Physiotherapy Care - Part 4: Frequently Asked Questions

In Part 4 of our 4-part series on ‘Holistic’ Physiotherapy, we’ll delve into frequently asked questions, including what to expect at your appointment, the scientific evidence supporting physiotherapy’s efficacy for specific conditions, and more …

Part 4: Frequently Asked Questions

We are sorry that you had that experience and agree completely that that is not quality care. The machine they likely used is called Interferential and can be used to reduce swelling, manage pain, reduce muscle spasm or even stimulate a muscle response.

We could get into a lengthy discussion about the efficacy of interferential machines, along with the use of TENS machines and ultrasound therapy, however its probably easiest to say that the ‘pain and dysfunction’ practitioners at Effortless Superhuman don’t use any electrotherapy. In fact, we don’t even own an interferential, TENS, or ultrasound at (ES).

The physiotherapy you will receive is our focused one-on-one attention and a practitioner who follows the (ES) Method of analysis and treatment. All treatment is hands-on and individualized.

All of our initial consultations are 30-40 minutes in duration. This allows us the time needed to perform a detailed, head-to-toe, assessment in accordance with the (ES) Method. In many instances the client’s case is challenging enough to warrant a second session that is 30 minutes in duration as well. Our main goal is to fully understand what is going on in your body, create a strong Summary Table, and then to have a clear idea of how to solve your challenge. In some instances, this can take up to 60 to 90 minutes.

Once the Summary Table has been created and the practitioner is clear on how to proceed, they will then book consultations for you that are either 15, 20 or 30 minutes. Although 5-10 minutes does not seem like much time, in practitioner terms this can make a massive difference as to the effectiveness of treatment.

In some instances, three (3) shorter sessions of 15-20 minutes may be far more effective in achieving your “Good Outcome” than two longer sessions of 30 minutes. This is especially true in acute pain cases.

Once you get to the Functional Risk Profile stage of the (ES) Method and begin corrective exercises, often 30 minutes sessions once per week or once per fortnight becomes far more effective.

Your practitioner we be very open and clear about what is needed to help you achieve your ‘Good Outcome’.

Chronic Low Back Pain

Another 2015 study in the British Medical Journal, “Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and meta-analysis”, demonstrated that a multidisciplinary approach (including physiotherapy) was more effective than standard approaches to overcoming chronic low back pain. Interesting to note that (ES) is a multidisciplinary facility and echoes the findings of this report.

http://www.bmj.com/content/350/bmj.h444

All Musculoskeletal Conditions

A 2014 study called “Cost-Effectiveness of Manual Therapy for the Management of Musculoskeletal Conditions: A Systematic Review and Narrative Synthesis of Evidence From Randomized Controlled Trials” revealed that all forms of manual therapy for neck, back, shoulder, and ankle pain were more effective than general medical care alone.

Manual therapy techniques such as osteopathic spinal manipulation, physiotherapy manipulation and mobilization techniques, and chiropractic manipulation with or without other treatments, were more cost-effective than usual general practitioner (GP) care alone. It’s also interesting to note that chiropractic manipulation was found to be less costly and more effective than alternative treatment compared with either physiotherapy or GP care in improving neck pain.

https://www.ncbi.nlm.nih.gov/pubmed/24986566

Knee Pain

A 2015 study entitled “Effectiveness of physiotherapy exercise following total knee replacement: systematic review and meta-analysis”, clearly demonstrated how effective physiotherapy management can be post surgery.

https://www.ncbi.nlm.nih.gov/pubmed/25886975

A 2000 study by Clark et al. entitled “Physiotherapy for anterior knee pain: a randomized controlled trial demonstrated that the proprioceptive muscle stretching and strengthening aspects of physiotherapy have a significantly beneficial effects for people with anterior knee pain and that these benefits were still present at one-year follow-up.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1753277/

There are many other studies supporting physiotherapy treatment in relation to knee pain. Here is another example:

https://www.ncbi.nlm.nih.gov/pubmed/23036842

Neck Pain

A 2003 study in the British Medical Journal entitled “Cost effectiveness of physiotherapy, manual therapy and general practitioner care for neck pain: economic evaluation alongside a randomized controlled trial” demonstrated that Manual therapy (spinal mobilization) is more effective and less costly for treating neck pain than physiotherapy or care by a general practitioner.

It should be noted that all of the (ES) ‘Pain and Dysfunction’ practitioners, including our physiotherapists utilize spinal mobilization (when appropriate) for treating neck pain.

https://www.ncbi.nlm.nih.gov/pubmed/12714472

Tennis Elbow

A 2006 study entitled “Mobilisation with movement and exercise, corticosteroid injection, or wait and see for tennis elbow: randomised trial” demonstrated that physiotherapy treatment that combined elbow manipulation and exercise has a superior benefit to wait and see in the first six weeks and to corticosteroid injections after six weeks, providing a reasonable alternative to injections in the mid to long term. It’s interesting to note that the significant short-term benefits of corticosteroid injection are paradoxically reversed after six weeks, with high recurrence rates, implying that this treatment should be used with caution in the management of tennis elbow.

http://www.bmj.com/content/333/7575/939

A 1996 study entitled “The initial effects of a cervical spine manipulative physiotherapy treatment on the pain and dysfunction of lateral epicondylalgia” demonstrated that cervical spinal manipulation had a significant benefit in alleviating the pain associated with tennis elbow. A second study in 2008 backed up these findings.

https://www.ncbi.nlm.nih.gov/pubmed/9252000
https://www.ncbi.nlm.nih.gov/pubmed/19028251

A 2001 article entitled “Specific manipulative therapy treatment for chronic lateral epicondylalgia produces uniquely characteristic hypoalgesia” demonstrated that a precise elbow mobilization technique resulted in statistically significant improvements in pain-free grip strength in patients suffering from tennis elbow.

https://www.ncbi.nlm.nih.gov/pubmed/11673930

A 2003 article entitled “Lateral epicondylalgia: a musculoskeletal physiotherapy perspective” highlighted that precise exercise prescription in addition to manipulation and sports taping techniques provide substantial initial pain relief for the vast majority of clients.

Shoulder Pain and Injury

A 2011 study by Brantingham et al. demonstrated that there is evidence to support manual and manipulative therapy for common shoulder pain and disorders. The outcome measures were enhanced when this form of therapy was used in conjunction with additional forms of therapy and improvements in lifestyle factors.

https://www.ncbi.nlm.nih.gov/pubmed/21640255

A systematic review of the literature in 2012 by Maund et al. revealed that there was limited clinical evidence on the effectiveness of treatments for primary frozen shoulder. Evidence such as this once again guides the (ES) Practitioners and helps shape their treatment protocols. In the vast majority of clients presenting with primary frozen shoulders (females, age 40 to 55), there are almost always compounding health challenges that may be driving the shoulder capsulitis or preventing it from healing. As such, following the protocol set by the (ES) Performance Pyramid, the client’s health issues would be addressed before any form of manual therapy or exercise therapy is considered. Our clinical findings to date would suggest that this approach is far more successful for the client in the long run than manual therapy alone.

https://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0047025/

If you would like to investigate some of the literature yourself, you may consider researching the evidence at this website.

http://back.cochrane.org/our-reviews

Thank you for joining us on this 4-Part series through what it means to be a ‘Holistic Physiotherapist’ at Effortless Superhuman.

To book an appointment with an ES practitioner please call (08) 9388 2768 or click here.

We look forward to seeing you soon,

Sincerely,

The ES Team