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Second thoughts about Physiotherapy??


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Hi there, 

I'm currently in my first year of PT and have just began my first placement in a private orthopaedic clinic that largely treats patients with back, hip, and knee issues.

I'm trying to keep an open mind and maximize my learning by staying positive about the experience. However, I'm beginning to realize that perhaps a large portion of manual therapy which consists of myofascial release/massage is not something I see myself doing for the rest of my life. I admit that this is only my first placement experience and different settings/physios will employ different types of treatments, but is there a way to avoid performing manual therapy? perhaps by choosing a specialty in cardio-resp instead of ortho? I'm beginning to feel like maybe I need to look into rehab research or something different after this program because I know my hands are not made to take the kind of load required to perform hours worth of manual therapy every day. Any  insight and advice would be much appreciated. 

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Cardiorespiratory physio does not involve the same level of manual therapy. Even ortho positions vary. I know some PTs that work in ortho and prefer a more hands off and more active approach (still not completely hands off however). There’s always paediatrics as well. Much less strenuous to work on a smaller body!

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Two thoughts, you will likely get stronger, more confident and more accustom to hands-on work. My second thought is that the other branches of physio that I have been involved in, primarily neuro and gerontological were much less hands-on and more rehab exercise based. So maybe these practicums will resonate with you more. I'm not sure exactly what your struggling with ortho-wise but you will see a wide variety of patients throughout your career and many unique cases!

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  • 2 months later...

Hey dont sweat it you could do any kind of treatment you like once your a PT. your CI most likely is the type to base  majority of treatments on myofacial release

I have had CIs who I have maybe seen perform about 10 min of myofacial release/massage over 6 weeks. not to mention this was in an MSK/orthopaedic unit

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Phyios are independent practitioners! Meaning you can practice however you would like. Some workplaces will prefer you do *some* hands on at least, because the patient feels like they are getting more treatment *from* you ...but at the end of the day, you decide what is best for your patients. I work in private ortho, and with many of my patients we use a lot of exercises, education, and graded exposure to the specific movements/activities that are causing them harm. And for the patients who really do require myofascial release - needling will be an important asset to you - it gets the job done and saves your hands. Many physios provide passive care, and I think it's because so many patients expect passive care...like physio is something to be "done to them", rather than them actively participating. I've had plenty of patients like this and I find that once you thoroughly educate them on what the evidence shows (active rehab>passive modalities) and ensure they understand WHY they are exercising, most are happy to oblige (some don't accept that, and that is ok. They will likely find a therapist who will rub their muscles for the 30 min treatment- but that type of treatment doesn't sit well with me).

Las thought - some patients who need and want lots of soft tissue release - I refer them to massage therapy and educate them that physio is about getting stronger!

Don't let this turn you off of physio - manual therapy is NOT all the profession is, or all that it should be. Also many specialties (vestibular, pelvic, concussion management) have significantly less hands-on components of treatment 

 

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On 1/16/2019 at 2:05 PM, Rajalgool said:

Two thoughts, you will likely get stronger, more confident and more accustom to hands-on work. My second thought is that the other branches of physio that I have been involved in, primarily neuro and gerontological were much less hands-on and more rehab exercise based. So maybe these practicums will resonate with you more. I'm not sure exactly what your struggling with ortho-wise but you will see a wide variety of patients throughout your career and many unique cases!

Neuro is VERY hands on! Think: helping someone post stroke (who can't use half their body) get up into sitting, balance, and stand up. Neuro physios (and ICU physios) have the most back injuries, ortho physios have the most hand injuries!

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13 hours ago, whistler27 said:

Neuro is VERY hands on! Think: helping someone post stroke (who can't use half their body) get up into sitting, balance, and stand up. Neuro physios (and ICU physios) have the most back injuries, ortho physios have the most hand injuries!

Truth. I was more referring to the literal meaning of hands on. But I can see how that could easily be misinterpreted. 

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