Physiotherapists
Assess, diagnose, treat and prevent disorders in human movement caused by injury or disease.
A Saturday morning at the clinic
You are a physiotherapist at a clinic next to a sports ground, with a mix of weekend footballers, older patients and a new colleague to look after. It is 8am on Saturday. The clinic opens in thirty minutes and the waiting room is already filling up. A busy morning of back-to-back appointments is ahead of you.
Choose what you would do. Then see what happens. There are often good reasons for each choice.
My son Tariq twisted his ankle at the game this morning. He says he's fine, and he has another match this afternoon. I just need you to tape it up so he can play. Can you do that?
Tape it up as asked, since both Tariq and his dad say he is fine and the match is soon
Tariq plays, falls awkwardly in the second half, and the injury is worse than before. Tape can hide a problem, and the season is now at risk.
Examine the ankle properly, explain what you find and advise on what is safe
The ankle is swollen, and Tariq admits it hurts to put weight on it. His dad listens and agrees to rest. Tariq sits out the match and returns the next week.
Tell Mr Salim that Tariq should not play at all and send them home
You may be right, but you gave advice without examining the ankle. Mr Salim, annoyed, takes Tariq to play anyway, and you lose the chance to guide him.
I'm worried about a patient I saw yesterday. His pain wasn't what I expected for his injury, and he didn't improve. I don't want to look like I don't know what I'm doing. Should I just keep going with the plan?
Reassure her that she is doing well and suggest she keep the plan and see how it goes
She feels better but is still uneasy. The patient's pain continues, and she realises a week later she should have asked sooner.
Ask her to talk you through the case, then agree what to recheck
Your talk through reveals a gap, and she calls the patient back for a recheck. It is the right thing to do, but you spend your morning break on it.
Tell her how you would handle it and ask her to follow your approach
She follows you without understanding. She cannot explain her choices to the patient later, and her own confidence does not grow.
I only want the massage today. No exercises, please. I'm too tired and the massage is the only thing that makes me feel better. Can we just do that? You know what I'm like.
Acknowledge she is tired, offer a shorter exercise set after treatment and explain why it matters
She sighs, and then does the shorter set. She says it was less awful than she expected, and she leaves with a plan that fits her day.
Tell her you will only treat her if she does the exercises
She feels bullied and cancels her next appointment. A patient who stays away does not get better, however good your reasoning.
Agree, since she is tired and will be happier
She leaves content, but her recovery stalls over the next month. Making a patient happy for an hour is not always the same as helping them.
How it went
The waiting room finally empties at lunchtime and your hands are tired. Physiotherapy mixes science with patience, from reading an injury to reading a person who is nervous, sore or in a hurry. Does it sound like work you could do all day?
This is a simplified, fictional situation to help you explore. It is not professional instruction or a test of your ability.
Case study: The grandmother who stopped her exercises
A fictional case set in a busy physiotherapy clinic near a suburban sports ground.
The situation
Kavita was a physiotherapist at a suburban clinic. Mrs Burke, seventy-four, had been recovering from a knee operation. She had been making good progress for three weeks, then arrived limping and told Kavita she had stopped doing her exercises because they hurt. Her follow-up with the surgeon was in a week. Kavita had a full waiting room and fifteen minutes. Mrs Burke was embarrassed, and the quickest response would have been to repeat the instructions firmly.
What they did
Kavita asked Mrs Burke to show her what she'd been doing. It turned out she was doing one of the exercises with the wrong movement and pushing through a sharp pain, not the stretch she was supposed to feel. Kavita did not blame her. She showed her again, adjusted the exercise, and explained in plain words the difference between a good ache and a warning pain. She phoned Mrs Burke two days later to see how it was going.
How it turned out
Mrs Burke did her exercises properly, and the limp eased within the week. The surgeon was pleased with the progress. Kavita said she'd learned to ask patients to show her what they do, rather than assuming they know.
What would you do?
- Why did Kavita ask Mrs Burke to show her the exercise?
- How can a good ache feel different from a warning pain?
- What might you say to someone who has stopped doing what they were told?