Updated January 2020
You’re all geared up to come to your physiotherapy session, but you don’t know what to expect or how to prepare. You’re in luck! This article will outline a typical physiotherapy session at Royal City Physio: what to expect, what to wear, when to arrive, and more!
Whether you’re recovering from an overuse injury, a sports related injury, surgery, or simply want to improve your physical strength and health, you want to get the most out of your physiotherapy session and we want to help you achieve your maximum potential. This occurs by preparing for your session at home and understanding how your physiotherapist organizes your session in the clinic.
First, you want to ask yourself: ‘How have I been feeling since my last visit to Royal City Physio?’ This question can be broken down into questions such as:
Are there activities that you have been finding difficult?
Are there areas where you’ve noticed improvement such as a reduction in symptoms like pain, stiffness, swelling, or bruising?
What exercises are feeling easy?
Do you have questions about how to perform an exercise?
Your physiotherapist will use your answers to these questions to gauge your progress throughout the stages of healing and the appropriateness of adding new exercises and even return to sport and activity.
Second, you want to ask yourself: ‘Am I dressed so that I can do exercises and receive treatment for my injury?’
Being appropriately dressed is key to receiving good physiotherapy. Whether your injury is to a knee, back, shoulder or neck, physiotherapists often need to perform hands on treatment. To effectively apply our treatment we need to see the skin and understand how a particular joint is moving and how muscles, tendons and ligaments feel around the joint. This is virtually impossible through clothing as it changes how tissue and joints feel and makes it impossible to see what we are doing.
This may sound like obvious advice, but what follows is often missed. Physiotherapists often need to assess the joint above and below the one that is causing problems. If you have a shoulder injury, we often need to assess your neck, or if you have low back pain we may assess your hip and vice versa. This is because no portion of the body operates in isolation and pain can be referred from the problem area to a different part of the body.
What does this translate to with respect to clothing? It means wearing a T-shirt or tank top when you have a shoulder or neck injury so your physiotherapist can roll the sleeve up or pull the collar to one side. It also means wearing shorts that can be rolled up close to the hip so your therapist can see and release the muscles on your thigh when you have a knee injury. At Royal City Physio, we have shorts and shirts that can be borrowed in an emergency, but this takes up treatment time and we know you want the most out of your time with your physiotherapist!
A good warm-up is the first step to a good physiotherapy session. This can include cycling for 5-10 minutes, performing an exercise like the ‘Ball on Wall’ that Karen Nichol loves for leg injuries, or warming up your arms and shoulders on the pulleys.
Warm-ups should be done before the therapist sees you and depending on which physiotherapist you see, you may be asked to arrive earlier than your appointment time to do these warm-ups before you’re treated by the physiotherapist. If you’re early or we’re running late, come into the clinic and jump on the bike or grab a high bed to do your exercises to warm up.
Re-Assessment occurs during your first interaction with the therapist each session. You’ll be asked: ‘How have you been feeling since last session?’ This is the time to bring up any concerns or questions that you might have and to tell us of those symptoms that have been better or worse and what activities you’ve been doing. Please, don’t save your questions for the end of your appointment! After answering questions and talking about your symptoms, you’ll perform a movement screen of the joint that is injured followed by questions about pain, stiffness, stretch or any other sensation you might feel in the moment. Re-assessment allows your therapist to keep track of your progress and compare it with other sessions. It also informs your therapist of your current state and guides how they progress, or subtract exercises, and what manual therapy treatment techniques they might perform.
Manual Treatment follows and typically consists of your physiotherapist pushing on your joints in seemingly nebulous ways. While it may appear complicated and you may not feel much more than the pressure of your therapist’s hands, we have a reason for performing each technique. Our goal may be to reduce pain, reduce stiffness, improve joint range, break down scar tissue and tissue adhesions, or release tight muscles. If you’re ever wondering, just ask! We love explaining how the body works and it can help you understand how you’re healing, why you feel certain things, and what structures your exercises target.
Reviewing your exercises for either progression and/or subtraction are the next steps in a successful physiotherapy session. There’s only so much that we can do for you with manual therapy, which is why we prescribe exercises to build strength, improve flexibility, increase stamina, and reduce pain. It’s in this part of the session where we check your form, ask you how difficult your exercises are, and determine whether to progress you if they’re easy or reduce their intensity if you’ve suffered a setback. We’ll talk to you in more detail about activities that you find difficult and we’ll design exercises to improve your ability to do those activities. We also offer tips and tricks for reducing pain and pacing for managing energy and fatigue.
Finally we let you, as the patient, loose in the clinic to perform your old and new exercises, and mobility drills for return to sport. This is the time for you to try everything out while also having the opportunity to ask questions and raise concerns.
While many patients choose to do their programs at the clinic, some prefer to do them at home; the key is that you’re faithful to your program! Talk to your physiotherapist if you’re having difficulty managing the time required for your program as it may be possible to reduce the number and length of daily exercises. Keep in mind that this reduction may come at a slower progression in strength, endurance and balance, and may keep you away from your chosen sport or activity for longer as you take longer to condition your body to position it optimally to avoid future re-injury.
Stephen Baker graduated from Western University with a Masters of Physical Therapy. He has a passion for helping those with neck, hand or knee injuries return to their daily adventures. Book with Stephen today.