Beyond the Massage Table: What Exactly Is A Physiotherapist?

When you think of the term physiotherapy, what comes to mind?

Perhaps someone recovering after surgery.

Someone with back or knee pain.

Someone getting a massage or being shown a few exercises.

These are all things that physiotherapists can help with, but the scope of physiotherapy is much broader than that. Physiotherapists work with people across different ages, conditions and stages of life. They help people recover after an injury, manage long-term health conditions, regain movement after illness, prevent problems before they happen, and sometimes even help people without injuries move and perform more effectively.

So, what exactly is a physiotherapist?

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What is a Physiotherapist?

In Singapore, physiotherapy is a regulated healthcare profession.

According to the Allied Health Professions Council (AHPC), physiotherapy involves the assessment, treatment, rehabilitation and prevention of pain, injury and problems affecting physical function.

Put simply, physiotherapists help people understand and improve how their bodies move and function.

Depending on the person and their goals, this could mean helping someone:

• understand why they are having difficulty moving or doing certain activities;

• identify what might be contributing to a problem;

• improve their strength, mobility, balance or physical abilities;

• recover after an injury, surgery or illness;

• reduce their risk of future injury or physical problems; or

• improve how they move and perform during physical activity or sport.

Physiotherapy can involve exercise, education, hands-on treatment, technology and other approaches depending on what is appropriate for the individual.

But before we talk about what physiotherapists do, it is worth understanding what it takes to become one.

What do physiotherapists learn?

If you have ever wondered why physiotherapists seem to know so much about different parts of the body, there's a reason.

Physiotherapy education covers much more than muscles and joints. Depending on their programme and level of training, physiotherapists learn about areas such as:

• Anatomy — how the body is structured

• Physiology — how the body works

• How the body moves

• The brain and nervous system

• Muscles, bones and joints

• The heart and lungs

• Exercise and physical activity

• Pain

• How to choose appropriate exercises

• Medical conditions affecting children, adults and older adults

• Communication

• Research and evidence-based practice

  
  

And that's just part of it.

You might be wondering why a physio needs to learn about the brain, heart and lungs if they're treating someone's knee pain?

That's because physiotherapists work with people with many different health conditions! Not just muscle and joint problems.

For example, a physiotherapist working with someone after a stroke needs to understand how an injury to the brain can affect communication, movement, balance, coordination and strength.

A physiotherapist working with someone with a heart or lung condition may help them safely improve their endurance, exercise capacity and ability to carry out everyday activities without placing excessive strain on their heart or lungs.

Having a broad understanding of how the body works allows physiotherapists to consider different possible causes of a problem and decide how best to assess and manage it.

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So, what exactly does a physiotherapist do?

Before deciding what treatment someone needs, a physiotherapist first needs to understand what is happening. This is why your first appointment may involve a lot more talking, observing and testing than you might expect.

A physiotherapist may ask about:

• what you are having difficulty with;

• when the problem started;

• what makes it better or worse;

• your medical history;

• your usual activities and lifestyle;

• your goals; and

• how the problem is affecting your everyday life.

  
  

They may then look at how you move, check your strength and flexibility, assess your balance, or perform other tests depending on your situation.

This process is part of what is known as clinical reasoning.

In simple terms, clinical reasoning means combining a physiotherapist’s knowledge and experience with the information gathered from your assessment to work out what may be happening, what needs to be addressed, and whether physiotherapy is appropriate for you.

An example would be having knee pain — it might seem obvious that the problem is simply "having something wrong with my knee".

But the movement of your hip, ankle and other parts of your body can sometimes also affect how much stress is placed on your knee. Therefore, your physiotherapist needs to look beyond where you feel the pain.

This doesn't mean that every knee problem is actually caused by the hip or ankle. Rather, it is an example of why physiotherapists need to look at the bigger picture instead of focusing only on the painful area.

And sometimes, the answer isn't physiotherapy at all.

A good physiotherapist also needs to recognise when an injury or condition may require further medical investigation or another healthcare professional's expertise.

In other words, part of a physiotherapist's job is knowing when physiotherapy is appropriate and when it isn't.

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Beyond the Massage Table

So, what does a physiotherapist actually do?

They assess.

They educate.

They rehabilitate.

They prescribe and guide safe exercise.

They help people manage pain and physical problems.

They help people improve strength, movement and independence.

They help people prevent problems.

And sometimes, they help people move and perform better than before.

Physiotherapy can be done in a hospital, clinic, gym, community centre, swimming pool, home or sports environment.

And the person seeing a physiotherapist doesn't necessarily have to be injured.

Ultimately, physiotherapy is about helping people move, function and participate in the things that matter to them.

That's why physiotherapy extends far beyond the massage table.