I was inspired to write this post following a week in which a good number of new clients were meeting a Physiotherapist (and me) for the very first time.
Pondering a few things eventually led me to write this. So this aims to answer some questions, stimulate thinking about more questions and generally aim to give a little insight into Physiotherapy, whether you’ve experienced it or not. This will cover more of an initial assessment but follow up assessments will be similar too.
Note: I am only referencing what I personally do. Everyone has their own style and training background but some of these should be fundamental in a good assessment.
This might sound obvious but let’s sit down and start with our informally formal introductions. Whether it is an initial assessment or a follow up, we’re not going to talk Physiotherapy business right away. I want to hear about what you did at the weekend, how you found the egg soufflé slider from Gails bakery (seriously good, thoroughly recommend!) or what was the last film you watched.
Physiotherapists in the main have one thing in common – we are people people. We love to talk and we love to listen to others talk. So much so I am currently on a course devoted to learning how to communicate better! (Thank you Nick Hannah http://www.hannahmoves.com).
That leads me on to the next bit…
The Talking Bit
Actually, the entire session could be constituted as “the talking bit” but for arguments sake, let’s call this bit the talking bit.
This is your time to shine. Take hold of that mic and offload. Unload. Empty out all of your thoughts, feelings, worries and/or concerns. This is why you’re here. Don’t worry about whether any of what you’re saying is relevant to your specific complaint/reason you’re here or not (to some extent it all is!). I’ll guide you through the assessment if necessary but I won’t interrupt your flow.
Now, this could get a bit personal but I have to ask some probing questions. I promise I’m not being nosey, they will be relevant to you and your story. To help ease the discomfort, there will be some explanation as to why I’m asking. Everything is linked and general health questions are an excellent way to establish causative or contributory factors to your specific issue.
The crucial crucial bit and the reason you’re in Physiotherapy. Never let anyone tell you that your story doesn’t matter. It might sound ridiculous but trust me, I have heard some extremely worrying dialogue around this recently. More on that to come.
- What brings you to Physiotherapy right now?
- What has led you to this point?
- What has the current issue prevented you from doing?
- What are you expecting from me today and in the future?
- How much has this issue impacted you?
These will underpin everything that we do in the future together, otherwise it’s about as useful as opening google maps before a journey and asking it to go without a destination!
The Physical Bit
Any questions before we begin? No? Okay, so let’s push, pull, lift, carry, move, etc etc. Let’s see exactly what it is that might be contributing to your pain experience. At this stage it should be specific to you and your story. It should focus on the bits you’re finding most difficult at the moment and carry on from the first section of the assessment. It might cause some discomfort but that can be normal at this stage. You’ll be tested at first but as you progress through your sessions, you’ll get used to this.
*As you progress, you will be pushed that little bit more each time, safe in the knowledge you’re being guided through this by a trained professional*
The Second Talking Bit
Now we can wrap everything up and off you go!
Wait, not quite. This part is the glue that binds together everything in the session. This part aims to pop the pieces of the puzzle together and most importantly, formulate a plan. The plan should outline a way of getting you from A to Z (A to B doesn’t allow for any deviations or bumps in the road, of which there will be some/many).
The plan should have:
- Timescale (approximate)
- When to progress and why
- Self management
- Flare up strategy (again, these can be extremely common and not a sign of anything wrong)
I might even check I have done my job properly and ask you to recite what we have chatted about in the session. This helps you and I confirm we’re on the same page.
Some of you at this point (good on you for getting this far) might notice there hasn’t been any “treatment” included in this. There might be a number of reasons for this.
Firstly what constitutes “treatment”? To me, the moment you step through the door you’re receiving treatment.
I don’t like to feel rushed or you to feel like I have rushed anything. Now 45 minutes might sound like a lot of time, but when you do a decent, thorough assessment, even 45 minutes is pushing it.
Sometimes you can get as much, I would argue more, value from the formulation of a thorough plan in the first session following a detailed assessment than you can get from 5 minutes of massage or manual therapy.
You cannot underestimate the power of reassurance following a thorough assessment!
There might be some “treatment” but maybe don’t arrive expecting that. There might be time for that in future but in general, the other bits are invaluable in comparison.
Wrapping it up
So there you have it. That should cover what to expect in a Physiotherapy appointment.
Was it what you have experienced before? In your opinion, what would you change? I welcome any questions or comments.