Physiotherapy Treatment: My philosophy

Physiotherapy is not unique to me, and in many aspects, I don't consider myself unique to physiotherapy. My treatment philosophy is simple; I think my patients are important, what's important to them is important, and keeping their bodies and minds engaged in those activities is important. It fuels their happiness, which is a critical pillar to the human experience. Losing the ability to partake in our favourite activities due to injury or illness can be devastating. I've watched it happen, and I've experienced it personally. With my physiotherapy treatment philosophy, I identify each person’s unique valued activities, and do everything possible to get them back to doing what they love. 

Since 2008, I have been providing physiotherapy services to Ottawa's downtown core. This is an interesting subset of the city's population, made up almost entirely of Government of Canada public servants, plus a handful of large and small operation white-collar businesses.  As a group, they typically age between 30 and 60, have a university-level education (often with more than one degree), and are in the most exciting part of their career.  They come from all over the world and have a variety of special talents and interests.  They are encouraged to prioritize their health, and most of them do. Ottawa is an active city, and people balance their professional pursuits with whatever physical challenge they love doing. I have treated people with all kinds of interests: triathlon, rock climbing, dragon boating, CrossFit, power lifting, ultimate frisbee, football, dodgeball, fencing, and ski racing just to name a few. The list is as interesting and varied as the people that comprise it. However, most of this crew is in the busiest part of their personal and professional lives, and time is valuable. They tend to walk into my office only once an injury or pain has stopped them from doing what they love, whatever that may be.

It is from this consistent story that I developed my physiotherapy practices and processes. My first goal is to establish a connection with each client and understand their priorities. With this information, we outline a treatment pathway. Is their recreational activity the stress reliever that balances their life? Are they training for an event or race they don't want to miss, even if they have to complete it in some pain? Will they do anything to get back to their previous activities, or are they ready to give up one sport and replace it with another?  Often there are various paths we can take during treatment, and it is important to understand and accommodate the person's specific priorities, as these are ultimately what push someone to seek help in the first place. 

The next step is to establish a meaningful change. This involves altering symptoms or pain to improve at least one aspect of the person’s life. These are typically daily life sort of things that may have been limited, such as bending forward to put on socks, sleeping on their favourite side, or sitting through dinner with their family.  Early progress confirms we are on the right path. Initial change typically happens with a manual therapy or dry needling technique, or the right home exercises. I try to establish change quickly, within the first session or two.

I prescribe a lot of home exercises for my patients, encouraging them to play an active roll in their recovery. This is an important part of rehabilitation. I believe to live your best life, you need to take action. I help facilitate this process by establishing the plan, but it is ultimately the patient who makes it happen. 

Throughout the rehabilitation process, I am continually evaluating the individual's movement, with the goal of optimizing movement patterns and establishing a base level of function and fitness. It is important for my patients to commit to their plan and finish their rehab. However, this is easier said than done. People are busy, and rehab takes time. This is especially difficult when the initial pain is gone, but there is still work to be done to improve movement, strength, muscle imbalances, or body conditioning (all things that cause injury in the first place). If this final step is not complete, the individual is more likely to relapse. This is how people can end up with the same injury over and over, and why I encourage my patients to make their health a priority and finish their rehabilitation.  It is self-care in its true form, and it's important.

I love what I do, and I hope that is evident to everyone I have had the pleasure of working with. I am grateful for  the brilliant physiotherapists I mentored under during the early stages of my career. I owe much of my manual therapy and clinical reasoning skills to these individuals. To them, I am forever in debt. I am also thankful for everyone who has taken the time to read my random spattering of blog posts. But most of all I need to thank my patients. You are seriously the best part of my job. One of the silver linings to being a physiotherapist is the one-on-one conversations I get to have free of devices, screens, and distractions - the way interactions were meant to be had. I love getting to know people. I feel everyone has a story to tell and I find that fascinating. Thanks to everyone who has put their trust in me, opened their lives, and shared their stories.  YOU are the biggest reason I love my job.