Physiotherapy is health care profession concerned with human function and movement and maximising your body’s potential:

• It uses physical approaches to promote, maintain and restore physical, psychological and social well-being, taking account of variations in health status.
• It is science-based, committed to extending, applying, evaluating and reviewing the evidence that underpins and informs its practice and delivery.
• The exercise of clinical judgement and informed interpretation is at its core.

Our Physiotherpists specialise in a very hands on approach to treatment, using various manual therapy techniques and exercise prescription. They can work closely with your Chiropractor or Personal Trainer in the gym to encourage continued exercise during treatment. Where possible they will alway try to show clients how to help themselves between sessions by providing general advice and “homework”.
Below is a list of conditions our Physiotherapists specialise in and enjoys great rewards from treating:

• Back and neck pain
• Muscle strains, spasms and contusions
• Joint injuries
• Arthritis
• Tendinitis and bursitis
• Muscle imbalance or weakness
• Sports injury
• Workplace injury
• Whiplash
• Post surgical rehabilitation
• Injury prevention

The title of “Chartered Physiotherapist” is limited to those who have completed a certified 3-4 year degree course and maintained registration with the Health and Care Professions Council (HCPC). The HCPC is an independent statutory regulatory body that has been set up to regulate health professionals established by the Health and Social Work Professions Order 2001 by ensuring standards of care through continued professional development regulations. Most Physiotherapists also hold a membership with the Chartered Society of Physiotherapy who is the professional, educational and trade union body for the UK’s 48,000 chartered physiotherapists, physiotherapy students and assistants and provide practicing therapists’ professional indemnity insurance.

Your initial appointment usually lasts between 45 mins and an hour. The consultation will start with the therapist taking a full history of the reasons that led you to seek physiotherapy and a full past medical history. This discussion will allow us to see what problems you are having, how it is affecting your life and what your aims of treatment are.

The physiotherapist will then ask you to undress down to your underwear (or a vest and shorts) in order to perform a full musculoskeletal (joints, muscles and nerves) examination.

Once the examination has been completed, your physiotherapist will then explain your diagnosis, likely contributing factors as to why this has occurred and map out the course of treatment required to resolve the issue. You will be given ample opportunity to ask questions at this time. Information we aim to provide should include a likely prognosis, time scale to recovery, and the number of treatments expected to reach your goals.

Assuming there is time and it is appropriate, you will then be offered treatment at this stage. If physiotherapy is not deemed appropriate, we will arrange a referral to the required specialist or for investigations to further assess your condition.

Physiotherapy treatment is specifically tailored to the individuals needs and goals. Once we have discussed all our findings with you and you know what to expect, then treatment can begin!

All courses of treatment will vary and are likely to be different with subsequent sessions as your condition improves.

Physiotherapy treatment normally consists of a variety of manipulation and mobilisations techniques, soft tissue techniques, including massage and scar tissue breakdown, exercise prescription of stretches, Pilates, core work and strengthening exercises will be specifically designed to improve your function and movement quality. Education will form part of your care in order to alter possible lifestyle factors that contribute to your condition, this is where your responsibility for your recovery is outlined and we will explain what you need to work on outside of treatment sessions. Other techniques may involve Dry Needling, Ultrasound and Strapping for proprioception, support or pain relief.

Sacha has specific training in Ergonomics, movement patterns and posture control. This will allow her to teach you how you should set up your computer workstation or job environment to optimise your function and reduce unneccessary strain on your body.

Our Physiotherapists have trained in Pilates, and will teach you how to improve your posture and provide some exercises as homework for you!

A bonus of having our satelite clinic based within a gym is that, if required, our team can utilise the state of the art facilities available at the Fitness First Gym to increase your rehabilitation programme and analyse your performance.

Research supports Physiotherapy – numerous studies throughout the world have shown that physiotherapy treatment, including mobilisation therapy, massage, prescriptive exercise and education is effective in both treating and preventing neuro-musculoskeletal injuries. Most recently the National Institute for Health and Clinical Excellence (NICE) has published new guidelines to improve the early management of persistent non-specific low back pain.

The guidelines recommend what care and advice the NHS should offer to people affected by low back pain. NICE assessed the effectiveness, safety and cost-effectiveness of available treatments and the recommendations include offering a course of manual therapy, including spinal manipulation, spinal mobilisation and massage. This treatment may be provided by a range of health professionals, including physiotherapists. In addition, NICE also recommended a structured exercise programme tailored to the person:

“Consider offering a structured exercise programme consisting of a maximum of 8 sessions over a 12 week period.”

Pilates is now widely used in a clinical framework to rehabilitate people back from injury. However, there is not a wealth of evidence that Pilates alone can prevent injury or ensure your recovery. As part of a package of care that addresses the causes of injury or inhibition, Pilates can be used to specifically address resultant stiffness or weakness that has ensued (N. Segal et al 2004).

NICE also discusses the use of a combined physical and psychological treatment programme.

“Consider referral for a combined physical and psychological treatment programme, comprising around 100hours over a maximum of 8 weeks for people who have received at least one less intensive treatment and have a high disability and/or significant psychological distress”.

A Psychological approach can be very important in chronic pain cases, to help people address issues of fear and avoidance behaviour. It can return a level of control allowing people to manage their problems while returning to a more normal life.

At Active Health our Physiotherapist, Sacha Swift-Smith is fully qualified in both Pilates Instruction and the use of Cognitive Behaviour Therapy (CBT). So be assured that these pillars of our care are in the most recent guidelines, but also offered in combination with other methods to ensure your treatment is tailored to your specific requirements.

Below is a selection of other research papers and reports of relevance and interest.

Low back pain: early management of persistent non-specific low back pain. NICE; May 2009
Furlan AD, van Tulder MW, Cherkin D, Tsukayama H, Lao L, Koes BW, Berman BM. Acupuncture and dry-needling for low back pain. Cochrane Database of Systematic Reviews 2005, Issue 1
Furlan AD, Imamura M, Dryden T, Irvin E. Massage for low-back pain. Cochrane Database of Systematic Reviews 2008, Issue 4. Thirteen randomized trials (1596 participants) assessing various types of massage therapy for low-back pain were included in this review. Massage was more likely to work when combined with exercises and education. The amount of benefit was more than that achieved by joint mobilization, relaxation, physical therapy, self-care education or acupuncture. It seems that acupressure or pressure point massage techniques provide more relief than classic (Swedish) massage.

Hayden J, van Tulder MW, Malmivaara A, Koes BW. Exercise therapy for treatment of non-specific low back pain. Cochrane Database of Systematic Reviews 2005, Issue 3 The review found that exercise therapy decreased pain and improved function for adults with chronic low-back pain. There was also some evidence that graduated activity exercise programs were effective for sub-acute low back pain in the occupational settings.

Engers AJ, Jellema P, Wensing M, van der Windt DAWM, Grol R, van Tulder MW. Individual patient education for low back pain. Cochrane Database of Systematic Reviews 2008 Patient education was no more effective than other interventions such as cognitive behavioural group therapy, work-site visits, x-rays, acupuncture, chiropractic, physiotherapy, massage, manual therapy, heat-wrap therapy, interferential therapy, spinal stabilisation, yoga, or Swedish back school. One study found that patient education was more effective than exercises alone for some measures of function.

Carter JT, Birrell LN (Editors) 2000. Occupational health guidelines for the management of low back pain at work – principal recommendations. Faculty of Occupational Medicine. London. Occupational health guidelines for the management of low back pain at work – leaflet for practitioners. Faculty of Occupational Medicine. London. 2000. Waddell G, Burton AK 2000.

Musculoskeletal Services Framework – Department of Health. July 2006 The main treatment interventions, as recommended by the current evidence review and that of clinical guidelines is a biopsychosocial approach: a) Guidance on activity, lifestyle, prognosis and prevention. b) Physical treatments drawn from all types of manual therapy, spinal manipulation and rehabilitation exercise. c) Advice about pain control, including non-prescription medication. d) Psychosocial interventions aimed at resolving cognitive barriers to recovery.

Non-rigid stabilisation procedures for the treatment of low back pain – National Institute for Health and Clinical Excellence. June 2006 Acute low back pain can be treated by muscle relaxants or analgesic therapy. Chiropractic intervention and posture training can limit episodes of acute pain. Spinal rehabilitation, which may include components such as education, lifestyle change, weight loss, general fitness and specific low-back training exercises, may be required.

Physiotherapy in the management of arthritis and musculoskeletal conditions November 2005 – The Australian Physiotherapy Association. Physiotherapy has been recommended in a number of international guidelines (American College of Rheumatology 2000, Jordan et al 2003) for the management of knee osteoarthritis. Intensive rehabilitation programs led by physiotherapists have also been shown to be as effective as spinal surgery in improving outcomes for patients with chronic low back pain (LBP) and are associated with lower costs.