The majority of people who are considering a musculoskeletal (orthopaedic) physiotherapy consultation do so because they have pain.  Pain will affect the way you move.  The way you move will affect your pain.  It can be a vicious cycle.

In order to deal with the causes of your pain, it is essential that a detailed musculoskeletal examination is performed.  This will often include both a patho-anatomical assessment, to determine the extent of any tissue damage that is causing the pain.  If you recently sprained your knee or ankle, it may be easy to determine the cause and extent of the injury.  What if your pain has existed for a longer period of time (weeks or months)?  In these cases, it will be necessary to perform a functional evaluation of your movement as well.

The functional evaluation (movement evaluation) is an area that many physiotherapists have specialized training in.  This is very important to perform in cases of long term low back pain, knee pain, shoulder pain, neck pain, etc.  The low back may be persistent because of stiffness (decreased mobility) in your hip or upper back (thoracic spine).  Chronic (long term) knee pain is often related to weakness in some of the hip muscles.  Unless these muscles are strengthened, the pain may continue.

 The longer the problem exists, the more complicated it often becomes.

A question many people ask is: “Should I see a physiotherapist, a chiropractor, a massage therapist, a physician, an osteopath, an athletic therapist?”

Regardless of who you see, it will be important that you understand what needs to be done.  How severe is the tissue injury?  Will you require surgery for a torn ligament or tendon?  If the tissue injury is not severe, what needs to be done to help the area heal?  Do you need to improve you mobility (flexibility and/or range of motion), your stability/motor control, or your strength.  The treatment should be focused on addressing the key contributing factors.  If the treatment provided is for mobility (manipulation, mobilization, massage, etc), but you require stability/motor control and strength, the problem will probably be persistent or recurrent.

You should choose a health care provider who is able to assess the extent of the tissue damage, your mobility, stability, motor control, and strength.  This will allow them to design an appropriate treatment plan to help you.  The longer the problem exists, the more complicated it often becomes.  Seeking a solution to your pain is important.  If you aren’t satisfied with previous answers or treatment, keep looking for another opinion.

Allen Hicks
BA(Hon)PE, BScPT, FCAMPT, CSCS
Owner / Physiotherapist
Evolution Physiotherapy

The Canadian Physiotherapy Association (CPA) represents physiotherapists, physiotherapist assistants and physiotherapist students across Canada. CPA members are rehabilitation professionals dedicated to the health, mobility and fitness of Canadians.

Physiotherapists are primary health care professionals who combine their in-depth knowledge of the body and how it works with specialized hands-on clinical skills to assess, diagnose and treat symptoms of illness, injury or disability.

More than 20,000 registered physiotherapists work in Canada, in private clinics, general and rehabilitation hospitals, community health centres, residential care and assisted-living facilities, home visit agencies, workplaces, and schools.

The CPA presents its educational references as a public service and for informational purposes only. The content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. The opinions expressed do not necessarily represent the opinions of the CPA membership.