This question can be more complex than it would appear at first glance! As a patient, it is important to have a goal in mind for physiotherapy treatment. This does a few things - it keeps you on track, it holds us (your physio!) accountable and it guides the treatment plan. We believe that, at any given time, your treatment plan should be focused on one of these three reasons. Which best describes you right now?
1. You want to get out of pain.
This would be the most common reason that patients come to see us. Back pain, knee pain, shoulder pain, weird shooting pains that run off in different directions - pain limits your ability to do what you want to do, it can make you tired, it changes your mood, and if it sticks around long enough it even changes itself (that's a whole separate blog topic!!). When we are working to get you out of pain, the things we prioritise include:
- giving you a clear and accurate diagnosis - this helps you know what you're dealing with, and a plan for how to manage it
- educating you on the injury, the healing process, the prognosis (i.e. how we expect it to go) and relevant timelines
- keeping you positive! Most problems we see have a good prognosis with the right approach - physical, mental and beyond.
- manual therapy, dry needling, taping and other modalities we can use to help your recovery. We don't use machines...that's a bit 'old school' physio and we think there are better ways.
- advice on anything that impacts the injury, from training advice, to posture, mobility, strength, endurance, lifestyle factors...this is where understanding you as an individual gives you the best outcome.
- exercise! Exercise takes many forms, and is inarguably one of the most important things in aiding all things related to pain and the body.
At this stage, we might see you once or twice a week, hopefully for only a short period, making sure you feel you have the tools to help yourself out of the clinic. If your issue is pretty simple and short-lived, this may be all we need to do together. In other situations, you should start thinking about point 2.
2. You need to rehabilitate.
You might think sports injuries or surgery here; but if you have a longstanding shoulder problem, you too are going to need to unwind any counterproductive patterns and work on improving your mobility, movement patterning, endurance and strength around that shoulder. Equally so if you have an on-again/off-again neck problem or an Achilles tendon pain that keeps popping up. This stage of physiotherapy is about understanding the key causes of your problem, and working to rectify them. Sometimes, this is where patients drop out of physio. However, if you complete your rehabilitation (i.e. get yourself back to a strong, high-functioning, non-pain-limited level) then your problem is far less likely to come back! This = happy patient. So what are the things we are working on with you at this stage?
- a home/gym/field/work exercise and rehabilitation program. We show you the important things for you, coach you through the exercises, and talk about how much/when, how to recover and so on.
- we talk about markers for progression. In other words, what should you be able to do to move onto the next step? For example, where should your calf raise be at before you start to run? At what point in your back rehab should you return to golf?
- a graded return to activity. Many a flare up in pain at this stage relates to doing too much too soon. Sounds simple, but you need advice on how to safely and smoothly reload your body when you're coming off the back of an injury.
- all these things are about integrating the things you are doing to specifically rehabilitate your injury/problem with your life in general, and your goals beyond that.
The hard part? YOU have to work for this. We will give you all the tools and guidance you need, and take you through a thorough process to move better, strengthen, and adopt behaviours that are good for your body. At this stage, we would normally touch base anywhere from once/twice a week to once every three/four weeks.
3. You want to be able to perform.
Did you think about sports there? Being back on the footy field or running a marathon is certainly performance; but depending where you're at, being able to walk the dog every day without your knee giving way is also 'performance'. In this context, being able to perform simply means being able to not just partake but to perform at the level you want to in any given activity of life - be that elite sport, to weekend warrior, to the simple ambitions of daily life. We help people with these seemingly benign things - hips that get sore with sitting at the desk, backs that won't let you get through half an hour's gardening, foot pain that stops you from walking with your kids. At the other end of town, perhaps you're training Crossfit and you just know that something is stopping you from taking your performance to the next level. How do we help at this stage?
- we find out about you, make sure we have assessed and diagnosed the problem, worked out the components that are holding you back, and put together a very specific plan to address it. This will often include strengthening exercises, postural work, mobility exercises, building cardiovascular endurance and lifestyle modifications.
- manual therapy can be useful depending on the problem. Our goal however is to return YOU to being in control of the problem and having the tools to address it.
- often this performance goal draws on principles from both points 1 and 2, potentially with some high level exercises or out of the box thinking to bring your goals to life!
Frequency of treatment varies according to the person and the problem. We might do a few sessions to set up a plan, then touch base periodically. With some conditions, for example a knee that is starting to feel the effects of osteoarthritis or a rotator cuff problem, a 'maintenance' approach to physiotherapy can be helpful - touching base once every four to six weeks, to check in with your progress, keep you motivated, and keep your exercises on track.
If you're in doubt as to what your needs would be or whether physio would be helpful for you, give the clinic a call on 0421 195 553 or drop into the clinic (4 Stack St, Fremantle) and say hi!
At Stack St Physio our vision is to provide the best physiotherapy and sports rehabilitation service in the Fremantle area!