• Impact Physiotherapy

Physiotherapy Management – when is the right time?


As a physiotherapist, we regularly see patients with injuries and one of the most common questions

is when do I start physiotherapy?


Truth be told; physiotherapy is a profession and not something we “start”. The correct question

should be, when do I start my rehabilitation. The best person to answer this is a physiotherapist.


What physiotherapists are very good at is, assessing, diagnosing and managing injuries/pain. They

identify the problem, decide if the symptom needs further investigations or if they can be managed

via physiotherapy guidance. The initial management might very well be advice and a few simple

exercises, but this will progress as your symptoms improve. Within a sports setting, a

physiotherapist will be the first person an athlete will see post injury and the management of that

injury starts immediately. This should be no different within the normal population. Deciding the

most appropriate pathway for recovery will usually start with a physiotherapist and studies have

identified an early intervention to an injury, usually yields the best outcomes.



A physiotherapist, being the most accessible specialist within the local community should be the

main person managing your symptoms. Physiotherapists have the ability to refer to GPs and

consultants and request appropriate investigations via the GP. However, we also hold the skills

necessary to issue an early intervention to help manage your symptoms.


This usually starts with advice. What we think is causing your symptoms, what to do, what not to

do, when to commence and progress exercises, when to return to sport or work and how to bridge

the gap between injury and returning to full activities or duties.


One of the main roles is to address any negative emotions, concerns or stressors that may act as

barriers to recovery and hinder return to sport or work. Without addressing these concerns, the

injury may manifest itself as chronic pain, result in a longer recovery time, affect their ability to

return to sport / work and create unnecessary anxiety and worry. This is when a physiotherapists

role is paramount for early assessment and intervention.


Some counties are highlighting the need of “first contact” physiotherapy services to allow such an

early intervention. To allow the patient the opportunity to access a specialist quickly and effectively

to get appropriate management without delay. One study highlighted this early intervention is seen

to also speed up recovery times for patients with acute whiplash and another suggested this was

beneficial for those experiencing acute low back pain in the initial acute phase. It provided the

patient with confidence, assurance, positivity and early advice which not only led to

improvement in patient symptoms, but it cut out unnecessary onward referrals and scans and

investigations.



References:

Lau et al (2008). Early physiotherapy intervention in an Accident and Emergency Department

reduces pain and improves satisfaction for patients with acute low back pain: a randomised trial.

Australian journal of physiotherapy. 54, 243.

Sterling (2014). Physiotherapy management of whiplash-associated disorders (WAD). Journal of

Physiotherapy. 60, 5-12.

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