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What is Physiotherapy Treatment?

Physiotherapists help people affected by illness, injury or disability through exercise, manual joint therapy, soft tissue techniques education and advice.  Physiotherapists maintain physical health, allow patients to manage pain and prevent disease for people of all ages. Physiotherapists help encourage pain-relief, injury recovery, enabling people to stay playing a sport, working or performing daily living activities while assisting them to remain functionally independent.

There is a multitude of different physiotherapy treatment approaches.

Acute & Sub-Acute Injury Management

Hands-On Physiotherapy Techniques

physiotherapy treatment

Your physiotherapist's training includes hands-on physiotherapy techniques such as:

Your physiotherapist has skilled training. Physiotherapy techniques have expanded over the past few decades. They have researched, upskilled and educated themselves in a spectrum of allied health skills. These skills include techniques shared with other healthcare practitioners. Professions include exercise physiologists, remedial massage therapists, osteopaths, acupuncturists, kinesiologists, chiropractors and occupational therapists, to name a few.

Physiotherapy Taping

Your physiotherapist is a highly skilled professional who utilises strapping and taping techniques to prevent and assist injuries or pain relief and function.

Alternatively, your physiotherapist may recommend a supportive brace.

Acupuncture and Dry Needling

Many physiotherapists have acquired additional training in acupuncture and dry needling to assist pain relief and muscle function.

Physiotherapy Exercises

Physiotherapists have been trained in the use of exercise therapy to strengthen your muscles and improve your function. Physiotherapy exercises use evidence-based protocols where possible as an effective way that you can solve or prevent pain and injury. Your physiotherapist is highly-skilled in the prescription of the "best exercises" for you and the most appropriate "exercise dose" for you, depending on your rehabilitation status. Your physiotherapist will incorporate essential components of pilates, yoga and exercise physiology to provide you with the best result. They may even use Real-Time Ultrasound Physiotherapy so that you can watch your muscles contract on a screen as you correctly retrain them.

Biomechanical Analysis

Biomechanical assessment, observation and diagnostic skills are paramount to the best treatment. Your physiotherapist is a highly skilled health professional. They possess superb diagnostic skills to detect and ultimately avoid musculoskeletal and sports injuries. Poor technique or posture is one of the most common sources of a repeat injury.

Hydrotherapy

Aquatic water exercises are an effective method to provide low bodyweight exercises.

Sports Physiotherapy

Sports physio requires an extra level of knowledge and physiotherapy to assist injury recovery, prevent injury and improve performance. For the best advice, consult a Sports Physiotherapist.

Vestibular Physiotherapy

Women's Health

Women's Health Physiotherapy is a particular interest group of therapies.

Workplace Physiotherapy

Not only can your physiotherapist assist you in sport, but they can also help you at work. Ergonomics looks at the best postures and workstation set up for your body at work or home. Whether it be lifting technique improvement, education programs or workstation setups, your physiotherapist can help you.

Electrotherapy

Plus Much More

Your physiotherapist is a highly skilled body mechanic. A physiotherapist has particular interests in certain injuries or specific conditions. For advice regarding your problem, please contact your PhysioWorks team.

Pain

Pain is the built-in alarm that informs you something is wrong! Pain is your body's way of sending a warning to your brain. Your spinal cord and nerves provide the pathway for messages to travel to and from your brain and the other parts of your body. Pain travels along these nerve pathways as electrical signals to your brain for interpretation. Receptor nerve cells in and beneath your skin sense heat, cold, light, touch, pressure, and pain. You have thousands of these receptor cells. Most cells sense pain. When there is an injury to your body, these tiny cells send messages along nerves into your spinal cord and then up to your brain. In general, pain receptors are classified according to their location. Receptors that respond to injury or noxious stimuli are termed nociceptors and are sensitive to thermal (heat), electrical, mechanical, chemical and painful stimuli. Each nociceptor is connected to a nerve that transmits an electrical impulse along its length towards the spinal cord and then, ultimately, your brain. It is your brain that informs you whether or not you are experiencing pain. Plus, your pain can plays tricks - especially when you suffer chronic pain.

Pain messages travel slower than other nerve stimulation.

Nerves can also be categorised according to their diameter (width) and whether a myelin sheath is present. Three types of nerves are concerned with the transmission of pain: A-beta fibres, which have a large diameter and are myelinated A delta fibres, which have a small diameter and also have myelinated sheaths. C fibres have small diameters and are non-myelinated (slowing their conduction rate) and are generally involved with the transmission of dull, aching sensations. Nerves with large diameter conduct impulses faster than those with a small diameter. The presence of a myelin sheath also speeds up the nerve conduction rate. One method of easing your pain is to provide your nervous system with high speed "good feelings" such as rubbing your injured area. This is the same principle that a tens machine (pain-relieving machines) utilises to provide pain relief.

Tendinopathy (tendon injuries) can develop in any tendon of the body. You may have heard of tendinopathies referred to as its aliases: tendonitis, tendinitis, tenosynovitis and tendinosis. In simple terms, they are all tendon injury pathologies, so the medical community now refers to them as tendinopathies.

Typically, tendon injuries occur in three areas:

  • tendon insertion (where the tendon attaches to the bone)
  • mid-tendon (non-insertional tendinopathy)
  • musculotendinous junction (where the tendon attaches to the muscle)

What is a Tendon Injury?

Tendons are the tough fibres that connect muscle to bone. Most tendon injuries occur near joints, such as the shoulder, elbow, knee, and ankle. A tendon injury may seem to occur suddenly, but usually, it is the result of repetitive tendon overloading. As mentioned earlier, health care professionals may use different terms to describe a tendon injury. You may hear:

Tendinitis (or Tendonitis): This means "inflammation of the tendon".

Mild inflammation is actually a normal tendon healing response to exercise or activity loading, but it can become excessive, where the rate of injury exceeds your healing capacity.

Tendinopathy Phases

The inability of your tendon to adapt to the load quickly enough causes the tendon to progress through four phases of tendon injury. While it is healthy for normal tissue adaptation during phase one, further progression can lead to tendon cell death and subsequent tendon rupture.

1. Reactive Tendinopathy

  • Normal tissue adaptation phase
  • Prognosis: Excellent.
  • Normal Recovery!

2. Tendon Dysrepair

  • Injury rate > Repair rate
  • Prognosis: Good.
  • The tendon tissue is attempting to heal.
  • You must prevent deterioration and progression to permanent cell death (phase 3).

3. Degenerative Tendinopathy

  • Cell death occurs
  • Prognosis: Poor!
  • Tendon cells are dying!

4. Tendon Tear or Rupture

  • Catastrophic tissue breakdown
  • Loss of function.
  • Prognosis: very poor.
  • Surgery is often the only option.

What is Your Tendinopathy Phase?

It is crucial to have your tendinopathy professionally assessed to identify its current injury phase. Identifying your tendinopathy phase is vital to direct your most effective treatment since certain treatment modalities or exercises should only be applied or undertaken in specific tendon healing phases.

Systemic Risk Factors

The evidence is growing that it is more than just the tendon and overload that causes tendinopathy. People with diabetes, post-menopausal women and men with high central adiposity (body fat) seem to be predisposed to tendinopathies and will need to observe their training loads.

What are the Symptoms of Tendinopathy?

Tendinopathy usually causes pain, stiffness, and loss of strength in the affected area.

  • The pain may get worse when you use the tendon.
  • You may have more pain and stiffness during the night or when you get up in the morning.
  • The area may be tender, red, warm, or swollen if there is inflammation.
  • You may notice a crunchy sound or feeling when you use the tendon.

The symptoms of a tendon injury can be similar or combined with bursitis.

How is a Tendon Injury Diagnosed?

To diagnose a tendon injury, your physiotherapist or doctor will ask questions about your past health, symptoms, and recent exercise regime. They'll undertake a thorough physical examination to confirm the diagnosis. They will then discuss your condition and devise an individualised treatment plan.

They may refer you for specific diagnostic tests, such as an ultrasound scan or MRI.

Tendinopathy Treatment

Tendinopathies can normally be quickly and effectively rehabilitated. However, there is a percentage of tendinopathies that can take months to treat effectively.

As mentioned earlier in this article, it is important to know what phase your tendinopathy currently is. Your physiotherapist can assist not only in your diagnosis but also guide your treatment to fast-track your recovery.

Before you seek the advice of your physiotherapist or doctor, you can start treating an acute tendon injury at home. To achieve the best results, start these steps right away:

  • Rest the painful area, and avoid any activity that makes the pain worse.
  • Apply ice or cold packs for 20 minutes at a time, as often as 2 times an hour, for the first 72 hours. Keep using ice as long as it helps.
  • Do gentle range-of-motion exercises and stretching to prevent stiffness.

When to Return to Sport

Every tendinopathy is different, so please be guided by your physiotherapist assessment. Be patient, and stick with the treatment exercises and load doses prescribed by your physiotherapist. If you start using the injured tendon too soon, it can lead to more damage and set you back weeks! It may take weeks or months for some tendon injury to heal and safely cope with a return to sporting loads.

Tendinopathy Prevention

To minimise reinjuring your tendon, you may require some long-term changes to your exercise activities. These should be discussed with your physiotherapist. Some factors that could influence your tendinopathy risk include:

  • Altering your sport/activities or your technique
  • Regular prevention exercises.
  • Closely monitoring and record your exercise loads. Discuss your loading with your physiotherapist and coach. They will have some excellent tips.
  • Always take time to warm up before and cool down / stretch after you exercise.

Tendinopathy Prognosis

While most acute tendinopathies can resolve quickly, persisting tendon injuries may take many months to resolve. Long-term or repeat tendinopathies usually have multifactorial causes that will require a thorough assessment and individualised rehabilitation plan.  Researchers have found that tendon injuries respond differently to muscle injuries and can take months to solve or potentially render you vulnerable to tendon ruptures, which can require surgery.

For specific advice regarding your tendinopathy, please seek the advice of your trusted healthcare professional with a special interest in tendinopathies.

Article by John Miller

What is Therapeutic Ultrasound?

Therapeutic ultrasound is an electrotherapy modality that has been used by physiotherapists since the 1940s. Via an ultrasound probe through a transmission coupling gel in direct contact with your skin, ultrasound waves are applied. ultrasound Therapeutic ultrasound may increase:
  • healing rates
  • tissue heating
  • local blood flow
  • tissue relaxation
  • scar tissue breakdown.

How Could Ultrasound Help?

Ultrasound increases local blood flow. This increase may help to reduce local swelling and promote soft tissue healing rates. A higher power density may soften scar tissue.

Specific Ultrasound Uses

Mastitis or blocked milk ducts successfully respond to therapeutic ultrasound. The effect is quite dramatic, with improvement within 24 to 72 hours. The most common conditions treated with ultrasound include soft tissue injuries such as muscle, ligament injuries or some tendinopathies. Phonophoresis uses ultrasound in a non-invasive way of administering medications to tissues below the skin. This method may assist patients who are uncomfortable with injections. With phonophoresis, the ultrasonic energy forces the drug through the skin.

What is an Ultrasound Dose?

A typical ultrasound treatment will take from 3-10 minutes. Where scar tissue breakdown is the goal, this treatment time could be much longer. During the procedure, the head of the ultrasound probe is in constant motion. If kept in continuous motion, the patient should feel no discomfort at all. Some conditions treated with ultrasound include soft tissues injuries such as muscles or ligament injuries, tendinopathy, non-acute joint swelling and muscle spasm.

How Does an Ultrasound Work?

A piezoelectric effect, caused by the vibration of crystals within the ultrasound head of the probe creates the sound waves. The ultrasound waves generated then pass through the skin cause a vibration of the local soft tissues. This repeated cavitation can cause deep heating locally though usually no sensation of heat will be felt by the patient. In situations where a heating effect is not desirable, an athermal application occurs. Athermal doses are typical during acute fresh injury and the associated acute inflammation.

When Should Ultrasound be Avoided?

Contraindications of ultrasound include:
  • local malignancy,
  • over metal implants,
  • local acute infection,
  • vascular abnormalities,
  • active epiphyseal regions (growth plates) in children,
  • over the spinal cord in the area of a laminectomy,
  • over the eyes, skull, or testes
  • and, directly on the abdomen of pregnant women. Treatment ultrasound differs from diagnostic ultrasound!
Like all medical equipment, when used by highly trained professionals, such as your physiotherapist, therapeutic ultrasound is very unlikely to cause any adverse effects. Please consult your physiotherapist for their opinion on whether therapeutic ultrasound could assist your injury. Therapeutic Ultrasound differs from Real-Time Ultrasound Treatment.

What is Osteoarthritis?

Osteoarthritis is one of the most common forms of arthritis, often referred to as degenerative arthritis. The joints show signs of wear: joint cartilage becomes thin, extra bony spurs grow in response to stress, and joint motion lessens. In advanced stages, osteoarthritis can be painful, functionally limiting and depressing.

What is the Osteoarthritis Cure?

Unfortunately, there is no cure for osteoarthritis. But the good news is that there are some better ways to manage your osteoarthritis and slow the degeneration process. This improvement will result in making your life easier and more comfortable. Physiotherapy is a significant part of making your life living with osteoarthritis less painful, comfier and keeping you active. Research supports physiotherapy. Physio can reduce the pain and disability associated with arthritis, especially knee osteoarthritis. http://dx.doi.org/10.1136/bjsports-2016-096458 Seek the professional and helpful advice of your physiotherapist to start enjoying life again today!

Your Osteoarthritis Diagnosis

X-rays are the most straightforward test to confirm osteoarthritis. An experienced practitioner will have an excellent idea of whether you have osteoarthritis when they examine you.

How Does Osteoarthritis Affect Older People?

As you age, most people develop some degree of osteoarthritis. Our joints' wear and tear may occur due to ageing, injury, prolonged microtrauma, overuse of joints, or excess weight. Permanent bony changes occur and will exist even when there are no painful symptoms. Your degree of suffering varies. Whereas some people may be symptom-free others may suffer continuous disabling pain. The most common is mild or intermittent pain provoked by episodes of increased use or minor trauma. The joints most commonly affected are the weight-bearing joints: hip, knee, ankles, feet and spine. However, osteoarthritis can affect any joint in the body and is quite common in the hands and shoulders. Severe cases may require surgical treatment, but most will respond very well to your doctor's physiotherapy and medication.

Osteoarthritis Symptoms

You can suspect osteoarthritis if you experience one or more of the following symptoms:
  • joint pain or tenderness that intermittently returns
  • stiffness, particularly early morning stiffness
  • joint swelling or deformity
  • noticeable joint heat and redness
  • joint movement is strenuous.

Osteoarthritis Treatment

For advice on your osteoarthritis diagnosis, self-help tips or the best treatment of your osteoarthritis, please contact your physiotherapist or trusted health care professional.

Growing Pains

Growing Pains are a concern for most teenagers, pre-teens and their parents. As a rule, growing pains are poorly understood and often brushed aside as something you must go through during adolescence. This is not necessarily true. In fact, most "growing pains" can be eliminated or at least eased with some quality care and attention.

What Causes "Growing Pains"?

A prevalent time to suffer  "growing pains" is when your bones are quickly lengthening.  Consequently, your muscles also have to lengthen to keep a normal "muscle length-tension ratio".  Unfortunately, this doesn't always happen naturally. If your muscles do not lengthen adequately, it increases muscular tension pulling on the soft bone growth plates. Commonly we find that those kids who suffer "growing pains" have excessively tight muscles that cause their pain.

What Can Be Done to Help Growing Pain?

The good news is that your physiotherapist is trained to assess your child's normal muscle length.  Immediately after their assessment, your child will be prescribed corrective techniques to lengthen any tight soft tissue. Every child is different, and they do have individual genetics. As you would be well aware, not everyone can be a contortionist! Therefore, the rate your child's improvement, techniques used, or exercises performed will vary from individual to individual.

What Results Can You Expect?

Luckily, growing pains usually disappear within days or just a few weeks once the correct treatment commences. Considering that most untreated "growing pains" can last 18 months or more, that's very pleasing news for your child.  Why let your child needlessly suffer when there is a straightforward, safe and effective solution available?

Yes! You Can Definitely Improve Your Balance.

The research has confirmed for many years that balance retraining works. It can also take only a few weeks progressed balance exercises to improve or normalise your balance and corrective reactions. You can perform simple exercises initially, such as standing on one leg with eyes open and progress to eyes closed. Still, after that, the best way to improve your balance is to exercise on an unstable surface. For more information about balance assessment and retraining, please contact your physiotherapist.

Balance Enhancement Products:

Over the years, there have been numerous devices developed to assist clinicians in improving their clients' balance. This has greatly reduced the incidence of ankle and knee ligament sprains and, at the same time, improves the athlete's performance. These balance devices can be used by you, in your own home to improve your balance and reduce your injury chance or eliminate your joint pain.

Article by John Miller

Are You Tired of Your Joints Clicking?

Can You Be Click Free?

Would you love your joints not to crack?  Have you ever wondered what really makes your bones moan and groan in the first place?  Despite many myths, here are three real and different reasons why your joints persist in clicking... Your tendons may be simply slipping over some bumps on your bones so that when the tendon slips over the bump, it clicks.  But don't worry, this isn't usually a problem.  Occasionally it is due to poor joint positioning or ligament damage.  Easy remedies include simple alignment or stabilisation exercises. Ask your helpful physiotherapist if you have any doubts. Joints are held under tight compression that results in the two bone surfaces grating back and forth over the top of each other. It sounds as unpleasant as running your fingernails down a blackboard. However, this can usually be easily fixed through some simple physiotherapy treatment and sticking to an exercise program that improves your joint alignment, muscle strength and flexibility. In severe cases of osteoarthritis, persistent cracking may be normal due to significant joint damage. Check with your physiotherapist or doctor for specific advice. But don't procrastinate ... the problem can rapidly deteriorate if left unattended. The third main reason is gas, which normally builds up within a joint, suddenly popping out of the joint when the joint is forcibly stretched or compressed.  It's just like bursting a balloon, but much quieter. You'll know the guilty people—those who regularly crack their knuckles, neck, back or toes. You can achieve the same result with less long-term harm by gentle joint stretching and mobility techniques to gradually loosen stiff joints.  You'll probably also require some simple strength exercises to control the newly gained movement. Ultimately, these conservative methods are preferable in the long term, as repeat manipulation or cracking excessively stretches the supportive ligaments, and eventually, the joints fall out of position much easier! And the looser your joints, the quicker they develop degenerative arthritis and subsequent pain. Grandma was right - excessive knuckle cracking can cause arthritis. By performing specific exercises and stretches and following the advice of your physio, you can wake up, stand or sit up - click free!

More info:

Why does my hip click? Why does my jaw click? Why does my shoulder click?

Why Do Physiotherapists Prescribe You Exercises?

The prescription of exercise appropriate to you and your injury or fitness level is one of the many professional skills of a physiotherapist. Whether you have suffered an acute injury, chronic deconditioning or are recovering from surgery, the correct exercise prescription is essential. That's why your physiotherapist's knowledge and skills will personalise your exercise dose. Your physiotherapist not only is educated in injury diagnosis but also exercise physiology or the science of exercise. This training enables your physiotherapist to assess and diagnose your injury, plus also to prescribe injury, fitness or age-appropriate activities targeted to you now.

What Exercises Should You Do?

Your exercises shouldn't be painful. Please take caution with some overzealous exercise prescribers who believe that the more painful the activity, the better. Thus simply isn't true—notably, the frail, immunosuppressed, deconditioned or post-operative person. You'll find that your physiotherapist will thoroughly examine you and prescribe a series of exercises suitable for you in quantities that will not injure you further. Please seek an exercise expert, such as your physiotherapist, when you are planning your rehabilitation.

What Happens When You Stop Exercises?

Without some simple exercises, we know that specific muscles can become weak. When these supporting muscles are weak, your injured structures are inadequately supported and predispose you to linger symptoms or further injury. You can also over-activate adjacent muscles that may lead to further damage. It is also essential to understand that even if you are "in good shape", you may have crucial but weak localised or stability muscles. When you have an injury, you should perform specific exercises that specifically strengthen the muscles around your injury and the adjacent joints. Your physiotherapist will assess your muscle function and prescribe the right exercises specific to your needs. The exercises prescribed will usually be relatively simple, and do not require any special weights equipment, and can be performed safely at home.

Would You Stop Your Daily Prescription Drugs?

Your physiotherapist will prescribe your individualised dose or exercises. They are using their professional expertise to optimise your exercise dose. Would you just stop taking your regular blood pressure medication because you were too busy or didn't think it was working? We would hope not! Exercise, when prescribed by an expert such as your physiotherapist, should be treated as your recommended dose. Just like when you don't take your blood pressure medication, you can't expect the drugs to work if you don't take them as prescribed by your health professional. So, next time you skip your "exercise dose" just remember that you are not putting your health first. If you have any questions, please contact your Physio Works physiotherapist for your best care.

Private Health Insurance Rebates

PhysioWorks Physiotherapy and Remedial Massage are more affordable than you think. Your Private Health Insurance (PHI) usually pays for the majority of your treatment fees, leaving you with only a small gap payment.

However, Private Health Funds do vary their rebates payable depending upon the level of cover that you have taken. Some funds have kept up with the costs of modern medicine whereas, sadly others haven't, with rebates similar to what they were a decade ago.

HICAPS - Instant Health Fund Claims


Most health funds are members of the HICAPS instant claims system.  Swipe your health insurance card at our reception counter, and you can instantly claim your physiotherapy treatment via our online Hicaps System. Remedial Massage is claimable via Hicaps for some but not all funds. For more information, please visit Hicaps for the latest funds which can use their instant claiming system.

Private health insurance rebates are available for all of our physiotherapists. Instant claims are possible via our in-practice Hicaps system.

Third-Party Insurers

PhysioWorks practitioners are registered providers for government, Workcover and insurance companies including:

  • Workcover
  • InjuryNet
  • Australia Post; Coles Myer; Woolworths
  • Medicare
  • Department of Veterans' Affairs
  • CTP & Sports Insurers

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