Why Physio Clinics Should Look Like Gyms

Physiotherapy has many different subdivisions. You have physiotherapists that specialise in neurological injuries like strokes and spinal cord injuries, you have physiotherapists who work in respirator wards and ICUs with patients who have had serious illnesses like COPD and heart attacks, and then you have physiotherapists who specialise in treating musculoskeletal injuries, which is mainly comprised of injuries around joints, bones, muscles, and other soft tissues.

At MVMNT Physiotherapy, we pride ourself in being a specialist musculoskeletal (or MSK for short) clinic. We treat patients who have all types of MSK injuries, ranging form total knee replacements to sports-specific injuries. Our belief is that a specialist MSK clinic should look more like a gym than a GP clinic, and we will discuss a few reasons why.

What is MSK Physiotherapy?

MSK Physiotherapy is the assessment, treatment, and rehabilitation of injuries to the musculoskeletal system. Assessment involves observing how the body moves, identifying any sinister issues with the injured body part, and ensuring that the injury doesn’t need further imaging and referral to hospital services. Treatment of the injury can involve reducing the pain and sensitivity around an injured area. This can involve mobilisation of the area, manipulation of joints, and employing strategies to reduce pain, such as changing gait mechanics, using tape, or instructing on the use of walking aids or braces. Rehabilitation is the key part of physiotherapy, and usually takes the most time to conduct, and what will give long-lasting changes. Rehabilitation means improving an injured area’s strength, control, and power to meet pre-injury levels, or even surpass pre-injury levels.

‘Traditional Physio’ & The Tiny Office Room

If you’ve ever needed to see a physio, either through the NHS or through the private sector, then you may be familiar with the ‘classic’ physio room. You’ll be led into a small room with a desk, two chairs, a physio table, and usually some resistance bands hanging on the wall. The physio in this room can often have a wealth of experience and conduct an amazing subjective and objective assessment of your injury. So you have your diagnosis, now what? In these small clinic rooms, the physio only has two choices. First, session after session of manual therapy lying on the physio table. Acupuncture, massage, joint mobilisations, and lots of other ‘feel good treatments’. Secondly, underloaded, inappropriate bodyweight exercises with a light resistance band, and if you’re lucky, a 5kg dumbbell. If you are an active individual, placing up to 3x times your bodyweight through each leg while sprinting, or a rugby player having to tackle a 110kg prop forward, then this is a completely inadequate setting for you.

Weights > Massage & Acupuncture

There is a large group of people who attend the classic physio clinic for massage and acupuncture because they want to feel good. If the case is that they are aware that these are short term fixes and that they don’t have any sporting or high-level exercise goals then this is completely fine. It is ok to want to be taken care of and to relax some sore muscles. However, if your aim is to be stronger, fitter, more resilient to external forces and to excel in your sporting endeavours, then you need to be challenged. All resistance is good resistance. Some patients require heavy barbells to increase their hip extension power for running. Some patients require kettlebells and dumbbells to challenge the stability and control of 3D joints like the hips and shoulders. In any case, there has never been a patient that has walked into a physio clinic that is already too string, or too athletic, or too explosive. If you want short term relaxation then the massage and acupuncture needles are your best option. If you want to improve and excel in your sporting endeavours, then you need a gym environment, or create a gym environment at home.

‘I Need To See My Physio For Maintenance’

Some clinicians unintentionally create reliance with their manual therapy treatments. It is usual that we would want to help someone’s back pain with some initial soft tissue treatment. However, the largest focus should be placed on movements and lifestyle changes to reduce the frequency and intensity of back pain, and empower patients to build a more resilient back. If you feel like you ‘need’ soft tissue treatment every month to stay mobile, then not enough effort has been spent by your physiotherapist to help you build a stronger back that can withstand the pressures of sports and life. An average physiotherapy follow up with a physiotherapist should look more like a personal training session than a spa treatment.

Summary

If you attend a physiotherapy clinic, and the heaviest weights there barely pass 10kg, and it lacks gym equipemnt that can challenge your strnegth, power, cardio, and athletic ability, then it’s probably not the best palce to go for a sports injury. If the room has acupuncture needles, TENS machines, electrotherapy equipment, and lots of massage oils, then you’re probably going to leave the session very relaxed, but with no extra knowledge or strength taht you can use for the rest of your life.

If you have any questions on whether physio is the best option for you, or you have any questions about MVMNT in general, feel free to contact via email.

- Jay Towolawi, Specialist Sports Physiotherapist and MVMNT Founder.