As an addition to the ongoing and ever popular Facebook “Tip-of-the-week”, we are proud to announce the addition of a fortnightly blog to our website. The idea behind the “Tip-of-the-week” was to be able to share some of the pearls of wisdom and general physiotherapy advice that we find ourselves (in the clinic, at barbecues, in the supermarket) sharing with patients and friends over and over and over, ad nauseum, ad infinitum. This way, the thinking goes, the more people that read these tips – the fewer people we have to tell. Initially these were simple things like
“Don’t keep your wallet in your back pocket – it can cause pelvic asymmetry, lower back pain, and sciatica” or “If you suffer neck pain from long hours driving, adjust your rear-view mirror so that it’s a bit too high to see perfectly behind you. Every time you check it, you’ll have to sit up a little taller, reminding you to keep better driving posture”.

As the years have past and we’ve exhausted some of the more simple pieces of advice (though many of them could do with recycling, check out the archive here), and some of the later posts have become more detailed and lengthy, which is not so appropriate for the Facebook space – we all know Facebook should be full of pictures, polls, like-chasers, pictures of your friends’ dinners, and “Game of Thrones” spoilers.

So what piece of advice could be important enough to share for this auspicious occasion, the Virgin Blog post? Let’s start with something that no physio will ever tell you – NOT ALL PHYSIO’S ARE GOOD. One thing we’re all pretty quiet about generally is the fact that, just like Builders, Plumbers, Doctors and Hairdressers – there are good Physios and bad Physios. The problem is that you, the general public, aren’t to know really who are the therapists who really care, put in their time and effort, do plenty of professional development to stay current and upskilled.


So, here are some signs that your physiotherapist is worth your hard earned money;
1) They listen: simple, I know, but how else do you know that they are hearing your concerns? You’ve been referred for a neck problem, but actually your lower back is bothering you most today – do they treat your neck blindly or work out what your main concerns are. Is it important for you to get back to sport or do you just want to walk the dog and garden? Do you really need a $300 knee brace and two treatments a week if you’re struggling on a pension, or might a self-managed exercise or hydrotherapy program be better?

2) Re-Assessment: You’ve been bent, poked, and prodded at the start of the session to find out what the problem is, and then (hopefully) offered some form of treatment to ease the symptoms, such as massage, needling, stretching, taping etc. Did the treatment make a difference? It is unacceptable to walk out of a physiotherapy practice worse than you came in, with no explanation other than “it can take a few days to settle”. Your physio should always re-check the assessment after the treatment, to see if it has been effective, because this is how we tell that the diagnosis is correct.

3) One-on-One: Does your physio set you up with a hot pack, interferential or ultrasound and then leave the room to treat someone else? You are paying good money for their expertise and hands-on skills, and shouldn’t tolerate more than a couple of interruptions in your sessions. It is difficult to fit in assessment, treatment, reassessment, and exercise prescription into one 30min treatment session, certainly if your therapist has left the room for more than five or so minutes, they are going to have to cut corners to stay on time. One possible exception is traction, since this treatment is totally hands off. A good therapist will spend your treatment time treating you and then put you on traction at the end of the session, while they move on to their next patient.

4) Referral: If you’ve had treatment and being faithfully doing your exercises and ice for four or five weeks, but the pain doesn’t seem to be improving then your physiotherapist should be reexamining their diagnosis. Some problems DO take 8-12 weeks to get better, but usually show some sign of improvement within four to six weeks. If there has been no change, then further information is required. This may take the form of referral on for medical imaging (Xray, MRI) or possibly referral to a specialist. Physiotherapists treat many patients who have seen many different specialists, and we get a pretty good idea of who the best people are to manage each type of injury or condition. Sometimes the best thing a physiotherapist can do for you is realise that your problem is beyond the scope of physiotherapy, and not treat you at all – rather guide you on to someone who can.

If you’ve been going to see a physiotherapist, osteopath, or chiropractor who doesn’t do these things, perhaps its time to reconsider . . .