiplash associated disorder, rotator cuff tears, temporomandibular joint disorders (TMJ)
  • Cardiovascular: chronic heart disease, post-myocardial infarction (MI), rehabilitation after a heart attack
  • Respiratory: asthma, cystic fibrosis, chronic obstructive pulmonary disease bronchiectasis
  • Pediatric conditions: developmental delays, cerebral palsy, muscular dystrophy
  • Women’s health and pelvic floor dysfunction: urinary incontinence, lymphedema
  • Nervous: carpal tunnel syndrome, thoracic outlet syndrome, radicular pain, radiculopathy 
  • Sports-related: concussion, tennis elbow

How Does Physiotherapy Help Recovery? Aren’t You Supposed To Rest?

The human body is made to move. When we move, our muscles work, our joints bend, our heart beats faster and our breathing becomes heavier. All these help in maintaining and improving muscle strength, joint mobility, blood circulation, healing and respiratory health. 

When we are not well, it is important to rest and let the body heal. However, resting too much after the body has recovered can harm rather than help, as the repair tissue may end up becoming too stiff. This could lead to weak or imbalanced muscles, increasing the risk of re-injury and chronic pain when we return to previous activities.

Physical activity and exercise is pivotal in maintaining health and function, particularly for the elderly who are more susceptible to comorbidities and conditions such as osteopenia, osteoporosis or sarcopenia. Reduced physical activity is commonly associated with reduced mobility, walking function, aerobic fitness, impaired balance and depression. This may create a vicious cycle as movement becomes more strenuous and effortful. 

Physiotherapists can guide you to exercise safely within your abilities and journey with you in achieving your goals.

Why Home Physiotherapy? Is it safe?

Home physiotherapy is safe. Physiotherapists are trained and will perform a thorough assessment to be sure that your loved one is in good condition to exercise before they begin the session. They will also discuss expectations and set goals prior to tailoring a programme specialised for your loved one. At any point in time, if your loved one is in discomfort, they will be sure to perform an assessment and cease the exercise if necessary.  

Home therapy seeks to be functional, achievable and accessible. Even though the equipment used at clinics and hospitals may not be easily accessible at homes, most exercises can still be carried out safely and as effectively, at home. Common household items such as water bottles and chairs can be used for exercise, and many activities may not even require any equipment at all. 

With the option of home physiotherapy, those who find it inconvenient or challenging to head down to clinics and hospitals can now get the treatment they need in the comfort of their home, office or gym.

Learn more about the benefits of home physiotherapy here.

Is Home Physiotherapy Expensive?

Costs vary, but Homage’s home physiotherapy price is on-par with many hospitals and clinics. When looking at costs, you should also consider transport costs and the cost of taking time off work to accompany a loved one. Depending on how mobile your loved one is, travelling by taxi can add an additional $40 to $60 per visit. Here are some of the cost and benefits of home physiotherapy.

How Often Should I Get Physiotherapy? 

The frequency and dosage of therapy are dependent on your goals and tolerance towards exercise. Although intensity is key and recommended, especially in the early stages of recovery, understanding your needs and goals are also important. As it differs from individual to individual, it would be beneficial to have a physiotherapist assess you prior to prescribing you a program. 

Similarly, if you are recovering well and improving, you can reduce the frequency of physiotherapy. This will all be assessed by your physiotherapist who will monitor your progress and advise accordingly. Alternatively, if you require more time and specialised attention, you may also request to increase the frequency of your sessions to achieve a higher level of independence and meet your own goals.

If you are looking for home physiotherapy services, feel free to reach out to our Care Advisors at 6100 0055 to learn more about how we can help.

References
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About the Writer
Brenna Ng
Brenna is a neurological rehabilitation physiotherapist with a special interest in stroke, spinal cord injuries, vestibular rehabilitation, sports for persons with disabilities and teaching. She has experience in hospitals and polyclinics, conducting group exercise classes for Parkinson Society Singapore and Singapore National Stroke Association in the community, and is also a certified AHPC supervisor and clinical educator supervising physiotherapy students from the Singapore Institute of Technology during their neurological placements.
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